allopurinol and Syndrome

The Drug Reaction with Eosinophilia and Systemic Symptom (DRESS) is a severe adverse drug-induced reaction. Diagnosing DRESS is challenging due to the diversity of cutaneous eruption and organs involved. We used the RegiSCAR scoring system that grades DRESS cases as "no," "possible," "probable," or "definite" to classify cases reported in the literature. We also analyzed the clinical course and treatments of the cases. A total of 44 drugs were associated with the 172 cases reported between January 1997 and May 2009 in PubMed and MEDLINE. The most frequently reported drug was carbamazepine, and the vast majority of cases were classified as "probable/definite" DRESS cases. Hypereosinophilia, liver involvement, fever, and lymphadenopathy were significantly associated with "probable/definite" DRESS cases, whereas skin rash was described in almost all of the cases, including "possible cases." Culprit drug withdrawal and corticosteroids constituted the mainstay of DRESS treatment. The outcome was death in 9 cases. However, no predictive factors for serious cases were found. This better knowledge of DRESS may contribute to improve the diagnosis and management of this syndrome in clinical practice.

Topics: Adolescent; Adrenal Cortex Hormones; Adult; Aged; Aged, 80 and over; Allopurinol; Carbamazepine; Diagnosis, Differential; Drug Eruptions; Eosinophilia; Exanthema Subitum; Female; Fever; Herpesvirus 6, Human; Humans; Lymphatic Diseases; Male; Middle Aged; Syndrome; Treatment Outcome

DRESS syndrome (drug rash, eosinophilia and systemic symptoms) is an idiosyncratic drug reaction characterised by rash, fever, lymphadenopathy and internal organ involvement. The authors report a case of this syndrome presenting with fever, generalised pruritus, macular rash and cholestatic hepatitis during allopurinol treatment. This case resolved with drug withdrawal, but the death rate in the setting of hepatic failure can reach 10%. Rapid diagnosis is crucial as prompt withdrawal of the offending drug is the key of the treatment, while the potential role of corticosteroids remains controversial.

Topics: Aged, 80 and over; Allopurinol; Drug Eruptions; Eosinophilia; Female; Fever; Humans; Lymphatic Diseases; Syndrome

Topics: Allopurinol; Anticonvulsants; Carbamazepine; Drug Eruptions; Drug Hypersensitivity; Herpesvirus 6, Human; Humans; Solvents; Sulfasalazine; Syndrome; T-Lymphocytes; Trichloroethylene; Virus Activation

Hypersensitivity syndromes are severe drug induced side effects with skin rashes, fever and/or multiorgan-system abnormalities which are not pharmacologically related. They are well known in relation to allopurinol, anticonvulsants and sulfonamides, but only rarely described with other drugs. These reactions are considered to be immune-mediated but the precise mechanisms are not completely understood. Clinical features, which resemble an EBV infection, and some immunological studies suggest that T-cell mediated immunity is involved in the pathogenesis of this rare disease. In the literature, allopurinol and anticonvulsant hypersensitivity syndromes are clinically well characterized entities, while the definition of hypersensitivity syndrome elicited by other drugs is rather confusing. We present two patients, one with sulfamethoxazole- and one with allopurinol-induced hypersensitivity syndrome. In both cases a lymphocyte transformation test (LTT) was performed and we analyzed the T-cell activation parameters CD25 and HLA-DR on CD4- and CD8- T-cells to demonstrate in vivo activation of T-cells during the active disease. Both patients show increased activation of T-cells with elevated levels of HLA-DR on CD8+ cells. The T-cell activation correlated with the clinical course. Our data support an immunological pathogenesis for hypersensitivity syndromes and the concept that drug specific T-cells are involved in hypersensitivity syndromes.

Topics: Adult; Aged; Allopurinol; CD8 Antigens; Drug Eruptions; Drug Hypersensitivity; Female; HLA-DR Antigens; Humans; Lymphocyte Activation; Sulfamethoxazole; Syndrome; T-Lymphocytes

Allopurinol is a drug of wide clinical use and good tolerance. Some patients develop severe hypersensitivity due to immunologic reaction to the drug. A new case which fulfills all the diagnostic criteria of the syndrome of allopurinol hypersensitivity with associated clinical manifestations of multiple mononeuritis and evidence of granulomas and vasculitis in liver biopsy as the most significant data is reported. The syndrome was favorably resolved following withdrawal of the drug without need for corticoid therapy. The characteristics of the cases described in the Spanish literature over the last few years are globally reviewed. The absence of mortality is of note. The inconvenience of prescribing allopurinol to patients with asymptomatic hyperuricemia is emphasized.

