Association of HLA-B*1502 and *1511 allele with antiepileptic drug-induced Stevens-Johnson syndrome in central China.
10.1007/s11596-014-1247-7
- Author:
Dan SUN
1
;
Chun-hua YU
;
Zhi-sheng LIU
;
Xue-lian HE
;
Jia-sheng HU
;
Ge-fei WU
;
Bing MAO
;
Shu-hua WU
;
Hui-hui XIANG
Author Information
1. Department of Pediatric Neurology, Wuhan Children's Hospital, Wuhan, 430016, China, bloveriver@163.com.
- Publication Type:Journal Article
- MeSH:
Adolescent;
Alleles;
Anticonvulsants;
adverse effects;
Asian Continental Ancestry Group;
genetics;
Carbamazepine;
adverse effects;
analogs & derivatives;
Child;
Child, Preschool;
China;
Female;
Genetic Predisposition to Disease;
ethnology;
genetics;
Genotype;
HLA-B15 Antigen;
genetics;
Humans;
Infant;
Male;
Phenobarbital;
adverse effects;
Polymerase Chain Reaction;
Stevens-Johnson Syndrome;
ethnology;
etiology;
genetics
- From:
Journal of Huazhong University of Science and Technology (Medical Sciences)
2014;34(1):146-150
- CountryChina
- Language:English
-
Abstract:
Previous studies have demonstrated a strong association between carbamazepine (CBZ)-induced Stevens-Johnson syndrome (SJS) and HLA-B*1502 in Han Chinese. Here, we extended the study of HLA-B*1502 susceptibility to two different antiepileptic drugs, oxcarbazepine (OXC) and phenobarbital (PB). In addition, we genotyped HLA-B*1511 in a case of CBZ-induced SJS with genotype negative for HLA-B*1502. The presence of HLA-B*1502 was determined using polymerase chain reaction with sequence-specific primers (PCR-SSP). Moreover, we genotyped HLA-B*1502 in 17 cases of antiepileptic drugs (AEDs)-induced cutaneous adverse drug reactions (cADRs), in comparison with AEDs-tolerant (n=32) and normal controls (n=38) in the central region of China. The data showed that HLA-B*1502 was positive in 5 of 6 cases of AEDs-induced SJS (4 CBZ, 1 OXC and 1 PB), which was significantly more frequent than AEDs-tolerant (2/32, 18 CBZ, 6 PB and 8 OXC) and normal controls (3/38). Compared with AEDs-tolerant and normal controls, the OR for patients carrying the HLA-B*1502 with AEDs-induced SJS was 6.25 (95% CI: 1.06-36.74) and 4.86 (95% CI: 1.01-23.47). The sensitivity and specificity of HLA-B*1502 for prediction of AEDs-induced SJS were 71.4%. The sensitivity and specificity of HLA-B*1502 for prediction of CBZ-induced SJS were 60% and 94%. HLA-B*1502 was not found in 11 children with maculopapular exanthema (MPE) (n=9) and hypersensitivity syndrome (HSS) (n=2). However, we also found one case of CBZ-induced SJS who was negative for HLA-B*1502 but carried HLA-B*1511. It was suggested that the association between the CBZ-induced SJS and HLA-B*1502 allele in Han Chinese children can extend to other aromatic AEDs including OXC and PB related SJS. HLA-B*1511 may be a risk factor for some patients with CBZ-induced SJS negative for HLA-B*1502.
