Carbamazepine and phenytoin induced Stevens‐Johnson syndrome is associated with HLA‐B1502 allele in Thai population
Summary 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). Thi...
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| Published in | Epilepsia (Copenhagen) Vol. 49; no. 12; pp. 2087 - 2091 |
|---|---|
| Main Authors | , , , , , , , , , |
| Format | Journal Article |
| Language | English |
| Published |
Oxford, UK
Blackwell Publishing Ltd
01.12.2008
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| Subjects | |
| Online Access | Get full text |
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| Abstract | Summary
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.
Methods: Eighty‐one Thai epileptic patients between 1994 and 2007 from the Chulalongkorn Comprehensive Epilepsy Program were recruited. Thirty‐one subjects had antiepileptic drug (AED)‐induced SJS or MPE (6 CBZ‐SJS, 4 PHT‐SJS, 9 CBZ‐MPE, 12 PHT‐MPE), and 50 were AED‐tolerant controls.
Results: For the first time, a strong association between HLA‐B*1502 and PHT‐induced SJS was found (p = 0.005). A strong association was also found between the HLA‐B*1502 and CBZ‐induced SJS (p = 0.0005), making Thai the first non‐Chinese population demonstrating such an association. Some patients, who were HLA‐B*1502 and suffered from CBZ‐induced SJS, could be tolerant to PHT and vice versa. This suggests that HLA‐B*1502 may be a common attribute required for a Thai patient to develop SJS from these two AEDs; other different elements, however, are also needed for each AED. In addition, no association between HLA‐B alleles and CBZ‐ or PHT‐induced MPE was found.
Conclusions: CBZ‐ and PHT‐induced SJS, but not MPE, is associated with HLA‐B*1502 allele in Thai population. |
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| AbstractList | Summary
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.
Methods: Eighty‐one Thai epileptic patients between 1994 and 2007 from the Chulalongkorn Comprehensive Epilepsy Program were recruited. Thirty‐one subjects had antiepileptic drug (AED)‐induced SJS or MPE (6 CBZ‐SJS, 4 PHT‐SJS, 9 CBZ‐MPE, 12 PHT‐MPE), and 50 were AED‐tolerant controls.
Results: For the first time, a strong association between HLA‐B*1502 and PHT‐induced SJS was found (p = 0.005). A strong association was also found between the HLA‐B*1502 and CBZ‐induced SJS (p = 0.0005), making Thai the first non‐Chinese population demonstrating such an association. Some patients, who were HLA‐B*1502 and suffered from CBZ‐induced SJS, could be tolerant to PHT and vice versa. This suggests that HLA‐B*1502 may be a common attribute required for a Thai patient to develop SJS from these two AEDs; other different elements, however, are also needed for each AED. In addition, no association between HLA‐B alleles and CBZ‐ or PHT‐induced MPE was found.
Conclusions: CBZ‐ and PHT‐induced SJS, but not MPE, is associated with HLA‐B*1502 allele in Thai population. 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. Methods: Eighty‐one Thai epileptic patients between 1994 and 2007 from the Chulalongkorn Comprehensive Epilepsy Program were recruited. Thirty‐one subjects had antiepileptic drug (AED)‐induced SJS or MPE (6 CBZ‐SJS, 4 PHT‐SJS, 9 CBZ‐MPE, 12 PHT‐MPE), and 50 were AED‐tolerant controls. Results: For the first time, a strong association between HLA‐B*1502 and PHT‐induced SJS was found (p = 0.005). A strong association was also found between the HLA‐B*1502 and CBZ‐induced SJS (p = 0.0005), making Thai the first non‐Chinese population demonstrating such an association. Some patients, who were HLA‐B*1502 and suffered from CBZ‐induced SJS, could be tolerant to