Topics: Aged; Allopurinol; Chemical and Drug Induced Liver Injury; Drug Hypersensitivity; Granuloma; Humans; Liver Diseases; Male; Neuritis; Spain; Syndrome; Vasculitis

Topics: Adolescent; Adult; Allopurinol; Anti-Anxiety Agents; Antidepressive Agents; Antipsychotic Agents; Behavior Therapy; Child; Humans; Lesch-Nyhan Syndrome; Narcotic Antagonists; Psychotropic Drugs; Self Mutilation; Syndrome

Celsior solution (CS) is a high-sodium, low-potassium, low-viscosity extracellular solution that has been used for liver graft preservation in recent years, although experience with it is still limited. We performed an open-label randomized active-controlled trial comparing CS with the University of Wisconsin solution (UW) for liver transplantation (LT), with a follow-up period of 5 years.. Adult transplant recipients (n=102) were prospectively randomized to receive either CS (n=51) or UW (n=51). The two groups were comparable with respect to donor and recipient characteristics. The primary outcome measure was the incidence of postreperfusion syndrome (PRS). Secondary outcome measures included primary nonfunction (PNF) or primary dysfunction (PDF), liver retransplantation, and graft and patient survival. Other secondary outcome measures were days in the intensive care unit (ICU) and the rates of acute rejection, chronic rejection, infectious complications, postoperative reoperations, and vascular and biliary complications.. In all, 14 posttransplant variables revealed no significant differences between the groups. There were no cases of PNF or PDF. The incidence of PRS was 5.9% in the CS group and 21.6% in the UW group (P=0.041). After reperfusion, CS revealed greater control of serum potassium (P=0.015), magnesium levels (P=0.005), and plasma glucose (P=0.042) than UW. Respective patient survivals at 3, 12, and 60 months were 95.7, 87.2, and 82.0% for the CS group and 95.7, 83.3, and 66.6% for the UW group (P=0.123).. While retaining the same degree of safety and effectiveness as UW for LT, CS may yield postliver graft reperfusion benefits, as shown in this study by a significant reduction in the incidence of PRS and greater metabolic control.

Topics: Adenosine; Adolescent; Adult; Aged; Allopurinol; Disaccharides; Electrolytes; Female; Follow-Up Studies; Glutamates; Glutathione; Histidine; Humans; Insulin; Liver Transplantation; Male; Mannitol; Middle Aged; Organ Preservation; Organ Preservation Solutions; Postoperative Complications; Prospective Studies; Raffinose; Reperfusion Injury; Syndrome; Time Factors; Young Adult

Topics: Adult; Allopurinol; Antitubercular Agents; Drug Eruptions; Drug Hypersensitivity; Humans; Isoniazid; Lymphocyte Activation; Male; Patch Tests; Syndrome

Allopurinol is the most commonly used urate-lowering therapy in gout. Allopurinol hypersensitivity syndrome (AHS) is a rare but potentially fatal adverse event. Dosing guidelines based on creatinine clearance have been proposed based on the recognition that dosages of ≥300 mg/day may be associated with AHS, particularly in patients with renal impairment. However, the relationship between the allopurinol starting dose and AHS is unknown. This study was undertaken to determine the relationship between allopurinol dosing and AHS.. A retrospective case-control study of patients with gout who developed AHS between January 1998 and September 2010 was undertaken. For each case, 3 controls with gout who were receiving allopurinol but did not develop AHS were identified. Controls were matched with cases for sex, diuretic use at the time of initiating allopurinol, age (±10 years), and estimated glomerular filtration rate (estimated GFR). Starting dose and dose at the time of the reaction in cases were compared between cases and controls.. Fifty-four AHS cases and 157 controls were identified. There was an increase in the risk of AHS as the starting dose of allopurinol corrected for the estimated GFR increased. For the highest quintile of starting dose per estimated GFR, the odds ratio was 23.2 (P < 0.01). Receiver operating characteristic analysis indicated that 91% of AHS cases and 36% of controls received a starting dose of allopurinol of ≥1.5 mg per unit of estimated GFR (mg/ml/minute).. Our findings indicate that starting allopurinol at a dose of 1.5 mg per unit of estimated GFR may be associated with a reduced risk of AHS. In patients who tolerate allopurinol, the dose can be gradually increased to achieve the target serum urate level.

