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Clinical features of and genetic predisposition to drug-induced Stevens-Johnson syndrome and toxic epidermal necrolysis in a single Korean tertiary institution patients-investigating the relation between the HLA -B*4403 allele and lamotrigine

Authors
 Hye Jung Park  ;  Sung Ryeol Kim  ;  Dong Woo Leem  ;  Il Joo Moon  ;  Beom Seok Koh  ;  Kyung Hee Park  ;  Jung-Won Park  ;  Jae-Hyun Lee 
Citation
 EUROPEAN JOURNAL OF CLINICAL PHARMACOLOGY, Vol.71(1) : 35-41, 2015 
Journal Title
 EUROPEAN JOURNAL OF CLINICAL PHARMACOLOGY 
ISSN
 0031-6970 
Issue Date
2015
MeSH
Acetaminophen/adverse effects ; Acetazolamide/adverse effects ; Adult ; Aged ; Aged, 80 and over ; Alleles ; Allopurinol/adverse effects ; Anti-Bacterial Agents/adverse effects ; Anticonvulsants/adverse effects* ; Asian Continental Ancestry Group/genetics* ; Female ; Genetic Predisposition to Disease* ; HLA-B Antigens/genetics* ; Humans ; Male ; Middle Aged ; Plants, Medicinal/adverse effects ; Republic of Korea ; Stevens-Johnson Syndrome/etiology ; Stevens-Johnson Syndrome/genetics* ; Tertiary Care Centers ; Triazines/adverse effects* ; Young Adult
Keywords
Stevens–Johnson syndrome ; Toxic epidermal necrolysis ; Lamotrigine ; Human leukocyte antigens
Abstract
PURPOSE: Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are rare but fatal adverse mucocutaneous reactions to certain drugs. Recent studies suggest that ethnicity and genetic predisposition may play a crucial role in the manifestation of the reaction. In this study, we described the role of human leukocyte antigen (HLA)-B alleles in the development of clinical characteristics and treatment outcomes of SJS/TEN in a single Korean tertiary hospital. METHODS: We retrospectively reviewed the medical records (from March 1, 2010 to February 28, 2014) of 30 patients diagnosed with SJS and/or TEN. RESULTS: The main causative drugs were anticonvulsants (26.7 %) and allopurinol (26.7 %), followed by antibiotics (16.7 %), acetazolamide (10.0 %), acetaminophen (10.0 %), and herbal medication (6.7 %). The mean latencies of these drugs were variable. Liver damage was the most common symptom (observed in 63.3 % of the patients). Of the five patients with lamotrigine-induced SJS/TEN, three expressed the HLA-B*4403 allele (60.0 %). Of the seven patients with allopurinol-induced SJS/TEN, five expressed the HLA-B*5801 allele (71.4 %). CONCLUSIONS: The major SJS/TEN-inducing drugs were found to be allopurinol and anticonvulsants (such as lamotrigine). We speculated that Korean individuals expressing the HLA-B*4403 allele may be highly susceptible to lamotrigine-induced SJS/TEN.
Full Text
http://link.springer.com/article/10.1007%2Fs00228-014-1764-0
DOI
10.1007/s00228-014-1764-0
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Koh, Beom Seok(고범석)
Kim, Sung Ryeol(김성렬) ORCID logo https://orcid.org/0000-0001-7418-0049
Moon, Il Joo(문일주)
Park, Kyung Hee(박경희) ORCID logo https://orcid.org/0000-0003-3605-5364
Park, Jung Won(박중원) ORCID logo https://orcid.org/0000-0003-0249-8749
Park, Hye Jung(박혜정) ORCID logo https://orcid.org/0000-0002-1862-1003
Lee, Jae Hyun(이재현) ORCID logo https://orcid.org/0000-0002-0760-0071
Leem, Dong Woo(임동우)
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/139319
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