Application of e-Mail in Successful Desensitization to Allopurinol:

Abstract

Allopurinol hypersensitivity can develop in 2% of cases (severe in 0.4%). If no alternative, oral desensitization is effective but it is associated with difficulties in monitoring and safety. A 65-years old Saudi male presented to allergy clinic at King Abdulaziz University Hospital as a case of type I hypersensitivity to Allopurinol. Phase I desensitization was conducted in the clinic over 4 hours by increasing doses of oral Allopurinol, starting from 0.01 mg up to 1 mg. Phase II desensitization was performed at home over 5 weeks with increasing doses from 1 mg up to 100 mg/day (pharmaceutical dose). Daily e-Mail messages were very helpful in patient monitoring by providing proper advice. Minor allergy symptoms, like itching and rash, resolved with oral antihistamines and maintaining the same dose until clear. To our knowledge, this is the first case report of using e-Mail as an effective tool for monitoring successful oral drug desensitization.