Topics: Adult; Aged; Aged, 80 and over; Allopurinol; Case-Control Studies; Dose-Response Relationship, Drug; Drug Hypersensitivity; Female; Glomerular Filtration Rate; Gout; Gout Suppressants; Humans; Male; Middle Aged; Retrospective Studies; Risk Factors; ROC Curve; Syndrome; Uric Acid

Topics: Adolescent; Adult; Allopurinol; Anti-Infective Agents; Anti-Inflammatory Agents, Non-Steroidal; Anticonvulsants; Carbamazepine; Child; Drug Combinations; Drug Eruptions; Eosinophilia; Exanthema; Female; Glucosamine; Gout Suppressants; Humans; Male; Middle Aged; Pruritus; Retrospective Studies; Sulfasalazine; Syndrome; Trimethoprim, Sulfamethoxazole Drug Combination; Young Adult

Topics: Allopurinol; Antibodies, Monoclonal; Antibodies, Monoclonal, Humanized; Bevacizumab; Drug Hypersensitivity; Drug Interactions; Humans; Intravitreal Injections; Male; Middle Aged; Syndrome

In some patterns of cutaneous adverse drug reactions, and depending on the culprit drug, patch testing has been helpful in confirming its cause. Its value in Drug Rash with Eosinophilia and Systemic Symptoms (DRESS) has not been established in a large cohort of patients.. The aim of the present study is to evaluate the safety and usefulness of patch testing in DRESS.. Between January 1998 and December 2008, we studied 56 patients with DRESS induced by antiepileptic agents in 33 patients (59%), allopurinol in 19 (34%) and sulfasalazine, cotrimoxazole, tenoxicam, and amoxicillin in 1 patient each (7%).. A positive patch test reaction was observed in 18 patients (32.1%), of which 17 were with antiepileptics and 1 with tenoxicam. In the antiepileptic group, carbamazepine alone was responsible for 13 of 17 positive reactions (76.5%). Patch tests with allopurinol and its metabolite were negative in all cases attributed to this drug.. In this study, patch testing was a safe and useful method in confirming the culprit drug in DRESS induced by antiepileptic drugs, whereas it had no value in DRESS induced by allopurinol. The pathogenesis of DRESS is not yet entirely clarified, but positive patch tests suggest a drug-dependent delayed hypersensitivity mechanism.

Topics: Allopurinol; Amoxicillin; Anticonvulsants; Drug Hypersensitivity; Eosinophilia; Exanthema; Female; Humans; Male; Middle Aged; Patch Tests; Sulfasalazine; Syndrome; Trimethoprim, Sulfamethoxazole Drug Combination

Topics: Aged; Allopurinol; Diagnosis, Differential; Drug Eruptions; Eosinophilia; Epilepsy; Gout Suppressants; Humans; Hyperuricemia; Male; Syndrome

Topics: Allopurinol; Female; Glutamate Dehydrogenase; Humans; Hyperammonemia; Hyperinsulinism; Infant; Mutation, Missense; Pedigree; Syndrome

Topics: Alleles; Allopurinol; Anticonvulsants; Asian People; Carbamazepine; Chemical and Drug Induced Liver Injury; Drug Hypersensitivity; Gout Suppressants; HLA-B Antigens; Humans; Japan; Stevens-Johnson Syndrome; Syndrome; Virus Activation

Hyperuricemia is present in approximately 5% of the population. The vast majority is asymptomatic and at no clinical risk. Allopurinol, an analog of hypoxanthine, has been widely used in clinical practice for more than 30 years for the treatment of hyperuricemia and gout. Two percent of patients develop a mild exanthema when on this drug, which usually resolves after withdrawal of the drug. A syndrome characterized by exfoliative dermatitis, hepatitis, interstitial nephritis, and eosinophilia, termed allopurinol hypersensitivity syndrome, has been described, and its etiology related to the accumulation of one of allopurinol's metabolites, oxypurinol, of which clearance is decreased in the setting of renal insufficiency and the use of thiazide diuretics. The term DRESS (Drug Rash with Eosinophilia and Systemic Symptoms) Syndrome has been recently used to describe an entity presenting with similar features.

