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Allopurinolinduziertes Hypersensitivitätssyndrom mit Todesfolge

Allopurinol-Induced Hypersensitivity Syndrome Resulting in Death

  • KASUISTIK
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Zusammenfassung

Die vorliegende Kasuistik schildert den Fall eines 67-jährigen Patienten, der ein allopurinolinduziertes Hypersensitivitätssyndrom (AHS) mit toxisch- epidermaler Nekrolyse entwickelte und in der Folge an einem septischen Multiorganversagen verstarb. Mit dieser Falldarstellung soll in Anbetracht der zunehmenden Verschreibungshäufigkeit von Allopurinol die unterschätzte Gefahr eines AHS demonstriert werden.

Abstract

The present report describes the case of a 67-year-old patient who developed an allopurinol-induced hypersensitivity syndrome (AHS) with toxic epidermal necrolysis and subsequently died of septic multiorgan failure. Considering the increasing prescription rate of allopurinol, the present case report intends to demonstrate the underestimated threat of AHS.

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Literatur

  1. Shawk RK, Shukman RN, Davidson JK, et al. Studies with the experimental antitumor agent 4-amino pyrazolo (3,4-d) pyrimidine. Cancer 1960;13:482–9.

    Article  Google Scholar 

  2. Wortmann RL. Gout and other disorders of purine metabolism. In: Fauci AS, Braunwald E, Isselbacher KJ, et al, eds. Harrison's principles of internal medicine, 14th edn. New York: McGraw-Hill, 1998:2158–65.

    Google Scholar 

  3. Wortmann RL. Gout and hyperuricemia. Curr Opin Rheumatol 2002;14:281–6.

    Article  PubMed  Google Scholar 

  4. Terkeltaub RA. Clinical practice: gout. N Engl J Med 2003;349:1647–55.

    Article  CAS  PubMed  Google Scholar 

  5. Underwood M. Diagnosis and management of gout. BMJ 2006;332:1315–9.

    Article  PubMed  Google Scholar 

  6. Pluim HJ, van Deuren M, Wetzels JF. The allopurinol hypersensitivity syndrome. Neth J Med 1998;52:107–10.

    Article  CAS  PubMed  Google Scholar 

  7. Halevy S, Ghislain PD, Mockenhaupt M, et al. Allopurinol is the most common cause of Stevens-Johnson syndrome and toxic epidermal necrolysis in Europe and Israel. J Am Acad Dermatol 2008;58:25–32.

    Article  PubMed  Google Scholar 

  8. Singer JZ, Wallace SL. The allopurinol hypersensitivity syndrome: unnecessary morbidity and mortality. Arthritis Rheum 1986;29:82–7.

    Article  CAS  PubMed  Google Scholar 

  9. Tas S, Simonart T. Management of drug rash with eosinophilia and systemic symptoms (DRESS syndrome): an update. Dermatology 2003;2006:353–6.

    Article  Google Scholar 

  10. Sullivan JR, Shear NH. The drug hypersensitivity syndrome: what is the pathogenesis? Arch Dermatol 2001;137:357–64.

    CAS  PubMed  Google Scholar 

  11. Sontheimer RD, Houpt KR. DIDMOHS: a proposed consensus nomenclature for the drug-induced delayed multiorgan hypersensitivity syndrome. Arch Dermatol 1998;134:874–6.

    Article  CAS  PubMed  Google Scholar 

  12. Anderson BE, Adams DR. Allopurinol hypersensitivity syndrome. J Drugs Dermatol 2002;1:60–2.

    PubMed  Google Scholar 

  13. Arellano F, Sacristán JA. Allopurinol hypersensitivity syndrome: a review. Ann Pharmacother 1993;27:337–43.

    CAS  PubMed  Google Scholar 

  14. Markel A. Allopurinol-induced DRESS syndrome. Isr Med Assoc J 2005;7:656–60.

    CAS  PubMed  Google Scholar 

  15. Lee HY, Ariyasinghe JTN, Thirumoorthy T. Allopurinol hypersensitivity syndrome: a preventable severe cutaneous adverse reaction? Singapore Med J 2008;49:384–7.

    CAS  PubMed  Google Scholar 

  16. Hung SI, Chung WH, Liou LB, et al. HLA-B*5801 allele as a genetic marker for severe cutaneous adverse reactions caused by allopurinol. Proc Natl Acad Sci U S A 2005;102:4134–9.

    Article  CAS  PubMed  Google Scholar 

  17. Hashimoto K, Yasukawa M, Tohyama M. Human herpesvirus 6 and drug allergy. Curr Opin Allergy Clin Immunol 2003;3:255–60.

    Article  CAS  PubMed  Google Scholar 

  18. Becker MA, Schumacher HR Jr, Wortmann RL, et al. Febuxostat compared with allopurinol in patients with hyperuricemia and gout. N Engl J Med 2005;353:2450–61.

    Article  CAS  PubMed  Google Scholar 

  19. Bardin T. Current management of gout in patients unresponsive or allergic to allopurinol. Joint Bone Spine 2004;71:481–5.

    Article  PubMed  Google Scholar 

  20. Perez-Ruiz F, Hernando I, Villar I, Nolla JM. Correction of allopurinol dosing should be based on clearance of creatinine, but not plasma creatinine levels:another insight to allopurinol-related toxicity. J Clin Rheumatol 2005;11:129–33.

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Klinik für Kardiologie und Angiologie, Medizinische Hochschule Hannover, Hannover, Germany

    Sören Laurisch, Maren Jaedtke, Reyhan Demir, Martin Fuchs, Gunnar Klein, Hartmut Drexler †, Bernhard Schieffer & L. Christian Napp

  2. Klinik für Nieren- und Hochdruckerkrankungen, Medizinische Hochschule Hannover, Hannover, Germany

    Sajoscha A. Sorrentino & Jan T. Kielstein

  3. Klinik für Plastische, Hand- und Wiederherstellungschirurgie, Medizinische Hochschule Hannover, Hannover, Germany

    Hans-Oliver Rennekampff & Peter M. Vogt

  4. Klinik für Kardiologie, Angiologie, Pneumologie und internistische Intensivmedizin, Asklepios Klinik Hamburg-Altona, Hamburg-Altona, Germany

    Gerd P. Meyer

  5. Klinik für Kardiologie und Angiologie, Medizinische Hochschule Hannover, Carl-Neuberg-Straße 1, 30625, Hannover, Germany

    Sören Laurisch

Authors
  1. Sören Laurisch
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  2. Maren Jaedtke
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  3. Reyhan Demir
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  4. Sajoscha A. Sorrentino
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  5. Jan T. Kielstein
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  6. Hans-Oliver Rennekampff
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  7. Peter M. Vogt
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  8. Gerd P. Meyer
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  9. Martin Fuchs
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  10. Gunnar Klein
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  11. Hartmut Drexler †
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  12. Bernhard Schieffer
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  13. L. Christian Napp
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Corresponding author

Correspondence to Sören Laurisch.

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Laurisch, S., Jaedtke, M., Demir, R. et al. Allopurinolinduziertes Hypersensitivitätssyndrom mit Todesfolge. Med Klin 105, 262–266 (2010). https://doi.org/10.1007/s00063-010-1037-3

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  • DOI: https://doi.org/10.1007/s00063-010-1037-3

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