[HLA-B58.01 and allopurinol hypersensitivity renal vasculitis in a Chinese patient].

Rev Med Interne

Centre de néphrologie et transplantation rénale, AP-HM, CHU de la Conception, 147, boulevard Baille, 13005 Marseille, France; C2VN, Inserm 1263, Institut national de la recherche agronomique (INRA) 1260, faculté de Pharmacie, Marseille, France.

Published: July 2022

Introduction: Allopurinol, widely used in the treatment of hyperuricemia and gout, has been shown to cause severe cutaneous reactions, including Stevens-Johnson syndrome and toxic epidermal necrolysis, as well as systemic reactions such as DRESS (Drug Reaction with Eosinophilia and Systemic Symptoms). The HLA-B*5801 allele is known to be a risk factor for severe cutaneous manifestations of hypersensitivity to allopurinol, mostly in Asian populations.

Observation: We report the observation of a 47-year-old Chinese patient, with no previous medical history, carrying the HLA-B*5801 allele, who developed an isolated allopurinol hypersensitivity necrotizing renal vasculitis without cutaneous manifestations.

Discussion: . The identification of this allele should be proposed before prescribing allopurinol in patients originating from certain regions of Asia, and the imputability of allopurinol should be evoked in case of necrotizing renal vasculitis, even without associated cutaneous involvement.

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Source
http://dx.doi.org/10.1016/j.revmed.2022.04.018DOI Listing

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