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ORIGINAL ARTICLE
Year : 2009  |  Volume : 75  |  Issue : 6  |  Page : 579-582

Association of HLA-B*1502 allele and carbamazepine-induced Stevens-Johnson syndrome among Indians


1 Dr. Rasiklal Shah Sarvajanik Hospital, Modasa 383315, India
2 Shri B. M. Shah College of Pharmaceutical Education and Research, Modasa 383315, India
3 Department of Molecular Biology, Krishna Institute of Medical Sciences, Hyderabad 500003, India
4 Deparment of Animal Biotechnology, Anand Agricultural University, Anand 388001, India
5 Institute of Human Genetics, Ahmedabad 380015, India
6 Deep Hospital, Modasa 383315, India
7 Department of Pharmacology, L M College of Pharmacy, Ahmedabad 380009, India

Date of Web Publication12-Nov-2009

Correspondence Address:
Timir Y Mehta
Dr. Rasiklal Shah Sarvajanik Hospital, Modasa - 383 315, Gujarat
India
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DOI: 10.4103/0378-6323.57718

PMID: 19915237

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  Abstract 

Background: Stevens-Johnson Syndrome (SJS) and toxic epidermal necrolysis are severe cutaneous reactions caused by certain drugs, including antiepileptic carbamazepine. A strong association has been reported between human leucocyte antigen (HLA)-B*1502 and carbamazepine-induced SJS in Han Chinese patients. European studies suggested that HLA-B*1502 is not a universal marker but is ethnicity-specific for Asians. Aim: To study the association between HLA-B*1502 and carbamazepine-induced SJS in Indian patients. Methods: Eight individuals who fulfilled the diagnostic criteria of SJS induced by carbamazepine were identified and HLA-B molecular typing was performed. HLA-B genotyping was carried out by polymerase chain reaction using sequence-specific primers. Results: Out of eight patients studied for genotype, six patients were found to have the HLA-B*1502 allele. Conclusion: This study suggests an association between HLA-B*1502 and carbamazepine-induced SJS in Indian patients.


Keywords: Carbamazepine, HLA-BFNx011502, Hindu, Indian, Stevens-Johnson syndrome


How to cite this article:
Mehta TY, Prajapati LM, Mittal B, Joshi CG, Sheth JJ, Patel DB, Dave DM, Goyal RK. Association of HLA-B*1502 allele and carbamazepine-induced Stevens-Johnson syndrome among Indians. Indian J Dermatol Venereol Leprol 2009;75:579-82

How to cite this URL:
Mehta TY, Prajapati LM, Mittal B, Joshi CG, Sheth JJ, Patel DB, Dave DM, Goyal RK. Association of HLA-B*1502 allele and carbamazepine-induced Stevens-Johnson syndrome among Indians. Indian J Dermatol Venereol Leprol [serial online] 2009 [cited 2014 Jul 29];75:579-82. Available from: http://www.ijdvl.com/text.asp?2009/75/6/579/57718



  Introduction Top


 Stevens-Johnson syndrome More Details (SJS) and toxic epidermal necrolysis (TEN) are acute life-threatening reactions of the skin to drugs. SJS and TEN are two related mucocutaneous blistering disorders with significant mortality (especially with TEN) and prolonged morbidity. Patients develop an acute exanthema, which progresses toward a widespread blistering (TEN) or more limited purpura, vesicles (SJS) and erosion of the skin and mucous membranes, resulting from apoptosis of keratinocytes. The incidence of SJS is estimated to be one to six cases per million person-years and of TEN at 0.4-1.2 cases per million person-years. Various drugs are reported to be associated with a high risk for SJS and TEN. These include several antiepileptic agents, especially carbamazepine, phenytoin, phenobarbital and lamotrigine, antibacterials, anti-inflammatory drugs of the oxicam family and allopurinol. [1],[2]

