![Int J Dermatol. 2011 Feb;50(2):221-4. doi: 10.1111/j.1365-4632.2010.04745.x.
Association of HLA-B*1502 allele with carbamazepine-induced toxic
epidermal necrolysis and Stevens-Johnson syndrome in the multi-
ethnic Malaysian population.
Chang CC, Too CL, Murad S, Hussein SH.
Department of Dermatology, Kuala Lumpur Hospital Allergy and Immunology Research Center, Kuala
Lumpur, Malaysia. ccchor@gmail.com
BACKGROUND: Carbamazepine (CBZ), a frequently used anticonvulsant drug, is one
of the most common causes of life-threatening cutaneous adverse drug reactions such
as toxic epidermal necrolysis (TEN) and Stevens-Johnson syndrome (SJS). Recent
studies have revealed a strong association between HLA-B*1502 and CBZ-induced
TEN/SJS in the Taiwan Han Chinese population.
OBJECTIVES: This study is aimed to investigate the association between human
leucocyte antigens (HLA) and CBZ-induced TEN/SJS in the multi-ethnic Malaysian
population.
METHODS: A sample of 21 unrelated patients with CBZ-induced TEN/SJS and 300
race-matched, healthy controls were genotyped for HLA-A, -B and -DR using
polymerase chain reaction (PCR). Allele frequencies were compared.
RESULTS: HLA-B*1502 was present in 75.0% (12/16) of Malay patients with CBZ-
induced TEN/SJS but in only 15.7% (47/300) of normal controls (odds ratio 16.15, 95%
= 7.87 × 10(-6) ), which confidence interval 4.57-62.4; corrected P-value suggests a
strong association between HLA and CBZ-induced TEN/SJS. Additionally, HLA-B*1502
was found in all three Chinese and two Indian patients. Existing data show that
frequencies of the HLA-B*1502 allele are generally much higher in Asian populations
than in White European populations, which explains the higher incidences of SJS and
TEN in Asian countries.
CONCLUSIONS: HLA-B*1502 is strongly associated with CBZ-induced TEN/SJS in the
Malay population in Malaysia, as has been seen in Han Chinese in Taiwan. This
indicates that the genetic association apparent in the incidence of CBZ-induced
TEN/SJS is linked with the presence of HLA-B*1502, irrespective of racial origin.
Screening of patients for this genetic marker can help to prevent the occurrence of TEN/
SJS.
© 2011 The International Society of Dermatology. PMID:21244392 [PubMed - indexed for MEDLINE]](https://image.slidesharecdn.com/myarticlepubmed-110731144057-phpapp01/85/My-article-pubmed-1-320.jpg)
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- 1. Int J Dermatol. 2011 Feb;50(2):221-4. doi: 10.1111/j.1365-4632.2010.04745.x. Association of HLA-B*1502 allele with carbamazepine-induced toxic epidermal necrolysis and Stevens-Johnson syndrome in the multi- ethnic Malaysian population. Chang CC, Too CL, Murad S, Hussein SH. Department of Dermatology, Kuala Lumpur Hospital Allergy and Immunology Research Center, Kuala Lumpur, Malaysia. ccchor@gmail.com BACKGROUND: Carbamazepine (CBZ), a frequently used anticonvulsant drug, is one of the most common causes of life-threatening cutaneous adverse drug reactions such as toxic epidermal necrolysis (TEN) and Stevens-Johnson syndrome (SJS). Recent studies have revealed a strong association between HLA-B*1502 and CBZ-induced TEN/SJS in the Taiwan Han Chinese population. OBJECTIVES: This study is aimed to investigate the association between human leucocyte antigens (HLA) and CBZ-induced TEN/SJS in the multi-ethnic Malaysian population. METHODS: A sample of 21 unrelated patients with CBZ-induced TEN/SJS and 300 race-matched, healthy controls were genotyped for HLA-A, -B and -DR using polymerase chain reaction (PCR). Allele frequencies were compared. RESULTS: HLA-B*1502 was present in 75.0% (12/16) of Malay patients with CBZ- induced TEN/SJS but in only 15.7% (47/300) of normal controls (odds ratio 16.15, 95% = 7.87 × 10(-6) ), which confidence interval 4.57-62.4; corrected P-value suggests a strong association between HLA and CBZ-induced TEN/SJS. Additionally, HLA-B*1502 was found in all three Chinese and two Indian patients. Existing data show that frequencies of the HLA-B*1502 allele are generally much higher in Asian populations than in White European populations, which explains the higher incidences of SJS and TEN in Asian countries. CONCLUSIONS: HLA-B*1502 is strongly associated with CBZ-induced TEN/SJS in the Malay population in Malaysia, as has been seen in Han Chinese in Taiwan. This indicates that the genetic association apparent in the incidence of CBZ-induced TEN/SJS is linked with the presence of HLA-B*1502, irrespective of racial origin. Screening of patients for this genetic marker can help to prevent the occurrence of TEN/ SJS. © 2011 The International Society of Dermatology. PMID:21244392 [PubMed - indexed for MEDLINE]