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    Allopurinol Hypersensitivity Screen

    2 minute(s) read
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    Bangkok Hospital Phuket
    Updated on: 23 Dec 2025
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    Genolife Service
    Allopurinol Hypersensitivity Screen
    Bangkok Hospital Phuket
    Updated on: 23 Dec 2025

    HLA-B*58:01 Pharmacogenomic Panel

    Why Genotyping Before the First Dose Matters

    Clinical risk

    Severe cutaneous adverse reactions (SCAR: SJS, TEN, DRESS) develop in ≈ 0.1 – 0.4 % of new allopurinol users, yet case-fatality can exceed 20 %.

    Genetic prevalence

    HLA-B*58:01 occurs in 10 – 15 % Han-Chinese, ≈ 12 % Korean, ≈ 6 – 16 % Thai, ~6 % Japanese, ≈ 3 – 4 % African-American, and < 1 % European populations.

    Effect size

    Carriers face ≥ 70-fold higher odds of allopurinol-induced SJS/TEN compared with non-carriers.

    Guideline consensus

    CPIC and the American College of Rheumatology (ACR 2020) advise HLA-B*58:01 testing for patients of Southeast-Asian or African-American ancestry before starting allopurinol.

     

    Who Should Be Tested?

    • All Han-Chinese, Thai, Korean, or other SE-Asian patients – Because: Highest allele prevalence & SCAR risk

    • African-American patients – Because: Intermediate prevalence with documented SCAR cases

    • Individuals of mixed / unknown ancestry – Because: “Genotype, not appearance, drives risk”

    • Anyone with personal / family history of drug-induced SJS/TEN or DRESS – Because: Possible undisclosed HLA-B*58:01 carrier status

    • Patients with CKD starting allopurinol – Because: Renal impairment amplifies SCAR risk

    Your Journey with Genolife Services

    We guide you through every step, from counselling to creating a health safety plan.

    Pre-test Counselling

    Understand benefits, limits, and alternatives.

    Sample Collection

    A simple 2 mL EDTA blood draw.

    Expert Interpretation

    Reviewed by a multidisciplinary team of specialists.

    Post test

    description for family screening

    Ready to plan for a safer health future?

    Contact us for a consultation with our Genetic Counselor/Pharmacogenomics Specialist about the Allopurinol Hypersensitivity Screen or other genetic tests.

    Book a Consultation


    References

    • Hershfield MS et al. CPIC Guideline for HLA-B Genotype and Allopurinol Dosing. Clin Pharmacol Ther. 2013.
    • Saito Y et al. CPIC guideline update review, 2015.
    • NCBI GeneReviews®. Allopurinol Therapy and HLA-B*58:01 Genotype. 2020 update.
    • ACR Gout Management Guideline. 2020.
    • Somkrua R et al. Meta-analysis: OR ≈ 74 for SJS/TEN in HLA-B*58:01 carriers. Pharmacoepidemiol Drug Saf. 2011.
    • Puangpetch A et al. HLA-B allele diversity in Thais: 16 % HLA-B*58:01. Hum Immunol. 2015.
    • Tassaneeyakul W et al. Allopurinol-induced SJS/TEN and HLA-B*58:01 in Thai patients: sensitivity 100 %, specificity 87 %. Clin Pharmacol Ther. 2009.

    For more information, please contact

    Genolife Services

    4th Floor

    [email protected]

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