Topics: Aged; Allopurinol; Dermatitis, Exfoliative; Eosinophilia; Gout Suppressants; Humans; Hyperuricemia; Male; Syndrome

Topics: Aged; Aged, 80 and over; Alleles; Allopurinol; Drug Eruptions; Drug Hypersensitivity; Follow-Up Studies; Gout; HLA-B Antigens; Humans; Male; Middle Aged; Risk Assessment; Sampling Studies; Stevens-Johnson Syndrome; Syndrome

Topics: Aged; Aged, 80 and over; Allopurinol; Drug Hypersensitivity; Fatal Outcome; Gout; Gout Suppressants; Humans; Hyperuricemia; Male; Syndrome

Topics: Allopurinol; Female; Gout Suppressants; Humans; Hyperuricemia; Kidney Diseases; Male; Mutation; Patient Compliance; Syndrome

Topics: Aged; Allopurinol; Drug Eruptions; Eosinophilia; Female; Humans; Syndrome

We report a case of DRESS syndrome also called drug hypersensitivity reaction occurring a 47 years old Senegalese man who has been taking allopurinol for 3 months. That drug was prescribed for peripheric arthralgias associated to a hyperuricemia. He presented a generalised pruritus, cutaneous lesions, fever and facial oedema. On the biological examens, hyperleucocytosis with hypereosinophilia and hyperlymphocytosis associated to the presence of segmented basophiles. In addition, a hepatic cytolysis and cholestasis were documented. Liver ultrasound was normal. The hemocults were negative. These following serologies have been performed and were negative: hepatitis B and C, Epstein Barr-virus, cytomegalovirus, syphilis, toxoplasma and parvovirus B19. The anti-nuclear and anti-DNA antibodies were negative. A favourable clinical evolution was remarked after allopurinol treatment withdrawal. A desquamation occurred after 6 days and hemogram turned out to the normal as well as the hepatic tests after 2 weeks. The virologic examens performed 2 months later were unremarkable. This case point out the importance of the early diagnosis and quick withdrawal of the drug in order to prevent serious forms leading to the 10% of death.

Topics: Allopurinol; Antimetabolites; Arthralgia; Drug Eruptions; Edema; Fever; Humans; Hyperuricemia; Male; Middle Aged; Senegal; Syndrome

Association of drug-induced hypersensitivity syndrome with viral infection is debated. Human herpesvirus 6 (HHV-6) reactivation has been the most frequently reported infection associated with this syndrome. However, a case of cytomegalovirus (CMV) infection was recently described associated with anticonvulsant-induced hypersensitivity syndrome. We report a case of severe allopurinol-induced hypersensitivity syndrome with pancreatitis associated with Epstein-Barr virus (EBV) infection. Active EBV infection was demonstrated in two consecutive serum samples by the presence of anti-EBV early antigen (EA) IgM antibodies and an increase in anti-EBV EA IgG antibodies, whereas no anti-EBV nuclear antigen IgG antibodies were detected. EBV DNA was detected by polymerase chain reaction (PCR) in peripheral blood mononuclear cells. Reactivation of HHV-6 was suggested only by the presence of anti-HHV-6 IgM antibodies, but HHV-6 DNA was not detected by PCR in the serum. Other viral investigations showed previous infection (CMV, rubella, measles, parvovirus B19), immunization after vaccination (hepatitis B virus), or absence of previous infection (hepatitis C virus, human immunodeficiency virus). We suggest that EBV infection may participate in some cases, as do the other herpesviruses HHV-6 or CMV, in the development of drug-induced hypersensitivity syndrome.

Topics: Adult; Allopurinol; Antimetabolites; Drug Hypersensitivity; Epstein-Barr Virus Infections; Herpesvirus 4, Human; Herpesvirus 6, Human; Humans; Male; Pancreatitis; Roseolovirus Infections; Syndrome; Virus Activation

The efficacy of allopurinol in autosomal dominant familial juvenile hyperuricaemic nephropathy (FJHN) has been disputed.. To address this question, in the absence of controlled trials.. Retrospective long-term follow-up study.. All kindreds were biochemically screened. Measurements included uric acid clearance, creatinine clearance, serum creatinine, and glomerular filtration rate (GFR). We used five siblings who had died or progressed to transplantation, ten other deceased relatives, and two index cases (one untreated, one non-compliant) as controls to assess the effects of allopurinol.. Of eight families with FJHN, six had a strong history of renal disease and early parental death (mean age 41 years, n=10). Of 27 patients started immediately on allopurinol and treated uninterruptedly, 21 responded well, including three children born subsequently. Eight siblings (mean age 19 years) with a normal plasma creatinine at start (<120 micromol/l, mean GFR 80 ml/min/1.73 m(2)) retained stable renal function (mean 14.5 years, mean age 34 years, GFR 85 ml/min/1.73 m(2)). Of the 13 other responders, treated for up to 34 years, 10 with a creatinine <200 micromol/l at diagnosis (mean age 28 years, mean creatinine 137 micromol/l at start) now have a mean creatinine of 210 micromol/l. In contrast, five patients (mean age 26 years) with a creatinine >200 micromol/l (GFR <35 ml/min/1.73 m(2)) when allopurinol commenced, plus one untreated index case, all progressed rapidly (mean 6 years) to end-stage renal failure. In two others (one non-compliant, one initially untreated), GFR fell by >50% in 7 years. Introduction of allopurinol in the latter has stabilized GFR.. Allopurinol reduced the morbidity and mortality from renal failure seen in untreated siblings and previous generations of these families. Early diagnosis of FJHN is important, so that treatment can begin before irreversible renal damage has developed.

