Allopurinol 투여 후 발생한 심한 약물 이상 반응 13예의 임상적 고찰

Background: Allopurinol-induced hypersensitivity reactions are rare but increasing recently in clinical practice; however, little has been known about its clinical characteristics and underlying mechanism. Objective: The goal of this study was to obtain more accurate information on the clinical feature and course of allopurinol-induced hypersensitivity reactions. Method: We retrospectively reviewed medical records of 13 patients diagnosed with allopurinol-induced severe cutaneous adverse drug reactions between September, 2003 and April, 2006. Result: All patients (n=13) showed skin rash as an initial manifestation. Eleven patients had severe skin rash and multiple organ involvements such as peripheral blood eosinophilia, hepatitis, or renal dysfunction. They were diagnosed with drug hypersensitivity syndrome (n=5), Stevens-Johnson syndrome (n=5), or toxic epidermal necrolysis (n=1). There was one mortality with toxic epidermal necrolysis. Conclusion: Allopurinol-induced hypersensitivity is associated with significant morbidity, and potentially life-threatening. Therefore, attention should be given when prescribing allopurinol. (Korean J Asthma Allergy Clin Immunol 2006; 26:225-232)