Abstract
A 78-year-old woman with no history of diabetes mellitus, who had been treated with allopurinol for a month, was hospitalized to examine the cause of general malaise, loss of appetite and skin rash that appeared on both thighs. She had a sudden onset of a high fever after admission, and meropenem was administered. An erythema-like rash was noted on her left forearm two days thereafter. All medication was discontinued due to the suspicion of a drug eruption. We suspected DIHS and initiated steroid pulse therapy followed by oral administration of prednisolone (40 mg). The patient's HHV-6 IgG titer increased from 20 to 5,120 within three weeks, thus she was diagnosed with DIHS. One month after discharge, the patient developed fulminant type 1 diabetes mellitus. After medical treatment, she developed viral encephalitis and died due to multiple organ failure. In this paper, we described a case that developed fulminant type 1 diabetes mellitus after remission of DIHS due to allopurinol use. Similar cases have been reported regarding the development of fulminant type 1 diabetes 2 to 3 weeks after DIHS remission. In such cases, we should be careful not to delay the diagnosis of fulminant type 1 diabetes.