Chung and colleagues [3] reported a very strong association between carbamazepine-induced SJS in Han Chinese patients and the human leucocyte antigen (HLA)-B*1502 allele. They studied 44 Han Chinese patients with carbamazepine-induced SJS and two groups of controls, 101 tolerant patients and 93 healthy controls. All 44 SJS or TEN patients had an HLA-B*1502 allele in contrast with 3% of the carbamazepine-tolerant patients and 8.6% of the unexposed controls, respectively. [3] In Europe, HLA-B genotyping was carried out in 12 patients of carbamazepine-induced SJS. Of the 12, only four had HLA-B*1502. Remarkably, all the four had an Asian ancestry and originated from China, Vietnam, Cambodia, and the Reunion Island. It was suggested that HLA-B*1502 is not a universal marker for carbamazepine-induced SJS but is ethnicity-specific for Asians. [4] Studies in other Asian populations from Malaysia, Thailand and Hong Kong have also reported an association between HLA-B*1502 and SJS induced by carbamazepine. [5],[6],[7] None of these studies have been reported from India although the incidences of SJS were found to be higher among Indians compared with Europeans. [8],[9],[10],[11] Carbamazepine is a widely prescribed antiepileptic in India and is found to be the most commonly implicated drug responsible for SJS/TEN among Indians. [12] In the light of the above observations, we have undertaken an HLA genotyping study of Indian patients suffering from carbamazepine-induced SJS.


  Methods Top


Patient recruitment and sample collection

Eight individuals who fulfilled the diagnostic criteria of SJS induced by carbamazepine were identified at Dr. Rasiklal Shah Sarvajanik Hospital and Samarpan Centre for Treatment of Diseases of Skin, STD and Leprosy, Modasa, India. All the patients were assessed by dermatologists who had received photographs, pathological slides and medical records. Patients with definite diagnosis and ready to sign written consent were included in the study. Ten unrelated normal controls from the same population were selected randomly. The study was approved by the Institutional Review Board of Dr. Rasiklal Shah Sarvajanik Hospital, Modasa. The diagnostic criteria of SJS were based on the clinical morphology defined by Roujeau. [13] We defined SJS as skin detachment up to 10% of the body surface area and overlap SJS/TEN as skin detachment of 10-30%. Our five patients (no. 2, 3, 4, 7, 8) received carbamazepine as an antiepileptic therapy. Two patients (no. 5, 6) received carbamazepine as a post head injury anticonvulsant prophylaxis. In the remaining one patient (no. 1), trigeminal neuralgia was the indication for carbamazepine. Peripheral blood was collected in ethylene diammine tetra acetic acid-coated sterile vials and stored in a refrigerator. [Table 1] shows the clinical characteristics of eight patients with carbamazepine-induced SJS identified in our study.

DNA extraction

Genomic DNA from peripheral lymphocytes was extracted by the standard phenol-chloroform method.

HLA-B genotyping

The quality and quantity of the extracted DNA was checked on 0.8% agarose gel and a spectrophotometer. The concentration of each DNA sample was finally adjusted to 30 ng/µl, which was used for HLA-B molecular typing. HLA-B genotyping was carried out by polymerase chain reaction (PCR) using sequence-specific primers (Micro SSP HLA-B kits; One Lambda Inc., Canoga Park, CA, United States. Low-resolution HLA-B genotyping was carried out with the One Lambda HLA-B kit in a PCR with sequence-specific primers according to the protocol and recommendations of the manufacturer (PCR-SSP, One Lambda Inc.).

Statistical analysis

Allele frequency between the two groups was compared by the Chi-square method with Yates' correction by constructing 2 x 2 tables. The odds ratio was calculated with Haldane's modification, which adds 0.5 to all cells to accommodate a possible zero count.


  Results Top


We determined the HLA-B genotypes of eight carbamazepine-induced cases and 10 normal controls by PCR using sequence-specific primers (Micro SSP HLA-B kits; One Lambda Inc.). We found that six out of eight patients had the HLA-B*1502 allele (all being heterozygous). One patient was found to be homozygous with HLA-B*1508 allele. All the 10 controls were found to be negative for HLA-B*1502. The genotypes observed are shown in [Table 2]. The odds ratio was found to be 71.40 (95% CI, 3.0-1698) and the P-value was found to be 0.0014.


  Discussion Top


HLA-B*1502 as a marker for carbamazepine-induced SJS is well established in the Han Chinese by different studies. The allele frequency of HLA-B*1502 in the Han Chinese population is 8%, which is relatively higher than any other population of the world. [14] From India, a 0-6% (average 2.5%) prevalence of HLA-B*1502 in different communities has been reported. Most of them are sub-Hindu communities, except Parsi, in which a 0% prevalence is reported. [15],[16],[17],[18],[19],[20] Our eight patients also belong to the Hindu community, which is the biggest community of India comprising of one billion Indians. Our six out of eight patients had HLA-B*1502 while none of the 10 controls were found to be positive. This clearly indicates a significant association (Odds ratio: 71.40 [95% CI, 3.0-1698]; P = 0.0014) between carbamazepine-induced SJS and HLA-B*1502 among Indians.

