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 PHTMPE),
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 HLAB
∗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 associationbetween HLA-B∗1502 and carbamazepine(CBZ)-induced Stevens-Johnson syndrome (SJS) inHan Chinese, but not in Caucasian populations.Even in Han Chinese, the HLA-B∗1502 was notassociated with CBZ-induced maculopapular eruptions(MPE). This study seeks to identify whetherHLA-B∗1502 is associated with CBZ- or phenytoin(PHT)-induced SJS or MPE in a Thai population.Methods: Eighty-one Thai epileptic patients between1994 and 2007 from the Chulalongkorn ComprehensiveEpilepsy Program were recruited. Thirty-onesubjects had antiepileptic drug (AED)-induced SJS orMPE (6 CBZ-SJS, 4 PHT-SJS, 9 CBZ-MPE, 12 PHTMPE),and 50 were AED-tolerant controls.Results: For the first time, a strong associationbetween HLA-B∗1502 and PHT-induced SJS was found (p = 0.005). A strong association was alsofound between the HLA-B∗1502 and CBZ-inducedSJS (p = 0.0005), making Thai the first non-Chinesepopulation demonstrating such an association.Some patients, who were HLA-B∗1502 and sufferedfrom CBZ-induced SJS, could be tolerant toPHT and vice versa. This suggests that HLAB∗1502 may be a common attribute required for aThai patient to develop SJS from these two AEDs;other different elements, however, are alsoneeded for each AED. In addition, no associationbetween HLA-B alleles and CBZ- or PHT-inducedMPE was found.Conclusions: CBZ- and PHT-induced SJS, but notMPE, is associated with HLA-B∗1502 allele in Thaipopulation.
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