Allopurinol hypersensitivity syndrome and pure red cell aplasia associated with allopurinol treatment / 대한내과학회지

Allopurinol is widely used to reduce serum uric acid levels and, generally, has mild side effects. Rarely, allopurinol hypersensitivity syndrome occurs and this consists of severe systemic skin lesions, fever, reduced kidney and liver function, and leukocytosis with eosinophilia. Extremely rarely, allopurinol-induced pure red cell aplasia is reported. We report a case of allopurinol hypersensitivity syndrome and pure red cell aplasia following allopurinol therapy for eight weeks and the disease response to steroid therapy in a patient with chronic renal insufficiency.

A case of minimal change nephrotic syndrome with polycythemia vera / 대한내과학회지

The cause of secondary polycythemia is known to be renal diseases such as renal tumors, renal cysts, hydronephrosis, renal artery stenosis, renal transplantation and Bartter's syndrome. Yet this disease rarely reported in conjunction with nephrotic syndrome, nephrosclerosis, pyelonephritis or chronic glomerulonephritis. There are only rare reports of glomerulonephritis with polycythemia vera. We report here on a case of a minimal change nephrotic syndrome with polycythemia vera. A 60-year-old man visited our hospital due to his elevated hemoglobin level and proteinuria and his elevated neuron specific enolase. The blood hemoglobin level was 22.4 g/dL. The blood level of neuron specific enolase was 36.7 ng/mL. The bone marrow aspirate showed hypercellularity and panmyelosis. Electron microscopy showed diffuse effacement of the epithelial foot processes and microvillous transformation of the foot processes. Treatment was done by performing phlebotomy and administering hydroxyurea. There was decreased urinary protein and normalization of the hemoglobin level following treatment with phlebotomy and hydroxyurea.