Stevens-Johnson syndrome and toxic epidermal necrolysis induced by methazolamide: a systematic review_Chinese Journal of Evidence-Based Medicine

Authors：

LIU Shangke ¹ , YANG Zhibo ² , GU Qiumei ³ ,  CHEN Zhengju ² , CHEN Lei ²

1. School of Medicine UESTC, Chengdu 610054, P. R. China;
2. West China Hospital of Sichuan University, Chengdu 610041, P. R. China;
3. Eye School of Chengdu University of TCM, Chengdu 610075, P. R. China;

Corresponding author：

CHEN Zhengju, Email: chenzhengju@wchscu.cn

Keywords：

Methazolamide; Stevens-Johnson syndrome; Toxic epidermal necrolysis; HLA gene

DOI：

10.7507/1672-2531.202111081

Video：

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Objective To summarize the genotypes associated with Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) induced by methazolamide and to provide references for the diagnosis and treatment of SJS and TEN induced by methazolamide. Methods Databases including PubMed, EMbase, CNKI, and WanFang Data were electronically searched from database inception to September 2021. Two reviewers independently screened literature and extracted data, and then a systematic review was performed. Results A total of 18 studies involving 49 patients were included. HLA genetic testing was performed on 37 patients. HLA-B*59:01 was detected in 27 patients, HLA-C*01:02 was detected in 15 patients, and 14 patients carried both genes. Statistical analysis showed that the positive rate of HLA-B*59:01 was 73% (95% CI 0.58 to 0.88) and that of HLA-C*01:02 was 40.5% (95%CI 0.24 to 0.57). The latent time until the symptoms were observed was 14.08 ± 8.77 days, and the mean dosage of methazolamide administered was 88.95±39.45 mg/d. Glucocorticoid and immunoglobulin were the main treatments prescribed. Conclusion Methazolamide can cause SJS and TEN. As the presence of HLA-B*59:01 or HLA-C*01:02 has been reported as a genetic risk factor for these adverse drug reactions, the implementation of genetic screening can effectively reduce their occurrence. Glucocorticoid and immunoglobulin, anti-infectives, should be administered to control the symptoms.

Citation： LIU Shangke, YANG Zhibo, GU Qiumei, CHEN Zhengju, CHEN Lei. Stevens-Johnson syndrome and toxic epidermal necrolysis induced by methazolamide: a systematic review. Chinese Journal of Evidence-Based Medicine, 2022, 22(3): 345-350. doi: 10.7507/1672-2531.202111081 Copy

