HLA-B*58:01與別嘌醇皮膚不良反應關聯性研究

To investigate the relationship between HLA-B*58:01 and allopurinol-induced skin adverse reactions

目的了解鏡湖醫院病人檢測HLA-B*58:01等位基因情況,以及與别嘌醇誘導的皮膚不良反應的相關性。方法採用回顧性分析方法,調查2021年11月~2022年6月開立HLA-B*58:01基因檢驗項目患者的藥物過敏史及用藥史等情況,應用統計軟件進行數據處理和分析。結果期間接受檢驗病人131例,21例(16%)檢驗結果為陽性。曾服用别嘌醇的病人中HLA-B*58:01基因陽性組發生皮膚不良反應3例(50%),HLA-B*58:01陰性組只有2例(3.6%),差異具有統計學意義(P<0.05)。結論檢測HLA-B*58:01等位基因攜帶率16%,HLA-B*58:01等位基因與别嘌醇所致皮膚不良反應具有顯著相關性,建議在開始使用别嘌醇之前應先進行檢測。並且使用較低初始劑量,用藥期間對腎功能進行評估,以盡量減低嚴重皮膚不良反應發生的風險。

Objective To survey the carrier status of HLA-B*58:01 allele in patients in Kiang Wu Hospital(hereinafter referred to as our hospital)and its correlation with Allopurinol-induced skin adverse reactions.Methods A retrospective analysis method was used to investigate the drug allergy history and medication history of patients who were prescribed the HLA-B*58:01genetic test item from November 2021 to June 2022.The basic data and HLA-B*58:01 gene of the above patients were analyzed by statistical software.Results During the period,131 patients were tested,and 21 patients(16%)had positive test results.Among patients who had taken allopurinol,there were 3 cases(50%)of adverse skin reactions in HLA-B*58:01 gene positive group,and only 2 cases(3.6%)in HLA-B*58:01 negative group.Conclusion In view of 16% of HLA-B*58:01 allele in our hospital,and the results of the study showed a significant correlation between HLA-B*58:01 gene and Allopurinol-induced skin adverse reactions.It is suggested that detection should be performed before starting Allopurinol use.With a lower initial dose of Allopurinol,renal function should be assessed during treatment to minimize the risk of serious skin adverse reactions.