Because the association is not 100%, as observed in the Han Chinese community, other genes or combinations of genes might be playing a role. To conclude, we suggest HLA-B*1502 testing before initiating carbamazepine drug therapy in Indians. To obtain a clear Indian picture, the study should be extended to different subethnic groups from different regions.

 
  References Top

1.Bastuji-Garin S, Rzany B, Stern RS, Shear NH, Naldi L, Roujeau JC. Clinical classification of cases of toxic epidermal necrolysis, Stevens-Johnson syndrome, and erythema multiforme. Arch Dermatol 1993;129:92-6.  Back to cited text no. 1  [PUBMED]  [FULLTEXT]  
2.Roujeau JC, Kelly JP, Naldi L, Rzany B, Stern RS, Anderson T, et al. Medication use and risk of Stevens-Johnson syndrome or toxic epidermal necrolysis. New Engl J Med 1995;333:1600-7.  Back to cited text no. 2  [PUBMED]  [FULLTEXT]  
3.Chung WH, Hung SI, Hong HS, Hsih MS, Yang LC, Ho HC, et al. A marker for Stevens-Johnson syndrome. Nature 2004;428:86.  Back to cited text no. 3      
4.Lonjou C, Thomas L, Borot N, Ledger N, de Toma C, LeLouet H, et al. A marker for Stevens-Johnson syndrome: Ethnicity matters. Pharmacogenomics J 2006;6:265-8.  Back to cited text no. 4  [PUBMED]  [FULLTEXT]  
5.Chang CC, Too CL, Murad S, Hussein S. Association of HLA-B*1502 with carbamazepine-induced toxic epidermal necrolysis and Stevens-Johnson syndrome in Malaysian population. Proceeding in 7th Asian- Oceanian Epilepsy Congress, Xiamen. 2008.  Back to cited text no. 5      
6.Locharernkul C, Loplumlert J, Limotai C, Korkij W, Desudchit T, Tongkobpetch S, et al. Carbamazepine and phenytoin induced Stevens-Johnson syndrome is associated with HLA-B*1502 allele in Thai population. Epilepsia 2008;49:2087-91.  Back to cited text no. 6  [PUBMED]  [FULLTEXT]  
7.Man CB, Kwan P, Baum L, Yu E, Lau KM, Cheng AS, et al. Association between HLA-B*1502 Allele and antiepileptic drug-induced cutaneous reactions in Han Chinese. Epilepsia 2007;48:1015-8.  Back to cited text no. 7  [PUBMED]  [FULLTEXT]  
8.Uppal R, Jhaj R, Malhotra S. Adverse drug reactions among inpatients in a North Indian referral hospital. Natl Med J India 2000;13:16-8.  Back to cited text no. 8  [PUBMED]  [FULLTEXT]  
9.Naldi L, Conforti A, Venegoni M, Troncon MG, Caputi A, Ghiotto E, et al. Cutaneous reactions to drugs. An analysis of spontaneous reports in four Italian regions. Br J Clin Pharmacol 1999;48:839-46.  Back to cited text no. 9      
10.Hunziker T, Künzi UP, Braunschweig S, Zehnder D, Hoigné R. Comprehensive hospital drug monitoring (CHDM): Adverse skin reactions, a 20-year survey. Allergy 1997;52:388-93.   Back to cited text no. 10      
11.Noel MV, Sushma M, Guido S. Cutaneous adverse drug reactions in hospitalized patients in a tertiary care center. Indian J Pharmacol 2004;36:292-5.  Back to cited text no. 11    Medknow Journal  
12.Devi K, George S, Criton S, Suja V, Sridevi PK. Carbamazepine - The commonest cause of toxic epidermal necrolysis and Stevens-Johnson syndrome: A study of 7 years. Indian J Dermatol Venereol Leprol 2005;71:325-8.  Back to cited text no. 12  [PUBMED]  Medknow Journal  
13.Roujeau JC. The spectrum of Stevens-Johnson syndrome and toxic epidermal necrolysis: A clinical classification. J Invest Dermatol 1994;102:28-30.  Back to cited text no. 13      
14.Geer L, Terasaki PI, Gjertson DW. HLA frequency. In: Gjertson DW, Terasaki PI, editors. HLA 1998. Lenexa, KS: American Society for Histocompatibility and Immunogenetics; 1998. p. 327-63.  Back to cited text no. 14      
15.Shankarkumar U. HLA-A, -B and -Cw allele frequencies in a Bhil population from Western India. Hum Immunol 2004;65:960-61.  Back to cited text no. 15      
16.Shankarkumar U. HLA-A, -B and -Cw allele frequencies in a Maratha population from Mumbai, India India Mumbai Marathas. Hum Immunol 2004;65:954-6.  Back to cited text no. 16      
17.Shankarkumar U. HLA-A, -B and -Cw allele frequencies in a Pawra population from Khandesh, India. Hum Immunol 2004;65:952-53.  Back to cited text no. 17      
18.Shankarkumar U. HLA-A, -B and -Cw allele frequencies in a Parsi population from Western India. Hum Immunol 2004;65:992-93.  Back to cited text no. 18      
19.Rajalingam R, Parham P, Mehra NK. HLA-A, -B, -Cw, -DQA1, -DQB1 and -DRB1 Alleles and KIR Alleles in a Hindu Population from Punjab, India. Hum Immunol 2004;65:958-60.  Back to cited text no. 19      
20.Rani R, Marcos C, Lazaro AM, Zhang Y, Stastny P. Molecular diversity of HLA-A, -B and -C alleles in a North Indian population as determined by PCR-SSOP. Int J Immunogenet 2007;34:201-8.  Back to cited text no. 20  [PUBMED]  [FULLTEXT]  



