A case of allopurinol - induced fever myositis and dermatitis

概要

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A 52 - year - old man with hyperuricemia was diagnosed as having gout. He developed high fever and generalized skin eruption 4 weeks after allopurinol treatment was started. The skin lesions disappeared promptly following withdrawal of the treatment. When the treatment with allopurinol was tried again because of his high serum uric acid level, high fever, generalized skin eruption, edema and serious muscular atrophy in his face and limbs. Routine laboratory tests revealed elevated levels of serum CK and transaminases. The muscular weakness was relieved in three months with high - dose of steroid therapy. Histological examination of the biopsy specimens obtained from muscle and skin tissues demonstrated infiltration of inflammatory cells. Blast formation of lymphocytes by the incubation with the drug were tested. The patient's lymphocytes reacted more sensitively to allopurinol than those from a control. These observations indicated that the clinical and pathological myopathy observed in this patient was allopurinol - induced myositis in which cell mediated immune mechanism was involved.
Japanese Society of Gout and Nucleic Acid Metabolismの論文