Vasculitis with allopurinol therapy

Abstract

Hypersensitive vascular reactions have been described with a large number of drugs. A case of the hypersensitivity type of vasculitis with fibrinoid necrosis and eosinophilic reaction, involving multiple organs, especially the kidney, marked by generalized maculopapular body rash, resulting in uremia and death, has been reported. The only possible drug to be implicated was allopurinol (4-hydroxypyrazolo-[3,4- d]pyrimidine), a xanthine oxidase inhibitor currently used in the treatment of disorders of uric acid metabolism. The literature concerning hypersensitivity angiitis and the periarteritis-polyarteritis entities have been reviewed. No previous instances of this type of hypersensitivity angiitis connected with the administration of allopurinol have been reported. It is our feeling that the reported case represents hypersensitivity angiitis of the type involving the small arterioles especially of the lung, spleen, and kidney, and that this was secondary to the administration of allopurinol.