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A Review of HLA Genes in Pharmacogenetics: Risk Assessment of Adverse Drug Reactions

  • Yu, Shinae
    • Journal of Interdisciplinary Genomics
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    • v.3 no.1
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    • pp.7-12
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    • 2021
  • Adverse drug reactions (ADRs) is a hypersensitivity reactions to specific medications, and remain a common and major problem in healthcare. ADRs suchc as drug-induced liver injury and life-threatening severe cutaneous adverse drug reactions including Stevens-Johnson syndrome, toxic epidermal necrolysis, and drug rash with eosinophilia and systemic symptoms can be occurred by uncontrolled expansion of oligoclonal T cells according to genetically predisposing HLA. In this review, I summarized the alleles of HLA genes which have been proposed to have association with ADRs caused by different drugs.

A Case study on the improvement in acne patient using Ortho-Cellular Nutrition Therapy (OCNT) (세포교정영양요법(OCNT)을 이용한 여드름 개선 사례 연구)

  • Jongbin Jo
    • CELLMED
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    • v.13 no.16
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    • pp.59.1-59.4
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    • 2023
  • Objective: Case study on the improvement of acne through application of Ortho-Cellular Nutrition Therapy (OCNT) Method: Implementation of OCNT on a 25-year old Korean male due to severe acne symptoms Results: Symptoms such as skin rash and wounds as well as the overall skin conditions improved following the implementation of OCNT. Conclusion: Application of OCNT can be helpful in alleviation of symptoms in patients suffering from acne.

One Case of Systemic Lupus Erythematosus treated by Integrated Therapy of Western Medicine with Oriental Differential Diagnosis of Symptoms and Signs (한방 변증과 양방 협진에 의한 전신성 홍반성 낭창(Systemic Lupus Erythematosus) 치료 1예)

  • Jung, Dae-Young;Baek, Dong-Gi;Hwang, Sang-Il;Shin, Sun-Ho;Kim, Dong-Woung;Han, Myoung-Ah
    • The Journal of Internal Korean Medicine
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    • v.23 no.2
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    • pp.306-312
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    • 2002
  • Systemic Lupus Erythematosus(SLE) is a autoimmune disease characterized by combined symtoms of malar rash, discoid rash, neuropsychiatric disorder, renal disorder, hematologic disorder, photosensitivity immunologic disorder, oral ulcer, anti-nuclear antibody, arthritis, pleuritis and pericarditis, etc. Multiple genetic or environmental causes are supposed to facilitate antiboby production to autoantigen such as ds-DNA, histone, phospholipid, red blood cell, platelet, etc. And defective complementary system fail to remove autoantigen-antibody complex, which deposit in multiple organs and result in inflammatory damages. SLE does not correctly correspond to any specific category of oriental medicine. But, accoring to previous reports, it can be controlled by herb medications used differently patients-to-patients. So we are to report this one SLE case being successfully controlled by classic corticosteroids with herb medications based on oriental diffrential diagnosis of symptoms and signs.

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DRESS syndrome with acute interstitial nephritis caused by quinolone and non-steroidal anti-inflammatory drugs (퀴놀론과 비스테로이드소염제 투여 후 발생한 급성 간질성 신염이 동반된 DRESS 증후군)

  • Kim, Soo Jin;Nam, Young-Hee;Juong, Ji Young;Kim, Eun Young;Lee, Su Mi;Son, Young Ki;Nam, Hee-Joo;Kim, Ki-Ho;Lee, Soo-Keol
    • Journal of Yeungnam Medical Science
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    • v.33 no.1
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    • pp.59-63
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    • 2016
  • Drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome is a rare and severe drug-induced hypersensitivity syndrome characterized by hematological abnormalities and multiorgan involvement. Liver involvement is the most common visceral manifestation. However, renal failure has been rarely described. The common culprit drugs are anticonvulsants and allopurinol. We experienced a patient with DRESS syndrome with acute interstitial nephritis caused by concomitant administration of quinolone and non-steroidal anti-inflammatory drugs (NSAIDs). A 41-year-old man presented with a diffuse erythematous rash and fever which developed after administration of quinolone and NSAIDs for a month due to prostatitis. He was diagnosed with DRESS syndrome. Skin rash, fever, eosinophilia, and elevations of liver enzymes improved with conservative treatment and discontinuation of the causative drugs. However, deterioration of his renal function occurred on day 8 of admission. The levels of blood urea nitrogen and serum creatinine increased and oliguria, proteinuria and urinary eosinophils were observed. Ultrasonography showed diffuse renal enlargement. The clinical features were compatible with acute interstitial nephritis. Despite intravenous rehydration and diuretics, renal function did not improve. After hemodialysis, his renal function recovered completely within 2 weeks without administration of systemic corticosteroid.

