Analysis of ocular manifestation and genetic association of allopurinol-induced Stevens-Johnson syndrome and toxic epidermal necrolysis in South Korea

Hyo Seok Lee, Mayumi Ueta, Mee Kum Kim, KyoungYul Seo, Chie Sotozono, Shigeru Kinoshita, Kyung Chul Yoon

Research output: Contribution to journalArticle

7 Citations (Scopus)

Abstract

Purpose: To describe the clinical characteristics and genetic background of allopurinol-induced Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) in South Korea. Methods: This is a prospective, noncomparative case series. Visual acuity, detailed medical history, ocular findings, and systemic manifestations of 5 patients (10 eyes) with allopurinol-induced SJS/TEN were recorded. The acute ocular involvement score and the chronic ocular manifestation score were graded on scales of 0-3 and 0-39, respectively, based on severity. Human leukocyte antigen (HLA) genotyping was also performed during the hospitalization. Results: Three patients were diagnosed with SJS, and 2 with TEN. Mild ocular involvement with only conjunctival hyperemia (acute ocular involvement score ≤1) was present in all 10 eyes during the acute stage. Patients were treated with systemic steroids and topical antibiotics, steroids, and preservative-free artificial tears, with rinsing of the ocular surface, in the acute stages of SJS/TEN. In the final follow-up, none of the patients had developed severe chronic ocular complications (chronic ocular manifestation score ≤8), including keratinization, corneal conjunctivalization, mucocutaneous junction involvement, or symblepharon. One patient developed bilateral persistent epithelial defects 3 months after the disease onset, which healed after conservative treatment, leaving a bilateral central corneal haze. HLA genotyping showed that 4 of the 5 patients (80%) were positive for HLA-B∗58:01. Conclusions: Allopurinol-induced SJS/TEN might not cause serious acute or chronic complications of the ocular surface. In addition, our HLA genotyping results are consistent with previous studies reporting a strong association between HLA-B∗58:01 and allopurinol-induced SJS/TEN among Koreans.

Original languageEnglish
Pages (from-to)199-204
Number of pages6
JournalCornea
Volume35
Issue number2
DOIs
Publication statusPublished - 2016 Jan 1

Fingerprint

Eye Manifestations
Stevens-Johnson Syndrome
Republic of Korea
Allopurinol
HLA Antigens
Steroids
Hyperemia
Visual Acuity
Hospitalization

All Science Journal Classification (ASJC) codes

  • Ophthalmology

Cite this

Lee, Hyo Seok ; Ueta, Mayumi ; Kim, Mee Kum ; Seo, KyoungYul ; Sotozono, Chie ; Kinoshita, Shigeru ; Yoon, Kyung Chul. / Analysis of ocular manifestation and genetic association of allopurinol-induced Stevens-Johnson syndrome and toxic epidermal necrolysis in South Korea. In: Cornea. 2016 ; Vol. 35, No. 2. pp. 199-204.
@article{53fc4c59e79846fe9635858f8518335d,
title = "Analysis of ocular manifestation and genetic association of allopurinol-induced Stevens-Johnson syndrome and toxic epidermal necrolysis in South Korea",
abstract = "Purpose: To describe the clinical characteristics and genetic background of allopurinol-induced Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) in South Korea. Methods: This is a prospective, noncomparative case series. Visual acuity, detailed medical history, ocular findings, and systemic manifestations of 5 patients (10 eyes) with allopurinol-induced SJS/TEN were recorded. The acute ocular involvement score and the chronic ocular manifestation score were graded on scales of 0-3 and 0-39, respectively, based on severity. Human leukocyte antigen (HLA) genotyping was also performed during the hospitalization. Results: Three patients were diagnosed with SJS, and 2 with TEN. Mild ocular involvement with only conjunctival hyperemia (acute ocular involvement score ≤1) was present in all 10 eyes during the acute stage. Patients were treated with systemic steroids and topical antibiotics, steroids, and preservative-free artificial tears, with rinsing of the ocular surface, in the acute stages of SJS/TEN. In the final follow-up, none of the patients had developed severe chronic ocular complications (chronic ocular manifestation score ≤8), including keratinization, corneal conjunctivalization, mucocutaneous junction involvement, or symblepharon. One patient developed bilateral persistent epithelial defects 3 months after the disease onset, which healed after conservative treatment, leaving a bilateral central corneal haze. HLA genotyping showed that 4 of the 5 patients (80{\%}) were positive for HLA-B∗58:01. Conclusions: Allopurinol-induced SJS/TEN might not cause serious acute or chronic complications of the ocular surface. In addition, our HLA genotyping results are consistent with previous studies reporting a strong association between HLA-B∗58:01 and allopurinol-induced SJS/TEN among Koreans.",
author = "Lee, {Hyo Seok} and Mayumi Ueta and Kim, {Mee Kum} and KyoungYul Seo and Chie Sotozono and Shigeru Kinoshita and Yoon, {Kyung Chul}",
year = "2016",
month = "1",
day = "1",
doi = "10.1097/ICO.0000000000000708",
language = "English",
volume = "35",
pages = "199--204",
journal = "Cornea",
issn = "0277-3740",
publisher = "Lippincott Williams and Wilkins",
number = "2",

}

Analysis of ocular manifestation and genetic association of allopurinol-induced Stevens-Johnson syndrome and toxic epidermal necrolysis in South Korea. / Lee, Hyo Seok; Ueta, Mayumi; Kim, Mee Kum; Seo, KyoungYul; Sotozono, Chie; Kinoshita, Shigeru; Yoon, Kyung Chul.

