Co-Occurrence of Multiple Endocrine Abnormalities Induced by the DIHSDRESS

Abstract EN

Background.

Drug-induced hypersensitivity syndrome/drug reaction with eosinophilia and systemic symptoms (DIHS/DRESS) is a severe adverse reaction caused by specific drugs.

However, little information is available about sequelae following DIHS/DRESS resolution from an endocrinologist’s perspective.

This study aimed to investigate the endocrine sequelae following DIHS/DRESS, from clinical feature to etiology.

Methods.

We retrospectively analyzed the patients diagnosed with DIHS/DRESS in Peking Union Medical College Hospital (PUMCH) during the period of 1 January 2012 to 31 December 2017, and those who developed endocrine disorders after DIHS/DRESS were further examined.

We also reviewed the literature, from 1 January 2000 to 31 December 2017, on involvement of endocrine glands in DIHS/DRESS patients.

Results.

Three patients developed both autoimmune thyroid disease (AITD) and type 1 diabetes (T1DM)/fulminant type 1 diabetes (FT1DM) of the 45 patients.

Seven cases involving more than two endocrine glands were reported in the literature.

Our results indicated that DIHS/DRESS is a potential etiological factor of autoimmune polyendocrine syndrome (APS), especially APS III.

Conclusions.

Patients require careful long-term follow-up after DIHS/DRESS.

Involvement of endocrine glands, especially FT1DM, should always be monitored in patients with a history of DIHS/DRESS.

This study indicated that DIHS/DRESS could lead to APS, especially APS III, providing novel insights into the etiological factors of APS.