{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,1]],"date-time":"2025-12-01T01:32:06Z","timestamp":1764552726687,"version":"3.46.0"},"reference-count":17,"publisher":"Korean Pediatric Society","issue":"12","license":[{"start":{"date-parts":[[2025,10,2]],"date-time":"2025-10-02T00:00:00Z","timestamp":1759363200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100013238","name":"Faculty of Medicine Siriraj Hospital, Mahidol University","doi-asserted-by":"publisher","award":["R016732020"],"award-info":[{"award-number":["R016732020"]}],"id":[{"id":"10.13039\/501100013238","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["e-cep.org"],"crossmark-restriction":true},"short-container-title":["Clin Exp Pediatr"],"published-print":{"date-parts":[[2025,12,15]]},"abstract":"<jats:p>Background: Allopurinol is widely used to prevent hyperuricemia in patients with tumor lysis syndrome. However, its use can trigger severe cutaneous adverse reactions (SCARs) with a mortality rate of approximately 11.39%. The human leukocyte antigen (HLA)\u2013B*58:01 genotype is a major risk factor for SCARs. Although most studies to date have examined HLA\u2013B*58:01 in Thai adults, data on pediatric patients are limited.Purpose: Here we aimed to evaluate the association between HLA-B*58:01 and skin reactions in children with hematological or oncological diagnoses receiving allopurinol and determine its prevalence in this population.Methods: Pediatric patients (age\u226418 years) with hematological or oncological diseases who received allopurinol were enrolled in this cross-sectional study of previously exposed and newly prescribed cases. HLA-B*58:01 genotyping was performed to assess its association with skin reactions.Results: A total of 108 patients (mean age, 9.3 years) were included. Most patients (n=93, 86.1%) received allopurinol as prophylaxis for tumor lysis syndrome. Of them, 75 (69.4%) received allopurinol concomitantly with chemotherapy for malignancies, whereas the remaining patients received allopurinol during conditioning for hematopoietic stem cell transplantation. The prevalence of HLA\u2013B*58:01 positivity was 17.6% (n=19 of 108 patients). The median exposure duration was 5 days (range, 1-19 days). No HLA\u2013B*58:01\u2013positive patients experienced a skin reaction. However, one patient who tested negative for HLA-B*58:01 developed a maculopapular rash on day 2 of the allopurinol therapy and required intravenous antihistamines.Conclusion: Short-duration allopurinol exposure likely mitigates the risk of SCARs regardless of HLA\u2013B*58:01 status. Routine HLA-B*58:01 testing may not be warranted in pediatric patients receiving brief allopurinol courses. However, larger studies are required to confirm these findings.<\/jats:p>","DOI":"10.3345\/cep.2025.01032","type":"journal-article","created":{"date-parts":[[2025,10,2]],"date-time":"2025-10-02T05:21:53Z","timestamp":1759382513000},"page":"974-980","update-policy":"https:\/\/doi.org\/10.3345\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["HLA\u2012B*58:01 and skin reactions in pediatric hematology and oncology patients treated with allopurinol"],"prefix":"10.3345","volume":"68","author":[{"ORCID":"https:\/\/orcid.org\/0009-0008-7904-3121","authenticated-orcid":true,"given":"Parisa","family":"Maneechai","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-4962-8418","authenticated-orcid":true,"given":"Cholada","family":"Ratanatharathron","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5240-1071","authenticated-orcid":true,"given":"Jassada","family":"Buaboonam","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3452-1894","authenticated-orcid":true,"given":"Kleebsabai","family":"Sanpakit","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1897","reference":[{"key":"ref1","doi-asserted-by":"publisher","DOI":"10.1097\/fpc.0b013e328330a3b8"},{"key":"ref2","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2350-12-118"},{"key":"ref3","doi-asserted-by":"publisher","DOI":"10.3389\/fphar.2016.00186"},{"key":"ref4","doi-asserted-by":"publisher","DOI":"10.1097\/fpc.0000000000000285"},{"key":"ref5","doi-asserted-by":"publisher","DOI":"10.1001\/jamainternmed.2015.3536"},{"key":"ref6","doi-asserted-by":"publisher","DOI":"10.1073\/pnas.0409500102"},{"key":"ref7","doi-asserted-by":"publisher","DOI":"10.1186\/s13075-020-02273-1"},{"key":"ref8","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0094294"},{"key":"ref9","doi-asserted-by":"publisher","DOI":"10.1111\/j.1399-0039.2010.01448.x"},{"key":"ref10","doi-asserted-by":"publisher","DOI":"10.1016\/j.dmpk.2021.100399"},{"key":"ref11","doi-asserted-by":"publisher","DOI":"10.56808\/3027-7922.2967"},{"volume-title":"","key":"ref12"},{"volume-title":"","key":"ref13"},{"key":"ref14","doi-asserted-by":"publisher","DOI":"10.1056\/nejm199512143332404"},{"key":"ref15","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaad.2007.08.036"},{"key":"ref16","doi-asserted-by":"publisher","DOI":"10.1136\/ard.40.3.245"},{"volume-title":"Hyperuricemia [Internet]","author":"George","key":"ref17"}],"container-title":["Clinical and Experimental Pediatrics"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/e-cep.org\/upload\/pdf\/cep-2025-01032.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/e-cep.org\/journal\/view.php?doi=10.3345\/cep.2025.01032","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/e-cep.org\/upload\/pdf\/cep-2025-01032.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,1]],"date-time":"2025-12-01T01:30:36Z","timestamp":1764552636000},"score":1,"resource":{"primary":{"URL":"http:\/\/e-cep.org\/journal\/view.php?doi=10.3345\/cep.2025.01032"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,12,15]]},"references-count":17,"journal-issue":{"issue":"12","published-print":{"date-parts":[[2025,12]]}},"URL":"https:\/\/doi.org\/10.3345\/cep.2025.01032","relation":{},"ISSN":["2713-4148"],"issn-type":[{"type":"electronic","value":"2713-4148"}],"subject":[],"published":{"date-parts":[[2025,12,15]]},"assertion":[{"value":"2025-05-07","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-07-21","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-10-02","order":2,"name":"published","label":"Published online","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-12-15","order":3,"name":"published","label":"Print publication","group":{"name":"publication_history","label":"Publication History"}}]}}