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Rebecca J. Brown, MD; Kristina I. Rother, MD; Henry Artman, MD; Mary Gail Mercurio, MD; Roger Wang, MD; R. John Looney, MD; Edward W. Cowen, MD, MHSc

Arch Dermatol. 2009;145(1):63-66.

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.

Observations  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.

Author Affiliations: Developmental Endocrinology Branch, National Institute of Child Health and Human Development, Rockville, Maryland (Dr Brown); Clinical Endocrinology Branch, National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, Maryland (Dr Rother); Division of Endocrinology, Departments of Pediatrics (Dr Artman) and Dermatology (Dr Mercurio), and Section of Allergy/Immunology and Rheumatology, Department of Medicine (Drs Wang and Looney), University of Rochester School of Medicine and Dentistry, Rochester, New York; and Dermatology Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda (Dr Cowen).

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Journal Watch Dermatology 2009;2009:1-1.
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