Topics: Adolescent; Adult; Allopurinol; Child; Female; Follow-Up Studies; Gout Suppressants; Humans; Kidney Diseases; Male; Pedigree; Renal Insufficiency; Retrospective Studies; Syndrome; Treatment Outcome; Uremia; Uric Acid; Uricosuric Agents

Allopurinol hypersensitivity syndrome is an idiosyncratic drug reaction characterised by an acute and severe multiorgan disease. It usually begins 2 to 6 weeks after starting allopurinol. The most important and critical characteristics are the presence of visceral involvement and haematological abnormalities; hepatitis, interstitial nephritis and eosinophilia are most frequently seen. However, cardiac involvement has not been previously reported.. Two previously well young Chinese men presented with fever, rash and hepatitis 3 weeks after taking allopurinol. The clinicopathological presentation was typical of allopurinol hypersensitivity syndrome.. Both men received systemic corticosteroid therapy and had full recovery. A few months later, they each had an acute myocardial infarction with a fatal outcome, despite minimal cardiac risk factors and no family history of coronary artery disease.. The immunologic process in allopurinol hypersensitivity syndrome may have caused coronary vasculitis and subsequent myocardial infarct. Alternatively, the idiosyncratic reaction may have damaged myocardium, with the resultant myocarditis masquerading as coronary artery disease. Patients with allopurinol hypersensitivity syndrome should be followed up for cardiac involvement.

Topics: Adult; Allopurinol; Drug Hypersensitivity; Fatal Outcome; Gout Suppressants; Humans; Male; Myocardial Infarction; Myocarditis; Syndrome; Vasculitis

Topics: Aged; Allopurinol; Drug Hypersensitivity; Gout Suppressants; Humans; Male; Syndrome

We describe a 61-year-old male patient who was treated with allopurinol and developed fever, a skin rash, eosinophilia and severe renal and liver dysfunction. We discuss the allopurinol hypersensitivity syndrome as a serious complication of the use of allopurinol, and briefly review the aetiology, prevention and treatment modalities.

Topics: Acute Kidney Injury; Allopurinol; Anti-Inflammatory Agents; Diagnosis, Differential; Drug Hypersensitivity; Gout; Gout Suppressants; Humans; Male; Middle Aged; Prednisone; Syndrome

Topics: Allopurinol; Chemical and Drug Induced Liver Injury; Drug Eruptions; Female; Gout Suppressants; Humans; Middle Aged; Nephritis, Interstitial; Syndrome

Two patients with chronic sialoadenitis had features of Bartter's and Gitelman's syndrome, respectively. The main complaints were leg paraesthesiae and acute arthritis. A good response to oral K+ supplementation, allopurinol and low-dose prednisone was obtained. The features of Sjögren's-related renal diseases are reviewed.

Topics: Adult; Aged; Alkalosis; Allopurinol; Anti-Inflammatory Agents; Antimetabolites; Bartter Syndrome; Calcium; Chronic Disease; Dose-Response Relationship, Drug; Female; Humans; Hypokalemia; Magnesium; Potassium; Prednisone; Sialadenitis; Sjogren's Syndrome; Syndrome

Topics: Aged; Allopurinol; Drug Hypersensitivity; Fatal Outcome; Female; Gout; Humans; Kidney Failure, Chronic; Male; Middle Aged; Syndrome

Topics: Allopurinol; Brain Diseases; Child; Diagnosis, Differential; Female; Fever; Heat Exhaustion; Humans; Hungary; Male; Shock, Hemorrhagic; Syndrome; Terminology as Topic

Topics: Allopurinol; Creatinine; Humans; Hypoxanthine Phosphoribosyltransferase; Infant; Kidney Calculi; Male; Syndrome; Ultrasonography; Uric Acid

The results of a 12 month follow-up of 3 groups of age-matched children (7 boys in each group) with an identically malignant course of Duchenne's myodystrophy determined by means of a genealogical analysis are presented. The fastest progression of the disease was observed in children receiving conventional treatment. Untreated children showed slower progression of the disease. In patients on allopurinol treatment the process was somewhat checked or there was some regression of symptomatology.

