HLA ‐ B *58:01 is strongly associated with allopurinol‐induced severe cutaneous adverse reactions in H an C hinese patients: a multicentre retrospective case–control clinical study

Funding sources: This work was supported by the National Scientific Foundation of China (No. 81273595), the ‘863’ Project (No. 2012AA02A518) and the China Scholarship Council (CSC). Conflicts of interest: none declared. Dear Editor, Severe cutaneous adverse drug reactions (SCARs) are rare but life‐threatening conditions, which can even be fatal in some patients. These include drug reaction with eosinophilia and systemic symptoms (DRESS), Stevens–Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN). Over one hundred drugs have been associated with SCARs, one of which is allopurinol, a drug widely used to treat hyperuricaemia and its complications.1 2 3 Allopurinol‐induced DRESS/SJS/TEN has previously been shown to occur almost exclusively in individuals positive for the human leucocyte antigen allele HLA‐B*58:01 and of Han Chinese4 5 6 or Thai descent;7 this variant allele is commonly found in these specific Asian subpopulations. However, in Japanese8 and white populations,9 10 where the presence of HLA‐B*58:01 is less frequent, only a moderate association between allopurinol‐induced SCARs and HLA‐B*58:01 has been seen. To elucidate this relationship we conducted a multicentre retrospective case–control study of Han Chinese patients.