HLA-B*58:01 allele is associated with augmented risk for both mild and severe cutaneous adverse reactions induced by allopurinol in Han Chinese.
OBJECTIVE
Allopurinol is widely used as an effective urate-lowering drug and is one of the most frequent causes of cutaneous adverse drug reactions (cADRs). Recently, a strong association of HLA-B*58:01 with allopurinol-induced severe cADRs was identified. This study investigated the predisposition to different types of allopurinol-cADRs conferred by HLA-B*5801 in a Han population from mainland China.


METHODS
HLA-B genotyping was performed on 38 Chinese patients with different types of allopurinol-cADRs from 2008 to 2011.


RESULTS
All the allopurinol-cADR patients carried HLA-B*58:01, in contrast with only 11.11% (7/63) in the allopurinol-tolerant patients (odds ratio [OR] = 580.07; p < 0.0001) and 13.99% (80/572) in a Han Chinese population from the human MHC database (dbMHC; OR: 471.09; p < 0.0001) carried the genotype. Each type of allopurinol cADRs revealed a statistically significant association with HLA-B*58:01. In particular, the risk of allopurinol-induced maculopapular eruption was significantly higher in patients with HLA-B*58:01 (OR: 339.00; p < 0.0001).


CONCLUSIONS
The strong association of both the mild and severe types of allopurinol cADRs with the HLA-B*58:01 allele were observed. The results indicated that the prospective use of a genetic test of HLA-B*58:01 might reduce the prevalence of allopurinol-induced cADRs.   Original submitted 7 March 2012; Revision submitted 21 May 2012.
Huashan Hospital, Fudan University, Shanghai, China.
Zhi-hao
ZH
Cao
Zhi-yun
ZY
Wei
Qin-yuan
QY
Zhu
Jun-yu
JY
Zhang
Lun
L
Yang
Sheng-ying
SY
Qin
Li-yan
LY
Shao
Yi-ting
YT
Zhang
Jie-kun
JK
Xuan
Qiao-li
QL
Li
Jin-Hua
JH
Xu
Feng
F
Xu
Li
L
Ma
Hui-yuan
HY
Huang
Qing-he
QH
Xing
Xiao-qun
XQ
Luo
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000483:Alleles; D000493:Allopurinol / Q000008:administration & dosage / Q000633:toxicity; D002681:China; D064420:Drug-Related Side Effects and Adverse Reactions / Q000235:genetics; D005076:Exanthema / Q000139:chemically induced / Q000235:genetics; D005260:Female; D020022:Genetic Predisposition to Disease; D005838:Genotype; D015235:HLA-B Antigens / Q000235:genetics*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012306:Risk; D013262:Stevens-Johnson Syndrome / Q000139:chemically induced / Q000235:genetics*
D015235:HLA-B Antigens; D000493:Allopurinol