Study On The Correlation Of Drug Eruption Caused By Non-Carbamazepine AEDs And Genotype Of HLA-B*1502

Research Background:Epilepsy is a relatively common chronic nervous system disease in childhood.The incidence of epilepsy is the highest in the first year of life.The main physiological function change is abnormal synchronous discharge of abnormal neurons in the brain.The clinical manifestations are consciousness,movement,sensation and mental or autonomic motor disorders.Epidemiological survey shows that the prevalence of epilepsy is about 3‰-6‰,and there are about 50 million epileptic patients in the world.Among them,the incidence of epilepsy in economically backward countries is significantly higher than that in developed countries and countries with economies in transition.The incidence of epilepsy in China is on the international average,which is about 5‰-7‰.The incidence of epilepsy in children is higher than that in adults.With the improvement of medical level,the incidence of epilepsy is increasing year by year.At present,the main treatment of epilepsy is still based on drug therapy,and the treatment of epilepsy is a long-term process.Therefore,it is very important to pay attention to the adverse reactions of antiepileptic drugs(AEDs)while paying attention to the therapeutic effects.Studies have confirmed that carbamazepine-induced drug eruption has a clear association with HLA-B*1502,but no but no study has proved whether non-carbamazepine drugs are associated with it.Therefore,this study explored whether the drug eruptions caused by non-carbamazepine drugs are related to the HLA B*1502 gene,thus providing a basis for clinical drug selection.Purpose:To explore the correlation between HLA-B*1502 gene and non-carbamazepine drug eruption patients,so as to guide the follow-up clinical treatment of patients with non-carbamazepine drug eruption.Methods:The HLA-B*1502 gene in peripheral blood of 34 patients with epilepsy caused by antiepileptic drugs and 32 patients with epilepsy without drug eruption hospitalized in Qilu Hospital of Shandong University were detected.66 patients were divided into four groups:non-carbamazepine drug eruption group,non-carbamazepine drug tolerance group,carbamazepine drug eruption group and carbamazepine drug tolerance group.To further analyze the difference the positive rate of the HLA-Ba*1502 gene between different groups,the correlation of the HLA-B*1502 gene with non-carbamazepine drug rash and carbamazepine drug eruption,the difference in the positive rate of the HLA-B*1502 gene of 4 groups,the positive rate of the HLA-B*1502 gene in 4 groups were compared.According to the results of the detections,the patients of non-carbamazepine drug rash group without the HLA-B*1502 gene were changed to carbamazepine,and other patients of this rash group with the HLA-B*1502 gene chose levetiracetam as the follow-up treamtment.Results:Though our study,we found that the positive rate of the HLA-B*1502 gene was 62.5%in the non-carbamazepine drug rash group,but only 3.8%in the non-carbamazepine drug rash group(p=0.037),which was statistically significant.In addition,the results of the two groups of drug tolerance groups showed that the positive rate of carbamazepine group and non-carbamazepine group were 18.2%VS 9.5%(p=0.093),without statistically significance.In patients who did not accept carbamazepine,the p-value of the HLA-B*1502 gene-positive in the rash group(3.8%)and the drug-tolerant group(9.5%)was 0.782,which had no statistically significance.While,the positive rates of the HLA-B*1502 gene in carbamazepine drug eruption group and carbamazepine drug tolerance group were 62.5%VS 18.2%(p=0.042),which had significant statistical significance.In our study,25 patients without the HLA-B*1502 gene in the non-carbamazepine drug rash group were changed to carbamazepine,and there was no adverse reaction.5 patients of this rash group with the HLA-B*1502 gene chose levetiracetam,which also had no adverse reaction.Conclusion:Through our study,we found that the HLA-B*1502 gene is associated with drug eruption caused by carbamazepine but has no correlation with drug-induced rash caused by non-carbamazepine.Carbamazepine could be chosen to the drug eruption of non-carbamazepine patients without the HLA-B*1502 gene,as the follow-up clinical treatment.