Anaphylaxis due to bromovalerylurea

Abstract

which are caused by mutations resulting in activation of mTOR. 5 Thus, we speculate that vemurafenib-associated gingival hyperplasia may be related to increased activation of the PI3K-mTOR pathway that potentially occurs during the course of treatment. This hypothesis is supported by the observation of gingival hyperplasia occurring relatively later on during the treatment course when resistance is expected to emerge.Our report of the second case of gingival hyperplasia in association with vemurafenib further highlights the need to address oral symptoms while evaluating the patients treated with BRAF inhibitors.The most interesting observation is that, although BU has been used worldwide, all nine eruption cases were discovered in Japan. Recently, the relationships between genetic background and immediate type allergic reaction or aspirin intolerance has attracted considerable attention. 2-4 For example, gene variants of human leukocyte antigen (HLA)-DRA and the HLA-DRA-HLA-DRB5 interregion has been observed in penicillin-induced immediate allergic reaction by genome-wide association study. 2 Whereas, in the case of aspirin-intolerant urticaria, HLA-DB1*0609 has been identified as a possible genetic marker. 4 According to these observations, which suggest that certain HLA alleles could be genetic markers for certain immediate type drug eruptions, it is possible to speculate that genetic differences may contribute to a distinctive BU hypersensitivity rate. Further investigations would be needed to determine whether this speculation is accurate.