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  • 1. Int J Dermatol. 2011 Feb;50(2):221-4. doi: 10.1111/j.1365-4632.2010.04745.x.Association of HLA-B*1502 allele with carbamazepine-induced toxicepidermal necrolysis and Stevens-Johnson syndrome in the multi-ethnic Malaysian population.Chang CC, Too CL, Murad S, Hussein SH.Department of Dermatology, Kuala Lumpur Hospital Allergy and Immunology Research Center, KualaLumpur, Malaysia. ccchor@gmail.comBACKGROUND: Carbamazepine (CBZ), a frequently used anticonvulsant drug, is oneof the most common causes of life-threatening cutaneous adverse drug reactions suchas toxic epidermal necrolysis (TEN) and Stevens-Johnson syndrome (SJS). Recentstudies have revealed a strong association between HLA-B*1502 and CBZ-inducedTEN/SJS in the Taiwan Han Chinese population.OBJECTIVES: This study is aimed to investigate the association between humanleucocyte antigens (HLA) and CBZ-induced TEN/SJS in the multi-ethnic Malaysianpopulation.METHODS: A sample of 21 unrelated patients with CBZ-induced TEN/SJS and 300race-matched, healthy controls were genotyped for HLA-A, -B and -DR usingpolymerase chain reaction (PCR). Allele frequencies were compared.RESULTS: HLA-B*1502 was present in 75.0% (12/16) of Malay patients with CBZ-induced TEN/SJS but in only 15.7% (47/300) of normal controls (odds ratio 16.15, 95%= 7.87 × 10(-6) ), which confidence interval 4.57-62.4; corrected P-value suggests astrong association between HLA and CBZ-induced TEN/SJS. Additionally, HLA-B*1502was found in all three Chinese and two Indian patients. Existing data show thatfrequencies of the HLA-B*1502 allele are generally much higher in Asian populationsthan in White European populations, which explains the higher incidences of SJS andTEN in Asian countries.CONCLUSIONS: HLA-B*1502 is strongly associated with CBZ-induced TEN/SJS in theMalay population in Malaysia, as has been seen in Han Chinese in Taiwan. Thisindicates that the genetic association apparent in the incidence of CBZ-inducedTEN/SJS is linked with the presence of HLA-B*1502, irrespective of racial origin.Screening of patients for this genetic marker can help to prevent the occurrence of TEN/SJS.© 2011 The International Society of Dermatology. PMID:21244392 [PubMed - indexed for MEDLINE]