1.	Tangamornsuksan W, Lohitnavy M. Association between HLA-B*5901 and methazolamide-induced Stevens-Johnson syndrome/toxic epidermal necrolysis: a systematic review and meta-analysis. Pharmacogenomics J, 2019, 19(3): 286-294.
2.	董娟, 李冬芹, 尹光文. 醋甲唑胺致重症药疹2例. 中国皮肤性病学杂志, 2020, 34(12): 1465-1466.
3.	杨梦瑶, 韩秀萍. 药物致儿童Stevens-Johnson综合征1例. 中国皮肤性病学杂志, 2021, 35(8): 954-956.
4.	平晓芳, 卢桂玲. 重症多形红斑型药疹52例和中毒性表皮坏死松解症31例回顾性分析. 中国皮肤性病学杂志, 2013, 27(2): 46-48.
5.	Yang F, Xuan J, Chen J, et al. HLA-B*59: 01: a marker for Stevens-Johnson syndrome/toxic epidermal necrolysis caused by methazolamide in Han Chinese. Pharmacogenomics J, 2016, 16(1): 83-87.
6.	Kim SH, Kim M, Lee KW, et al. HLA-B*5901 is strongly associated with methazolamide-induced Stevens-Johnson syndrome/toxic epidermal necrolysis. Pharmacogenomics, 2010, 11(6): 879-884.
7.	Sohn KH, Kim SH, Kang HR. Cross-reactivity between carbonic anhydrase inhibitor cofirmed by lymphocyte transformation test: a case of methazolamide-induced toxic epidermal necrolysis. J Investig Allergol Clin Immunol, 2021, 31(5): 455-456.
8.	Gao Y, Liu W, Zhu C, et al. Successful treatment of methazolamide-induced toxic epidermal necrolysis in a Han Chinese patient with HLA-B59: 01 and HLA-Cw01: 02. Dermatologic Therapy, 2020, 33(6): e13862.
9.	Shi L, Li M, Zhang F, et al. A rare case of topical methazolamide ophthalmic solution causing death due to toxic epidermal necrolysis. Clin Exp Dermatol, 2018, 43(3): 326-327.
10.	Jiang YY, Nguyen GH, Jin HZ, et al. Methazolamide-induced toxic epidermal necrolysis in a man carrying HLA-B*59: 01: successful treatment with infliximab and glucocorticoid. Int J Dermatol, 2018, 57(4): 494-496.
11.	张蕊. 醋甲唑胺片致重症多形红斑型药疹1例. 大家健康(学术版), 2016, 10(18): 153.
12.	Shu C, Shu D, Tie D, et al. Toxic epidermal necrolysis induced by methazolamide in a Chinese-Korean man carrying HLA-B*59: 01. Int J Dermatol, 2015, 54(11): 1242-1245.
13.	徐永豪, 苏英. 醋甲唑胺致HLA-B5901阳性患者中毒性表皮坏死松解症一例. 中华皮肤科杂志, 2015, 48(2): 131-133.
14.	周晨霞, 陈川, 支敏, 等. 醋甲唑胺片致Stevens-Johnson综合征1例. 中国药物警戒, 2014, 11(12): 762-763.
15.	吴苗琴, 余洁, 郦晓霞. 玻璃体切除术后高眼压服用醋甲唑胺致中毒性表皮坏死松解症2例. 2014浙江省眼科学术年会论文汇编, 2014.
16.	朱磊, 巫毅. 醋甲唑胺导致重症药疹1例. 中国麻风皮肤病杂志, 2013, 29(11): 730-731.
17.	闫成, 薛洪源, 蔡长春. 醋甲唑胺片致Stevens-Johnson综合征. 中国药物应用与监测, 2012, 9(3): 179-181.
18.	陈积愫. 醋甲唑胺至重症多形红斑样药疹2例. 2011年浙江省皮肤病学学术会议论文汇编, 2011.
19.	Flach AJ, Smith RE, Fraunfelder FT. Stevens-Johnson syndrome associated with methazolamide treatment reported in two Japanese-American women. Ophthalmology, 1995, 102(11): 1677-1680.
20.	Shirato S, Kagaya F, Suzuki Y, et al. Stevens-Johnson syndrome induced by methazolamide treatment. Arch Ophthalmol, 1997, 115(4): 550-553.
21.	古秋梅, 范家明, 陈正举, 等. 醋甲唑胺片致中毒性表皮坏死松解症1例. 中华实验眼科杂志, 2022.
22.	中华医学会皮肤性病学分会药物不良反应研究中心. Stevens-Johnson综合征/中毒性表皮坏死松解症诊疗专家共识. 中华皮肤科杂志, 2021, 54(5): 376-381.
23.	郭俊荣, 刘曼. 124例药源性中毒性表皮坏死松解症不良反应病例分析. 中国药物应用与监测, 2020, 17(5): 329-332.
24.	闫成, 蔡长春, 薛洪源. 醋甲唑胺致Stevens-Johnson综合征及中毒性表皮坏死溶解症文献分析. 医药导报, 2013, 32(2): 269-272.
25.	Lerch M, Mainetti C, Terziroli Beretta-Piccoli B, et al. Current perspectives on Stevens-Johnson syndrome and toxic epidermal necrolysis. Clin Rev Allergy Immunol, 2018, 54(1): 147-176.
26.	Mockenhaupt M, Viboud C, Dunant A, et al. Stevens-Johnson syndrome and toxic epidermal necrolysis: assessment of medication risks with emphasis on recently marketed drugs. The EuroSCAR-study. J Invest Dermatol, 2008, 128(1): 35-44.
27.	Albanidou-Farmaki E, Deligiannidis A, Markopoulos AK, et al. HLA haplotypes in recurrent aphthous stomatitis: a mode of inheritance. Int J Immunogenet, 2008, 35(6): 427-432.
28.	李健, 陶建军, 陆炯, 等. 口服醋甲唑胺诱发SJS/TEN重叠一例. 中华眼科杂志, 2015, 51(12): 934-935.
29.	廖玲玲. 醋甲唑胺致超敏反应1例. 海峡药学, 2020, 32(6): 225.
30.	李健, 邢茜, 陆炯, 等. 醋甲唑胺诱发Stevens-Johnson综合征和中毒性表皮坏死松解症分析. 中华眼外伤职业眼病杂志, 2018, 40(9): 708-711.
31.	陈娜娜, 张立明, 肖汀. Stevens-Johnson综合征的治疗及预后: 38例回顾性分析. 中国皮肤性病学杂志, 2016, 30(8): 796-798.
32.	张晓, 李冰, 王雷, 等. 注射用重组人Ⅱ型肿瘤坏死因子受体抗体融合蛋白联合甲泼尼龙治疗中毒性表皮坏死松解症5例. 中国皮肤性病学杂志, 2020, 34(9): 1018-1022.