PHT and vice versa. This suggests that HLA‐B*1502 may be a common attribute required for a Thai patient to develop SJS from these two AEDs; other different elements, however, are also needed for each AED. In addition, no association between HLA‐B alleles and CBZ‐ or PHT‐induced MPE was found. Conclusions: CBZ‐ and PHT‐induced SJS, but not MPE, is associated with HLA‐B*1502 allele in Thai population. SummaryPurpose: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.Methods:Eighty-one Thai epileptic patients between 1994 and 2007 from the Chulalongkorn Comprehensive Epilepsy Program were recruited. Thirty-one subjects had antiepileptic drug (AED)-induced SJS or MPE (6 CBZ-SJS, 4 PHT-SJS, 9 CBZ-MPE, 12 PHT-MPE), and 50 were AED-tolerant controls.Results:For the first time, a strong association between HLA-B*1502 and PHT-induced SJS was found (p = 0.005). A strong association was also found between the HLA-B*1502 and CBZ-induced SJS (p = 0.0005), making Thai the first non-Chinese population demonstrating such an association. Some patients, who were HLA-B*1502 and suffered from CBZ-induced SJS, could be tolerant to PHT and vice versa. This suggests that HLA-B*1502 may be a common attribute required for a Thai patient to develop SJS from these two AEDs; other different elements, however, are also needed for each AED. In addition, no association between HLA-B alleles and CBZ- or PHT-induced MPE was found.Conclusions:CBZ- and PHT-induced SJS, but not MPE, is associated with HLA-B*1502 allele in Thai population. 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. Eighty-one Thai epileptic patients between 1994 and 2007 from the Chulalongkorn Comprehensive Epilepsy Program were recruited. Thirty-one subjects had antiepileptic drug (AED)-induced SJS or MPE (6 CBZ-SJS, 4 PHT-SJS, 9 CBZ-MPE, 12 PHT-MPE), and 50 were AED-tolerant controls. For the first time, a strong association between HLA-B*1502 and PHT-induced SJS was found (p = 0.005). A strong association was also found between the HLA-B*1502 and CBZ-induced SJS (p = 0.0005), making Thai the first non-Chinese population demonstrating such an association. Some patients, who were HLA-B*1502 and suffered from CBZ-induced SJS, could be tolerant to PHT and vice versa. This suggests that HLA-B*1502 may be a common attribute required for a Thai patient to develop SJS from these two AEDs; other different elements, however, are also needed for each AED. In addition, no association between HLA-B alleles and CBZ- or PHT-induced MPE was found. CBZ- and PHT-induced SJS, but not MPE, is associated with HLA-B*1502 allele in Thai population. 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.PURPOSEPrevious 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.Eighty-one Thai epileptic patients between 1994 and 2007 from the Chulalongkorn Comprehensive Epilepsy Program were recruited. Thirty-one subjects had antiepileptic drug (AED)-induced SJS or MPE (6 CBZ-SJS, 4 PHT-SJS, 9 CBZ-MPE, 12 PHT-MPE), and 50 were AED-tolerant controls.METHODSEighty-one Thai epileptic patients between 1994 and 2007 from the Chulalongkorn Comprehensive Epilepsy Program were recruited. Thirty-one subjects had antiepileptic drug (AED)-induced SJS or MPE (6 CBZ-SJS, 4 PHT-SJS, 9 CBZ-MPE, 12 PHT-MPE), and 50 were AED-tolerant controls.For the first time, a strong association between HLA-B*1502 and PHT-induced SJS was found (p = 0.005). A strong association was also found between the HLA-B*1502 and CBZ-induced SJS (p = 0.0005), making Thai the first non-Chinese population demonstrating such an association. Some patients, who were HLA-B*1502 and suffered from CBZ-induced SJS, could be tolerant to PHT and vice versa. This