title: Phenytoin-induced Stevens-Johnson syndrome with negative HLA-B*1502 allele in mainland China: two cases.
abstract: Antiepileptic drugs-induced Stevens-Johnson syndrome (SJS) is a life-threatening severe cutaneous adverse reaction. Recent studies in Thailand and Taiwan showed a significant association between phenytoin (PHT)-induced SJS and human leucocyte antigen HLA-B*1502 allele. Although the US FDA had issued an alert to clinicians, insufficient information is available to recommend testing for HLA-B*1502 in Asian patients in line for PHT treatment. Therefore, extended studies are necessary to further evaluate the potential association between PHT-induced SJS and HLA-B*1502 allele in various populations. To date, no similar data exist in mainland China. Here, we describe two Chinese Han cases of PHT-induced SJS with negative HLA-B*1502 allele, in which HLA high-resolution genotyping showed two heterozygous HLA-B*4601/B*5102 and HLA-B*3701/B*4601 allele, respectively. Our findings provide evidence to support that other genetic markers or nongenetic factors could contribute to the susceptibility of PHT-induced SJS, except for HLA-B*1502 allele. Further studies are encouraged to investigate the genetic link with PHT-induced serious skin reactions in future.
authors.affiliation: Department of Neurology, West China Hospital, Sichuan University, Chengdu, Sichuan Province 610041, China.
authors.forename: Fa-Yun
authors.initials: FY
authors.lastname: Hu
authors.forename: Xin-Tong
authors.initials: XT
authors.lastname: Wu
authors.forename: Dong-Mei
authors.initials: DM
authors.lastname: An
authors.forename: Bo
authors.initials: B
authors.lastname: Yan
authors.forename: Hermann
authors.initials: H
authors.lastname: Stefan
authors.forename: Dong
authors.initials: D
authors.lastname: Zhou
mesh_terms: D000328:Adult; D000483:Alleles; D002681:China; D005260:Female; D006580:Genetic Carrier Screening; D005819:Genetic Markers / Q000235:genetics; D015235:HLA-B Antigens / Q000235:genetics; D059910:HLA-B15 Antigen / Q000235:genetics*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010672:Phenytoin / Q000009:adverse effects*; D013262:Stevens-Johnson Syndrome / Q000139:chemically induced* / Q000175:diagnosis / Q000235:genetics*
chemical_list: D005819:Genetic Markers; D015235:HLA-B Antigens; C483536:HLA-B*15:02 antigen; C469674:HLA-B*46:01 antigen; D059910:HLA-B15 Antigen; D010672:Phenytoin