Chinese Journal of Dermatology ›› 2020, Vol. 53 ›› Issue (9): 680-684.doi: 10.35541/cjd.20200296

• Original Articles • Previous Articles     Next Articles

Analysis of culprit drugs and screening for human leukocyte antigen genes in patients of Han nationality with Stevens-Johnson syndrome/toxic epidermal necrolysis in Inner Mongolia

Li Xin, Han Jianwen   

  1. Department of Dermatology, The Affiliated Hospital of Inner Mongolia Medical University, Hohhot 010010, China
  • Received:2020-03-27 Revised:2020-07-09 Online:2020-09-15 Published:2020-08-31
  • Contact: Han Jianwen E-mail:hanjianwen1981@hotmail.com
  • Supported by:
    National Natural Science Foundation of China (81660513); Open Research Fund of Ministry of Education Key Laboratory of Dermatology (AY2017?1?009); Youth Innovation Fund Project of Inner Mongolia Medical University (YKD2016QNCX031)

Abstract: 【Abstract】 Objective To analyze culprit drugs and screen susceptible genes in patients of Han nationality with Stevens-Johnson syndrome (SJS)/toxic epidermal necrolysis (TEN) in Inner Mongolia. Methods A total of 68 patients of Han nationality with confirmed SJS/TEN were collected from Department of Dermatology, the Affiliated Hospital of Inner Mongolia Medical University between 2015 and 2019. DNA was extracted from peripheral blood samples, and PCR was performed to screen HLA-B*5801, HLA-B*1502 and HLA-A*3101 alleles. Clinical data were collected from the patients, and culprit drugs were analyzed according to the genotypes. Results Among the 68 patients with SJS/TEN, there were 36 males and 32 females, aged 46.06 ± 19.97 (range, 3 - 84) years. Five cases were positive for HLA-B*5801 allele, of which 4 were induced by allopurinol; 14 cases were positive for HLA-B*1502 allele, of which 5 were induced by carbamazepine, 4 were induced by lamotrigine, and 5 were induced or likely induced by antibiotics and antipyretic analgesics; only 1 case was positive for HLA-A*3101 allele, and the suspected culprit drug was a traditional Chinese medicine injection for promoting blood circulation with unclear ingredients. Conclusions HLA-B*5801 has a good predictive effect on allopurinol-induced drug eruptions, and HLA-B*1502 on carbamazepine- and lamotrigine-induced drug eruptions. It is recommended to screen susceptible genes before medication. However, the positive rate of HLA-A*3101 was not very high in the population in Inner Mongolia.

Key words: Stevens-Johnson syndrome, Epidermal necrolysis, toxic, HLA-A antigens, HLA-B antigens, Genotype, Carbamazepine, Allopurinol