Allopurinol
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DRESS syndrome and fatal liver failure in an elderly patient: case report An 89-year-old woman developed DRESS (drug rash with eosinophilia and systemic symptoms) syndrome and later died of liver failure following treatment with allopurinol. The woman was treated with allopurinol [dosage, route and indication not stated] for 1 month before being hospitalised for syncope and a generalised rash that had started 1 week earlier. Dermatological examination revealed a diffuse morbilliform, blanchable, erythematous rash that was also present on the palms and soles. She also had anasarca with abdominal distension and scleral icterus. Laboratory investigations showed a WBC count of 14 000 U/L with 30% eosinophils, AST, ALT and ALP levels of 188, 234 and 1127 IU/L, respectively, total and direct bilirubin levels of 3.4 and 2.4 mg/dL, respectively, a creatinine level of 2.17 mg/dL and an INR of 8.6. She was diagnosed with allopurinol-induced DRESS syndrome. Allopurinol was discontinued and the woman was treated with prednisone without an improvement. She died from fulminant liver failure with an increasing INR. Kalasapudi B, et al. Acute Hepatic Failure Due to Allopurinol. 75th Annual Scientific Meeting of the American College of Gastroenterology : abstr. P199, 15 803042754 Oct 2010. Available from: URL: http://www.acg.gi.org - USA
0114-9954/10/1340-0001/$14.95 © 2010 Adis Data Information BV. All rights reserved
Reactions 26 Feb 2011 No. 1340
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