Abstract
BackgroundThe relationship between the HLA-B*1502 gene and maculopapular exanthema (MPE) induced by antiepileptic drugs (AEDs) has not yet been elucidated. In this study, we investigated the association between AED-induced MPE (AED-MPE) and the HLA-B*1502 gene in patients in Northwest China.MethodsWe enrolled 165 subjects including nine patients with AED-MPE and 156 AED-tolerant patients as controls. HLA-B*1502 gene polymorphism was detected using digital fluorescence molecular hybridization (DFMH). The results of HLA genotyping were expressed as positive or negative for the HLA-B*1502 allele. An analysis of AED-MPE risk factors was performed using binary logistic regression, and differences in genotype frequencies between groups were assessed with the continuity correction chi-square test.ResultsWe found that the HLA-B*1502 gene was a risk factor for AED-MPE (P = 0.028). The incidence of MPE induced by the two types of AEDs was different, and the incidence of aromatic AEDs use was higher that of non-aromatic AEDs use (P = 0.025). The comparison of the gene frequencies of the HLA-B*1502 allele between the two groups taking aromatic AEDs was also statistically significant (P = 0.045). However, there were no significant differences in terms of age, gender, ethnicity, or region in patients with MPE induced by AEDs. In addition, no association between the HLA-B1502 allele and CBZ- or OXC-induced MPE was found.ConclusionsIn northwestern China, the HLA-B*1502 allele was associated with aromatic AED-MPE. Since MPE can develop into Stevens–Johnson syndrome (SJS) or toxic epidermal necrolysis (TEN), the HLA-B*1502 gene should be evaluated before administering AEDs.
Highlights
The relationship between the HLA-B*1502 gene and maculopapular exanthema (MPE) induced by antiepileptic drugs (AEDs) has not yet been elucidated
Depending on the severity of the drug eruption, the main symptoms are maculopapular exanthema (MPE) and severe cutaneous adverse reactions (SCARs) with potentially life-threatening consequences, including drug reactions with eosinophilia and systemic symptoms (DRESS), Stevens–Johnson syndrome (SJS), and toxic epidermal necrolysis (TEN); the mortality rate for the latter two diseases is as high as 30 %, and the fatality rate is very high [4, 5]
Of the 165 patients with EP treated with AEDs (N = 165), nine patients who had been diagnosed with AEDMPE were treated with aromatic AEDs (CBZ/OXC)
Summary
The relationship between the HLA-B*1502 gene and maculopapular exanthema (MPE) induced by antiepileptic drugs (AEDs) has not yet been elucidated. We investigated the association between AEDinduced MPE (AED-MPE) and the HLA-B*1502 gene in patients in Northwest China. As a derivative of CBZ, OXC is relatively safe to use, whereas some studies have shown that OXC-induced cutaneous adverse drug reactions (CADRs) are related to HLA-B*1502, of which MPE is the most common [8]. Some studies have found no correlation between the HLA-B*1502 gene and OXC-induced MPE (OXC-MPE) in northern and southern China [9, 10]. This study was conducted because these current results are controversial and because no studies on the HLA-B*1502 gene and AEDinduced MPE (AED-MPE) have been previously conducted in northwest China
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