HLA-B*1502 and carbamazepine-induced severe cutaneous adverse drug reactions in Vietnamese
| Autor: | Dinh Van Nguyen, Doan Van Nguyen, Sheryl van Nunen, Minh Hong Phan, Karl Baumgart, Timothy J. Craig, Hieu Chi Chu |
|---|---|
| Rok vydání: | 2015 |
| Předmět: |
medicine.medical_specialty
business.industry Incidence (epidemiology) Scars Dermatology Carbamazepine Pharmacology medicine.disease Rash Drug-related side effects and adverse reactions Toxic epidermal necrolysis HLA-B antigens stomatognathic diseases medicine HLA-B Antigens Immunology and Allergy Eosinophilia Original Article Risk factor medicine.symptom Pharmacogenomics business medicine.drug |
| Zdroj: | Asia Pacific Allergy |
| ISSN: | 2233-8276 |
| DOI: | 10.5415/apallergy.2015.5.2.68 |
| Popis: | Background In Vietnam, we observed a high incidence of carbamazepine (CBZ)-induced severe cutaneous adverse drug reactions (SCARs)-Stevens-Johnson syndrome (SJS)/toxic epidermal necrolysis (TEN), and drug-induced hypersensitivity rash with eosinophilia and systemic symptoms (DRESS). In other Asian countries, HLA-B*1502 is an established risk factor for SCARs. Objective The aim of our study was to determine the frequency of HLA-B*1502 in SCARs patients at a large University Medical Center in Hanoi, Vietnam. Methods Thirty-eight cases of SCARs caused by CBZ and 25 patients with epilepsy tolerating CBZ were enrolled in a case-controlled study. Clinical manifestations and laboratory findings were recorded for each subject. Genomic DNA was isolated using the QIAamp DNA purification system. The combination of polymerase chain reaction and sequence specific oligonucleotide probes with the Luminex 100×MAP flow cytometry dual laser system was then used to quantitate fluorescently labelled oligonucleotides attached to colour-coded microbeads. Results Cases comprised 20 SJS (52.6%), 7 TEN (18.4%), 8 overlap syndrome (21.1%), and 3 DRESS patients (7.9%). A strong association between HLA B*1502 and bullous skin reactions such as SJS/TEN and overlap was confirmed with an odds ratio (OR) of 33.78 (95% confidence interval [CI], 7.55-151.03), p < 0.0001, Sensitivity 91.4%, Specificity 76.0%, positive predictive value 84.2%, and negative predictive value 86.4%. We did not, however, observe any correlation between the presence of this allele and CBZ-induced nonbullous skin reactions (DRESS) (OR, 6.33; 95% CI, 0.48-82.74; p = 0.1592). Conclusion Our results indicate the presence of HLA-B*1502 in Vietnamese is a pharmacogenetic risk factor for developing CBZ-induced SJS/TEN. |
| Databáze: | OpenAIRE |
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