Potential Pharmacogenomics (PGx), Human Leukocyte Antigen (HLA) Antiviral to Cephalosporin Crossover Reaction

Key Points

• To investigate whether an HLA-B*57:01 positive, abacavir sensitive individual can experience agranulocytosis as a cross reaction to cefepime.
• Case report of a 43-year-old male with HLA-B*57:01 positivity and a history of diabetes and osteomyelitis.
• Observation of symptoms following cefepime treatment, including agranulocytosis and thrombocytopenia.
• Substitution of cefepime with piperacillin-tazobactam leading to symptom resolution.
• The patient exhibited agranulocytosis and other symptoms after three weeks on cefepime.
• Symptoms resolved upon switching to piperacillin-tazobactam, indicating a potential reaction to cefepime.
• Further investigations are recommended to clarify the implications of HLA-B*57:01 positivity in drug reactions.

Abstract