1. Tangamornsuksan W, Lohitnavy M. Association between HLA-B*5901 and methazolamide-induced Stevens-Johnson syndrome/toxic epidermal necrolysis: a systematic review and meta-analysis. Pharmacogenomics J, 2019, 19(3): 286-294.
2. 董娟, 李冬芹, 尹光文. 醋甲唑胺致重症药疹2例. 中国皮肤性病学杂志, 2020, 34(12): 1465-1466.
3. 杨梦瑶, 韩秀萍. 药物致儿童Stevens-Johnson综合征1例. 中国皮肤性病学杂志, 2021, 35(8): 954-956.
4. 平晓芳, 卢桂玲. 重症多形红斑型药疹52例和中毒性表皮坏死松解症31例回顾性分析. 中国皮肤性病学杂志, 2013, 27(2): 46-48.
5. Yang F, Xuan J, Chen J, et al. HLA-B*59: 01: a marker for Stevens-Johnson syndrome/toxic epidermal necrolysis caused by methazolamide in Han Chinese. Pharmacogenomics J, 2016, 16(1): 83-87.
6. Kim SH, Kim M, Lee KW, et al. HLA-B*5901 is strongly associated with methazolamide-induced Stevens-Johnson syndrome/toxic epidermal necrolysis. Pharmacogenomics, 2010, 11(6): 879-884.
7. Sohn KH, Kim SH, Kang HR. Cross-reactivity between carbonic anhydrase inhibitor cofirmed by lymphocyte transformation test: a case of methazolamide-induced toxic epidermal necrolysis. J Investig Allergol Clin Immunol, 2021, 31(5): 455-456.
8. Gao Y, Liu W, Zhu C, et al. Successful treatment of methazolamide-induced toxic epidermal necrolysis in a Han Chinese patient with HLA-B*59: 01 and HLA-Cw*01: 02. Dermatologic Therapy, 2020, 33(6): e13862.
9. Shi L, Li M, Zhang F, et al. A rare case of topical methazolamide ophthalmic solution causing death due to toxic epidermal necrolysis. Clin Exp Dermatol, 2018, 43(3): 326-327.
10. Jiang YY, Nguyen GH, Jin HZ, et al. Methazolamide-induced toxic epidermal necrolysis in a man carrying HLA-B*59: 01: successful treatment with infliximab and glucocorticoid. Int J Dermatol, 2018, 57(4): 494-496.
11. 张蕊. 醋甲唑胺片致重症多形红斑型药疹1例. 大家健康(学术版), 2016, 10(18): 153.
12. Shu C, Shu D, Tie D, et al. Toxic epidermal necrolysis induced by methazolamide in a Chinese-Korean man carrying HLA-B*59: 01. Int J Dermatol, 2015, 54(11): 1242-1245.
13. 徐永豪, 苏英. 醋甲唑胺致HLA-B5901阳性患者中毒性表皮坏死松解症一例. 中华皮肤科杂志, 2015, 48(2): 131-133.
14. 周晨霞, 陈川, 支敏, 等. 醋甲唑胺片致Stevens-Johnson综合征1例. 中国药物警戒, 2014, 11(12): 762-763.
