ALLOPURINOL INDUCED ADVERSE DRUG REACTIONS: CASE SERIES

Allopurinol is widely used drug for patients of hyperuricemia and gout. The few adverse drug reactions related to allopurinol are diarrhea, fever, hepatotoxicity, Steven Johnson Syndrome- Toxic Epidermal Necrolysis (SJS-TEN), congestive heart failure and renal failure. In this article we have described eleven cases to evaluate the causality, cause and management of this syndrome. In this study eleven retrospective cases were selected from the ADR reports. The full details of the cases were collected from Christian Medical College from the period of 2012 to 2016. Causality was established using Naranjo scale and classi?cation was done based on severity and resolution of ADR. It was observed that cases presented with mild to severe reactions of allopurinol, which is the suspected offending agent. Cases were resolved with supportive treatment while ?ve case had a prolong hospitalization and two cases had a life threatening drug reaction. Early detection and management of this severe form of systemic reaction is very important for better will be the prognosis.

Pharmacogenetic research in the association between human leukocyte antigen and adverse drug reactions / 中南大学学报(医学版)

With the rapid development of pharmacogenetics, more and more studies have shown evidence in the association between polymorphisms at the human leukocyte antigen (HLA) loci and severe adverse drug reactions (SADRs). Several HLA-B alleles proved to be associated with SADRs for drugs such as carbamazepine, allopurinol, lamotrigine, and lfucloxacillin. hTe USA Food and Drug Administration (FDA) has even recommended routine screening for HLA-B allele before the use of abacavir and carbamazepine. With the completion of human genome project and the Hapmapproject, several new pharmacogenetics approaches such as genome-wide association study (GWAS) have emerged. hTese newly developed methods will undoubtedly accelerate the identiifcation and clinical utilization of the pharmacogenetic biomakers. In addition, the immunogenetic mechanisms by which the HLA alleles cause SADRs are explored at the cellular and molecular level. hTis review focuses on the recent progresses in HLA alleles and ADRs regarding both the clinical translation and modern pharmacogenetic methods.