suggests that HLA-B*1502 may be a common attribute required for a Thai patient to develop SJS from these two AEDs; other different elements, however, are also needed for each AED. In addition, no association between HLA-B alleles and CBZ- or PHT-induced MPE was found.RESULTSFor the first time, a strong association between HLA-B*1502 and PHT-induced SJS was found (p = 0.005). A strong association was also found between the HLA-B*1502 and CBZ-induced SJS (p = 0.0005), making Thai the first non-Chinese population demonstrating such an association. Some patients, who were HLA-B*1502 and suffered from CBZ-induced SJS, could be tolerant to PHT and vice versa. This suggests that HLA-B*1502 may be a common attribute required for a Thai patient to develop SJS from these two AEDs; other different elements, however, are also needed for each AED. In addition, no association between HLA-B alleles and CBZ- or PHT-induced MPE was found.CBZ- and PHT-induced SJS, but not MPE, is associated with HLA-B*1502 allele in Thai population.CONCLUSIONSCBZ- and PHT-induced SJS, but not MPE, is associated with HLA-B*1502 allele in Thai population. |
| Author | Locharernkul, Chaichon Loplumlert, Jakrin Hirankarn, Nattiya Suphapeetiporn, Kanya Shotelersuk, Vorasuk Tongkobpetch, Siraprapa Desudchit, Tayard Limotai, Chusak Korkij, Wiwat Kangwanshiratada, Oratai |
| Author_xml | – sequence: 1 givenname: Chaichon surname: Locharernkul fullname: Locharernkul, Chaichon – sequence: 2 givenname: Jakrin surname: Loplumlert fullname: Loplumlert, Jakrin – sequence: 3 givenname: Chusak surname: Limotai fullname: Limotai, Chusak – sequence: 4 givenname: Wiwat surname: Korkij fullname: Korkij, Wiwat – sequence: 5 givenname: Tayard surname: Desudchit fullname: Desudchit, Tayard – sequence: 6 givenname: Siraprapa surname: Tongkobpetch fullname: Tongkobpetch, Siraprapa – sequence: 7 givenname: Oratai surname: Kangwanshiratada fullname: Kangwanshiratada, Oratai – sequence: 8 givenname: Nattiya surname: Hirankarn fullname: Hirankarn, Nattiya – sequence: 9 givenname: Kanya surname: Suphapeetiporn fullname: Suphapeetiporn, Kanya – sequence: 10 givenname: Vorasuk surname: Shotelersuk fullname: Shotelersuk, Vorasuk |
| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/18637831$$D View this record in MEDLINE/PubMed |
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| Cites_doi | 10.1111/j.1528-1167.2007.01022.x 10.1097/01.fpc.0000199500.46842.4a 10.2217/14622416.7.6.813 10.1038/sj.tpj.6500356 10.1212/01.WNL.0000156354.20227.F0 10.1111/1523-1747.ep12388434 10.1038/428486a 10.2165/00002018-199921060-00005 10.1016/S0031-6997(24)01501-1 10.1212/01.wnl.0000261917.83337.db 10.1034/j.1399-0039.2002.590308.x |
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| References | 2006; 7 1994; 102 2005; 64 1999; 21 2006; 6 2002; 59 2004; 428 2007; 68 2006; 16 2007; 48 2001; 53 e_1_2_6_9_1 e_1_2_6_8_1 e_1_2_6_5_1 e_1_2_6_4_1 e_1_2_6_10_1 e_1_2_6_7_1 e_1_2_6_6_1 e_1_2_6_3_1 e_1_2_6_11_1 e_1_2_6_2_1 Svensson CK (e_1_2_6_12_1) 2001; 53 Epilepsia. 2009 Apr;50(4):971 19515277 - Curr Neurol Neurosci Rep. 2009 Jul;9(4):268-9 |
| References_xml | – volume: 16 start-page: 297 year: 2006 end-page: 306 article-title: Genetic susceptibility to carbamazepine‐induced cutaneous adverse drug reactions publication-title: Pharmacogenet Genomics – volume: 53 start-page: 357 year: 2001 end-page: 379 article-title: Cutaneous drug reactions publication-title: Pharmacol Rev – volume: 428 start-page: 486 year: 2004 article-title: Medical genetics: a marker for Stevens‐Johnson syndrome publication-title: Nature – volume: 102 start-page: 28S year: 1994 end-page: 30S article-title: The spectrum of