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International Journal of Clinical Pharmacy

, Volume 35, Issue 3, pp 319–322 | Cite as

HLA typing in Brazilian boys with aromatic antiepileptic drug-induced DRESS

  • Walderez Penteado Gaeti
  • Paulo Roque Obreli-NetoEmail author
  • Ricardo A. Moliterno
  • Gina Bressan Schiavon
  • Roberto Kenji Nakamura Cuman
Case Report

Abstract

Cases description We report two cases of drug rash with eosinophilia and systemic symptoms (DRESS) associated with the use of carbamazepine and phenytoin in Brazilian boys tested for human leukocyte antigen (HLA) class I and II alleles. The clinical manifestations were similar: a maculopapular eruption progressing to exfoliative erythroderma, fever, and lymphadenopathy. Leukocytosis, atypical lymphocytes, and liver injury were also observed. Assessment of causality using the Naranjo algorithm established a “probable” relationship (score 6) in both cases. Case 1 patient presented the following results of HLA typing: HLA-A*02,29 B*44,50 C*06,16 DRB1*01,07 DQA1*01,02. Case 2 patient presented the following results of HLA typing: HLAA*23,24 B*39,53 C*04,07 DRB1*04,08 DQA1*03,05 DQB1*03,03. Conclusion Neither of the cases reported here presented HLA typing similar to that strongly associated with the occurrence of DRESS in Asian or European patients.

Keywords

Adverse drug reactions Antiepileptic drugs Brazil Dress syndrome HLA Antigens 

Notes

Funding

None.

Conflicts of interest

None.

References

  1. 1.
    Criado PR, Criado RFJ, Avancini JM, Santi CG. Drug reaction with eosinophilia and systemic symptoms (DRESS)/drug-induced hypersensitivity syndrome (DIHS): a review of current concepts. An Bras Dermatol. 2012;87(3):435–49.PubMedCrossRefGoogle Scholar
  2. 2.
    Probst CM, Bompeixe EP, Pereira NF, de Dalalio MMO, Visentainer JE, Tsuneto LT, et al. HLA polymorphism and evaluation of European, African, and Amerindian contribution to the white and mulatto populations from Paraná. Brazil Hum Biol. 2000;72(4):597–617.Google Scholar
  3. 3.
    Descamps V, Valance A, Edlinger C, Fillet AM, Grossin M, Lebrun-Vignes B, et al. Association of human herpesvirus 6 infection with drug reaction with eosinophilia and systemic symptoms. Arch Dermatol. 2001;137(3):301–4.PubMedGoogle Scholar
  4. 4.
    Shiohara T, Inaoka M, Kano Y. Drug-induced hypersensitivity syndrome (DIHS): a reaction induced by a complex interplay among herpesviruses and antiviral and antidrug immune responses. Allergol Int. 2006;55(1):1–8.PubMedCrossRefGoogle Scholar
  5. 5.
    Kano Y, Inaoka M, Shiohara T. Association between anticonvulsant hypersensitivity syndrome and human herpesvirus 6 reactivation and hypogammaglobulinemia. Arch Dermatol. 2004;140(2):183–8.PubMedCrossRefGoogle Scholar
  6. 6.
    Jaquenoud Sirot E, van der Velden JW, Rentsch K, Eap CB, Baumann P. Therapeutic drug monitoring and pharmacogenetic tests as tools in pharmacovigilance. Drug Saf. 2006;29(9):735–68.PubMedCrossRefGoogle Scholar
  7. 7.
    Chung WH, Hung SI, Chen YT. Human leukocyte antigens and drug hypersensitivity. Curr Opin Allergy Clin Immunol. 2007;7(4):317–23.PubMedCrossRefGoogle Scholar
  8. 8.
    Bharadwaj M, Illing P, Theodossis A, Purcell AW, Rossjohn J, McCluskey J. Drug hypersensitivity and human leukocyte antigens of the major histocompatibility complex. Annu Rev Pharmacol Toxicol. 2012;52:401–31.PubMedCrossRefGoogle Scholar
  9. 9.
    Locharernkul C, Loplumlert J, Limotai C, Korkij W, Desudchit T, Tongkobpetch S, et al. Carbamazepine and phenytoin induced Stevens-Johnson syndrome is associated with HLA-B*1502 allele in Thai population. Epilepsia. 2008;49(12):2087–91.PubMedCrossRefGoogle Scholar
  10. 10.
    Alfirevic A, Jorgensen AL, Williamson PR, Chadwick DW, Park BK, Pirmohamed M. HLA-B locus in Caucasian patients with carbamazepine hypersensitivity. Pharmacogenomics. 2006;7(6):813–8.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media Dordrecht 2013

Authors and Affiliations

  • Walderez Penteado Gaeti
    • 1
  • Paulo Roque Obreli-Neto
    • 1
    Email author
  • Ricardo A. Moliterno
    • 2
  • Gina Bressan Schiavon
    • 3
  • Roberto Kenji Nakamura Cuman
    • 1
  1. 1.Department of Pharmacology and TherapeuticsState University of MaringaMaringáBrazil
  2. 2.Immunogenetic LaboratoryState University of MaringaMaringáBrazil
  3. 3.Department of MedicineState University of MaringaMaringáBrazil

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