 
 
    Tables

  [Table 1], [Table 2]

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49 Direct interaction between HLA-B and carbamazepine activates T cells in patients with Stevens-Johnson syndrome
Chun-Yu Wei,Wen-Hung Chung,Hsiao-Wen Huang,Yuan-Tsong Chen,Shuen-Iu Hung
Journal of Allergy and Clinical Immunology. 2012; 129(6): 1562
[Pubmed]
50 HLA Genotype and Carbamazepine-Induced Cutaneous Adverse Drug Reactions: A Systematic Review
V L Yip,A G Marson,A L Jorgensen,M Pirmohamed,A Alfirevic
Clinical Pharmacology & Therapeutics. 2012; 92(6): 757
[Pubmed]
51 Genome-wide mapping for clinically relevant predictors of lamotrigine- and phenytoin-induced hypersensitivity reactions
Mark McCormack,Thomas J Urban,Kevin V Shianna,Nicole Walley,Massimo Pandolfo,Chantal Depondt,Elijah Chaila,Gerard D O’Conner,Dalia Kasperaviciute,Rodney A Radtke,Erin L Heinzen,Sanjay M Sisodiya,Norman Delanty,Gianpiero L Cavalleri
Pharmacogenomics. 2012; 13(4): 399
[Pubmed]
52 Research Highlights: Highlights from the latest articles on pharmacogenetic studies of antiepileptic drugs
Sandeep Grover,Ritushree Kukreti
Pharmacogenomics. 2012; 13(5): 519
[Pubmed]
53 Integration of Pharmacogenetics and Pharmacogenomics in Drug Development: Implications for Regulatory and Medical Decision Making in Pediatric Diseases
Chiara Piana,Linda Surh,Sabine Furst-Recktenwald,Achille Iolascon,Evelyne M. Jacqz-Aigrain,Ineke Jonker,Roberta Russo,Ron H.N. van Schaik,Judith Wessels,Oscar E. Della Pasqua
The Journal of Clinical Pharmacology. 2012; 52(5): 704
[Pubmed]
54 Genetic and immune predictors for hypersensitivity syndrome to antiepileptic drugs
Neuman, M.G., Cohen, L., Nanau, R.M., Hwang, P.A.
Translational Research. 2012; 159(5): 397-406
[Pubmed]
55 Combinatorial approach for predicting antiepileptic drug specific hypersensitivity
[No author name available]
Pharmacogenomics. 2012; 13(5): 520-521
[Pubmed]
56 HLA-B*1502 allele is associated with a cross-reactivity pattern of cutaneous adverse reactions to antiepileptic drugs
Wang, J., Zhang, J., Wu, X., Yu, P., Hong, Z.
Journal of International Medical Research. 2012; 40(1): 377-382
[Pubmed]
57 A recent update of pharmacogenomics in drug-induced severe skin reactions
Wei, C.-Y., Ko, T.-M., Shen, C.-Y., Chen, Y.-T.
Drug Metabolism and Pharmacokinetics. 2012; 27(1): 132-141
[Pubmed]
58 Genome-wide mapping for clinically relevant predictors of lamotrigine-and phenytoin-induced hypersensitivity reactions
McCormack, M., Urban, T.J., Shianna, K.V., Walley, N., Pandolfo, M., Depondt, C., Chaila, E., (...), Cavalleri, G.L.
Pharmacogenomics. 2012; 13(4): 399-405
[Pubmed]
59 Drug hypersensitivity and human leukocyte antigens of the major histocompatibility complex
Bharadwaj, M., Illing, P., Theodossis, A., Purcell, A.W., Rossjohn, J., McCluskey, J.
Annual Review of Pharmacology and Toxicology. 2012; 52: 401-431
[Pubmed]
60 HLA-B*1502 Strongly Predicts Carbamazepine-Induced Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis in Thai Patients with Neuropathic Pain
