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HLA-B*58:01 Genotype and Allopurinol-Induced Hypersensitivity Reaction (Severe Cutaneous Adverse Drug Reaction, SCAR, DRESS)

Description

Allopurinol-induced hypersensitivity reactions (severe cutaneous adverse drug reactions, SCAR, Stevens-Johnson Syndrome, toxic epidermal necrolysis, DRESS, drug rash with eosinophilia and systemic symptoms) are potentially fatal reactions with multifactorial causation. One important risk factor for certain racial groups is the HLA-B genotype.


In certain Asian populations (Han Chinese, Thai, Koreans) have a high rate of SCAR. The presence of HLA-B*58:01 is associated with hypersensitivity reactions in these groups as well as in Europeans. The studies refer to carrier status and not zygosity.

 

Additional risk factors associated with allopurinol-induced SCAR:

(1) renal insufficiency (with reduced excretion and accumulation)

(2) higher maintenance dose

 

Testing for HLA-B*58:01 is indicated in patients prior to starting allopurinol therapy.


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