Hypersensitivity syndrome reactions to antiepileptic drugs, clinical characteristic and association with HLA-B*1502

Abstract

To investigate the cutaneous adverse reactions to antiepileptic drugs (AEDs), clinical characteristic and the association with HLA-B*1502. A retrospective analysis of four cases of antiepileptic drug hypersensitive syndrome (AHS) were performed on the basis of clinical data, cutaneous adverse reactions to carbamazepine (CBZ) (n = 2) including Stevens-Johnson syndrome (SJS) (n = 1) and hypersensitivity syndrome (HSS) (n = 1); phenobarbital-induced HSS (n = 1) and oxcarbazepine (OXC)-induced HSS (n = 1). All patients received the examinations of polymerase chain reaction (PCR) with sequence specific primers to analyze HLA-B*1502. Two healthy subjects had no history of using antiepileptic drugs as the control. All patients had manifestations of fever, eruption, mucosal involvement and visceral injury. Two cases were diagnosed as Stevens-Johnson syndrome associated with apparent bullae formation. Genotype positive for HLA-B*1502 was association with 2 patients with CBZ/OXC-induced SJS while the other 1 case of CBZ and 1 case of phenobarbital-induced HSS were genotype non-HLA-B*1502. AHS usually occurs within 1 to 2 weeks after initiation of AEDs therapy. The typical presentations are fever, eruption and internal organ involvements, etc. The epileptic patients with CBZ/OXC-induced SJS are related with HLA-B*1502 genotype. But it is not found in HSS patients.