Revista alergia Mexico (Tecamachalco, Puebla, Mexico : 1993) · 2018
[De-sensitization to allopurinol in a patient with tophi gout].
Клинический случайСтатьяНазвание и аннотация: Перевод в очереди
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López-Rocha Eunice Giselle, Hernández-Montoya Gerardo, Rodríguez-Pesina Alberto Hernán, Rodríguez-Mireles Karen Alicia
Аннотация
BACKGROUND: Allopurinol is a xanthine oxidase inhibitor used in the treatment of patients with gout. Approximately 2% of patients are affected by adverse reactions to this drug. Severity ranges from mild rashes to severe reactions in up to 0.4% of cases. De-sensitization is carried out by administering increasing doses of the drug.
CASE REPORT: Thirty-year old man diagnosed with hypercholesterolemia and hypertriglyceridemia treated with bezafibrate and pravastatin, systemic arterial hypertension treated with losartan and a 10-year history of hyperuricemia with gout. Tophi were found in metacarpophalangeal joints and elbows. Treatment was started with allopurinol 300 mg/day. Two weeks later, he experienced facial erythema with itching and maculopapular lesions on the malar region 1 hour after the medication was ingested. An outpatient drug de-sensitization protocol was initiated, starting with 5 mg, and with gradual dose increases every 4 to 5 days for 59 days until the desired maintenance dose (300 mg) was reached.
CONCLUSIONS: Experience shows that de-sensitization to allopurinol is a safe alternative when there is hypersensitivity and treatment with this drug is required.
CASE REPORT: Thirty-year old man diagnosed with hypercholesterolemia and hypertriglyceridemia treated with bezafibrate and pravastatin, systemic arterial hypertension treated with losartan and a 10-year history of hyperuricemia with gout. Tophi were found in metacarpophalangeal joints and elbows. Treatment was started with allopurinol 300 mg/day. Two weeks later, he experienced facial erythema with itching and maculopapular lesions on the malar region 1 hour after the medication was ingested. An outpatient drug de-sensitization protocol was initiated, starting with 5 mg, and with gradual dose increases every 4 to 5 days for 59 days until the desired maintenance dose (300 mg) was reached.
CONCLUSIONS: Experience shows that de-sensitization to allopurinol is a safe alternative when there is hypersensitivity and treatment with this drug is required.