Genetic determinants of antithyroid drug-induced agranulocytosis by human leukocyte antigen genotyping and genome-wide association study

PL Chen, SR Shih, PW Wang, YC Lin, CC Chu… - Nature …, 2015 - nature.com
PL Chen, SR Shih, PW Wang, YC Lin, CC Chu, JH Lin, SC Chen, CC Chang, TS Huang…
Nature communications, 2015nature.com
Graves' disease is the leading cause of hyperthyroidism affecting 1.0–1.6% of the
population. Antithyroid drugs are the treatment cornerstone, but may cause life-threatening
agranulocytosis. Here we conduct a two-stage association study on two separate subject
sets (in total 42 agranulocytosis cases and 1,208 Graves' disease controls), using direct
human leukocyte antigen genotyping and SNP-based genome-wide association study. We
demonstrate HLA-B* 38: 02 (Armitage trend P combined= 6.75× 10− 32) and HLA-DRB1 …
Abstract
Graves’ disease is the leading cause of hyperthyroidism affecting 1.0–1.6% of the population. Antithyroid drugs are the treatment cornerstone, but may cause life-threatening agranulocytosis. Here we conduct a two-stage association study on two separate subject sets (in total 42 agranulocytosis cases and 1,208 Graves’ disease controls), using direct human leukocyte antigen genotyping and SNP-based genome-wide association study. We demonstrate HLA-B*38:02 (Armitage trend Pcombined=6.75 × 10−32) and HLA-DRB1*08:03 (Pcombined=1.83 × 10−9) as independent susceptibility loci. The genome-wide association study identifies the same signals. Estimated odds ratios for these two loci comparing effective allele carriers to non-carriers are 21.48 (95% confidence interval=11.13–41.48) and 6.13 (95% confidence interval=3.28–11.46), respectively. Carrying both HLA-B*38:02 and HLA-DRB1*08:03 increases odds ratio to 48.41 (Pcombined=3.32 × 10−21, 95% confidence interval=21.66–108.22). Our results could be useful for antithyroid-induced agranulocytosis and potentially for agranulocytosis caused by other chemicals.
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