title: [Auto-immune thyroiditis and drug reaction with eosinophilia and systemic symptoms (DRESS) associated with HHV-6 viral reactivation].
abstract: BACKGROUND
  DRESS syndrome is a severe adverse drug reaction with visceral involvement. Its physiopathology includes immunological disorders associated with human herpes virus (HHV) reactivation. We report two cases of auto-immune thyroiditis occurring in the context of DRESS syndrome associated with HHV-6 reactivation.
  
  
  METHODS
  Case 1 : A 39-year-old woman presented DRESS syndrome with HHV-6 reactivation, cutaneous, lymph node, hepatic and renal disorders treated with systemic corticosteroids for 10 months. Following discontinuation of the corticosteroids, she developed Graves's disease, which was stabilized with carbimazole and a beta-blocker. CASE 2: A 31-year-old woman was hospitalized for DRESS syndrome with delayed HHV-6 reactivation and severe hepatic involvement. She was successfully treated by topical steroids. Six weeks later, she presented De Quervain thyroiditis associated with moderate relapsing DRESS, which were treated by sodium levothyroxine and topical steroids.
  
  
  CONCLUSIONS
  There is currently debate about the implication of viral reactivation, in particular HHV-6, in chronic DRESS, relapse and development of auto-immune diseases. These observations highlight the potential risk of patients developing auto-immune diseases and underline the need for prolonged clinical and laboratory follow-up of patients with DRESS.
authors: Service de dermatologie, hôpital Henri-Mondor, université Paris XII, centre de référence des maladies bulleuses immunologiques et toxiques, 51, avenue du Maréchal-de-Lattre-de-Tassigny, 94010 Créteil, France. elisa.funckbrentano@gmail.com
authors: E
authors: E
authors: Funck-Brentano
authors: T
authors: T
authors: Duong
authors: D
authors: D
authors: Family
authors: J-D
authors: JD
authors: Bouaziz
authors: N
authors: N
authors: Ortonne
authors: M
authors: M
authors: Bagot
authors: J-C
authors: JC
authors: Roujeau
authors: P
authors: P
authors: Wolkenstein
authors: L
authors: L
authors: Valeyrie-Allanore
mesh_terms: D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use; D000328:Adult; D018771:Arthralgia / Q000209:etiology; D002231:Carbimazole / Q000627:therapeutic use; D003875:Drug Eruptions / Q000150:complications*; D004802:Eosinophilia / Q000209:etiology*; D005260:Female; D006111:Graves Disease / Q000188:drug therapy / Q000209:etiology*; D006525:Hepatitis, Viral, Human / Q000188:drug therapy / Q000209:etiology*; D015654:Herpesvirus 6, Human / Q000502:physiology*; D006801:Humans; D019349:Roseolovirus Infections / Q000150:complications* / Q000821:virology; D013577:Syndrome; D013968:Thyroiditis, Subacute / Q000188:drug therapy / Q000209:etiology*; D013974:Thyroxine / Q000627:therapeutic use; D014580:Ursodeoxycholic Acid / Q000627:therapeutic use; D014775:Virus Activation
chemical_list: D000305:Adrenal Cortex Hormones; D000319:Adrenergic beta-Antagonists; D014580:Ursodeoxycholic Acid; D002231:Carbimazole; D013974:Thyroxine