Tuesday, 9 December 2014
Exhibition Hall-Poster Area (Sul America)
Hye Jung Park, MD
,
Division of Allergy and Immunology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, South Korea
Kyung Hee Park, MD
,
Division of Allergy and Immunology, Department of Internal Medicine, Yonsei University College of Medicine, South Korea
Jung-Won Park, MD, PhD
,
Division of Allergy and Immunology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, South Korea
Jae-Hyun Lee, MD, PhD
,
Division of Allergy and Immunology, Department of Internal Medicine, Yonsei University College of Medicine, South Korea
Background: Stevens–Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are rare but fatal adverse mucocutaneous reactions to certain drugs. Recent studies suggest that ethnicity and genetic predisposition may play a crucial role in the manifestation of the reaction. In this study, we described the role of human leukocyte antigen
(
HLA)
-B alleles in the development of clinical characteristics and treatment outcomes of SJS/TEN in a single Korean tertiary hospital.
Methods: We retrospectively reviewed the medical records (from March 1, 2010 to February 28, 2014) of 30 patients diagnosed with SJS and/or TEN.
Results: The main causative drugs were anticonvulsants (26.7%) and allopurinol (26.7%), followed by antibiotics (16.7%), acetazolamide (10.0%), acetaminophen (10.0%), and herbal medication (6.7%). The mean latencies of these drugs were variable. Liver damage was the most common symptom (observed in 63.3% of the patients). Of the 5 patients with lamotrigine-induced SJS/TEN, 3 expressed the HLA-B*4403 allele (60.0%). Of the 7 patients with allopurinol-induced SJS/TEN, 5 expressed the HLA-B*5801 allele (71.4%).
Conclusions: The major SJS/TEN-inducing drugs were found to be allopurinol and anticonvulsants (such as lamotrigine). We speculated that Korean individuals expressing the HLA-B*4403 allele may be highly susceptible to lamotrigine-induced SJS/TEN.
