|
KMID : 1031120160060020089
|
|
Journal of Epilepsy Research
2016 Volume.6 No. 2 p.89 ~ p.94
|
|
|
Spectrum of Cutaneous Adverse Reactions to Levetiracetam and Human Leukocyte Antigen Typing in North-Indian Patients
|
|
Ramanujam Bhargavi
Ihtisham Kavish
Kaur Gurvinder
Srivastava Shivani
Mehra Narinder Kumar
Khanna Neena
Singh Mahip
Tripathi Manjari
|
|
|
Abstract
|
|
|
Background and Purpose: Aromatic antiepileptic drugs are frequently implicated for cutaneous adverse drug reactions (cADRs); there are case-reports of even severe reactions like drug reaction eosinophilia and systemic symptoms (DRESS) and Stevens Johnson syndrome (SJS)-toxic epidermal necrolysis with Levetiracetam (LEV). Certain human leukocyte antigen (HLA)-alleles have strong association with cADRs due to specific drugs - HLA-B*15:02 and HLA-A*31:01 in Carbamazepine (CBZ)-related SJS in Han-Chinese and European populations, respectively. Here, the spectrum of cADRs to LEV was studied, and HLA-typing in patients with cADRs due to LEV and some who were LEV-tolerant was performed, in an attempt to find an association between HLA and such reactions.
Methods: 589 patients taking LEV were screened for skin reactions, and eight patients with LEV-related cADRs and 25 LEV-tolerant controls were recruited - all 33 of North Indian ethnicity, their HLA-A, B, DRB1 genotyping done. Statistical analysis was done to compare carrier-rates and allele-frequencies of HLA-alleles between cases and controls (and healthy population, where necessary) for alleles occurring more than two times in either group.
Results: Out of 589 patients on LEV screened, there were 8 cases of cADR: 5 with maculopapular exanthema (MPE), 2 of SJS, and 1 with DRESS. Although HLA-A*33:01 was seen to occur more in MPE cases as compared to tolerant controls, the difference was not statistically significant (odds ratio [OR] 6.00, 95% confidence interval [CI] 0.30?116.6; p = 0.31). HLA A*11:01 and 24:02 were found to occur more in LEV-tolerant controls than in cases (OR 0.23 [95% CI 0.02?2.36, p = 0.33] and 1.00 [95% CI 0.09?11.02, p = 1.00] respectively).
Conclusions: Cutaneous reactions to LEV are very unusual, and their association with HLA in North-Indian population was not statistically significant.
|
|
|
KEYWORD
|
|
|
Levetiracetam, Maculo-papular exanthem, Stevens-Johnson syndrome, Toxic Epidermal Necrolysis, Human leukocyte antigen (HLA)
|
|
|
FullTexts / Linksout information
|
|
|
|
|
|
Listed journal information
|
|
|
|
|