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Review
. 2016 Apr;12(4):235-42.
doi: 10.1038/nrrheum.2015.132. Epub 2015 Sep 29.

Allopurinol hypersensitivity: investigating the cause and minimizing the risk

Lisa K Stamp  1 , Richard O Day  2 , James Yun  3
Affiliations
Review

Allopurinol hypersensitivity: investigating the cause and minimizing the risk

Lisa K Stamp et al. Nat Rev Rheumatol. 2016 Apr.

Erratum in

  • Nat Rev Rheumatol. 2016 Apr;12(4):i

Abstract

Allopurinol is the most commonly prescribed urate-lowering therapy for the management of gout. Serious adverse reactions associated with allopurinol, while rare, are feared owing to the high mortality. Such reactions can manifest as a rash combined with eosinophilia, leukocytosis, fever, hepatitis and progressive kidney failure. Risk factors for allopurinol-related severe adverse reactions include the recent introduction of allopurinol, the presence of the HLA-B(*)58:01 allele, and factors that influence the drug concentration. The interactions between allopurinol, its metabolite, oxypurinol, and T cells have been studied, and evidence exists that the presence of the HLA-B(*)58:01 allele and a high concentration of oxypurinol function synergistically to increase the number of potentially immunogenic-peptide-oxypurinol-HLA-B(*)58:01 complexes on the cell surface, thereby increasing the risk of T-cell sensitization and a subsequent adverse reaction. This Review will discuss the above issues and place this in the clinical context of reducing the risk of serious adverse reactions.

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References

    1. Drug Saf. 2013 Oct;36(10):953-80 - PubMed
    1. Am J Med. 1984 Jan;76(1):47-56 - PubMed
    1. Pharmacogenet Genomics. 2011 May;21(5):303-7 - PubMed
    1. J Allergy Clin Immunol. 2004 Nov;114(5):1209-15 - PubMed
    1. Nat Med. 2008 Dec;14(12):1343-50 - PubMed

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