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Genome-wide association study of Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis in Europe

Emmanuelle Génin12*, Martin Schumacher3, Jean-Claude Roujeau45, Luigi Naldi6, Yvonne Liss7, Rémi Kazma12, Peggy Sekula3, Alain Hovnanian1089 and Maja Mockenhaupt7

Author Affiliations

1 Inserm U946, F-75010, Paris, France

2 Institut Universitaire d'Hématologie, Université Paris Diderot, F-75010, Paris, France

3 Institute of Medical Biometry and Medical Informatics, University Medical Center, D-79095Freiburg, Germany

4 Inserm U448, F-94010, Créteil, France

5 Service Dermatologie, Hôpital Henri-Mondor, Université Paris-Est, F-94010, Créteil, France

6 Department of Dermatology, Azienda Ospedaleria Ospedali Riuniti di Bergamo, Milano University, Bergamo, Italy

7 Dokumentationszentrum schwerer Hautreaktionen (dZh), Department of Dermatology, D-79095, Freiburg, Germany

8 INSERM U781, F-75743, Paris, France

9 Université René Descartes, F-75743, Paris, France

10 Centre Hospitalier Universitaire Necker-Enfants malades, Departments of Genetics and Dermatology, F-75743, Paris, France

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Orphanet Journal of Rare Diseases 2011, 6:52  doi:10.1186/1750-1172-6-52

Published: 29 July 2011



Stevens-Johnson syndrome (SJS) and Toxic Epidermal Necrolysis (TEN) are rare but extremely severe cutaneous adverse drug reactions in which drug-specific associations with HLA-B alleles were described.


To investigate genetic association at a genome-wide level on a large sample of SJS/TEN patients.


We performed a genome wide association study on a sample of 424 European cases and 1,881 controls selected from a Reference Control Panel.


Six SNPs located in the HLA region showed significant evidence for association (OR range: 1.53-1.74). The haplotype formed by their risk allele was more associated with the disease than any of the single SNPs and was even much stronger in patients exposed to allopurinol (ORallopurinol = 7.77, 95%CI = [4.66; 12.98]). The associated haplotype is in linkage disequilibrium with the HLA-B*5801 allele known to be associated with allopurinol induced SJS/TEN in Asian populations.


The involvement of genetic variants located in the HLA region in SJS/TEN is confirmed in European samples, but no other locus reaches genome-wide statistical significance in this sample that is also the largest one collected so far. If some loci outside HLA play a role in SJS/TEN, their effect is thus likely to be very small.