Before initiating carbamazepine in a patient of Han Chinese ancestry, which screening test is recommended to reduce the risk of severe cutaneous adverse reactions?
- A Serum baseline IgE levels
- B HLA-A*31:01 genotyping
- C HLA-B*15:02 genotyping ✓
- D Epidermal transglutaminase antibodies
Correct answer: C. HLA-B*15:02 genotyping
Explanation
Carbamazepine-induced Stevens-Johnson syndrome and toxic epidermal necrolysis in Han Chinese and several Southeast Asian populations are strongly associated with the HLA-B*15:02 allele, so guidelines recommend genotyping before prescribing. HLA-C*31:01 is associated with milder carbamazepine hypersensitivity reactions in European populations and is not the standard screening target here. IgE levels and transglutaminase antibodies have no role in predicting these T-cell mediated, genetically determined drug reactions.
Reference: Harrison's Principles of Internal Medicine, 21st ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
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