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Association between HLA‐B*58:01 allele and severe cutaneous adverse reactions with allopurinol in Han Chinese in Hong Kong
Author(s) -
Chiu M.L.S.,
Hu M.,
Ng M.H.L.,
Yeung C.K.,
Chan J.CY.,
Chang M.M.,
Cheng S.H.,
Li L.,
Tomlinson B.
Publication year - 2012
Publication title -
british journal of dermatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.304
H-Index - 179
eISSN - 1365-2133
pISSN - 0007-0963
DOI - 10.1111/j.1365-2133.2012.10894.x
Subject(s) - allopurinol , medicine , odds ratio , gout , scars , allele , gastroenterology , hla b , genotyping , human leukocyte antigen , genotype , surgery , immunology , genetics , biology , antigen , gene
Summary 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 . Objectives 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.