Malaysian Family Physician (Feb 2023)

Delayed hypersensitivity reaction to allopurinol: A case report

  • Mohammad Che Man,
  • Shahidah Che Alhadi,
  • Wan Fatimah Suriyani Wan Mahmud,
  • Salman Amiruddin,
  • Mohd Zhafri Mohd Razib,
  • Rasimah Ismail

DOI
https://doi.org/10.51866/cr.65
Journal volume & issue
Vol. 18
p. 11

Abstract

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Allopurinol is the well-known first-line treatment option for symptomatic hyperuricaemia and gout. It is cost-effective particularly for the management of chronic gout. The common early side effects of allopurinol are skin rashes, diarrhoea and nausea. Meanwhile, a dangerous concerning complication is Stevens–Johnson syndrome, which can cause severe morbidity and mortality. Delayed hypersensitivity to allopurinol is rare but should be one of the differential diagnoses if a patient with underlying gout on chronic allopurinol treatment presents with skin rashes. The present case highlights the importance of a high index of suspicion in at-risk patients with underlying gout along with skin rashes on long-term allopurinol treatment to avoid unnecessary patient management.

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