{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,30]],"date-time":"2026-04-30T23:48:51Z","timestamp":1777592931992,"version":"3.51.4"},"reference-count":15,"publisher":"BMJ","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Reports"],"accepted":{"date-parts":[[2018,8,10]]},"abstract":"<jats:p>We experienced a 6-year-old case of drug-induced hypersensitivity syndrome (DiHS)\/drug reaction with eosinophilia and systemic symptoms (DRESS) with subsequent development autoimmune thyroiditis (Hashimoto\u2019s thyroiditis), type 1 diabetes with antithyroglobulin, thyroid peroxidase, insulinoma-associated antigen and anti-insulin antibodies at 4 months, alopecia at 7 months, vitiligo, uveitis due to Vogt-Koyanagi-Harada disease at 8 months after clinical resolution of the DiHS\/DRESS. He was diagnosed as type III polyglandular autoimmune syndrome (PASIII) after DiHS\/DRESS. Prompted by this case, we sought to determine which triggering factors were responsible for later development of PASIII in previously published cases with autoimmune sequelae. In the literature review, five patients with DIHS\/DRESS were found to develop autoimmune sequelae consistent with PASIII. All cases with PASIII were much younger than those without them. Four out of the five patients were treated with intravenous immunoglobulin or pulsed prednisolone in the acute stage, although effective in short-term outcomes.<\/jats:p>","DOI":"10.1136\/bcr-2018-225528","type":"journal-article","created":{"date-parts":[[2018,10,27]],"date-time":"2018-10-27T05:28:08Z","timestamp":1540618088000},"page":"bcr-2018-225528","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":24,"title":["Aggressive treatment in paediatric or young patients with drug-induced hypersensitivity syndrome (DiHS)\/drug reaction with eosinophilia and systemic symptoms (DRESS) is associated with future development of type III polyglandular autoimmune syndrome"],"prefix":"10.1136","volume":"2018","author":[{"given":"Chiyo","family":"Morita","sequence":"first","affiliation":[{"name":"Dermatology, Onomichi General Hospital, Onomichi, Hiroshima, Japan"},{"name":"Kawasaki Medical School, Kurashiki, Okayama, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tetsuji","family":"Yanase","sequence":"additional","affiliation":[{"name":"Dermatology, Onomichi General Hospital, Onomichi, Hiroshima, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tetsuo","family":"Shiohara","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Kyorin University School of Medicine, Tokyo, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yumi","family":"Aoyama","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Kawasaki Medical School, Kurashiki, Okayama, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2018,10,27]]},"reference":[{"key":"2025082803513833000_2018.oct25_2.bcr-2018-225528.1","doi-asserted-by":"crossref","first-page":"91","DOI":"10.1007\/s40618-017-0740-9","article-title":"Polyglandular autoimmune syndromes","volume":"41","author":"Kahaly","year":"2018","journal-title":"J Endocrinol Invest"},{"key":"2025082803513833000_2018.oct25_2.bcr-2018-225528.2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaad.2012.10.017"},{"key":"2025082803513833000_2018.oct25_2.bcr-2018-225528.3","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2133.2007.07784.x"},{"key":"2025082803513833000_2018.oct25_2.bcr-2018-225528.4","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaad.2012.08.009"},{"key":"2025082803513833000_2018.oct25_2.bcr-2018-225528.5","doi-asserted-by":"publisher","DOI":"10.1016\/j.autrev.2009.02.029"},{"key":"2025082803513833000_2018.oct25_2.bcr-2018-225528.6","doi-asserted-by":"publisher","DOI":"10.1001\/archdermatol.2008.521"},{"key":"2025082803513833000_2018.oct25_2.bcr-2018-225528.7","first-page":"391","article-title":"A case of drug induced hypersensitivity syndrome triggering various autoimmune diseases","volume":"70","author":"Hirakawa","year":"2016","journal-title":"Clin Dermatol"},{"key":"2025082803513833000_2018.oct25_2.bcr-2018-225528.8","doi-asserted-by":"crossref","first-page":"494","DOI":"10.1001\/jamadermatol.2013.1949","article-title":"A case of recalcitrant DRESS syndrome with multiple autoimmune sequelae treated with intravenous immunoglobulins","volume":"149","author":"Singer","year":"2013","journal-title":"JAMA Dermatol"},{"key":"2025082803513833000_2018.oct25_2.bcr-2018-225528.9","first-page":"140","article-title":"Type III polyglandular autoimmune syndromes in children with type 1 diabetes mellitus","volume":"20","author":"Ben-Skowronek","year":"2013","journal-title":"Ann Agric Environ Med"},{"key":"2025082803513833000_2018.oct25_2.bcr-2018-225528.10","doi-asserted-by":"crossref","first-page":"18170","DOI":"10.5070\/D3195018170","article-title":"Carbamazepine-induced DRESS syndrome in a child: rapid response to pulsed corticosteroids","volume":"19","author":"Teng","year":"2013","journal-title":"Dermatol Online J"},{"key":"2025082803513833000_2018.oct25_2.bcr-2018-225528.11","doi-asserted-by":"crossref","first-page":"e249","DOI":"10.1016\/j.jaad.2011.06.038","article-title":"Successful treatment of lamotrigine-associated drug hypersensitivity syndrome with intravenous IgG","volume":"66","author":"Comfere","year":"2012","journal-title":"J Am Acad Dermatol"},{"key":"2025082803513833000_2018.oct25_2.bcr-2018-225528.12","doi-asserted-by":"crossref","unstructured":"Marcus N , Smuel K , Almog M , et al . Successful Intravenous Immunoglobulin Treatment in Pediatric Severe DRESS Syndrome. J Allergy Clin Immunol Pract 2018;6.doi:10.1016\/j.jaip.2017.10.016","DOI":"10.1016\/j.jaip.2017.10.016"},{"key":"2025082803513833000_2018.oct25_2.bcr-2018-225528.13","doi-asserted-by":"publisher","DOI":"10.2332\/allergolint.10-RAI-0260"},{"key":"2025082803513833000_2018.oct25_2.bcr-2018-225528.14","doi-asserted-by":"crossref","first-page":"944","DOI":"10.1111\/bjd.14677","article-title":"Longitudinal analysis of antibody profiles against plakins in severe drug eruptions: emphasis on correlation with tissue damage in drug-induced hypersensitivity syndrome and drug reaction with eosinophilia and systemic symptoms","volume":"175","author":"Takehara","year":"2016","journal-title":"Br J Dermatol"},{"key":"2025082803513833000_2018.oct25_2.bcr-2018-225528.15","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2002-06-1684"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2018-225528","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,28]],"date-time":"2025-08-28T10:51:44Z","timestamp":1756378304000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2018-225528"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,10,27]]},"references-count":15,"alternative-id":["10.1136\/bcr-2018-225528"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2018-225528","relation":{},"ISSN":["1757-790X"],"issn-type":[{"value":"1757-790X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018,10,27]]}}}