Antiepileptic drug-induced severe cutaneous adverse reactions and HLA alleles: A report of five cases with lymphocyte activation test
10.12793/tcp.2019.27.2.64
- Author:
Eun Young KIM
1
;
Mi Yeong KIM
;
Chan Sun PARK
;
Jae Hyeog CHOI
;
Jong Lyul GHIM
;
Ho Sook KIM
;
Jae Gook SHIN
Author Information
1. Department of Clinical Pharmacology, Inje University College of Medicine, Busan Paik Hospital, Busan 47392, Republic of Korea. phshinjg@gmail.com
- Publication Type:Case Report
- Keywords:
Antiepileptic drugs;
HLA class I alleles;
Lymphocyte activation test;
Severe cutaneous adverse reactions
- MeSH:
Alleles;
Anticonvulsants;
Carbamazepine;
Cicatrix;
Drug Hypersensitivity Syndrome;
Female;
HLA-A Antigens;
Humans;
Long-Acting Thyroid Stimulator;
Lymphocyte Activation;
Lymphocytes;
Male;
Methods;
Phenytoin;
Seizures;
Stevens-Johnson Syndrome;
Valproic Acid
- From:Translational and Clinical Pharmacology
2019;27(2):64-68
- CountryRepublic of Korea
- Language:English
-
Abstract:
Antiepileptic drugs (AEDs) can induce severe cutaneous adverse reactions (SCARs) such as Stevens-Johnson syndrome (SJS), toxic epidermal necrolysis (TEN), and drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome. We performed HLA genotyping and lymphocyte activation tests (LATs) for five AED-induced SCAR patients (three males and two females; aged 40–66 years old). Three patients were treated with carbamazepine (CBZ) for pain control, one was treated with phenytoin (PHT) for seizure prevention, and one was treated with valproic acid (VPA) for seizure prevention. One patient was diagnosed with CBZ-induced DRESS syndrome and the remaining patients were diagnosed with SJS. All patients recovered from SCARs after stopping suspicious drugs and supportive care. LATs were conducted to confirm the culprit drug responsible for inducing SCARs; and LAT results were positive for the suspected culprit drugs, in all except in one case. HLA-A,
