Carbamazepine and phenytoin induced Stevens‐Johnson syndrome is associated with HLA‐B*1502 allele in Thai population

  title={Carbamazepine and phenytoin induced Stevens‐Johnson syndrome is associated with HLA‐B*1502 allele in Thai population},
  author={Chaichon Locharernkul and Jakrin Loplumlert and Chusak Limotai and Wiwat Korkij and Tayard Desudchit and Siraprapa Tongkobpetch and Oratai Kangwanshiratada and Nattiya Hirankarn and Kanya Suphapeetiporn and Vorasuk Shotelersuk},
Purpose:  Previous studies found a strong association between HLA‐B*1502 and carbamazepine (CBZ)‐induced Stevens‐Johnson syndrome (SJS) in Han Chinese, but not in Caucasian populations. Even in Han Chinese, the HLA‐B*1502 was not associated with CBZ‐induced maculopapular eruptions (MPE). This study seeks to identify whether HLA‐B*1502 is associated with CBZ‐ or phenytoin (PHT)‐induced SJS or MPE in a Thai population. 
HLA‐B*1502 Strongly Predicts Carbamazepine‐Induced Stevens–Johnson Syndrome and Toxic Epidermal Necrolysis in Thai Patients with Neuropathic Pain
Background:  Carbamazepine (CBZ) is one of the standard pharmacological treatments for neuropathic pain. However, its serious adverse drug reactions include Stevens–Johnson syndrome (SJS) and toxic
Association between HLA‐B*1502 and carbamazepine‐induced severe cutaneous adverse drug reactions in a Thai population
Results from this study suggest that HLA‐B*1502 may be a useful pharmacogenetic test for screening Thai individuals who may be at risk for CBZ‐induced SJS and TEN.
HLA‐B alleles associated with severe cutaneous reactions to antiepileptic drugs in Han Chinese
HLA‐B*15:02 screening is recommended before starting carbamazepine in Han Chinese and Southeast Asians because the allele is strongly predictive of Stevens‐Johnson syndrome (SJS)/toxic epidermal
The association of HLA B*15:02 allele and Stevens–Johnson syndrome/toxic epidermal necrolysis induced by aromatic anticonvulsant drugs in a South Indian population
  • K. Devi
  • Medicine
    International journal of dermatology
  • 2018
The presence of HLA‐B*15:02 allele is considered a risk factor for development of Stevens–Johnson syndrome/toxic epidermal necrolysis (SJS/TEN) in patients taking aromatic anticonvulsant drugs like
Association of HLA‐B*1502 allele with lamotrigine‐induced Stevens–Johnson syndrome and toxic epidermal necrolysis in Han Chinese subjects: a meta‐analysis
Despite several studies investigating the association between the human leukocyte antigen HLA‐B*1502 allele and lamotrigine‐induced Stevens–Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN)
Phenytoin-induced Stevens–Johnson syndrome with negative HLA-B*1502 allele in mainland China: Two cases
Evidence is provided to support that other genetic markers or nongenetic factors could contribute to the susceptibility of PHT-induced SJS, except for HLA-B*1502 allele, and to investigate the genetic link with P HT-induced serious skin reactions in future.
Association between HLA and Stevens–Johnson Syndrome Induced by Carbamazepine in Southern Han Chinese: Genetic Markers besides B*1502?
Given the association between HLA‐B*1502 and CBZ‐induced SJS/TEN, genetic testing before initiating CBZ therapy is suggested in Han Chinese population, and physicians should also be vigilant about SJS /TEN in those negative for HLA•B* 1502.
HLA Class I markers in Japanese patients with carbamazepine‐induced cutaneous adverse reactions
Examination of HLA class I in Japanese patients with severe cADRs may suggest that HLA‐B*5901 is one of the candidate markers for CBZ‐induced SJS in Japanese, which is reported recently that the human leukocyte antigen HLA*1502 is associated with Stevens‐Johnson syndrome in Han Chinese.
HLA‐B*1511 is a risk factor for carbamazepine‐induced Stevens‐Johnson syndrome and toxic epidermal necrolysis in Japanese patients
The genotyped the HLA‐B locus from 14 Japanese typical and atypical SJS/TEN patients in whom carbamazepine was considered to be involved in the onset of adverse reactions and suggested that HLA·B*1511, a member of HLA•B75, is a risk factor for carbamazepsine‐induced SJS /TEN in Japanese.
Investigating the association of Lamotrigine and Phenytoin‐induced Stevens‐Johnson syndrome/Toxic Epidermal Necrolysis with HLA‐B*1502 in Iranian population
Lamotrigine‐induced SJS/TEN is associated with HLA‐B*1502 allele in an Iranian population but this is not the case for phenytoin‐induced TEN.


Association between HLA‐B*1502 Allele and Antiepileptic Drug‐Induced Cutaneous Reactions in Han Chinese
Identification of genetic polymorphisms predisposing to development of AED‐induced SCR offers the possibility of avoiding these high‐risk drugs in genetically susceptible individuals.
HLA-B locus in Caucasian patients with carbamazepine hypersensitivity.
HLA-B*1502 does not seem to be a marker for all forms of CBZ-induced hypersensitivity in a Caucasian population, and HLA- B*0702 allele may protect against severe CBZ hypersensitivity but warrants further study.
A marker for Stevens-Johnson syndrome …: ethnicity matters
Preliminary results from a European study of 12 carbamazepine-induced SJS/TEN cases (RegiSCAR) show that although the HLA region may contain important genes for SJS, the Hla-B*1502 allele is not a universal marker for this disease and that ethnicity matters.
Genetic susceptibility to carbamazepine-induced cutaneous adverse drug reactions
The data suggest that HLA-B*1502 could contribute to the pathogenesis ofCBZ-SJS/TEN, and that genetic susceptibility to CBZ-induced cADRs is phenotype-specific.
Medical genetics: A marker for Stevens–Johnson syndrome
It is shown that there is a strong association in Han Chinese between a genetic marker, the human leukocyte antigen HLA–B*1502, and Stevens–Johnson syndrome induced by carbamazepine, a drug commonly prescribed for the treatment of seizures.
Risk of Stevens–Johnson syndrome and toxic epidermal necrolysis in new users of antiepileptics
The risk of hospitalization for Stevens–Johnson syndrome or toxic epidermal necrolysis in new users is low for carbamazepine, lamotrigine, phenytoin, phenobarbital, and valproic acid.
Anticonvulsant hypersensitivity syndrome.
The timely recognition of anticonvulsant hypersensitivity syndrome is important, because accurate diagnosis avoids potentially fatal reexposure and affects subsequent anticonVulsant treatment options.
Distribution of HLA-B alleles in nasopharyngeal carcinoma patients and normal controls in Thailand.
HLA-B frequencies in 54 unrelated nasopharyngeal carcinoma patients and 49 healthy random controls in Thailand were investigated by direct DNA sequencing and B*44032 was associated with a decreased risk.
Comparison and predictors of rash associated with 15 antiepileptic drugs
The rate of an antiepileptic drug (AED) rash is approximately five times greater in patients with another AED rash vs those without, and these AED differences remained similar in Patients with and without other AED rashes.
The spectrum of Stevens-Johnson syndrome and toxic epidermal necrolysis: a clinical classification.
  • J. Roujeau
  • Biology, Medicine
    The Journal of investigative dermatology
  • 1994
An international group of dermatologists proposed a classification based on the pattern of "EM-like lesions" (categorized as typical targets, raised or flat atypical targets, and purpuric macules) and on the extent of epidermal detachment, and whether all five categories proposed represent distinct etiopathologic entities will require further epidemiologic and laboratory investigations.