Diagnostic utility of human leukocyte antigen B*15:02 screening in severe carbamazepine hypersensitivity syndrome
| Autor: | Yassir Bousliman, Yahia Cherrah, Jamal Lamsaouri, Youssef Moutaouakkil, Badr Adouani |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
medicine.medical_specialty
human leukocyte antigen-B*15:02 Human leukocyte antigen Gastroenterology lcsh:RC346-429 03 medical and health sciences 0302 clinical medicine Internal medicine medicine 030212 general & internal medicine Allele lcsh:Neurology. Diseases of the nervous system Receiver operating characteristic business.industry screening Odds ratio Carbamazepine medicine.disease Confidence interval Toxic epidermal necrolysis meta-analysis Meta-analysis Systematic Review Neurology (clinical) hypersensitivity business 030217 neurology & neurosurgery medicine.drug |
| Zdroj: | Annals of Indian Academy of Neurology Annals of Indian Academy of Neurology, Vol 22, Iss 4, Pp 377-383 (2019) |
| ISSN: | 0972-2327 |
| Popis: | Background: Despite many studies suggesting an association between human leukocyte antigen (HLA)-B*15:02 and carbamazepine (CBZ)-induced severe cutaneous adverse drug reactions essentially toxic epidermal necrolysis (TEN) and Stevens–Johnson syndrome (SJS), the evidence of association in different populations and the degree of association remain uncertain. Materials and Methods: The primary analysis was based on population control studies. Data were pooled by means of a random-effects model, and sensitivity, specificity, positive and negative likelihood ratios (LR+ and LR−), diagnostic odds ratios (DOR), and areas under the summary receiver operating characteristic curve (AUC) were calculated. Results: In 23 population control studies, HLA-B*15:02 was measured in 373 patients with CBZ-induced TEN/SJS and 3452 patients without CBZ-induced TEN/SJS. The pooled sensitivity, specificity, LR+, LR−, DOR, and AUC were 0.67 (95% confidence interval [CI] = 0.63–0.72), 0.98 (95% CI = 0.98–0.99), 19.73 (95% CI = 10.54–36.92), 0.34 (95% CI = 0.23–0.49), 71.38 (95% CI = 34.89–146.05), and 0.96 (95% CI = 0.92–0.98), respectively. Subgroup analyses for Han Chinese, Thai, and Malaysian populations yielded similar findings. Specifically, racial/ethnic subgroup analyses revealed similar findings with respect to DOR for Han Chinese (99.28; 95% CI = 22.20–443.88), Thai (61.01; 95% CI = 23.05–161.44), and Malaysian (30; 95% CI = 7.08–126.68) populations, which are similar to the pooled DOR for the relationship between the HLA-B*15:02 allele and CBZ-induced TEN/SJS across all populations (71.38; 95% CI = 34.89–146.05). Conclusions: The present study reveals that CBZ is the leading cause of TEN/SJS in many countries. Screening of HLA-B*15:02 may help patients to prevent the occurrence of CBZ-induced TEN/SJS, especially in populations with a higher (≥5%) risk allele frequency. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|