Epidemiology of Severe Cutaneous Adverse Drug Reaction and Its HLA Association among Pediatrics

Authors

  • Elmira Esmailzadeh Department of Internal Medicine, Division of Rheumatology, Shiraz University of Medical Sciences, Shiraz, Iran.
  • Hamid Nemati Shiraz Neuroscience Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
  • Hesamodin Nabavizadeh Allergy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran. | Department of Allergy and Clinical Immunology, Shiraz University of Medical Sciences, Shiraz, Iran.
  • Hossein Esmaeilzadeh Allergy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran. | Department of Allergy and Clinical Immunology, Shiraz University of Medical Sciences, Shiraz, Iran.
  • Shirin Farjadian Department of Immunology, Shiraz University of Medical Sciences, Shiraz, Iran.
  • Soheila Alyasin Allergy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran. | Department of Allergy and Clinical Immunology, Shiraz University of Medical Sciences, Shiraz, Iran.
Abstract:

Severe cutaneous adverse drug reaction (SCAR) is considered to be a multifactorial drug side effect. This study was designed to investigate the epidemiology and human leukocyte antigen (HLA)-A and -B gene polymorphisms in pediatric patients with SCAR admitted in tertiary referral center, southwestern of Iran from 2013 to 2017. Demographic data, past allergy and autoimmune history, clinical presentations, drugs confirmed to be the cause of SCAR as well as its therapy were reviewed for each patient. HLA-A and -B allele frequencies were determined in 40 of the patients using polymerase chain reaction based on sequence specific primers (PCR-SSP) and compared with 40 healthy individuals as control group.Sixty-one patients with mean age of 6 years old and boy to girl ratio was 1.2/1 in this study. The most common type of SCAR in our patients was Steven Johnson Syndrome (SJS)/Toxic Epidermal Necrosis (TEN) mainly caused by beta-lactam antibiotics. Carbamazepine was the second cause of drug–induced SCAR. Moreover, HLA-A*02:01 and A*51:01 were related to the increased risk of SCAR while A*11:01 seemed to be protective against SCAR. HLA-A*02:01, HLA-A*24:02, and HLA-B*51:01 showed associations to the increased risk of SJS. Based on our results, beta-lactam antibiotics and antiepileptic drugs are the most common causes of severe adverse drug reaction in southwestern Iranian pediatric patients. Moreover, some HLA-A alleles can influence risk of SCAR.  

Upgrade to premium to download articles

Sign up to access the full text

Already have an account?login

similar resources

Association of HLA-B*1502 allele and carbamazepine- induced severe adverse cutaneous drug reaction among Asians, a review

Strong association between HLA B*1502 and carbamazepine-induced Steven-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) was demonstrated among Han Chinese in 2004. Studies from Europe showed that the HLA B*1502 is not a universal marker for SJS/TEN, but is ethnicity specific for Asians. Reports across Asia has shown that the prevalence of HLA B*1502 is high among Han Chinese (5-15%),...

full text

Multiple drug hypersensitivity associated with severe cutaneous adverse reaction

Background Multiple Drug Hypersensitivity (MDH) was first described by Sullivan et al in 1989 as drug allergies to two or more chemically different drugs proven by in-vivo or in-vitro testing. Pichler et al added to this description by suggesting that there are two subtypes of MDH: one where sensitisation to different drug classes may occur simultaneously; the other, sequentially sometimes even...

full text

Anticonvulsant Drugs and Severe Adverse Cutaneous Drug Reactions: A Longitudinal Observational Study

Background: Severe Adverse Cutaneous Reactions to Drugs (SACRDs) are skin eruptions due to drugs, which can cause morbidity and morbidity in patients. Objectives: The aim of this study was to determine the offending drug/agents and clinical phenotypes of SACRDs leading to admissions to the hospital. Materials & Methods: We conducted a retrospective cross-sectional study during one year (March...

full text

A Severe Case of Cutaneous Adverse Drug Reaction Secondary to a Novice Drug: Idelalisib

Phosphatidylinositol 3-kinase δ (PIK3δ) is a tyrosine kinase essential for B cell survival, making it an important target in the treatment of chronic lymphocytic leukemia. Idelalisib is an inhibitor of PIK3δ demonstrating initial success in disease response, but is now shown to have a decreased overall survival and life-threatening serious adverse events. The following is an unfortunate case of...

full text

HLA-B*1502 and carbamazepine-induced severe cutaneous adverse drug reactions in Vietnamese

BACKGROUND In Vietnam, we observed a high incidence of carbamazepine (CBZ)-induced severe cutaneous adverse drug reactions (SCARs)-Stevens-Johnson syndrome (SJS)/toxic epidermal necrolysis (TEN), and drug-induced hypersensitivity rash with eosinophilia and systemic symptoms (DRESS). In other Asian countries, HLA-B(*)1502 is an established risk factor for SCARs. OBJECTIVE The aim of our study ...

full text

My Resources

Save resource for easier access later

Save to my library Already added to my library

{@ msg_add @}


Journal title

volume 18  issue 1

pages  506- 522

publication date 2019-01-01

By following a journal you will be notified via email when a new issue of this journal is published.

Hosted on Doprax cloud platform doprax.com

copyright © 2015-2023