Toxic Epidermal Necrolysis Observed in a Patient With the HLA-B*1502 Treated With Levofloxacin

Clin Ther. 2024 Dec;46(12):1082-1085. doi: 10.1016/j.clinthera.2024.09.014. Epub 2024 Sep 30.

Abstract

Purpose: To determine the relationship between HLA-B gene mutations and levofloxacin-induced toxic epidermal necrolysis (TEN).

Methods: A 71-year-old Chinese woman developed TEN after oral administration of solifenacin (5 mg) and levofloxacin (0.5 g) for cystitis. HLA-B*5801 and HLA-B*1502 alleles were detected using real-time PCR.

Findings: After supportive therapy (antiallergic treatments, plasma exchange, etc) and withdrawal of the culprit medication levofloxacin, the patient was discharged with re-epithelialization of the exfoliated skin. The patient was HLA-B*1502 allele positive and HLA-B*5801 allele negative.

Implications: This is the first report of levofloxacin-induced TEN suspected to be caused by mutations in the HLA-B*1502 allele.

Keywords: HLA-B*1502; HLA-B*5801; Levofloxacin; Stevens–Johnson syndrome; Toxic epidermal necrolysis.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Alleles
  • Anti-Bacterial Agents / administration & dosage
  • Anti-Bacterial Agents / adverse effects
  • Cystitis / chemically induced
  • Cystitis / drug therapy
  • Cystitis / genetics
  • Female
  • HLA-B15 Antigen / genetics
  • Humans
  • Levofloxacin* / adverse effects
  • Mutation
  • Stevens-Johnson Syndrome* / drug therapy
  • Stevens-Johnson Syndrome* / etiology
  • Stevens-Johnson Syndrome* / genetics

Substances

  • Levofloxacin
  • Anti-Bacterial Agents
  • HLA-B*15:02 antigen
  • HLA-B15 Antigen