HLA class I genes associated with Cold Medicine related Stevens-Johnson Syndrome with Severe Ocular Complications in the Brazilian population.

Abstract

Purpose : Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are immune-complex mediated hypersensitivity diseases that typically involve the skin and mucous membranes. Here we investigated etiologic factors such as causative drugs and the association between human leukocyte antigen (HLA) class I genes and cold medicine-related SJS/TEN (CM-SJS/TEN) with severe ocular complications (SOC) in Brazilian patients.

Methods : We enrolled 74 Brazilian patients with SJS/TEN with SOC and 135 healthy Brazilian volunteers. The patients' ethnicity was Pardo (51%), European ancestry (40%) and others. All were interviewed with respect to possible etiologic factors.
HLA class I (HLA-A, -B, -C) were examined to determine whether there was a genetic predisposition for CM-SJS/TEN with SOC.

Results : We identified cold medicine as the main causative drug (39 patients - 53%). HLA-A*66:01, HLA-B*44:03 and HLA-C*12:03 were associated, and HLA-A*11:01, HLA-B*08:01, and HLA-B*51:01 were inversely associated with Brazilian CM-SJS/TEN with SOC. After dividing in Pardo and European ancestry, HLA-A*66:01 was associated with among individuals both Pardo and European ancestry; HLA-B*44:03 and HLA-C*12:03 among individuals with only European ancestry.

Conclusions : In conclusion, our findings suggested that HLA-A*66:01 might be a marker in Pardo and European ancestry and HLA-B*44:03 and HLA-C*12:03 might be markers in only European ancestry. Moreover, HLA-A*11:01 might be a marker of resistance to CM-SJS/TEN with SOC.

This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.