Independent strong association of HLA-A*02:06 and HLA-B*44:03 with cold medicine-related Stevens-Johnson syndrome with severe mucosal involvement

Sci Rep. 2014 Apr 30:4:4862. doi: 10.1038/srep04862.

Abstract

Stevens-Johnson syndrome (SJS) and its severe variant, toxic epidermal necrolysis (TEN), are acute inflammatory vesiculobullous reactions of the skin and mucous membranes. Cold medicines including non-steroidal anti-inflammatory drugs (NSAIDs) and multi-ingredient cold medications are reported to be important inciting drugs. We used two sample sets of Japanese patients to investigate the association between HLA genotypes and cold medicine-related SJS/TEN (CM-SJS/TEN), including acetaminophen-related SJS/TEN (AR-SJS/TEN) with severe mucosal involvement such as severe ocular surface complications (SOC). HLA-A*02:06 was strongly associated with CM-SJS/TEN with SOC and AR-SJS/TEN with SOC. HLA-B*44:03 was also detected as an independent risk allele for CM-, including AR-SJS/TEN with SOC. Analyses using data obtained from CM-SJS/TEN patients without SOC and patients with CM-unrelated SJS/TEN with SOC suggested that these two susceptibility alleles are involved in the development of only CM-SJS/TEN with SOC patients.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Acetaminophen / adverse effects
  • Adolescent
  • Adult
  • Aged
  • Anti-Inflammatory Agents, Non-Steroidal / adverse effects*
  • Case-Control Studies
  • Child
  • Female
  • HLA-A Antigens / genetics*
  • HLA-B Antigens / genetics*
  • Humans
  • Male
  • Middle Aged
  • Mucous Membrane / pathology*
  • Stevens-Johnson Syndrome / complications
  • Stevens-Johnson Syndrome / etiology*
  • Stevens-Johnson Syndrome / pathology*
  • Vision Disorders / etiology
  • Young Adult

Substances

  • Anti-Inflammatory Agents, Non-Steroidal
  • HLA-A Antigens
  • HLA-B Antigens
  • Acetaminophen