HLA-A*31:01 and carbamazepine-induced DRESS syndrom in a sample of North African population.

PURPOSE: Drug rash with eosinophilia and systemic symptoms (DRESS) is a serious adverse drug reaction. Carbamazepine is the most common causes of this syndrome. The HLA-A*31:01 allele has been shown to be strongly correlated with carbamazepine-induced DRESS syndrome in European, Japanese, Han Chinese and other asian population but not in African populations. So, our purpose is to study there is a correlation between HLA-A*31:01 and carbamazepine-induced DRESS syndrome in africain population? METHODS: HLA class I (A and B) typing was performed on 7 subjects with carbamazepine-DRESS syndrome and 25 tolerants controls subjects. DNA typing HLA class I (A) alleles was checked by the polymerase chain reaction amplification Sequence Specific Oligonucleotide Probes (SSO) (reverse-SSO assay). High resolution HLA DNA Kit based on the Luminex technology (One Lambda®) was used according to the manufacturer's protocol. RESULTS: The HLA-A*31:01 allele, which has a prevalence of 1% in Tunisian population, was significantly associated with DRESS syndrome. It was detected in 57.14% of cases (4/7) and only 4% of controls subjects (1/25). Thus, the carrier frequency of HLA-A*31:01 allele in the cases group was also significantly higher than in the controls group (57, 14% vs 4% P = 0,004). Odds ratio is estimated 32 (OR = 32 [2.6; 389.2]) CONCLUSION: Similarly to other ethnicities, the presence of the HLA-A*31:01 allele was associated with carbamazepine-DRESS syndrome in a sample of North African population. Future study must be conducted on a larger sample in order to confirm these results.

Rifamycin lavage in the treatment of experimental intra-abdominal infection.

HYPOTHESIS: Peritoneal lavage with rifamycin reduces the number of intraperitoneal bacteria and adhesions and improves the outcome of intra-abdominal infection (IAI). MATERIAL AND METHODS: Experimental IAI was induced in Wistar rats. After 24 h, the animals underwent relaparotomy. A peritoneal fluid sample was obtained and lavage of the abdominal cavity was performed. Animals were randomly assigned to the three following groups: lavage with 0.9% sodium chloride solution (S group); lavage with rifamycin at the dose of 25 mg/kg (R25 group); and lavage with rifamycin at the dose of 12.5 mg/kg (R12.5 group). Mortality was recorded every 8 h for 7 d. All animals that died had a necropsy. Surviving rats were later sacrificed and also underwent a necropsy. At necropsy, intraperitoneal adhesions were noted and a peritoneal fluid sample was obtained for bacterial analysis. RESULTS: Peritoneal lavage with rifamycin improved survival from 50% in the S group to 91.7 and 100% in the R25 group and R12.5 group, respectively. Adhesion formation was significantly reduced in the R25 group and R12.5 group compared with the S group (P < or = 0.01 and P < 0.01, respectively). There was a greater reduction in bacterial counts in peritoneal fluid in the R25 group compared with the S group (P = 0.003) but there was no significant difference in the reduction of bacterial count between R25 group and R12.5 group. CONCLUSION: These results suggest that peritoneal lavage with rifamycin improves the outcome of IAI.