title: Carbamazepine and phenytoin induced Stevens-Johnson syndrome is associated with HLA-B*1502 allele in Thai population.
abstract: OBJECTIVE
  Previous studies found a strong association between HLA-B*1502 and carbamazepine (CBZ)-induced Stevens-Johnson syndrome (SJS) in Han Chinese, but not in Caucasian populations. Even in Han Chinese, the HLA-B*1502 was not associated with CBZ-induced maculopapular eruptions (MPE). This study seeks to identify whether HLA-B*1502 is associated with CBZ- or phenytoin (PHT)-induced SJS or MPE in a Thai population.
  
  
  METHODS
  Eighty-one Thai epileptic patients between 1994 and 2007 from the Chulalongkorn Comprehensive Epilepsy Program were recruited. Thirty-one subjects had antiepileptic drug (AED)-induced SJS or MPE (6 CBZ-SJS, 4 PHT-SJS, 9 CBZ-MPE, 12 PHT-MPE), and 50 were AED-tolerant controls.
  
  
  RESULTS
  For the first time, a strong association between HLA-B*1502 and PHT-induced SJS was found (p = 0.005). A strong association was also found between the HLA-B*1502 and CBZ-induced SJS (p = 0.0005), making Thai the first non-Chinese population demonstrating such an association. Some patients, who were HLA-B*1502 and suffered from CBZ-induced SJS, could be tolerant to PHT and vice versa. This suggests that HLA-B*1502 may be a common attribute required for a Thai patient to develop SJS from these two AEDs; other different elements, however, are also needed for each AED. In addition, no association between HLA-B alleles and CBZ- or PHT-induced MPE was found.
  
  
  CONCLUSIONS
  CBZ- and PHT-induced SJS, but not MPE, is associated with HLA-B*1502 allele in Thai population.
authors.affiliation: Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.
authors.forename: Chaichon
authors.initials: C
authors.lastname: Locharernkul
authors.forename: Jakrin
authors.initials: J
authors.lastname: Loplumlert
authors.forename: Chusak
authors.initials: C
authors.lastname: Limotai
authors.forename: Wiwat
authors.initials: W
authors.lastname: Korkij
authors.forename: Tayard
authors.initials: T
authors.lastname: Desudchit
authors.forename: Siraprapa
authors.initials: S
authors.lastname: Tongkobpetch
authors.forename: Oratai
authors.initials: O
authors.lastname: Kangwanshiratada
authors.forename: Nattiya
authors.initials: N
authors.lastname: Hirankarn
authors.forename: Kanya
authors.initials: K
authors.lastname: Suphapeetiporn
authors.forename: Vorasuk
authors.initials: V
authors.lastname: Shotelersuk
mesh_terms: D000293:Adolescent; D000328:Adult; D000927:Anticonvulsants / Q000009:adverse effects*; D002220:Carbamazepine / Q000009:adverse effects*; D002648:Child; D004827:Epilepsy / Q000188:drug therapy / Q000235:genetics; D005260:Female; D020022:Genetic Predisposition to Disease / Q000208:ethnology; D015235:HLA-B Antigens / Q000235:genetics*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010597:Pharmacogenetics; D010672:Phenytoin / Q000009:adverse effects*; D012189:Retrospective Studies; D013262:Stevens-Johnson Syndrome / Q000139:chemically induced* / Q000235:genetics*; D013785:Thailand / Q000208:ethnology; D055815:Young Adult
chemical_list: D000927:Anticonvulsants; D015235:HLA-B Antigens; D002220:Carbamazepine; D010672:Phenytoin