High Frequency of HLA B62 in Fulminant Type 1 Diabetes with the Drug-Induced Hypersensitivity Syndrome
High Frequency of HLA B62 in Fulminant Type 1 Diabetes with the Drug-Induced Hypersensitivity Syndrome
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DOI：
10.1210/jc.2012-2054
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发表时间：
2012-12-01
影响因子：
5.8
通讯作者：
Makino, Hideichi
中科院分区：
文献类型：
--
作者：
Onuma, Hiroshi;Tohyama, Mikiko;Makino, Hideichi
背景：暴发性1型糖尿病（FT 1D）是1型糖尿病的一种亚型，其特征是发病极为突然。目的：探讨FT 1D合并药物性超敏反应综合征（DIHS）的临床特点。结果：15例FT 1D的平均发病年龄为53.4岁，从发病到发病的平均时间为39.9d。FT 1D伴DIHS组HLA-B62阳性率明显高于无DIHS组（P < 0.001），而HLA-DR阳性率无明显差异（P> 0.05）。分别在11例和4例病例中检测到疱疹病毒6型和巨细胞病毒的再激活。在全国范围内调查的746例DIHS患者中，4例在3年期间发生了FT 1D。结论：FT 1D合并DIHS患者的临床特征与非DIHS患者相似，但HLA-B62的高频率表达可能与FT 1D合并DIHS的发病机制有关。由于其发生率远高于一般日本人群，因此在DIHS发生时应牢记FT 1D。（临床内分泌代谢杂志97：E2277-E2281，2012）
Context: Fulminant type 1 diabetes (FT1D) is a subtype of type 1 diabetes characterized by an extremely abrupt onset. FT1D cases associated with the drug-induced hypersensitivity syndrome (DIHS) have recently been reported.Objective: The clinical characteristics of FT1D associated with DIHS were investigated in this study.Methods: Case reports of FT1D associated with DIHS in Japanese subjects were collected and analyzed by means of a questionnaire to the authors. A nationwide questionnaire survey was administered to dermatology specialists, concerning the frequency of FT1D associated with DIHS.Results: In 15 case reports, the mean age at onset of FT1D was 53.4 yr and the mean time for its development from the onset of DIHS was 39.9 d. A higher frequency of human leukocyte antigen (HLA) B62, but not of HLA DR was found in FT1D with DIHS than that for cases without DIHS (P < 0.001). The reactivation of herpes virus 6 and cytomegalovirus was detected in 11 and four cases, respectively. Among 746 patients with DIHS in the nationwide survey, four developed FT1D during a 3-yr period. The frequency of FT1D in DIHS (0.54%) was much higher than that in the general Japanese population (0.010%).Conclusions: The clinical characteristics of FT1D with DIHS were similar to those without DIHS except for the high frequency of HLA B62, which may be involved in the pathogenesis of FT1D with DIHS. Because the frequency was much higher than that in the general Japanese population, FT1D should be kept in mind when DIHS develops. (J Clin Endocrinol Metab 97: E2277-E2281, 2012)