Kulkantrakorn, K., Tassaneeyakul, W., Tiamkao, S., Jantararoungtong, T., Prabmechai, N., Vannaprasaht, S., Chumworathayi, P., (...), Sritipsukho, P.
Pain Practice. 2012; 12(3): 202-208
[Pubmed]
61 Profile and pattern of Stevens-Johnson syndrome and toxic epidermal necrolysis in a general hospital in Singapore: Treatment outcomes
Tan, S.-K., Tay, Y.-K.
Acta Dermato-Venereologica. 2012; 92(1): 62-66
[Pubmed]
62 Pharmacogenetic screening to prevent carbamazepine-induced toxic epidermal necrolysis and Stevens-Johnson syndrome: A critical appraisal
Wu, K., Reynolds, N.J.
British Journal of Dermatology. 2012; 166(1): 7-11
[Pubmed]
63 Analysis of Body Constitution of Fifty-two Patients with Stevens-Johnson Syndrome (SJS) Using Kampo Medical Questionnaires: Prediction of SJS based on Body Constitution Using Decision Tree
Shigeru OHSHIMA,Yukiko HATORI,Seiichi HONMA,Katsutoshi TERASAWA,Yukiya SAITOH,Daisuke KOBAYASHI
YAKUGAKU ZASSHI. 2011; 131(5): 745
[Pubmed]
64 HLA-A*3101 and Carbamazepine-Induced Hypersensitivity Reactions in Europeans
Mark McCormack,Ana Alfirevic,Stephane Bourgeois,John J. Farrell,Dalia Kasperaviciute,Mary Carrington,Graeme J. Sills,Tony Marson,Xiaoming Jia,Paul I.W. de Bakker,Krishna Chinthapalli,Mariam Molokhia,Michael R. Johnson,Gerard D. OæConnor,Elijah Chaila,Saud Alhusaini,Kevin V. Shianna,Rodney A. Radtke,Erin L. Heinzen,Nicole Walley,Massimo Pandolfo,Werner Pichler,B. Kevin Park,Chantal Depondt,Sanjay M. Sisodiya,David B. Goldstein,Panos Deloukas,Norman Delanty,Gianpiero L. Cavalleri,Munir Pirmohamed
New England Journal of Medicine. 2011; 364(12): 1134
[Pubmed]
65 PharmGKB summary
Caroline F. Thorn,Susan G. Leckband,John Kelsoe,J. Steven Leeder,Daniel J. Müller,Teri E. Klein,Russ B. Altman
Pharmacogenetics and Genomics. 2011; 21(12): 906
[Pubmed]
66 Carbamazepine-induced severe cutaneous adverse reactions and HLA genotypes in Koreans
Sae-Hoon Kim,Kyung Wha Lee,Woo-Jung Song,Sang-Heon Kim,Young-Koo Jee,Sang-Min Lee,Hye-Ryun Kang,Heung-Woo Park,Sang-Heon Cho,Seong-Ho Park,Kyung-Up Min,Yoon-Seok Chang
Epilepsy Research. 2011; 97(1-2): 190
[Pubmed]
67 Drug reaction with eosinophilia and systemic symptoms (DRESS): a clinical update and review of current thinking
S. A. Walsh,D. Creamer
Clinical and Experimental Dermatology. 2011; 36(1): 6
[Pubmed]
68 Phenytoin-induced Stevens–Johnson syndrome with negative HLA-B*1502 allele in mainland China: Two cases
Fa-Yun Hu,Xin-Tong Wu,Dong-Mei An,Bo Yan,Hermann Stefan,Dong Zhou
Seizure. 2011; 20(5): 431
[Pubmed]
69 Phenotype Standardization for Immune-Mediated Drug-Induced Skin Injury
M Pirmohamed,P S Friedmann,M Molokhia,Y K Loke,C Smith,E Phillips,L La Grenade,B Carleton,M Papaluca-Amati,P Demoly,N H Shear
Clinical Pharmacology & Therapeutics. 2011; 89(6): 896
[Pubmed]
70 Toxic epidermal necrolysis and Stevens-Johnson syndrome: A review*
Roland Gerull,Mathias Nelle,Thomas Schaible
Critical Care Medicine. 2011; 39(6): 1521
[Pubmed]
71 Pilot association study of oxcarbazepine-induced mild cutaneous adverse reactions with HLA-B*1502 allele in Chinese Han population
