HLA B*58:01, Allopurinol Hypersensitivity

CPT: 81381
Updated on 10/20/2019
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Synonyms

  • Allopurinol Hypersensitivity
  • B58
  • B5801
  • HLA B*58:01
  • HLA B58

Special Instructions

If you have questions, please telephone 800-533-1037 (HLA customer service) for assistance in selecting the proper HLA test for the patient.


Expected Turnaround Time

3 - 7 days



Related Documents


Specimen Requirements


Specimen

Whole blood or buccal swabs


Volume

7 mL whole blood or 4 buccal swabs


Minimum Volume

7 mL whole blood or four (4) buccal swabs


Container

Lavender-top (EDTA) tube or four buccal swabs in a sealed envelope (buccal swab kit). When submitting buccal swabs, please use a buccal swab kit provided by LabCorp. To obtain the buccal kit, please telephone 800-533-1037.


Storage Instructions

Maintain whole blood at room temperature or refrigerate. Keep buccal swabs dry and at room temperature.


Causes for Rejection

Hemolysis; clotted specimen; insufficient volume of DNA


Test Details


Use

Allopurinol associated SCAR (severe cutaneous adverse drug reaction) including Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) has been shown to be associated with the human leukocyte antigen (HLA) B*58:01 of the major histocompatibility complex (MHC). The MHC family of genes codes for a highly variable set of cell surface glycoproteins (HLAs) that play a critical role in presenting antigens to T-cell receptors to elicit an immune response. The presence of the HLA B*58:01 allele increases the susceptibility to allopurinol SCAR in several populations studied.


Limitations

This test was developed, and its performance characteristics determined, by LabCorp. It has not been cleared or approved by the US Food and Drug Administration (FDA).

Even with appropriate precautions, an occasional specimen may not be satisfactory for testing. In such cases, an additional specimen should be collected for retesting.


Methodology

Sequence-based typing (SBT), sequence-specific oligonucleotide probes (SSOP), and/or sequence-specific primers (SSP) as needed to obtain the required resolution.


References

Hershfield MS, Callaghan JT, Tassaneeyakul W, et al, Clinical Pharmacogenetics Implementation Consortium guidelines for human leukocyte antigen-B genotype and allopurinol dosing. Clin Pharmacol Ther. 2013 Feb, 93(2):153-158.23232549
Hung S, Chung W, Liou L, et al, HLA B*58:01 allele as a genetic marker for severe cutaneous adverse reactions caused by allopurinol. PNAS. 2005 Mar 15;102(11):4134-4139.15743917
Khanna E, Fitzgerald JD, Khanna PP, et al. 2012 American College of Rheumatology guidelines for management of gout. Part 1: systematic nonpharmacologic and pharmacologic therapeutic approaches to hyperuricemia. Arthritis Care Res (Hoboken). 2012 Oct;64(10):1431-1446.23024028
Tassaneeyakul W, Jantararoungtong T, Chen P, et al, Strong association between HLA B*58:01 and allopurinol induced Stevens-Johnson syndrome and toxic epidermal necrolysis in a Thai population. Pharmacogenet Genomics. 2009 Sep;19(9):704-709.19696695

LOINC® Map

Order Code Order Code Name Order Loinc Result Code Result Code Name UofM Result LOINC
167351 HLA B*58:01 167343 HLA-B 13299-3
167351 HLA B*58:01 167345 HLA-B 13299-3
167351 HLA B*58:01 167384 HLA Methodology 49549-9

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