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Preliminary Communication

HLA-B*5901 is strongly associated with methazolamide-induced Stevens–Johnson syndrome/toxic epidermal necrolysis

    Sae-Hoon Kim*

    Department of Internal Medicine, Seoul National University College of Medicine, Seoul, South Korea

    Institute of Allergy & Clinical Immunology, Seoul National University College of Medicine, Seoul, South Korea

    Department of Internal Medicine, Seoul National University, Bundang Hospital, Seongnam, South Korea

    *These authors contributed equally to this work.

    Search for more papers by this author

    ,
    Myunghwa Kim*

    Department of Dermatology, Dankook University College of Medicine, Cheonan, South Korea

    *These authors contributed equally to this work.

    Search for more papers by this author

    ,
    Kyung Wha Lee

    Hallym Institute for Genome Application, Hallym University, Anyang, South Korea

    ,
    Sang-Heon Kim

    Department of Internal Medicine, Hanyang University College of Medicine, Seoul, South Korea

    ,
    Hye-Ryun Kang

    Department of Internal Medicine, Seoul National University College of Medicine, Seoul, South Korea

    Institute of Allergy & Clinical Immunology, Seoul National University College of Medicine, Seoul, South Korea

    ,
    Heung-Woo Park

    Department of Internal Medicine, Seoul National University College of Medicine, Seoul, South Korea

    Institute of Allergy & Clinical Immunology, Seoul National University College of Medicine, Seoul, South Korea

    &
    Young-Koo Jee

    † Author for correspondence

    Department of Internal Medicine, Dankook University College of Medicine, Cheonan, South Korea.

    Published Online:https://doi.org/10.2217/pgs.10.54

    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.

    Papers of special note have been highlighted as: ▪ of interest ▪▪ of considerable interest

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