PMID- 25634024
OWN - NLM
STAT- MEDLINE
DCOM- 20160413
LR  - 20220210
IS  - 1530-0366 (Electronic)
IS  - 1098-3600 (Linking)
VI  - 17
IP  - 10
DP  - 2015 Oct
TI  - An effective strategy to prevent allopurinol-induced hypersensitivity by HLA 
      typing.
PG  - 807-14
LID - 10.1038/gim.2014.195 [doi]
AB  - PURPOSE: This study was conducted to evaluate the usefulness of human leukocyte 
      antigen (HLA) typing in preventing allopurinol-induced severe cutaneous adverse 
      reactions (SCARs) through the application of an allopurinol tolerance induction 
      protocol or prescription of other alternative medications in high-risk patients. 
      METHODS: HLA typing was performed in patients with chronic renal insufficiency 
      who needed allopurinol. HLA-B*58:01-negative patients were prescribed the usual 
      dose of allopurinol. For HLA-B*58:01-positive patients, administration of either 
      allopurinol based on a 28-day tolerance induction protocol or alternative 
      medications was initiated. Hypersensitivity reactions were surveyed for 90 days 
      and compared with the result of a previous retrospective cohort study. RESULTS: 
      Among a total of 401 study subjects, no SCARs were noted in HLA-B*58:01-positive 
      patients with application of the tolerance induction protocol (n = 30) or 
      alternative medications (n = 16), nor were any SCARs observed in 
      HLA-B*58:01-negative patients who started allopurinol at the usual dose (n = 
      355). Compared with the previous retrospective cohort study, a significant 
      reduction in SCARs was observed in HLA-B*58:01-positive patients (0 vs. 18%; P = 
      0.002). CONCLUSION: This study shows the usefulness of HLA-B*58:01 screening in 
      identifying patients at high risk for the development of allopurinol-induced 
      SCARs and suggests that application of a tolerance induction protocol or 
      alternative medications could be an effective strategy to prevent 
      allopurinol-induced SCARs in HLA-B*58:01-positive patients.
FAU - Jung, Jae-Woo
AU  - Jung JW
AD  - Institute of Allergy and Clinical Immunology, Seoul National University Medical 
      Research Center, Seoul, Korea.
AD  - Department of Internal Medicine, Chung-Ang University College of Medicine, Seoul, 
      Korea.
FAU - Kim, Dong-Ki
AU  - Kim DK
AUID- ORCID: 0000-0002-2317-4201
AD  - Department of Internal Medicine, Seoul National University College of Medicine, 
      Seoul, Korea.
FAU - Park, Heung-Woo
AU  - Park HW
AD  - Institute of Allergy and Clinical Immunology, Seoul National University Medical 
      Research Center, Seoul, Korea.
AD  - Department of Internal Medicine, Seoul National University College of Medicine, 
      Seoul, Korea.
FAU - Oh, Kook-Hwan
AU  - Oh KH
AD  - Department of Internal Medicine, Seoul National University College of Medicine, 
      Seoul, Korea.
FAU - Joo, Kwon-Wook
AU  - Joo KW
AD  - Department of Internal Medicine, Seoul National University College of Medicine, 
      Seoul, Korea.
FAU - Kim, Yon-Su
AU  - Kim YS
AD  - Department of Internal Medicine, Seoul National University College of Medicine, 
      Seoul, Korea.
FAU - Ahn, Curie
AU  - Ahn C
AD  - Department of Internal Medicine, Seoul National University College of Medicine, 
      Seoul, Korea.
FAU - Lee, Kyung Wha
AU  - Lee KW
AD  - Hallym Institute for Genome Application, Hallym University College of Medicine, 
      Anyang, Korea.
FAU - Cho, Sang-Heon
AU  - Cho SH
AD  - Institute of Allergy and Clinical Immunology, Seoul National University Medical 
      Research Center, Seoul, Korea.
AD  - Department of Internal Medicine, Seoul National University College of Medicine, 
      Seoul, Korea.
FAU - Min, Kyung-Up
AU  - Min KU
AD  - Institute of Allergy and Clinical Immunology, Seoul National University Medical 
      Research Center, Seoul, Korea.
AD  - Department of Internal Medicine, Seoul National University College of Medicine, 
      Seoul, Korea.
FAU - Kang, Hye-Ryun
AU  - Kang HR
AD  - Institute of Allergy and Clinical Immunology, Seoul National University Medical 
      Research Center, Seoul, Korea.
AD  - Department of Internal Medicine, Seoul National University College of Medicine, 
      Seoul, Korea.
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20150129
PL  - United States
TA  - Genet Med
JT  - Genetics in medicine : official journal of the American College of Medical 
      Genetics
JID - 9815831
RN  - 0 (HLA-B Antigens)
RN  - 0 (Histocompatibility Antigens)
RN  - 63CZ7GJN5I (Allopurinol)
SB  - IM
MH  - Adult
MH  - Aged
MH  - Alleles
MH  - Allopurinol/administration & dosage/*adverse effects
MH  - Desensitization, Immunologic
MH  - Drug Hypersensitivity/diagnosis/epidemiology/*genetics/*immunology/prevention & 
      control
MH  - Female
MH  - HLA-B Antigens/genetics/immunology
MH  - Histocompatibility Antigens/*genetics/immunology
MH  - *Histocompatibility Testing
MH  - Humans
MH  - Immune Tolerance
MH  - Incidence
MH  - Male
MH  - Middle Aged
MH  - Risk Factors
EDAT- 2015/01/31 06:00
MHDA- 2016/04/14 06:00
CRDT- 2015/01/31 06:00
PHST- 2014/08/25 00:00 [received]
PHST- 2014/11/26 00:00 [accepted]
PHST- 2015/01/31 06:00 [entrez]
PHST- 2015/01/31 06:00 [pubmed]
PHST- 2016/04/14 06:00 [medline]
AID - S1098-3600(21)03159-2 [pii]
AID - 10.1038/gim.2014.195 [doi]
PST - ppublish
SO  - Genet Med. 2015 Oct;17(10):807-14. doi: 10.1038/gim.2014.195. Epub 2015 Jan 29.