Fa-yun Hu,Xin-tong Wu,Dong-mei An,Bo Yan,Hermann Stefan,Dong Zhou
Seizure. 2011; 20(2): 160
[Pubmed]
72 Exploratory Study on Biomarkers Associated with Severe Cutaneous Adverse Reactions
Nahoko KANIWA
YAKUGAKU ZASSHI. 2011; 131(2): 255
[Pubmed]
73 Epidemiology and risk factors for drug allergy
Bernard Y-H. Thong,Teck-Choon Tan
British Journal of Clinical Pharmacology. 2011; 71(5): 684
[Pubmed]
74 Carbamazepine-Induced Toxic Effects and HLA-B*1502 Screening in Taiwan
Pei Chen,Juei-Jueng Lin,Chin-Song Lu,Cheung-Ter Ong,Peiyuan F. Hsieh,Chih-Chao Yang,Chih-Ta Tai,Shey-Lin Wu,Cheng-Hsien Lu,Yung-Chu Hsu,Hsiang-Yu Yu,Long-Sun Ro,Chung-Ta Lu,Chun-Che Chu,Jing-Jane Tsai,Yu-Hsiang Su,Sheng-Hsing Lan,Sheng-Feng Sung,Shu-Yi Lin,Hui-Ping Chuang,Li-Chen Huang,Ying-Ju Chen,Pei-Joung Tsai,Hung-Ting Liao,Yu-Hsuan Lin,Chien-Hsiun Chen,Wen-Hung Chung,Shuen-Iu Hung,Jer-Yuarn Wu,Chi-Feng Chang,Luke Chen,Yuan-Tsong Chen,Chen-Yang Shen
New England Journal of Medicine. 2011; 364(12): 1126
[Pubmed]
75 Strong association between HLA-B*1502 and carbamazepine-induced Stevens-Johnson syndrome and toxic epidermal necrolysis in mainland Han Chinese patients
Yan Zhang,Jin Wang,Li-Mei Zhao,Wei Peng,Guo-Qing Shen,Ling Xue,Xiao-Xian Zheng,Xiao-Jing HE,Chun-Yan Gong,Li-Yan Miao
European Journal of Clinical Pharmacology. 2011; 67(9): 885
[Pubmed]
76 The Genetics of Antiepileptic Drug–Induced Skin Reactions
S Hakimian,J W Miller
Clinical Pharmacology & Therapeutics. 2011; 89(6): 908
[Pubmed]
77 Shared and restricted T-cell receptor use is crucial for carbamazepine-induced Stevens-Johnson syndrome
Tai-Ming Ko,Wen-Hung Chung,Chun-Yu Wei,Han-Yu Shih,Jung-Kuei Chen,Chia-Hsien Lin,Yuan-Tsong Chen,Shuen-Iu Hung
Journal of Allergy and Clinical Immunology. 2011; 128(6): 1266
[Pubmed]
78 Pharmacogenetics of cutaneous adverse drug reactions
Michiko AIHARA
The Journal of Dermatology. 2011; 38(3): 246
[Pubmed]
79 Drug reaction with eosinophilia and systemic symptoms (DRESS): A clinical update and review of current thinking
Walsh, S.A., Creamer, D.
Clinical and Experimental Dermatology. 2011; 36(1): 6-11
[Pubmed]
80 Carbamazepine-induced Stevens-Johnson syndrome: Genetic predisposition of Asian patients | [Stevens-Johnson-syndrom unter carbamazepin: Genetische prädisposition asiatischer patienten]
Spindelegger, C., Konstantinidis, A., Kasper, S.
Journal fur Neurologie, Neurochirurgie und Psychiatrie. 2011; 12(2): 176-178
[Pubmed]
81 Carbamzepine-induced toxic epidermal necrolysis
Chowta, N.K., Chowta, M.N., Ramapuram, J., Kumar, P., Fazil, A.
Indian Journal of Critical Care Medicine. 2011; 15(2): 123-125
[Pubmed]
82 Phenotype standardization for immune-mediated drug-induced skin injury
Pirmohamed, M., Friedmann, P.S., Molokhia, M., Loke, Y.K., Smith, C., Phillips, E., La Grenade, L., (...), Shear, N.H.
Clinical Pharmacology and Therapeutics. 2011; 89(6): 896-901
[Pubmed]
83 Analysis of body constitution of fifty-two patients with stevens-johnson syndrome (SJS) using kampo medical questionnaires: Prediction of SJS based on body constitution using decision tree
