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Letter to the Editor| Volume 71, ISSUE 2, P150-152, August 2013

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HLA-B*58:01 strongly associates with allopurinol-induced adverse drug reactions in a Japanese sample population

      Allopurinol, an inhibitor of xanthine oxidase, is widely used for the treatment of hyperuricemia associated with chronic gout, acute uric acid nephropathy, recurrent uric acid stone formation, certain enzyme/blood disorders, and cancer chemotherapy. It has been shown that severe cutaneous adverse drug reactions (ADRs) caused by allopurinol were strongly associated with HLA-B*58:01 in a Han Chinese sample population [
      • Hung S.I.
      • Chung W.H.
      • Liou L.B.
      • Chu C.C.
      • Lin M.
      • Huang H.P.
      • et al.
      HLA-B*5801 allele as a genetic marker for severe cutaneous adverse reactions caused by allopurinol.
      ]. Odds ratio (OR) for the association of HLA-B*58:01 with allopurinol-induced severe cutaneous ADR in this population was 580.3 and 95% CI was 34.4–9780.9. Although the relationship between HLA-B*58:01 and allopurinol-induced Stevens–Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) has subsequently been studied in European and Japanese patients, the association was much weaker than that reported in Han Chinese patients [
      • Lonjou C.
      • Borot N.
      • Sekula P.
      • Ledger N.
      • Thomas L.
      • Halevy S.
      • et al.
      A European study of HLA-B in Stevens–Johnson syndrome and toxic epidermal necrolysis related to five high-risk drugs.
      ,
      • Tohkin M.
      • Kaniwa N.
      • Saito Y.
      • Sugiyama E.
      • Kurose K.
      • Nishikawa J.
      • et al.
      A whole-genome association study of major determinants for allopurinol-related Stevens–Johnson syndrome and toxic epidermal necrolysis in Japanese patients.
      ]. The association study in Japanese patients was examined in only a limited number of allopurinol-induced ADR cases. We therefore conducted a case-controlled study to determine HLA types associated with allopurinol-induced ADR in a Japanese sample population.
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