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Allopurinol-induced drug eruptions: the analyses of clinical features and prognostic factors in 56 cases
Author(s): ZHOU Nai-hui, QIAN Qi-hong, ZHOU Jue-wei, YANG Zi-liang, FENG Xue-mei, SONG Lin-yi, MIN Wei, WANG Miao-miao, LIU Ming, LU Yi-feng, Department of Dermatology, the First Affiliated Hospital of Soochow University
Pages: 234-
238
Year: 2017
Issue:
4
Journal: Journal of Clinical Dermatology
Keyword: allopurinol; drug eruption; prognosis; risk factors;
Abstract: Objective: To investigate the clinical features and prognostic factors of allopurinol-induced drug eruptions.Methods: A retrospective analysis was performed in 56 cases of allopurinol-induced drug eruptions in our department from January 2009 to June 2015. The endpoints included induction period, onset features, primary diseases, skin and mucous involvements, systemic involvements, laboratory findings, treatment and prognosis. The prognostic factors were analyzed using logistic regression. Results: The induction period was(24.2±13.8) d, and serious drug eruption accounted for 55.4%. 64.3% of patients began with fever, and 53.6% with mucosal damage. Results of routine blood tests were abnormal in 85.7% of patients, and the drug induced liver injury occurred in 39.3% of patients. Estimated glomerular filtration rates(e GFRs) were <90 ml/(min·1.73 m2) in 66.1% of patients. All patients were treated systemically with corticosteroids, with the average maximal dose(prednisone) of(1.323±0.565)mg/kg·d. 23.2% of patients were also intravenously given gamma globulin. Following treatments, 7 cases(12.5%) died. Logistic regression analysis showed that e GFR and a history of drug allergy were the two major risk factors for the death of allopurinol-induced drug eruptions. Conclusions: Allopurinol can induce severe drug eruptions, leading to a high mortality rate. The severity of renal damage and the history of drug allergy were major risk factors for the poor prognosis of this disease.
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