15. 吴苗琴, 余洁, 郦晓霞. 玻璃体切除术后高眼压服用醋甲唑胺致中毒性表皮坏死松解症2例. 2014浙江省眼科学术年会论文汇编, 2014.
16. 朱磊, 巫毅. 醋甲唑胺导致重症药疹1例. 中国麻风皮肤病杂志, 2013, 29(11): 730-731.
17. 闫成, 薛洪源, 蔡长春. 醋甲唑胺片致Stevens-Johnson综合征. 中国药物应用与监测, 2012, 9(3): 179-181.
18. 陈积愫. 醋甲唑胺至重症多形红斑样药疹2例. 2011年浙江省皮肤病学学术会议论文汇编, 2011.
19. Flach AJ, Smith RE, Fraunfelder FT. Stevens-Johnson syndrome associated with methazolamide treatment reported in two Japanese-American women. Ophthalmology, 1995, 102(11): 1677-1680.
20. Shirato S, Kagaya F, Suzuki Y, et al. Stevens-Johnson syndrome induced by methazolamide treatment. Arch Ophthalmol, 1997, 115(4): 550-553.
21. 古秋梅, 范家明, 陈正举, 等. 醋甲唑胺片致中毒性表皮坏死松解症1例. 中华实验眼科杂志, 2022.
22. 中华医学会皮肤性病学分会药物不良反应研究中心. Stevens-Johnson综合征/中毒性表皮坏死松解症诊疗专家共识. 中华皮肤科杂志, 2021, 54(5): 376-381.
23. 郭俊荣, 刘曼. 124例药源性中毒性表皮坏死松解症不良反应病例分析. 中国药物应用与监测, 2020, 17(5): 329-332.
24. 闫成, 蔡长春, 薛洪源. 醋甲唑胺致Stevens-Johnson综合征及中毒性表皮坏死溶解症文献分析. 医药导报, 2013, 32(2): 269-272.
25. Lerch M, Mainetti C, Terziroli Beretta-Piccoli B, et al. Current perspectives on Stevens-Johnson syndrome and toxic epidermal necrolysis. Clin Rev Allergy Immunol, 2018, 54(1): 147-176.
26. Mockenhaupt M, Viboud C, Dunant A, et al. Stevens-Johnson syndrome and toxic epidermal necrolysis: assessment of medication risks with emphasis on recently marketed drugs. The EuroSCAR-study. J Invest Dermatol, 2008, 128(1): 35-44.
27. Albanidou-Farmaki E, Deligiannidis A, Markopoulos AK, et al. HLA haplotypes in recurrent aphthous stomatitis: a mode of inheritance. Int J Immunogenet, 2008, 35(6): 427-432.
28. 李健, 陶建军, 陆炯, 等. 口服醋甲唑胺诱发SJS/TEN重叠一例. 中华眼科杂志, 2015, 51(12): 934-935.
29. 廖玲玲. 醋甲唑胺致超敏反应1例. 海峡药学, 2020, 32(6): 225.
30. 李健, 邢茜, 陆炯, 等. 醋甲唑胺诱发Stevens-Johnson综合征和中毒性表皮坏死松解症分析. 中华眼外伤职业眼病杂志, 2018, 40(9): 708-711.
31. 陈娜娜, 张立明, 肖汀. Stevens-Johnson综合征的治疗及预后: 38例回顾性分析. 中国皮肤性病学杂志, 2016, 30(8): 796-798.
32. 张晓, 李冰, 王雷, 等. 注射用重组人Ⅱ型肿瘤坏死因子受体抗体融合蛋白联合甲泼尼龙治疗中毒性表皮坏死松解症5例. 中国皮肤性病学杂志, 2020, 34(9): 1018-1022.

Chinese Journal of Evidence-Based Medicine

Stevens-Johnson syndrome and toxic epidermal necrolysis induced by methazolamide: a systematic review

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