Aggressive Treatment in Pediatric Patients With Drug-Induced Hypersensitivity Syndrome/Drug Reaction With Eosinophilia and Systemic Symptoms Is Associated With Future Development of Type III Polyglandular Autoimmune Syndrome

    October 2018 in “ BMJ Case Reports ”
    Chiyo Morita, Tetsuji Yanase, Tetsuo Shiohara, Yumi Aoyama
    TLDR Aggressive treatment in young patients with certain drug reactions may lead to multiple autoimmune diseases later.
    A 6-year-old patient with drug-induced hypersensitivity syndrome (DiHS)/drug reaction with eosinophilia and systemic symptoms (DRESS) developed multiple autoimmune conditions, including autoimmune thyroiditis, type 1 diabetes, alopecia, vitiligo, and uveitis, leading to a diagnosis of type III polyglandular autoimmune syndrome (PASIII) within 8 months of DiHS/DRESS resolution. A literature review identified five similar cases where young patients with DiHS/DRESS developed PASIII, with most having received aggressive treatments like intravenous immunoglobulin or pulsed prednisolone during the acute phase. These findings suggested a potential link between aggressive treatment in young patients and the later development of PASIII.
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