HLA-B*1502 and carbamazepine-induced severe cutaneous adverse drug reactions in Vietnamese

BACKGROUND: In Vietnam, we observed a high incidence of carbamazepine (CBZ)-induced severe cutaneous adverse drug reactions (SCARs)-Stevens-Johnson syndrome (SJS)/toxic epidermal necrolysis (TEN), and drug-induced hypersensitivity rash with eosinophilia and systemic symptoms (DRESS). In other Asian countries, HLA-B*1502 is an established risk factor for SCARs. OBJECTIVE: The aim of our study was to determine the frequency of HLA-B*1502 in SCARs patients at a large University Medical Center in Hanoi, Vietnam. METHODS: Thirty-eight cases of SCARs caused by CBZ and 25 patients with epilepsy tolerating CBZ were enrolled in a case-controlled study. Clinical manifestations and laboratory findings were recorded for each subject. Genomic DNA was isolated using the QIAamp DNA purification system. The combination of polymerase chain reaction and sequence specific oligonucleotide probes with the Luminex 100×MAP flow cytometry dual laser system was then used to quantitate fluorescently labelled oligonucleotides attached to colour-coded microbeads. RESULTS: Cases comprised 20 SJS (52.6%), 7 TEN (18.4%), 8 overlap syndrome (21.1%), and 3 DRESS patients (7.9%). A strong association between HLA B*1502 and bullous skin reactions such as SJS/TEN and overlap was confirmed with an odds ratio (OR) of 33.78 (95% confidence interval [CI], 7.55-151.03), p < 0.0001, Sensitivity 91.4%, Specificity 76.0%, positive predictive value 84.2%, and negative predictive value 86.4%. We did not, however, observe any correlation between the presence of this allele and CBZ-induced nonbullous skin reactions (DRESS) (OR, 6.33; 95% CI, 0.48-82.74; p = 0.1592). CONCLUSION: Our results indicate the presence of HLA-B*1502 in Vietnamese is a pharmacogenetic risk factor for developing CBZ-induced SJS/TEN.

Evaluate on epidemic supervision and propose solutions to protect healthy for soldiers and people in malaria epidemic area

Background: Coordinating between soldiers and people bring significant results in protecting healthy for soldiers and people in malaria epidemic area.\r\n', u'Objectives: To evaluate epidemic supervision and propose solutions protecting healthy for soldiers and people in malaria epidemic area.\r\n', u'Subjects and methods: A retrospective cross sectional study was carried out on two provinces Binh Phuoc and Dak Lak\r\n', u'Results: there was 4 main disease types were fever, tuberculosis, diarrhea and malaria. Malaria at investigated times still accounted high rate comparing with general fever rate. Malaria risk contained in people living or working in forest and mountain field; free emigrants; armed forces and border guard. These subjects needed to improve regularly protection from malaria. Communication of health education is one of important method to prevent and control malaria.\r\n', u'Conclusion: It is necessary to implement strong methods (such as providing insecticide treated bed nets, indoor residual spray) to prevent and control malaria. \r\n', u'

Primarily study on allergic reactions of non-steroid anti-inflammatory drugs (NSAIDs) in the Clinical allergy and Immunological Department of Bach Mai hospital

Preliminary results of the study on allergic reaction of NSAID. Allergic patients due to antipyretics, analgesics, non-steroid anti-inflammatory drugs (1995-1999) were performed at Bach Mai Hospital. Result showed that: most anti-pyretics, analgesics, no-steroid anti-inflammatory drugs can cause allergic reactions. The first sign of allergy appeared early. Main clinical symptoms of allergy are itching, erythema, fever and urticaria. The average concentration of total serum IgE in the group of allergic patients is higher than in the group of healthy persons. Methyl prednisolon, dimedrol, glucose and ascorbic acid solutions are common medications to treat allergic patients. From 30 allergic patients, there was no death.

Situation of drug allergy for the past 20 years

During 1981-2000, in Bach Mai Hospital, 1,465 patients with drug allergy were consulted and treated. Among them, 9 cases died of Stevens-Johnson and Lyell syndrome. There were 121 kinds of drug allergy. 215 of health staffs suffered the drug allergy showed the risk of allergy among health staffs was higher 2.5 times.

Allergic patients due to carbamazepine in BachMai Hospital (1991- 1998)

A study on 24 allergic patients due to carbamazepine (1991- 1998) was performed at Bach mai Hospital. Results showed that: - The first signs of allergy appear late(11.37+4.56 days). - Main clinical symptoms of allergy are necrosis at natural cavities, erythema, fever. - The main clinical form of allergy is Stevens-Johnson syndrome (79.16%). - Elevated ESR, SGOT, SGPT are the main changes in tests. - It takes a long time to treat allergic patients due to carbamazepine (12.61+35days) - Glucocorticoid, dimedrol, glucose and ascorbic acid solution are the common medications.