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Epidemiology of Severe Cutaneous Adverse Drug Reaction and Its HLA Association among Pediatrics

Hossein Esmaeilzadeh1,2, Shirin Farjadian3, Soheila Alyasin1,2

  • 1Allergy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.

Iranian Journal of Pharmaceutical Research : IJPR
|May 16, 2019
PubMed

Insights

This study found beta-lactam antibiotics and antiepileptic drugs are common causes of severe cutaneous adverse drug reactions (SCAR) in Iranian children. Certain human leukocyte antigen (HLA) genes, like HLA-A*02:01, increase SCAR risk, while others may offer protection.

Area of Science:

  • Pharmacogenomics
  • Immunogenetics
  • Pediatric Dermatology

Background:

  • Severe cutaneous adverse drug reactions (SCAR) are complex, multifactorial drug side effects.
  • Understanding SCAR epidemiology and genetic predispositions is crucial for risk mitigation.

Purpose of the Study:

  • To investigate the epidemiology of SCAR in pediatric patients in southwestern Iran.
  • To analyze human leukocyte antigen (HLA)-A and -B gene polymorphisms associated with SCAR in this population.

Main Methods:

  • Retrospective review of 61 pediatric SCAR cases (2013-2017).
  • Analysis of demographic data, clinical presentations, and causative drugs.
  • HLA-A and -B allele frequency determination using PCR-SSP in 40 patients and 40 healthy controls.

Main Results:

  • Steven Johnson Syndrome/Toxic Epidermal Necrosis (SJS/TEN) was the most common SCAR, primarily caused by beta-lactam antibiotics.
  • Carbamazepine was the second leading cause of drug-induced SCAR.
  • HLA-A*02:01 and A*51:01 alleles were associated with increased SCAR risk; HLA-A*11:01 showed a protective effect. HLA-A*02:01, HLA-A*24:02, and HLA-B*51:01 linked to SJS risk.

Conclusions:

  • Beta-lactam antibiotics and antiepileptic drugs are significant causes of SCAR in Iranian pediatric patients.
  • Specific HLA-A alleles influence SCAR susceptibility, highlighting the role of pharmacogenetics in adverse drug reactions.

Keywords:
AGEPDHRDRESSHLASCARSTS/TEN

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