Effects of Permeation of Thioglycolic Acid with Hair Permanent Wave (두발용 퍼머 약제인 Thioglycolic Acid의 투과 영향)

  • Kim, Yong-Ryul;Yoon, Cheol-Hun;Hwang, Sung-Kwy
    • Journal of the Korean Applied Science and Technology
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    • v.19 no.1
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    • pp.19-24
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    • 2002
  • It is a great role that the character of man or woman could be distinguished by hair on the aspect of ornament. Hair will be support of beautifulness of human being in various permanent wave by many kinds of its drugs. Hair is based upon the skin which enroll the body of high living animals and have multiple membrane structure. This study used rat and the effects of commercial permanent wave products to skin which are composed with thioglycolic acid and bases. Results are as follows. Permanent wave penetrated to 4 hours later with steady state in skins and was not significant changeable after 20hr later. In case of neutralizer with thioglycolic acid lag time and permeability coefficient in healthy skin is 3.38hr and $0.094^{\mu}g/cm^{2}$ ${\cdot}$ hr, it old skin is 3.48hr and 0.129$^{\mu}g/cm^{2}$ ${\cdot}$ hr, and it wounded skin is 4.72hr and $0.158^{\mu}g/cm^{2}$ ${\cdot}$ hr. In conclusion, lag time and permeability coefficient in old skin and wounded skin are faster than healthy skin. In vivo which was studied by general time and method of permanent wave. We notified that fine rinkle and rash of skin were changeable in the case of treating with permanent wave drugs than normal skin. We can see even rash and eruption by the naked eye.

Adverse Drug Reactions of Dextran 40 Treated to the Cerebral Infarction Patients (뇌경색 환자에게 사용된 덱스트란 40의 부작용 분석)

  • Kim, Jae-Hyeon
    • The Journal of the Korea Contents Association
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    • v.16 no.9
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    • pp.473-481
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    • 2016
  • Adverse drug reactions(ADRs) were caused by dexran 40 in patient with ischemic stroke and related 22 patients reported to formal ADRs at Jesus Hospital in Jeonju. This study was aimed to search ADRs related factors, type and the degree associated with dextran 40. Adverse Effects of Dextran 40 is including marked hypotension, nausea, dyspnea, generalized urticaria, fever and pulmonary edema. The average hospitalization period was 20 days and it was extended 26.8%. ADRs of Dextran 40 to incidence is 12.4%, and 9 persons(28.1%), itching, rash was 7 people (21.9%). Dextran induced ADRs reaction may be reported on early injection period and first time shot, but adverse drug reactions occurred after 4 days in 4 patients(18.2%). US FDA has recommanded that Dextran 1 significantly reduces the incidence of severe ADRs in USA. Because low molecular weighted dextran 1 prevented dextran molecules from combined Ig G completely. In Korea. Generally not yet introduced dextran 1, active use dextran 1 is able to be a good way in order to reduce ADRs of dextran 40.

A Case of Delayed Severe Hypersensitivity Reaction during $Genexol-PM^{(R)}$ Infusion (Genexol-$PM^{(R)}$ 항암치료 중 발생한 지연성 중증 과민성반응 1예)

  • Kim, Hyun-Kyung;Kim, Su-Woo;Kang, Hye-Won;Kwon, Kyoung-Joo;Park, Hye-Sung;Ryu, Yon-Ju;Lee, Jin-Hwa;Chun, Eun-Mi;Cho, Young-Joo;Chang, Jung-Hyun
    • Tuberculosis and Respiratory Diseases
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    • v.68 no.5
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    • pp.294-297
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    • 2010
  • Although $Taxo^{(R)}$ is one of the most successful drugs in current cancer chemotherapy against solid tumors, a major problem is hypersensitivity reactions that arises as a consequence of activation of the complement (C) system, "C activation-related pseudo-allergy". Most severe hypersenstivity reactions occur within the first few minutes of $Taxo^{(R)}$ administration, usually after the first or second dose. Here we report a case of a severe hypersensitivity reaction in a 72-year-old man undergoing $Genexol-PM^{(R)}$ infusion. Hypotension and polymorphic pruritic skin rash appeared 2 hours after the start of $Genexol-PM^{(R)}$ infusion (with an appropriate premedication). Treating with methylprednisolone, epinephrine and inotropic agents, reduced the hypotension and the skin rash disappeared. We report this case with a review of the literature.

