title: HLA-B∗ 1502 is associated with carbamazepine induced Stevens-Johnson syndrome in North Indian population.
abstract: The evidence of association between HLA-B(∗)1502 and anticonvulsant induced Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) from the Indian population is scant. Patients with a history of SJS/TEN secondary to carbamazepine or phenytoin were enrolled. The control group comprised of patients who had received carbamazepine/phenytoin for ⩾ 6 months without any adverse cutaneous event. Low-resolution DNA typing for HLA-B and high resolution HLA-B(∗)15 typing was performed. Seventeen patients with history of SJS/TEN secondary to carbamazepine (9) or phenytoin (8) and 50 tolerant controls (carbamazepine-37; phenytoin-13) were enrolled. The mean age of patients and controls was 33.9 ± 11.6 and 28.1 ± 9.9 years, respectively. HLA-B(∗)1502 was observed in 2/9 (22.2%) carbamazepine-SJS/TEN patients and none of the 37 carbamazepine tolerant controls (p = 0.035). HLA-B(∗)1502 was not observed in any of the 8 phenytoin-SJS/TEN patients or the 13 phenytoin tolerant controls. Our data suggests that HLA-B(∗)1502 is a risk factor for carbamazepine induced SJS/TEN. Therefore, HLA-B(∗)1502 testing should be performed prior to initiating carbamazepine in North Indian population.
authors.affiliation: Department of Immunopathology, Post Graduate Institute of Medical Education and Research, Chandigarh, India. Electronic address: ritu_immunopath@yahoo.co.in.
authors.forename: Ritu
authors.initials: R
authors.lastname: Aggarwal
authors.affiliation: Department of Immunopathology, Post Graduate Institute of Medical Education and Research, Chandigarh, India.
authors.forename: Madhulika
authors.initials: M
authors.lastname: Sharma
authors.affiliation: Department of Neurology, Post Graduate Institute of Medical Education and Research, Chandigarh, India.
authors.forename: Manish
authors.initials: M
authors.lastname: Modi
authors.affiliation: Department of Neurology, Post Graduate Institute of Medical Education and Research, Chandigarh, India.
authors.forename: Vivek Kumar
authors.initials: VK
authors.lastname: Garg
authors.affiliation: Department of Immunopathology, Post Graduate Institute of Medical Education and Research, Chandigarh, India.
authors.forename: Manilla
authors.initials: M
authors.lastname: Salaria
mesh_terms: D000328:Adult; D000927:Anticonvulsants / Q000009:adverse effects*; D002220:Carbamazepine / Q000009:adverse effects*; D016022:Case-Control Studies; D005260:Female; D015870:Gene Expression; D059910:HLA-B15 Antigen / Q000235:genetics* / Q000276:immunology; D006801:Humans; D007194:India; D008297:Male; D008875:Middle Aged; D010672:Phenytoin / Q000627:therapeutic use; D012640:Seizures / Q000188:drug therapy / Q000473:pathology; D013262:Stevens-Johnson Syndrome / Q000209:etiology / Q000235:genetics* / Q000276:immunology / Q000473:pathology
chemical_list: D000927:Anticonvulsants; C483536:HLA-B*15:02 antigen; D059910:HLA-B15 Antigen; D002220:Carbamazepine; D010672:Phenytoin
keywords: HLA; India; PCR; Pharmacogenetics; Toxic epidermal necrolysis