Ohshima, S., Hatori, Y., Honma, S., Terasawa, K., Saitoh, Y., Kobayashi, D.
Yakugaku Zasshi. 2011; 131(5): 745-756
[Pubmed]
84 Epidemiology and risk factors for drug allergy
Thong, B.Y.-H., Tan, T.-C.
British Journal of Clinical Pharmacology. 2011; 71(5): 684-700
[Pubmed]
85 HLA-A*3101 and carbamazepine-induced hypersensitivity reactions in Europeans
McCormack, M., Alfirevic, A., Bourgeois, S., Farrell, J.J., Kasperavičiute, D., Carrington, M., Sills, G.J., (...), Pirmohamed, M.
New England Journal of Medicine. 2011; 364(12): 1134-1143
[Pubmed]
86 Carbamazepine-induced toxic effects and HLA-B*1502 screening in Taiwan
Chen, P., Lin, J.-J., Lu, C.-S., Ong, C.-T., Hsieh, P.F., Yang, C.-C., Tai, C.-T., (...), Shen, C.-Y.
New England Journal of Medicine. 2011; 364(12): 1126-1133
[Pubmed]
87 Pharmacogenetics of cutaneous adverse drug reactions
Aihara, M.
Journal of Dermatology. 2011; 38(3): 246-254
[Pubmed]
88 Pilot association study of oxcarbazepine-induced mild cutaneous adverse reactions with HLA-B*1502 allele in Chinese Han population
Hu, F.-Y., Wu, X.-T., An, D.-M., Yan, B., Stefan, H., Zhou, D.
Seizure. 2011; 20(2): 160-162
[Pubmed]
89 Drug hypersensitivity: Pharmacogenetics and clinical syndromes
Phillips, E.J., Chung, W.-H., Mockenhaupt, M., Roujeau, J.-C., Mallal, S.A.
Journal of Allergy and Clinical Immunology. 2011; 127(3 sup): s60-s66
[Pubmed]
90 Drug induced hypersensitivity and the HLA complex
Alfirevic, A., Pirmohamed, M.
Pharmaceuticals. 2011; 4(1): 69-90
[Pubmed]
91 Exploratory study on biomarkers associated with severe cutaneous adverse reactions
Kaniwa, N.
Yakugaku Zasshi. 2011; 131(2): 255-261
[Pubmed]
92 Do no harm-But first we need to know more: The case of adverse drug reactions with antiepileptic drugs
Singh, G.
Neurology India. 2011; 59(1): 53-58
[Pubmed]
93 Phenytoin-induced Stevens-Johnson syndrome with negative HLA-B*1502 allele in mainland China: Two cases
Hu, F.-Y., Wu, X.-T., An, D.-M., Yan, B., Stefan, H., Zhou, D.
Seizure. 2011; 20(5): 431-432
[Pubmed]
94 The genetics of antiepileptic drug-induced skin reactions
Hakimian, S., Miller, J.W.
Clinical Pharmacology and Therapeutics. 2011; 89(6): 908-910
[Pubmed]
95 Toxic epidermal necrolysis and Stevens-Johnson syndrome: A review
Gerull, R., Nelle, M., Schaible, T.
Critical Care Medicine. 2011; 39(6): 1521-1532
[Pubmed]
96 Carbamazepine-induced severe cutaneous adverse reactions and HLA genotypes in Koreans
Kim, S.-H., Lee, K.W., Song, W.-J., Kim, S.-H., Jee, Y.-K., Lee, S.-M., Kang, H.-R., (...), Chang, Y.-S.
Epilepsy Research. 2011; 97(1-2): 190-197
[Pubmed]
97 Strong association between HLA-Bz.ast1502 and carbamazepine-induced Stevens-Johnson syndrome and toxic epidermal necrolysis in mainland Han Chinese patients
Zhang, Y., Wang, J., Zhao, L.-M., Peng, W., Shen, G.-Q., Xue, L., Zheng, X.-X., (...), Miao, L.-Y.
European Journal of Clinical Pharmacology. 2011; 67(9): 885-887
[Pubmed]
98 Antiepileptic drugs
Zaccara, G., Tramacere, L.
Side Effects of Drugs Annual. 2011; 33(1): 125-204