A Case of Adult onset Henoch-Sch$\ddot{o}$nlein Purpura with Acute Renal Failure (급성 신부전을 동반한 성인 Henoch-Sch$\ddot{o}$nlein 자반증 1예)

  • Kim, Seok-Min;Chang, Kyung-Ae;Jung, Sun-Young;Park, Chan-Soh;Park, Jong-Won;Do, Jun-Young;Kim, Yong-Jin;Yoon, Kyung-Woo
    • Journal of Yeungnam Medical Science
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    • v.25 no.1
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    • pp.58-63
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    • 2008
  • Henoch-Sch$\ddot{o}$nlein purpura (HSP) is a leukocytoclastic vasculitis of small vessels with deposition of IgA, commonly resulting in skin, joint, gastrointestinal, and kidney involvement. HSP is an uncommon disorder in adults and accounts for 0.6% to 2% of adult nephropathy. We report a case of HSP with acute renal failure successfully treated with corticosteroid. In this case, the patient presented with vasculitic purpuric rash on lower extremity, arthralgia in the wrist, abdominal pain, hematochezia, oliguria and azotemia. Abdominal CT showed wall thickening of the small and large bowels. Skin biopsy revealed leukocytoclastic vasculitis. Percutaneous renal biopsy showed no crescent formation, but mesangial IgA and $C_3$ deposits were observed by immunofluorescence. The patient was treated with corticosteroid (1mg/kg per day) and hemodialysis. After treatment, renal function improved and purpuric lesion, arthralgia and abdominal pain disappeared. Thus, when adults present with purpuric rash and rapidly progressive glomerulonephritis (RPGN), HSP should be a diagnostic consideration.

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Treatment of refractory IgA vasculitis with dapsone: a systematic review

  • Lee, Keum Hwa;Hong, Sung Hwi;Jun, Jinhae;Jo, Youngheun;Jo, Woogyeong;Choi, Dayeon;Joo, Jeongho;Jung, Guhyun;Ahn, Sunghee;Kronbichler, Andreas;Eisenhut, Michael;Shin, Jae Il
    • Clinical and Experimental Pediatrics
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    • v.63 no.5
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    • pp.158-163
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    • 2020
  • IgA vasculitis, formerly known as Henoch-Schönlein purpura, is a systemic IgA-mediated vasculitis of the small vessels commonly seen in children. The natural history of IgA vasculitis is generally self-limiting; however, one-third of patients experience symptom recurrence and a refractory course. This systematic review examined the use of dapsone in refractory IgA vasculitis cases. A literature search of PubMed databases retrieved 13 articles published until June 14, 2018. The most common clinical feature was a palpable rash (100% of patients), followed by joint pain (69.2%). Treatment response within 1-2 days was observed in 6 of 26 patients (23.1%) versus within 3-7 days in 17 patients (65.4%). Relapse after treatment discontinuation was reported in 17 patients (65.4%) but not in 3 patients (11.5 %). Four of the 26 patients (15.4%) reported adverse effects of dapsone including arthralgia (7.7%), rash (7.7%), and dapsone hypersensitivity syndrome (3.8%). Our findings suggest that dapsone may affect refractory IgA vasculitis. Multicenter randomized placebo-controlled trials are necessary to determine the standard dosage of dapsone at initial or tapering of treatment in IgA vasculitis patients and evaluate whether dapsone has a significant benefit versus steroids or other medications.

The Comprehension of Herpes Zoster and The Approach of Physical Therapy (대상포진 질환에 대한 이해와 물리치료적 접근)

  • Han, Jin-Tae;Choi, Young-Won;Lee, Youn-Koung;Yuk, Goon-Chang;Kweon, Oh-Hyun
    • Journal of the Korean Society of Physical Medicine
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    • v.2 no.2
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    • pp.205-212
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    • 2007
  • Purpose : Herpes zoster is a common dermatologic disorder and is caused by reactivation of varicella zoster virus lying dormant in the ganglion of the dorsal root Methods : The aim of this study is to elucidate the clinical characteristics of herpes zoster and it's nature of pain, and is to review the method of physical therapy for pain control. Results : Herpes zoster is characterized by segmental rash, pain, and sensory symptoms, For most patients skin healing and pain resolution occur within 3-4 weeks, However, pain can continue after the rash has healed. Pain and paresthesia often the eruption of herpes zoster and vary from itching to stabbing. The preeruptive pain may simulate other diseases and may lead to misdiagnosis and misdirected interventions. Motor symptomatology is less well known and is most often related to central nervous system disease, although true lower motor neuron application is also thought to exist Subclinical motor involvement is relatively more common than clinical motor weakness and is easily detected by using electromyography. Higher incidences of herpes zoster were observed in female and in the elderly. Conclusion : The nature of pain associated with herpes zoster varied from a superficial itching to server stabbing or bursting, and paresthesia occurred most frequently. Therefore, the study of herpes zoster will be more research and comprehend, and the approach of physical therapy should be need positively.

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