Methazolamide-induced toxic epidermal necrolysis in a patient with HLA-B5901 allele
10.3760/cma.j.issn.0412-4030.2015.02.018
- VernacularTitle:醋甲唑胺致HLA-B5901阳性患者中毒性表皮坏死松解症一例
- Author:
Yonghao XU
;
Ying SU
;
Jie ZHAO
;
Yujie DU
;
Qing SUN
- Publication Type:Journal Article
- Keywords:
Methazolamide;
Epidermal necrolysis,toxic;
Drug toxicity;
HLA antigens
- From:
Chinese Journal of Dermatology
2015;48(2):131-133
- CountryChina
- Language:Chinese
-
Abstract:
A 56-year-old female patient of Han nationality presented with generalized erythema and vesicles for 6 days,as well as high fever for 2 days.Twenty days prior to hospitalization,the patient received surgical treatment combined with oral methazolamide and glucocorticoids for glaucoma.The patient had a history of allergy to sulfanilamides.On admission,the patient presented with generalized erythema,vesicles and occasional erosions with bilateral eyelid and oral involvement.Nikolsky's sign was positive.Wheezing sound was heard over the right lung.Genetic testing showed that HLA-B5901 allele was positive.The patient was diagnosed with methazolamide-induced toxic epidermal necrolysis (TEN) complicated by pneumonia,and managed with immunoglobulin (25 g/day,5 days),glucocorticoids (the largest dose equivalent to methylprednisolone 160 mg/day),fresh plasma,antibiotics,as well as other supporting and symptomatic treatments.The condition was controlled after 2 weeks,and the patient was cured and discharged from hospital after 25 days.The fact that the patient carried HLA-B5901 allele suggests that HLA-B5901 is strongly correlated with methazolamide-induced TEN or Stevens-Johnson syndrome in Chinese descendants or Han population,besides in Japanese and Korean descendants.