In: Cornea, Vol. 35, No. 2, 01.01.2016, p. 199-204.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Analysis of ocular manifestation and genetic association of allopurinol-induced Stevens-Johnson syndrome and toxic epidermal necrolysis in South Korea

AU - Lee, Hyo Seok

AU - Ueta, Mayumi

AU - Kim, Mee Kum

AU - Seo, KyoungYul

AU - Sotozono, Chie

AU - Kinoshita, Shigeru

AU - Yoon, Kyung Chul

PY - 2016/1/1

Y1 - 2016/1/1

N2 - Purpose: To describe the clinical characteristics and genetic background of allopurinol-induced Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) in South Korea. Methods: This is a prospective, noncomparative case series. Visual acuity, detailed medical history, ocular findings, and systemic manifestations of 5 patients (10 eyes) with allopurinol-induced SJS/TEN were recorded. The acute ocular involvement score and the chronic ocular manifestation score were graded on scales of 0-3 and 0-39, respectively, based on severity. Human leukocyte antigen (HLA) genotyping was also performed during the hospitalization. Results: Three patients were diagnosed with SJS, and 2 with TEN. Mild ocular involvement with only conjunctival hyperemia (acute ocular involvement score ≤1) was present in all 10 eyes during the acute stage. Patients were treated with systemic steroids and topical antibiotics, steroids, and preservative-free artificial tears, with rinsing of the ocular surface, in the acute stages of SJS/TEN. In the final follow-up, none of the patients had developed severe chronic ocular complications (chronic ocular manifestation score ≤8), including keratinization, corneal conjunctivalization, mucocutaneous junction involvement, or symblepharon. One patient developed bilateral persistent epithelial defects 3 months after the disease onset, which healed after conservative treatment, leaving a bilateral central corneal haze. HLA genotyping showed that 4 of the 5 patients (80%) were positive for HLA-B∗58:01. Conclusions: Allopurinol-induced SJS/TEN might not cause serious acute or chronic complications of the ocular surface. In addition, our HLA genotyping results are consistent with previous studies reporting a strong association between HLA-B∗58:01 and allopurinol-induced SJS/TEN among Koreans.

AB - Purpose: To describe the clinical characteristics and genetic background of allopurinol-induced Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) in South Korea. Methods: This is a prospective, noncomparative case series. Visual acuity, detailed medical history, ocular findings, and systemic manifestations of 5 patients (10 eyes) with allopurinol-induced SJS/TEN were recorded. The acute ocular involvement score and the chronic ocular manifestation score were graded on scales of 0-3 and 0-39, respectively, based on severity. Human leukocyte antigen (HLA) genotyping was also performed during the hospitalization. Results: Three patients were diagnosed with SJS, and 2 with TEN. Mild ocular involvement with only conjunctival hyperemia (acute ocular involvement score ≤1) was present in all 10 eyes during the acute stage. Patients were treated with systemic steroids and topical antibiotics, steroids, and preservative-free artificial tears, with rinsing of the ocular surface, in the acute stages of SJS/TEN. In the final follow-up, none of the patients had developed severe chronic ocular complications (chronic ocular manifestation score ≤8), including keratinization, corneal conjunctivalization, mucocutaneous junction involvement, or symblepharon. One patient developed bilateral persistent epithelial defects 3 months after the disease onset, which healed after conservative treatment, leaving a bilateral central corneal haze. HLA genotyping showed that 4 of the 5 patients (80%) were positive for HLA-B∗58:01. Conclusions: Allopurinol-induced SJS/TEN might not cause serious acute or chronic complications of the ocular surface. In addition, our HLA genotyping results are consistent with previous studies reporting a strong association between HLA-B∗58:01 and allopurinol-induced SJS/TEN among Koreans.

UR - http://www.scopus.com/inward/record.url?scp=84955369681&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84955369681&partnerID=8YFLogxK

U2 - 10.1097/ICO.0000000000000708

DO - 10.1097/ICO.0000000000000708

M3 - Article

C2 - 26655481

AN - SCOPUS:84955369681

VL - 35

SP - 199

EP - 204

JO - Cornea

JF - Cornea

SN - 0277-3740

IS - 2

ER -