Stevens‐Johnson syndrome and toxic epidermal necrolysis: a clinical classification publication-title: J Invest Dermatol – volume: 21 start-page: 489 year: 1999 end-page: 501 article-title: Anticonvulsant hypersensitivity syndrome: incidence, prevention and management publication-title: Drug Saf – volume: 6 start-page: 265 year: 2006 end-page: 268 article-title: A marker for Stevens‐Johnson syndrome …: ethnicity matters publication-title: Pharmacogenomics J – volume: 48 start-page: 1015 year: 2007 end-page: 1018 article-title: Association between HLA‐B*1502 allele and antiepileptic drug‐induced cutaneous reactions in Han Chinese publication-title: Epilepsia – volume: 64 start-page: 1134 year: 2005 end-page: 1138 article-title: Risk of Stevens‐Johnson syndrome and toxic epidermal necrolysis in new users of antiepileptics publication-title: Neurology – volume: 68 start-page: 1701 year: 2007 end-page: 1709 article-title: Comparison and predictors of rash associated with 15 antiepileptic drugs publication-title: Neurology – volume: 59 start-page: 223 year: 2002 end-page: 225 article-title: Distribution of HLA‐B alleles in nasopharyngeal carcinoma patients and normal controls in Thailand publication-title: Tissue Antigens – volume: 7 start-page: 813 year: 2006 end-page: 818 article-title: HLA‐B locus in Caucasian patients with carbamazepine hypersensitivity publication-title: Pharmacogenomics – ident: e_1_2_6_8_1 doi: 10.1111/j.1528-1167.2007.01022.x – ident: e_1_2_6_5_1 doi: 10.1097/01.fpc.0000199500.46842.4a – ident: e_1_2_6_2_1 doi: 10.2217/14622416.7.6.813 – ident: e_1_2_6_7_1 doi: 10.1038/sj.tpj.6500356 – ident: e_1_2_6_9_1 doi: 10.1212/01.WNL.0000156354.20227.F0 – ident: e_1_2_6_11_1 doi: 10.1111/1523-1747.ep12388434 – ident: e_1_2_6_4_1 doi: 10.1038/428486a – ident: e_1_2_6_6_1 doi: 10.2165/00002018-199921060-00005 – volume: 53 start-page: 357 year: 2001 ident: e_1_2_6_12_1 article-title: Cutaneous drug reactions publication-title: Pharmacol Rev doi: 10.1016/S0031-6997(24)01501-1 – ident: e_1_2_6_3_1 doi: 10.1212/01.wnl.0000261917.83337.db – ident: e_1_2_6_10_1 doi: 10.1034/j.1399-0039.2002.590308.x – reference: 19515277 - Curr Neurol Neurosci Rep. 2009 Jul;9(4):268-9 – reference: - Epilepsia. 2009 Apr;50(4):971 |
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Purpose: Previous studies found a strong association between HLA‐B*1502 and carbamazepine (CBZ)‐induced Stevens‐Johnson syndrome (SJS) in Han Chinese,... Purpose: Previous studies found a strong association between HLA‐B*1502 and carbamazepine (CBZ)‐induced Stevens‐Johnson syndrome (SJS) in Han Chinese, but... Previous studies found a strong association between HLA-B*1502 and carbamazepine (CBZ)-induced Stevens-Johnson syndrome (SJS) in Han Chinese, but not in... SummaryPurpose:Previous studies found a strong association between HLA-B*1502 and carbamazepine (CBZ)-induced Stevens-Johnson syndrome (SJS) in Han Chinese,... |
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| SubjectTerms | Adolescent Adult Anticonvulsants - adverse effects Carbamazepine Carbamazepine - adverse effects Child Epilepsy - drug therapy Epilepsy - genetics Female Genetic Predisposition to Disease - ethnology HLA-B Antigens - genetics HLA‐B1502 Humans Maculopapular eruption Male Middle Aged Pharmacogenetics Phenytoin Phenytoin - adverse effects Retrospective Studies Stevens-Johnson Syndrome - chemically induced Stevens-Johnson Syndrome - genetics Stevens‐Johnson syndrome Thai Thailand - ethnology Young Adult |
| Title | Carbamazepine and phenytoin induced Stevens‐Johnson syndrome is associated with HLA‐B1502 allele in Thai population |
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