Desensitization to allopurinol in patients with gout and cutaneous reactions.

Abstract

PURPOSE:

To determine the efficacy and safety of slow oral desensitization in the management of allopurinol-related pruritic cutaneous eruptions.

PATIENTS AND METHODS:

Nine patients with renal insufficiency and chronic tophaceous gouty arthritis, who had to interrupt their allopurinol therapy because of an allergic-type pruritic maculopapular eruption, were enrolled in an allopurinol oral desensitization protocol using a schedule of gradually increasing doses.

RESULTS:

Cautious reinstitution of allopurinol was successfully accomplished in all nine patients, but four individuals required dose adjustment because of development of a mild, recurrent, macular rash early during the protocol at allopurinol doses of less than or equal to 5 mg/d. Transient, postdesensitization cutaneous reactions occurred in two patients, one of whom also had an early rash.

CONCLUSION:

Oral desensitization to the minor rashes induced by allopurinol is a feasible and acceptably safe approach to therapy, particularly for those with renal insufficiency in whom no substitute urate-lowering drug is available.

• Authors: A G Fam, J Lewtas, J Stein, T W Paton
• Journal: The American journal of medicine (Am J Med) Vol. 93 Issue 3 Pg. 299-302 (Sep 1992) ISSN: 0002-9343 [Print] United States
• PMID: 1388001 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Allopurinol

Topics

• Administration, Oral
• Adolescent
• Adult
• Aged
• Allopurinol (administration & dosage, adverse effects, immunology)
• Chronic Disease
• Desensitization, Immunologic
• Drug Eruptions (etiology, prevention & control)
• Female
• Gout (complications, drug therapy)
• Humans
• Kidney Failure, Chronic (complications)
• Male
• Middle Aged
• Pruritus (chemically induced)