[Hypersensitivity syndrome reactions to antiepileptic drugs, clinical characteristic and association with HLA-B*1502].

ABSTRACT

OBJECTIVE: To investigate the cutaneous adverse reactions to antiepileptic drugs (AEDs), clinical characteristic and the association with HLA-B*1502. METHODS: A retrospective analysis of four cases of antiepileptic drug hypersensitive syndrome (AHS) were performed on the basis of clinical data, cutaneous adverse reactions to carbamazepine (CBZ) (n = 2) including Stevens-Johnson syndrome (SJS) (n = 1) and hypersensitivity syndrome (HSS) (n = 1); phenobarbital-induced HSS (n = 1) and oxcarbazepine (OXC)-induced HSS (n = 1). All patients received the examinations of polymerase chain reaction (PCR) with sequence specific primers to analyze HLA-B*1502. Two healthy subjects had no history of using antiepileptic drugs as the control. RESULTS: All patients had manifestations of fever, eruption, mucosal involvement and visceral injury. Two cases were diagnosed as Stevens-Johnson syndrome associated with apparent bullae formation. Genotype positive for HLA-B*1502 was association with 2 patients with CBZ/OXC-induced SJS while the other 1 case of CBZ and 1 case of phenobarbital-induced HSS were genotype non-HLA-B*1502. CONCLUSION: AHS usually occurs within 1 to 2 weeks after initiation of AEDs therapy. The typical presentations are fever, eruption and internal organ involvements, etc. The epileptic patients with CBZ/OXC-induced SJS are related with HLA-B*1502 genotype. But it is not found in HSS patients.