Drug Allergy

This review summarizes up-to-date insights and provides current management guidelines for Stevens-Johnson syndrome and toxic epidermal necrolysis, two…

This is probably the most feared complication of Allopurinol hypersensitivity reactions, with as high as 25-50% mortality risk. Allopurinol should not be prescribed for hyperuricaemia without clear clinical indications. Care should be exercised especially in those with renal impairment. Those started on it should be cautioned to look out for signs and symptoms of possible allergy (itch, rash, mouth ulcers). HLA-B5801 is an expensive test which may help predict those at risk for developing the adverse reaction.

Hyperuricemia-related diseases such as gout, Lesch-Nyham syndrome, and urate kidney stones are commonly treated with allopurinol. However, with widespread use of the drug has come the recognition of allopurinol hypersensitivity syndrome. This syndrome, which includes skin reactions such as Stevens-J…

Asians, especially Han Chinese, Koreans and Thais appear to be most at risk for developing Allopurinol hypersensitivity reactions, if they are HLA-B5801 positive. But this test is costly, and not widely available.