Mizukawa Y, Aoyama Y, Takahashi H, et al. - This study provides a new scoring system to detect patients at high-risk of developing autoimmune disease.

• In this retrospective analysis, 55 patients with drug-induced hypersensitivity syndrome/drug reaction with eosinophilia and systemic symptoms were observed for the likelihood of later development of autoimmune disease ∼18 years following resolution.

• Irrespective of treatment, progression to autoimmune sequelae was evident in nine patients.

• In 8 of the 9 patients, the production of autoantibodies preceded by 8 years.

• Significant risk factors for the future development of autoimmune disease were: the combination of rises in lymphocyte counts, severe liver damage, a rebound elevation in globulin, persistent reactivations of Epstein-Barr virus and human herpesvirus-6, and low interleukin (IL)-2 and IL-4 at the acute/subacute phases.

• A scoring system was established based on these factors, and this scoring system can detect high-risk patients.

• These patients were stratified into three risk groups (low/intermediate/high).

• In the high group, development of autoimmune disease was exclusively identified.