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Adverse drug reaction (ADRs) is a problem of interest
worldwide; it is an important cause of admission to hospital
and affect individual health. At the early 1970, the WHO
defined ADRs as ?¢????a response to a drug that is noxious and
unintended and occurs at doses normally used in man for the
prophylaxis, diagnosis or therapy of disease, or for modification
of physiological function?¢???. The mainly noticed ADRs are
hypersensitivity reactions, characterized by variant symptoms
including cutaneous reactions, bronchospasm, and multiple
organ involvement up to anaphylaxis, with time to appear
including few hours up to weeks. ADRs pathophysiological
explanation still not quietly understood current approaches
include immune reaction via interactions with human leucocyte
antigens (HLA); the pleomorphic glycoproteins that are located
on chromosome six, which are of an increasing interest in the
predication & diagnosis of ADRs.
My case Mr. JM, 43 years old male present to internal
medicine ward at the seventh. June 2019 (with a previous
history of cefotaxime allergy), after he developed
generalized skin rash and high-grade fever after ingesting
his medications (allopurinol & unspecified anti-inflammatory
drug; perhaps diclofenac) lasted for 3 days. After 3 days of
hospital management (Intravenous fluids, Parenteral steroids,
antihistamines & topical soothing agent) he was discharged
with wide spread of red skin rash on his trunk, upper limbs &
chest. Our physicians suggest that pt. developed Steven Johnson
syndrome, later medical follow up another dermatologist told
him that his illness was merely shingles.
I asked the pt. for his agreement to be pictured by my
colleagues [below], and to do him DNA extraction & genetic
test to reveal his case on my own behave. After his agreement,
he was subjected to HLA typing with polymerase chain reaction
at April 2021, his HLA genotypes were HLA-A 01:01/02:02
& HLA-B 15:10/73:01. Both HLA-genotypes were not related
to allopurinol induced drug reactions, which confer his late
diagnosis with shingles.
Keywords: Adverse drug reactions, HLA genotype, Allopurinol,
Cefotaxime
Biography
Alaa F. Hassan, a pharmacist has completed M.Sc. Pharmacology at the age of 28 years from Al-Mustansiriyah University, college of Medicine. She is the head of drug information centre & pharmacovigilence member. He has published two papers in reputed journals, 1 book chapter and has been serving as a peer-reviewer at request since 2019.
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