Delayed hypersensitivity reaction to allopurinol: a case report

• Main Authors: Che' Man, Mohamad, Che Alhadi, Shahidah, Wan Mahmod, Wan Fatimah Suriyani, Amiruddin, Salman, Mohd Razib, Mohd Zhafri, Ismail, Rasimah
• Format: Article
• Language: English; English
• Published: Academy of Family Physicians of Malaysia (AFPM) 2023
• Subjects: R Medicine (General); RA Public aspects of medicine; RC Internal medicine; RD Surgery
• Online Access: http://irep.iium.edu.my/103775/2/103775_Delayed%20hypersensitivity%20reaction.pdf; http://irep.iium.edu.my/103775/8/103775_Delayed%20hypersensitivity%20reaction%20to%20allopurinol_Scopus.pdf; http://irep.iium.edu.my/103775/; https://e-mfp.org/article/delayed-hypersensitivity-reaction-to-allopurinol-a-case-report/; https://doi.org/10.51866/cr.65
• Institution: Universiti Islam Antarabangsa Malaysia

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.