Transl Clin Pharmacol.  2016 Sep;24(3):143-146. 10.12793/tcp.2016.24.3.143.

HLA-A*24:02/B*51:01 haplotype and lamotrigine-induced cutaneous adverse drug reactions in Koreans

• Kim EY
• Ji KH
• Kim HJ
• Jung HE
• Cha EY
• Shin JG

• KMID: 2351801
• DOI: http://doi.org/10.12793/tcp.2016.24.3.143

Abstract

Antiepileptic drugs (AEDs) have been known to induce cutaneous adverse drug reaction (cADR), ranging from a mild maculopapular eruption (MPE) to potentially life-threatening cADRs such as Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN). Despite studies examining mechanisms associated with human leukocyte antigen (HLA), the association between lamotrigine (LTG)-induced cADR and HLA alleles still has room to investigate. We investigated HLA-A,-B, and -C alleles in LTG-induced cADR. The medical records of four patients with LTG-induced cADR were retrospectively reviewed. All patients were treated with LTG for epilepsy. All recovered from cADR after stopping LTG treatment and receiving intensive care. HLA-A, -B, and -C genotyping was performed in all four patients using a PCR-sequence-based typing (SBT) method. Two patients had SJS, and the other two had MPE due to LTG. The range of latency to cADR after the initial LTG dose was 19-42 days. Two patients experienced cross-reactivity with other aromatic or new AEDs. Expression of the HLA-A*24:02/B*51:01 haplotype was detected in three (75%) patients with LTG-induced cADR. The other patient carried homozygous HLA-B*58:01 alleles. The results suggest that Korean individuals with the HLA-A*24:02/B*51:01 haplotype may be susceptible to LTG-induced cADR. Further investigations are necessary to confirm these findings.

Keyword

Lamotrigine; cutaneous adverse drug reactions; Stevens–Johnson syndrome; maculopapular eruption; HLA class I genotype

MeSH Terms

Alleles
Anticonvulsants
Critical Care
Drug-Related Side Effects and Adverse Reactions*
Epilepsy
Haplotypes*
HLA-A Antigens
Humans
Leukocytes
Medical Records
Methods
Retrospective Studies
Stevens-Johnson Syndrome
Anticonvulsants
HLA-A Antigens

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