Allopurinol-induced aplastic anemia in a patient with chronic kidney disease.

Abstract

Aplastic anemia is a rare complication of allopurinol use. We report an unusual case of aplastic anemia associated with allopurinol therapy for hyperuricemia in a patient with chronic kidney disease. A 37-year-old female patient diagnosed with Stage III chronic kidney disease was admitted with pancytopenia. She had a history of taking allopurinol for 5 months. Her bone marrow showed extremely decreased cellularity (< 20%) and there was no malignant cell infiltration. She was free of infections, including parvovirus B19, cytomegalovirus and Epstein-Barr virus. These results suggested a diagnosis of aplastic anemia. Allopurinol was discontinued immediately and treatment with blood transfusions and prednisolone was begun. After 6 months, the bone marrow cellularity improved to approximately 70%. Recently, it was suggested that decreased activity of multidrug resistance P-glycoprotein may play a role in acquired aplastic anemia. So we measured the inhibitory effect of allopurinol and oxypurinol on P-glycoprotein activity. But neither allopurinol nor oxypurinol inhibited P-glycoprotein activity.

• Authors: Y W Kim, B S Park, C H Ryu, S J Park, S W Kang, Y H Kim, I S Song, J H Shon
• Journal: Clinical nephrology (Clin Nephrol) Vol. 71 Issue 2 Pg. 203-6 (Feb 2009) ISSN: 0301-0430 [Print] Germany
• PMID: 19203517 (Publication Type: Case Reports, Journal Article)

Chemical References

• Enzyme Inhibitors
• Allopurinol

Topics

• Adult
• Allopurinol (adverse effects)
• Anemia, Aplastic (chemically induced, therapy)
• Enzyme Inhibitors (adverse effects)
• Female
• Humans
• Kidney Failure, Chronic (complications)