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. 2022 Aug 6;18(1):69.
doi: 10.1186/s13223-022-00707-w.

Drug-induced hypersensitivity syndrome induced by propylthiouracil: case report and literature review

Fang Wu #  1 , Ting Jin #  1 , Chengxin Shang  1 , Xihua Lin  1   2 , Xiaoqin Gong  3 , Zhou Wang  4
Affiliations

Drug-induced hypersensitivity syndrome induced by propylthiouracil: case report and literature review

Fang Wu et al. Allergy Asthma Clin Immunol. .

Abstract

Background: Drug-induced hypersensitivity syndrome (DIHS) is a rare, potentially life-threatening systemic drug reaction. Antithyroid drugs (ATDs) causing DIHS have seldom been reported before.

Case presentation: We present a case of propylthiouracil (PTU)-induced DIHS, which included fever, skin rash, lymphadenopathy, hepatosplenomegaly, serious liver and kidney dysfunction, peripheral blood eosinophilia, and atypical lymphocytosis. Following supportive therapy, intravenous immunoglobulin (IVIG), and systemic corticosteroid, the patient experienced a resolution of fever and rash combined with progressive normalization of hematological index and organ function. These clinical features, and the skin lesion biopsy confirmed DIHS diagnosis.

Conclusions: To our knowledge, this is the second reported case of PTU-induced DIHS worldwide and the first human leukocyte antigen (HLA) typing of PTU-induced DIHS. Clinicians should cautiously distinguish hyperthyroidism etiology and identify the indication of ATDs. Timely recognition and formal DIHS treatment are required in patients with ATDs.

Keywords: Drug-induced hypersensitivity syndrome; Human leukocyte antigen; Propylthiouracil.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Haematoxylin and eosin staining of the skin biopsy. Finding from the skin biopsy: dermal lymphocytic infiltrate and occasional perivascular monocytic infiltrate, with the presence of interface vacuolization (a), perifollicular lymphocytic infiltration (b), epidermal spongiosis (c). Hematoxylin and eosin stain; original magnification: X200
See this image and copyright information in PMC

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