Topics: Allopurinol; Child; Combined Modality Therapy; Follow-Up Studies; Humans; Male; Methandrostenolone; Muscular Dystrophies; Nandrolone; Nandrolone Decanoate; Neostigmine; Syndrome; Vitamins

A case of combined deficiency of sulphite-oxidase and xanthine-oxidase with a defect of the molybdenum cofactor, which is vital to the activity of sulphite-, xanthine- and aldehyde-oxidase, is reported here. Seven cases of combined deficiencies have been described with regard to both clinical and laboratory findings. The clinical, laboratory and anatomo-pathological features and, in particular, the central nervous system lesions of the present case correspond exactly to those in the case described Rosenblum in which an isolated deficiency in sulphite-oxidase was present. As the cerebral alterations in the present case are comparable to those described in Rosenblum's case, they probably result from the defect in sulphite-oxidase activity.

Topics: Amino Acid Metabolism, Inborn Errors; Amino Acids, Sulfur; Brain; Child, Preschool; Coenzymes; Female; Humans; Liver; Metalloproteins; Microcephaly; Molybdenum; Molybdenum Cofactors; Oxidoreductases; Oxidoreductases Acting on Sulfur Group Donors; Pteridines; Purine-Pyrimidine Metabolism, Inborn Errors; Sulfates; Syndrome; Xanthine Oxidase; Xanthines

A life-threatening toxicity syndrome consisting of an erythematous, desquamative skin rash, fever, hepatitis, eosinophilia, and worsening renal function in 78 patients receiving allopurinol is described. In a majority of cases, the development of this syndrome was associated with the use of standard (200 to 400 mg per day) doses of allopurinol in patients with renal insufficiency. In pharmacologic studies, it was demonstrated that the renal clearance of the major metabolite of allopurinol, oxipurinol, is directly proportional to the renal clearance of creatinine (oxipurinol clearance = 0.22 X creatinine clearance -2.87). An inverse linear relation was noted between the serum oxipurinol half-life and the renal creatinine clearance [( serum oxipurinol half-life in hours]-1 = 0.00034 X creatinine clearance in milliliters per minute + 0.0045). Long-term use of 300 mg per day of allopurinol was found to result in elevated steady-state serum oxipurinol concentrations in patients with renal insufficiency (serum oxipurinol concentration in micromoles per liter = -2.5 X creatinine clearance in milliliters per minute + 326). Avoidance of allopurinol or use of reduced doses in patients with renal insufficiency according to proposed guidelines should be adequate to inhibit uric acid production in most patients and may reduce the incidence of life-threatening allopurinol toxicity.

Topics: Adult; Aged; Allopurinol; Creatinine; Female; Humans; Kidney Diseases; Male; Middle Aged; Syndrome; Uric Acid

Topics: Aged; Allopurinol; Antineoplastic Agents; Carcinoma, Small Cell; Humans; Lung Neoplasms; Male; Syndrome

Topics: Allopurinol; Humans; Leukopenia; Male; Middle Aged; Syndrome; Thrombocytopenia

Topics: Adolescent; Arthritis; Child; Child, Preschool; Female; Genetic Predisposition to Disease; Humans; Hypoxanthine Phosphoribosyltransferase; Infant; Male; Nervous System Diseases; Purine-Pyrimidine Metabolism, Inborn Errors; Syndrome; Xanthine Oxidase

There have been recent reports of a characteristic hypersensitivity syndrome associated with the use of allopurinol. The authors describe this syndrome, emphasizing predisposing factors and clinical features.

Topics: Adult; Aged; Allopurinol; Drug Hypersensitivity; Female; Humans; Male; Middle Aged; Syndrome; Uric Acid

Topics: Adolescent; Adult; Age Factors; Aged; Allopurinol; Calcium; Child; Child, Preschool; Crystallization; Diet; Female; Humans; Infant; Infant, Newborn; Kidney Calculi; Male; Middle Aged; Oxalates; Purines; Syndrome; Uric Acid

Topics: Allopurinol; Athetosis; Child, Preschool; Humans; Intellectual Disability; Lesch-Nyhan Syndrome; Male; Purine-Pyrimidine Metabolism, Inborn Errors; Self Mutilation; Sex Factors; Syndrome