title: Association between HLA-B*58:01 allele and severe cutaneous adverse reactions with allopurinol in Han Chinese in Hong Kong.
abstract: 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 populations with a high frequency of HLA-B*58:01.
  
  
  OBJECTIVE
  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 (EMM; n = 1) and in 30 patients tolerant to allopurinol.
  
  
  RESULTS
  All of the 19 patients with allopurinol-induced SCAR examined but not the patient with EMM carried HLA-B*58:01 whereas only four (13%) 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 (OR) 123·5, 95% confidence interval (CI) 12·8-1195·1; P < 1 × 10(-4) ] and was even higher after removal of the patient with EMM (OR 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.affiliation: Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Shatin, Hong Kong. monachiu_2000@yahoo.com.hk
authors.forename: M L S
authors.initials: ML
authors.lastname: Chiu
authors.forename: M
authors.initials: M
authors.lastname: Hu
authors.forename: M H L
authors.initials: MH
authors.lastname: Ng
authors.forename: C K
authors.initials: CK
authors.lastname: Yeung
authors.forename: J C-Y
authors.initials: JC
authors.lastname: Chan
authors.forename: M M
authors.initials: MM
authors.lastname: Chang
authors.forename: S H
authors.initials: SH
authors.lastname: Cheng
authors.forename: L
authors.initials: L
authors.lastname: Li
authors.forename: B
authors.initials: B
authors.lastname: Tomlinson
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000493:Allopurinol / Q000009:adverse effects*; D044466:Asian People / Q000208:ethnology; D016022:Case-Control Studies; D003875:Drug Eruptions / Q000208:ethnology / Q000235:genetics*; D005260:Female; D020022:Genetic Predisposition to Disease / Q000208:ethnology / Q000235:genetics; D005838:Genotype; D015235:HLA-B Antigens / Q000235:genetics*; D006723:Hong Kong / Q000208:ethnology; D006801:Humans; D008297:Male; D008875:Middle Aged; D014528:Uricosuric Agents / Q000627:therapeutic use*
chemical_list: D015235:HLA-B Antigens; D014528:Uricosuric Agents; D000493:Allopurinol