Published: June 2010

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Case report: Stevens-Johnson syndrome associated with the use of allopurinol

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Prescriber Update 31(2): 14
June 2010

Prescribers are reminded that allopurinol should be discontinued immediately if a rash appears during therapy.

A recent report received by CARM describes a case of Stevens-Johnson syndrome in a patient taking allopurinol. The patient developed a rash shortly after beginning treatment and was admitted to hospital with general malaise, fever, and confusion. The rash progressed and a diagnosis of Stevens-Johnson syndrome was made; the patient subsequently died.

A skin reaction such as a pruritic, maculopapular rash occurs in approximately 10% of patients treated with allopurinol. More serious allergic reactions may rarely occur and include exfoliative dermatitis, Stevens-Johnson syndrome, and toxic epidermal necrolysis. Skin reactions may be delayed and have rarely been followed by severe hypersensitivity reactions, which may be fatal. Allopurinol data sheets recommend that treatment be withdrawn immediately if a rash or other signs of allergy occur.¹ Future treatment with allopurinol is not recommended.

Patients should be advised to consult a healthcare professional promptly if they develop any type of skin reaction while being treated with allopurinol.

References

1. Apotex NZ Ltd. 18 September 2008. Apo-Allopurinol (allopurinol) data sheet www.medsafe.govt.nz/profs/Datasheet/a/apoallopurinoltab.pdf