药物超敏反应综合征所致暴发性1型糖尿病、Graves病伴纯红细胞再障及胸腺瘤及文献复习  

Fulminant Type 1 Diabetes Mellitus and Graves Disease Caused by Drug-induced Hypersensitivity Syndrome Followed by Pure Red Cell Aplasia with Thymoma:Report and Literature Review

作　　者：张秀珍 袁凤易 徐丹 吴炎 徐平 ZHANG Xiu-zhen;YUAN Feng-yi;XU Dan;WU Yan;XU Ping(Department of Endocrinology and Metabolism,Shenzhen People’s Hospital,Shenzhen 518020,Guangdong Province,China)

机构地区：[1]深圳市人民医院内分泌科,广东深圳518020

出　　处：《罕少疾病杂志》2022年第7期8-11,共4页Journal of Rare and Uncommon Diseases

基　　金：深圳市科技计划项目(JCY20180305163833160)

摘　　要：目的探讨药物超敏反应综合征(DIHS)所致暴发性1型糖尿病(FT1DM)的患者的临床特点和发病机制。方法对本院1例DIHS后出现FT1DM、Graves病、纯红细胞再生障碍性贫血伴胸腺瘤的病例进行临床资料总结。通过搜索中国知网、万方数据库和PubMed数据库上2000年至2020年间发表的相关文献并进行分析总结。结果本例患者因迟发性皮疹、发热、嗜酸性粒细胞升高及肝损害,确诊为DIHS,随访过程中出现FT1DM、Graves病、单纯红细胞再生障碍性贫血伴胸腺瘤。3个数据库2000年至2020年共报道36例DIHS所致1型糖尿病(T1DM),其中FT1DM 31例,典型T1DM 5例。T1DM可发生在DIHS缓解后10d至7个月。大部分病例中存在人疱疹病毒6型重新激活的证据。结论DIHS缓解期的患者需长期随访,及早发现并干预T1DM及其他自身免疫性后遗症,以改善患者预后。Objective To explore the clinical characteristics and pathophysiology of patients with fulminant type 1 diabetes mellitus(FT1DM)as autoimmune sequelae to drug-induced hypersensitivity syndrome(DIHS)patients.Methods We described a patient who developed FT1DM,Graves disease and pure red cell aplasia(PRCA)with thymoma after DIHS.A systemic search was performed in CNKI,WANFANG Database and PubMed for articles published between 2000 and 2020,and identified literatures were reviewed.Results The case was diagnosed with DIHS based on rashes,fever,eosinophilia and impaired liver function,and followed by FT1DM,Graves disease,and PRCA with thymoma.A total of 36 cases of T1DM seconded to DIHS were reported,including 31 cases of FT1DM and 5 cases of typical T1DM.T1DM could occur in 10 days to 7 months after the resolution of DIHS.Reactivation of Human herpesvirus type 6 was detected in most of the cases.Conclusion Long-term follow up of patients with remission of DIHS for early detection and intervention of T1DM and other autoimmune sequelae is very important.

关 键 词：药物超敏反应综合征 暴发性1型 疱疹病毒 自身免疫性疾病 

分 类 号：R587.1[医药卫生—内分泌]