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Strong association between HLA-B*5801 and allopurinol-induced Stevens–Johnson syndrome and toxic epidermal necrolysis in a Thai population
Abstract
OBJECTIVES: Allopurinol, a uric acid lowering drug commonly used for hyperuricemia and gouty arthritis, has been reported as a common cause of severe cutaneous adverse drug reactions (SCAR) including Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN). A strong association between allopurinol-induced SCAR and HLA-B*5801 was observed in a Han Chinese population with high frequency of this allele, whereas only a moderate association was observed in populations with low frequency (i.e. European and Japanese). This study investigated the relationship between SJS/TEN and HLA-B*5801 in a Thai population that has a high allelic frequency of this allele. METHODS: Twenty-seven allopurinol-induced SJS/TEN and 54 allopurinol-tolerant patients were enrolled in the study. The presence of HLA-B*5801 and HLA-B genotypes in these patients were analyzed using a PG5801 DNA detection kit and sequence-based typing, respectively. RESULTS: All of the 27 (100%) allopurinol-induced SJS/TEN patients who were examined carried HLA-B*5801 whereas only seven (12.96%) of the control patients had this allele. The risk of allopurinol-induced SJS/TEN was significantly greater in patients with HLA-B*5801 when compared with those who did not carry this allele, with an odds ratio of 348.3 (95% confidence interval=19.2-6336.9, P = 1.6 x10). The sensitivity and specificity of the HLA-B*5801 allele for prediction of allopurinol-induced SJS/TEN were 100 and 87%, respectively. By assuming a 0.2% prevalence rate, the positive predictive value and the negative predictive value of the HLA-B*5801 allele was 1.52 and 100%, respectively. CONCLUSION: A strong association of allopurinol-induced SJS/TEN with the HLA-B*5801 allele was observed in a Thai population. The results suggest that HLA-B*5801 is a valid genetic marker for screening Thai individuals who may be at risk for allopurinol-induced life-threatening SJS and TEN.
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Epidemiology and risk factors for drug allergy
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Current Perspectives on Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis
Lerch, M., Mainetti, C., Terziroli Beretta-Piccoli, B., & Harr, T. (2018) · Clinical Reviews in Allergy & Immunology · doi:10.1007/s12016-017-8654-z · Cited by 355
Jia, Y., Su, T., Gu, Y., Li, C., Zhou, X., Su, J., Sun, P., Tang, J., Yang, L., Liu, G., et al. (2018) · The Journal of Immunology · doi:10.4049/jimmunol.1800237 · Cited by 18
Metadata
- Authors
- Tassaneeyakul, W., Jantararoungtong, T., Chen, P., Lin, P.-Y., Tiamkao, S., Khunarkornsiri, U., Chucherd, P., Konyoung, P., Vannaprasaht, S., Choonhakarn, C., Pisuttimarn, P., Sangviroon, A., & Tassaneeyakul, W.
- Venue
- Pharmacogenetics and Genomics
- Published
- 2009-09
- Volume
- 19
- Issue
- 9
- Pages
- 704-709
- ISSN
- 1744-6872 (ISSN-L)
- OpenAlex
- W2155931624
- Cited by
- 401
- References
- 20
- FWCI
- 14.09
- Type
- journal article
- Language
- en
- Open access
- closed
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- Tassaneeyakul, W., Jantararoungtong, T., Chen, P., Lin, P.-Y., Tiamkao, S., Khunarkornsiri, U., Chucherd, P., Konyoung, P., Vannaprasaht, S., Choonhakarn, C., Pisuttimarn, P., Sangviroon, A., & Tassaneeyakul, W. (2009). Strong association between HLA-B*5801 and allopurinol-induced Stevens–Johnson syndrome and toxic epidermal necrolysis in a Thai population. Pharmacogenetics and Genomics. https://doi.org/10.1097/fpc.0b013e328330a3b8
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