Minocycline-induced drug hypersensitivity syndrome followed by multiple autoimmune sequelae.
BACKGROUND
Drug hypersensitivity syndrome (DHS) is a severe, multisystem adverse drug reaction that may occur following the use of numerous medications, including anticonvulsants, sulfonamides, and minocycline hydrochloride. Long-term autoimmune sequelae of DHS have been reported, including hypothyroidism.


METHODS
A 15-year-old female adolescent developed DHS 4 weeks after starting minocycline therapy for acne vulgaris. Seven weeks later she developed autoimmune hyperthyroidism (Graves disease), and 7 months after discontinuing minocycline therapy she developed autoimmune type 1 diabetes mellitus. In addition, she developed elevated titers of several markers of systemic autoimmune disease, including antinuclear, anti-Sjögren syndrome A, and anti-Smith antibodies.


CONCLUSIONS
Minocycline-associated DHS may be associated with multiple autoimmune sequelae, including thyroid disease, type 1 diabetes mellitus, and elevated markers of systemic autoimmunity. Long-term follow-up is needed in patients with DHS to determine the natural history of DHS-associated sequelae.
Brown
Rebecca J
RJ
Developmental Endocrinology Branch, National Institute of Child Health and Human Development, Rockville, Maryland, USA.
Rother
Kristina I
KI
Artman
Henry
H
Mercurio
Mary Gail
MG
Wang
Roger
R
Looney
R John
RJ
Cowen
Edward W
EW
D000152:Acne Vulgaris / Q000188:drug therapy; D000293:Adolescent; D000900:Anti-Bacterial Agents / Q000009:adverse effects* / Q000627:therapeutic use; D001327:Autoimmune Diseases / Q000139:chemically induced*; D003922:Diabetes Mellitus, Type 1 / Q000139:chemically induced; D004342:Drug Hypersensitivity / Q000209:etiology*; D005260:Female; D006111:Graves Disease / Q000139:chemically induced; D006801:Humans; D008911:Minocycline / Q000009:adverse effects* / Q000627:therapeutic use
D000900:Anti-Bacterial Agents; D008911:Minocycline