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

Hye Jung Park, Sung Ryeol Kim, Dong Woo Leem, Il Joo Moon, Beom Seok Koh, Kyung Hee Park, Jung Won Park, Jae Hyun Lee

Research output: Contribution to journalArticle

14 Citations (Scopus)

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.

Original languageEnglish
Pages (from-to)35-41
Number of pages7
JournalEuropean Journal of Clinical Pharmacology
Volume71
Issue number1
DOIs
Publication statusPublished - 2015 Jan

All Science Journal Classification (ASJC) codes

  • Pharmacology
  • Pharmacology (medical)

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