[Pubmed]
99 Shared and restricted T-cell receptor use is crucial for carbamazepine-induced Stevens-Johnson syndrome
Ko, T.-M., Chung, W.-H., Wei, C.-Y., Shih, H.-Y., Chen, J.-K., Lin, C.-H., Chen, Y.-T., Hung, S.-I.
Journal of Allergy and Clinical Immunology. 2011; 128(6): 1266-1276
[Pubmed]
100 PharmGKB summary: Carbamazepine pathway
Thorn, C.F., Leckband, S.G., Kelsoe, J., Steven Leeder, J., Müller, D.J., Klein, T.E., Altman, R.B.
Pharmacogenetics and Genomics. 2011; 21(12): 906-910
[Pubmed]
101 Carbamazepine-induced Stevens-Johnson syndrome sparing the skin previously affected by herpes zoster infection in a patient with systemic lupus erythematosus: A reverse isotopic phenomenon
Tenea, D.
Case Reports in Dermatology. 2010; 2(2): 140-145
[Pubmed]
102 Association study of lamotrigine-induced cutaneous adverse reactions and HLA-B*1502 in a Han Chinese population
An, D.-M., Wu, X.-T., Hu, F.-Y., Yan, B., Stefan, H., Zhou, D.
Epilepsy Research. 2010; 92(2-3): 226-230
[Pubmed]
103 HLA-B*1511 is a risk factor for carbamazepine-induced Stevens-Johnson syndrome and toxic epidermal necrolysis in Japanese patients
Kaniwa, N., Saito, Y., Aihara, M., Matsunaga, K., Tohkin, M., Kurose, K., Furuya, H., (...), Hasegawa, R.
Epilepsia. 2010; 51(12): 2461-2465
[Pubmed]
104 Genetic markers and danger signals in Stevens-Johnson syndrome and toxic epidermal necrolysis
Chung, W.-H., Hung, S.-I.
Allergology International. 2010; 59(4): 325-332
[Pubmed]
105 Drug Induced Hypersensitivity and the HLA Complex
Ana Alfirevic,Munir Pirmohamed
Pharmaceuticals. 2010; 4(1): 69
[Pubmed]
106 Genetic Markers and Danger Signals in Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis
Wen-Hung Chung,Shuen-Iu Hung
Allergology International. 2010; 59(4): 325
[Pubmed]
107 Genetic and ethnic risk factors associated with drug hypersensitivity
Seung-Hyun Kim,Young-Min Ye,Nami Shrestha Palikhe,Jeong-Eun Kim,Hae-Sim Park
Current Opinion in Allergy and Clinical Immunology. 2010; 10(4): 280
[Pubmed]
108 HLA-B*1511 is a risk factor for carbamazepine-induced Stevens-Johnson syndrome and toxic epidermal necrolysis in Japanese patients
Nahoko Kaniwa,Yoshiro Saito,Michiko Aihara,Kayoko Matsunaga,Masahiro Tohkin,Kouichi Kurose,Hirokazu Furuya,Yukitoshi Takahashi,Masaaki Muramatsu,Shigeru Kinoshita,Masamichi Abe,Hiroko Ikeda,Mariko Kashiwagi,Yixuan Song,Mayumi Ueta,Chie Sotozono,Zenro Ikezawa,Ryuichi Hasegawa
Epilepsia. 2010; 51(12): 2461
[Pubmed]
109 Association study of lamotrigine-induced cutaneous adverse reactions and HLA-B*1502 in a Han Chinese population
Dong-Mei An,Xin-Tong Wu,Fa-Yun Hu,Bo Yan,Hermann Stefan,Dong Zhou
Epilepsy Research. 2010; 92(2-3): 226
[Pubmed]
110 Genetic and ethnic risk factors associated with drug hypersensitivity
Kim, S.-H., Ye, Y.-M., Palikhe, N.S., Kim, J.-E., Park, H.-S.
Current Opinion in Allergy and Clinical Immunology. 2010; 10(4): 280-290
[Pubmed]



 

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Online since 15th March '04
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