What is allopurinol hypersensitivity syndrome?

Over 60% of patients had received allopurinol for asymptomatic hyperuricemia. Hallmarks of this hypersensitivity syndrome include a prolonged illness initially manifested by fever, a prominent cutaneous reaction, eosinophilia, hepatic abnormalities, and acute renal failure.

Why allopurinol is contraindicated in acute gout?

Allopurinol should not be stopped during acute flares of gout. Stopping allopurinol during an acute flare means therapeutic effect is lost and the urate level will rise. In addition, there is a real risk of the allopurinol not being recommenced as well as precipitating another flare when it is recommenced.

Can allopurinol precipitate gout?

Sometimes starting allopurinol can trigger a gout attack. This is because some of the crystals can dislodge into the joint as they get smaller which can cause an attack. You may be given another medicine to reduce the risk of these attacks.

Can too much allopurinol cause gout?

You may have an increased risk of allopurinol side effects. These include skin rash, diarrhea, nausea, changes in your liver function test results, and gout flare-ups.

Should I stop allopurinol when taking colchicine?

“Using colchicine prophylaxis when commencing allopurinol is very important to preventing flares and making sure people continue on the allopurinol, and consequently control their gout.

How to prevent allopurinol hypersensitivity reactions in gout?

The severity of allopurinol hypersensitivity syndrome warrants consideration of preventative measures. Screening for HLA-B*5801 in people with gout at high risk of allopurinol hypersensitivity syndrome is recommended. Low allopurinol starting dose may reduce risk; the relationship with maintenance dose in kidney disease is controversial.

Are there any side effects to taking allopurinol?

Allopurinol hypersensitivity: investigating the cause and minimizing the risk Allopurinol is the most commonly prescribed urate-lowering therapy for the management of gout. Serious adverse reactions associated with allopurinol, while rare, are feared owing to the high mortality.

Is there a relationship between allopurinol and AHS?

A low starting allopurinol dose may reduce AHS risk, but the relationship between maintenance dose and AHS is more controversial. Chronic kidney disease increases AHS risk, but slowly increasing the allopurinol dose in chronic kidney disease has not been associated with AHS.

Which is the most sensitive test for allopurinol?

A systematic review including 7,534 patients found that the HLA-B*58:01 test is 78% sensitive and 96% specific, with a negative predictive value of 99% for the development of severe cutaneous adverse reactions associated with allopurinol treatment. Most patients in the study were Asian.