allopurinol and Oliguria

The association of oliguria with hyperuricosuria is often overlooked. Herein, we report an infant who since the age of five months had recurrent oliguria secondary to hyperuricosuria documented several times in the hospital. The decreased urine output coincided with the presence of increased excretion of uric acid, which fluctuated within 24 hours as well as every few weeks. The child responded to treatment with increase in the fluid fluid intake along with the xanthine oxidase inhibitor, allopurinol. Being alert for hyperuricosuria in cases of oliguria, especially if there is history of gout or stones, may avoid performing many unnecessary investigations.

Topics: Alkyl and Aryl Transferases; Allopurinol; Child, Preschool; Female; Humans; Oliguria; Treatment Outcome; Uric Acid; Urologic Diseases

A 62-year-old male was sent to the emergency room due to a high fever and generalized skin rash after taking allopurinol for 9 days. Physical examination was normal except for the generalized skin rash presenting with erythematous macules. Complete blood count showed leukocytosis with eosinophilia. Blood biochemistry showed impaired renal and hepatic function. Pathologic examination concluded that the skin rash was erythema multiforme. These findings met the diagnostic criteria for allopurinol-induced hypersensitivity syndrome (AHS). Our patient not only had the most common skin lesion but soon developed acute renal failure that required intermittent hemodialysis, despite rapid discontinuation of allopurinol and adequate hydration and steroid therapy. No other causes of acute renal failure were found. Renal impairment was the worst part of the patient's condition and he never completely recovered. AHS should be considered in the differential diagnosis of acute renal and hepatic failure in patients with evidence of allergy and recent use of allopurinol.

Topics: Acute Kidney Injury; Allopurinol; Antimetabolites; Drug Hypersensitivity; Exanthema; Humans; Hyperuricemia; Male; Middle Aged; Oliguria; Renal Dialysis; Steroids; Treatment Outcome

A patient with acute oliguric uric acid nephropathy was treated with hemodialysis. Recovery in this disorder is based on treatment of both the uremic state and the intrarenal crystal obstruction. Hemodialysis with high uric acid clearance is much more efficient than other forms of therapy in this disorder.

Topics: Abdominal Neoplasms; Acute Kidney Injury; Allopurinol; Child; Cyclophosphamide; Humans; Lymphoma, Non-Hodgkin; Male; Oliguria; Prednisone; Renal Dialysis; Uric Acid; Vincristine