Fulminant Type 1 Diabetes Caused by DIHS Could Be Affected by the Reactivation of HHV-6

Context In the previous issue of this journal, we reported that the incidence of fulminant type 1 diabetes (FT1D) due to the drug-induced hypersensitivity syndrome (DIHS) in Japan is higher than that in the general population and is associated with HLAB62. On the other hand, the reactivation of human herpesvirus 6 (HHV-6), which has been reported to be associated with DIHS, was observed at a higher frequency, but its association with the development of FT1D was unclear.Objective We aimed to clarify the relationship between the onset of FT1D and the reactivation of HHV-6.Methods We conducted a literature search for cases of DIHS-induced FT1D in addition to previously reported cases and investigated the changes in the HHV-6 antibody titer before and after the onset of FT1D.Results The HHV-6 antibody titer was increased just before or after the onset of FT1D in all 8 cases. In 1 case, HHV-6 DNA was also identified shortly before the onset of FT1D.Conclusion These results indicate for the first time that the reactivation of HHV-6 is associated with the onset of FT1D caused by DIHS.