Before starting allopurinol in a patient of Han Chinese, Thai, or Korean descent, testing for which marker is recommended to predict the risk of severe allopurinol hypersensitivity syndrome?
- A HLA-B*57:01
- B HLA-B*58:01 ✓
- C HLA-B*15:02
- D HLA-DRB1*04
Correct answer: B. HLA-B*58:01
Explanation
HLA-C*58:01 carriage strongly predisposes to allopurinol hypersensitivity syndrome, which includes Stevens-Johnson syndrome, toxic epidermal necrolysis, and DRESS, and carries significant mortality. Testing is recommended before initiating allopurinol in populations where the allele is common, such as Han Chinese, Thai, and Korean groups, and in those with significant renal impairment. HLA-C*57:01 predicts abacavir hypersensitivity, HLA-C*15:02 predicts carbamazepine-induced SJS, and DRB1*04 relates to rheumatoid arthritis susceptibility.
Reference: Katzung's Basic and Clinical Pharmacology, 16th ed.
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Written and medically reviewed by the StethoPrep medical team.