The Negative HLA-B*1502 Status is Not an Absolute Exclusion of Carbamazepine-induced Steven Johnson Syndrome/toxic Epidermal Necrolysis: A Pediatric Case Report

Article Sidebar

Published: Nov 30, 2024
DOI: https://doi.org/10.47836/mjmhs.20.6.47
Keywords:
Steven-johnson syndrome, Toxic epidermal necrolysis, HLA B*1502, Carbamazepine, Anticonvulsant

Main Article Content

Anayasmin Azmi
Paediatric Department, Faculty of Medicine, Universiti Teknologi MARA, Sungai Buloh Campus
Lalitha Pillay B. Gopinathan
Paediatric Department, Paediatric Dermatologist, Hospital Tunku Ampuan Rahimah, Klang
Yusma Lyana Md Yusof
Paediatric Department, Faculty of Medicine, Universiti Teknologi MARA, Sungai Buloh Campus

Abstract

Stevens-Johnson Syndrome (SJS) and Toxic Epidermal Necrolysis (TEN) represent infrequent yet severe skin and mucous membrane disorders, frequently instigated by certain medications, notably carbamazepine. Diagnostic challenges arise due to the absence of definitive laboratory assays. While the presence of the HLA-B1502 allele is established as a predisposing factor for carbamazepine-induced SJS/TEN, instances of reaction manifestation in patients devoid of this genetic marker are documented. Essential to effective management is a comprehensive understanding of disease trajectory, precise discrimination from mimicking conditions, and prompt therapeutic intervention. This study underscores the critical importance of vigilant disease monitoring and personalized treatment approaches. Notably, this vigilance is imperative even in carbamazepine-treated patients lacking the HLA-B1502 genotype. Additionally, the potential utility of exploring other alleles, such as HLA-B75, warrants consideration to optimize treatment strategies.

Downloads

Download data is not yet available.

Article Details

How to Cite
Azmi, A., B. Gopinathan, L. P., & Md Yusof, Y. L. (2024). The Negative HLA-B*1502 Status is Not an Absolute Exclusion of Carbamazepine-induced Steven Johnson Syndrome/toxic Epidermal Necrolysis: A Pediatric Case Report. Malaysian Journal of Medicine and Health Sciences, 20(6), 382–385. https://doi.org/10.47836/mjmhs.20.6.47
Issue
Vol. 20 No. 6 (2024)
Section
Case Report
Crossref
Scopus
Google Scholar
Europe PMC

References

Liotti L, Caimmi S, Bottau P, Bernardini R, Cardinale F, Saretta F, Mori F, Crisafulli G, Franceschini F, Caffarelli C. Clinical features, outcomes and treatment in children with drug induced Stevens-Johnson syndrome and toxic epidermal necrolysis. Acta Bio-Medica: Atenei Parmensis. 2019;90(1):11-21. doi:10.12688/f1000research.20419.1

Ferrell PB, McLeod HL. Carbamazepine, HLA-B*1502 and risk of Stevens-Johnson syndrome and toxic epidermal necrolysis: US FDA recommendations. Pharmacogenomics. 2008;9(10):1543-1546. doi:10.2217/14622416.9.10.1543

Krauss G. Current understanding of delayed anticonvulsant hypersensitivity reactions. Epilepsy Curr. 2006;6(5):148-151. doi:10.1111/j.1535-7511.2006.00089.x

Tangamornsuksan W, Chaiyakunapruk N, Somkrua R, Lohitnavy M, Tassaneeyakul W. Relationship between the HLA-B*1502 allele and carbamazepine-induced Stevens-Johnson syndrome and toxic epidermal necrolysis: a systematic review and meta-analysis. JAMA Dermatol. 2013;149(9):1025-1032. doi:10.1001/jamadermatol.2013.4114

Capule F, Tragulpiankit P, Mahasirimongkol S, Jittikoon J, Wichukchinda N, Theresa Alentajan-Aleta L, et al. Association of carbamazepine-induced Stevens-Johnson syndrome/toxic epidermal necrolysis with the HLA-B75 serotype or HLA-B*15:21 allele in Filipino patients. Pharmacogenomics J. 2020;20(3):533-541. doi:10.1038/s41397-019-0143-8