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HLA-B*5901 is Strongly Associated with Methazolamide-Induced Stevens–Johnson Syndrome/Toxic Epidermal Necrolysis

2010; Future Medicine; Volume: 11; Issue: 6 Linguagem: Inglês

10.2217/pgs.10.54

1744-8042

Sae‐Hoon Kim, Myung‐Hwa Kim, Kyung Wha Lee, Sang‐Heon Kim, Hye–Ryun Kang, Heung‐Woo Park, Young‐Koo Jee,

Mast cells and histamine

Aims: The carbonic anhydrase inhibitor methazolamide infrequently causes Stevens–Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN). An association between these diseases and the HLA-B59 serotype has been suggested in case reports. This study examined the disease-associated B*59 allele and investigated the association of these diseases with other HLA class I alleles. Methods: We performed high-resolution HLA-A, -B and -C genotyping in five patients with methazolamide-induced SJS/TEN using a PCR-sequencing-based typing method and analyzed the association between HLA-class I alleles and occurrence of methazolamide-induced SJS/TEN. Results: B*5901 and Cw*0102 alleles were observed in all patients and A*2402 was observed in four patients. The B*5901 allele showed the strongest association with methazolamide-induced SJS/TEN (p < 0.001; odds ratio: 249.8; 95% CI: 13.4–4813.5), followed by Cw*0102 (p = 0.004; odds ratio: 22.1; 95% CI: 1.2–414.3), when compared with the general population as a control. The frequency of the patients carrying B*5901, Cw*0102 and A*2402 simultaneously was significantly higher than that in the general population (p < 0.001; odds ratio: 110.1; 95% CI: 11.7–1038.6). Conclusion: A strong association was observed between HLA-B*5901 and methazolamide-induced SJS/TEN in Korean patients. HLA-B*5901 may be a useful screening marker for predicting methazolamide-induced SJS/TEN in patients of Korean and Japanese ancestry.