Allopurinol
- PDF / 170,220 Bytes
- 1 Pages / 595.245 x 841.846 pts (A4) Page_size
- 69 Downloads / 154 Views
1 S
Allopurinol DRESS syndrome, Stevens-Johnson syndrome and toxic epidermal necrolysis: 11 case reports
In a retrospective cohort of 367 patients treated between 2003 and 2017, 11 patients (five male and six female) aged 13–63 years were described, who developed DRESS syndrome, Stevens-Johnson syndrome (SJS) or toxic epidermal necrolysis (TEN) during treatment with allopurinol for asymptomatic hyperuricaemia or gout. One of these 11 patients died due to TEN [routes and duration of treatments to reactions onset not stated]. The patients, who had asymptomatic hyperuricaemia (10 patients) and gout (1 patient), had been receiving treatment with allopurinol 50–200 mg/day. All the patients were HLA-B*58:01 carriers. The patients had various underlying conditions including dilated cardiomyopathy, Becker muscular dystrophy, membranoproliferative glomerulonephritis, chronic kidney disease (CKD), lymphoma, Alport syndrome, diabetic nephropathy, hypertensive nephropathy, CKD due to reflux, IgA nephropathy, CKD due to chronic glomerulonephritis, autosomal dominant polycystic kidney disease or focal segmental glomerulosclerosis. Subsequently, the patients developed allopurinol-induced severe cutaneous adverse reactions (SCARs) including SJS with oral or genital involvement (2 patients), TEN with oral and conjunctival involvement (1 patient) and DRESS syndrome (8 patients). Systemic manifestations of SCARs included fever, azotaemia, liver function impairment, myalgia, skin detachment, abdominal pain, diarrhoea, leucocytosis, eosinophilia, maculopapular eruption, cervical lymphadenopathy, worsening renal function or atypical lymphocytes. Allopurinol was discontinued in all the patients, and the duration of allopurinol treatment was 17–73 days. Eventually, one of the 11 patients died due to TEN [not all outcomes stated]. Shim JS, et al. The Presence of HLA-B75, DR13 Homozygosity, or DR14 Additionally Increases the Risk of Allopurinol-Induced Severe Cutaneous Adverse Reactions in HLA-B*58:01 Carriers. The Journal of Allergy and Clinical Immunology in Practice 7: 1261-1270, No. 4, Apr 2019. Available from: URL: http://doi.org/10.1016/ j.jaip.2018.11.039 803498421
0114-9954/20/1819-0001/$14.95 Adis © 2020 Springer Nature Switzerland AG. All rights reserved
Reactions 29 Aug 2020 No. 1819
Data Loading...
