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Association between HLA-B*58:01 allele and severe cutaneous adverse reactions with allopurinol in Han Chinese in Hong Kong.
MedLine Citation:
PMID:  22348415     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Background:  Allopurinol has been reported as a common cause of severe cutaneous adverse reactions (SCARs). Recent studies in various populations suggest that HLA-B*58:01 is a strong genetic marker for allopurinol-induced SCAR, especially in the populations with a high frequency of HLA-B*58:01. Objectives:  The aim of this study was to confirm the association link between HLA-B*58:01 and hypersensitivity reactions attributed to allopurinol use in Han Chinese patients in Hong Kong. Methods:  We performed a case-control study to investigate whether the HLA-B*58:01 allele predisposes to allopurinol-induced SCAR in Han Chinese patients in Hong Kong. The HLA-B*58:01 genotyping was performed in 20 patients with allopurinol-induced SCAR or erythema multiforme major (n=1) and 30 patients tolerant to allopurinol. Results:  All of the 19 patients with allopurinol-induced SCAR examined but not the case with erythema multiforme major (EMM) carried HLA-B*58:01 whereas only 4 (13.3%) of the control patients had this allele. The positive rate of the HLA-B*58:01 was significantly higher in the cases than in the allopurinol-tolerant control group (Odds ratio, 123.5; 95% CI, 12.8-1195.1; P < 1 x 10(-4) ) and was even higher after removal of the patient with EMM (Odds ratio, 229.7; 95% CI, 11.7-4520.4). The sensitivity and specificity of the HLA-B*58:01 allele for prediction of allopurinol-induced SCAR were 100% and 86.7%, respectively. Conclusions:  This study confirmed the strong association between the HLA-B*58:01 and allopurinol-induced SCAR in Hong Kong Han Chinese patients. A screening test for the HLA-B*58:01 allele should effectively reduce the risk for allopurinol-induced SCAR in Chinese populations.
Authors:
L S Chiu; M Hu; M H L Ng; C K Yeung; J C-Y Chan; M M Chang; S H Cheng; L Li; B Tomlinson
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-2-20
Journal Detail:
Title:  The British journal of dermatology     Volume:  -     ISSN:  1365-2133     ISO Abbreviation:  -     Publication Date:  2012 Feb 
Date Detail:
Created Date:  2012-2-21     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0004041     Medline TA:  Br J Dermatol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2012 British Association of Dermatologists.
Affiliation:
Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Shatin, Hong Kong SAR. Department of Anatomical and Cellular Pathology, The Chinese University of Hong Kong, Shatin, Hong Kong SAR. Division of Dermatology, Department of Medicine, The University of Hong Kong, Pokfulam, Hong Kong SAR.
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