Before starting allopurinol in a patient of Han Chinese, Thai or Korean descent, testing for which human leucocyte antigen allele is recommended to predict risk of severe cutaneous adverse reactions?
- A HLA-B*15:02
- B HLA-B*57:01
- C HLA-B*58:01 ✓
- D HLA-DQB1*03:01
Correct answer: C. HLA-B*58:01
Explanation
HLA-B*58:01 carriage is strongly associated with allopurinol-induced Stevens-Johnson syndrome and toxic epidermal necrolysis, particularly in Han Chinese, Thai and Korean populations where carrier frequency is high. Testing before initiation allows selection of an alternative urate-lowering agent such as febuxostat. HLA-B*15:02 predicts carbamazepine-induced SJS, and HLA-B*57:01 predicts abacavir hypersensitivity, making those alleles the key distractors.
Reference: Harrison's Principles of Internal Medicine, 21st ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.