Journals / Hitit Medical Journal / 2026 / Cilt: 8 Sayı: 2

A Case of toxic epidermal necrolysis induced by allopurinol

Allopurinolün neden olduğu toksik epidermal nekroliz vakası

Nazlı Yorulmaz(HİTİT ÜNİVERSİTESİ, TIP FAKÜLTESİ)0009-0003-4557-2555
Mert Burak Yıldırım(HİTİT ÜNİVERSİTESİ, TIP FAKÜLTESİ)0009-0009-0695-5389
Alpaslan Karabulut(HİTİT ÜNİVERSİTESİ TIP FAKÜLTESİ)0000-0003-2893-692X
Pages
440–445
Publication Date
2026-06-29
🏛️Bibliographic metadata and full text access for this article are provided via DergiPark.
DergiPark Record ↗
✨

AI Summary & Key Takeaways

AI Insight
⚡ TL;DR(Too Long; Didn't Read)

This case is important in terms of being careful against toxic drug reactions that may develop due to allopurinol use in elderly patients with gout.

📌 3 Key Takeaways

🎯
Objective & Hypothesis:Allopurinol reduces urate production by inhibiting xanthine oxidase.
📊
Key Findings & Data:It is oxidatively hydroxylated to oxypurinol.
💡
Conclusion & Impact:This case is important in terms of being careful against toxic drug reactions that may develop due to allopurinol use in elderly patients with gout.
🔬Design:Olgu Sunumu
📍Scope:Comprehensive Sample
⚙️Variables:allopurinol · gut · ilaç reaksyonu

Abstract

Allopurinol reduces urate production by inhibiting xanthine oxidase. It is oxidatively hydroxylated to oxypurinol. It is the most commonly prescribed drug for the treatment of gout. Although it has a beneficial effect in the treatment of this common disease, it is also known to have numerous side effects. The most dangerous side effects associated with allopurinol use are Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN). These immune-mediated disease processes affect nearly every organ system. It is important to diagnose them as early as possible, as they can be fatal and require discontinuation of the drug at the first sign of SJS/TEN, such as a rash or other early symptoms. This case is important in terms of being careful against toxic drug reactions that may develop due to allopurinol use in elderly patients with gout.

Özet

Allopurinol, ksantin oksidazı inhibe ederek ürat üretimini azaltır. Oksidatif olarak oksipurinole hidroksillenir. Gut tedavisi için en sık reçete edilen ilaçtır. Bu yaygın hastalığın tedavisinde yararlı bir etkiye sahip olmasına rağmen, çok sayıda yan etkisi olduğu da bilinmektedir. Allopurinol kullanımıyla ilişkili en tehlikeli yan etkiler Stevens-Johnson sendromu (SJS) ve toksik epidermal nekroliz (TEN)dir. Bu immün aracılı hastalık süreçleri neredeyse tüm organ sistemlerini etkiler. Ölümcül olabildikleri ve döküntü veya diğer erken belirtiler gibi SJS/TEN'in ilk belirtisinde ilacın kesilmesini gerektirebildikleri için mümkün olan en erken zamanda teşhis edilmeleri önemlidir. Bu durum, gutlu yaşlı hastalarda allopurinol kullanımına bağlı gelişebilecek toksik ilaç reaksiyonlarına karşı dikkatli olmak açısından önemlidir.

🔖

Cite This Article

Yorulmaz, N., Yıldırım, M. B., Bölük, K. N., Karabulut, A. (2026). A Case of toxic epidermal necrolysis induced by allopurinol. Hitit Medical Journal, Cilt: 8 Sayı: 2, 440–445. https://doi.org/10.52827/hititmedj.1779165

📄 Full Text PDF Viewer

📄

PDF görüntüleyici hazırlanıyor...

References (13)

  1. Roujeau JC, Stern RS. Severe cutaneous reactions to drugs. N Engl J Med. 1994;331:1272–1285.
  2. Schwartz RA, McDonough PH, Lee BW. Toxic epidermal necrolysis: Part II. J Am Acad Dermatol. 2013;69:187.e1–187.e16.
  3. Ranu H, Jiang J, Ming PS. A case series of allopurinol-induced toxic epidermal necrolysis. Indian J Dermatol. 2011;56(1):74–76.
  4. Frantz R, Huang S, Are A, Motaparthi K. Stevens–Johnson Syndrome and Toxic Epidermal Necrolysis: A Review of Diagnosis and Management. Medicina. 2021;57(9):895.
  5. Ryu HJ, Song R, Kim HW, et al. Clinical risk factors for adverse events in allopurinol users. J Clin Pharmacol. 2013;53:211–216.
  6. Stamp LK, Day RO, Yun J. Allopurinol hypersensitivity: investigating the cause and minimizing the risk. Nat Rev Rheumatol. 2016;12:235–242.
  7. Zimmerman D, Dang NH. Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN): immunologic reactions. In: Nates J, Price K, eds. Oncologic Critical Care. Springer, Cham; 2020.
  8. Turnheim K, Krivanek P, Oberbauer R. Pharmacokinetics and pharmacodynamics of allopurinol in elderly and young subjects. Br J Clin Pharmacol. 1999;48:501–509.
  9. Anis TR, Meher J. Allopurinol-induced Stevens-Johnson Syndrome (SJS). Clin Pharmacol. 2023;15:99–105.
  10. Harris V, Jackson C, Cooper A. Review of toxic epidermal necrolysis. Int J Mol Sci. 2016;17(12):2135.
  11. Chung WH, Hung SI, Chen YT. Human leukocyte antigens and drug hypersensitivity. Curr Opin Allergy Clin Immunol. 2007;7:317-323.
  12. Bastuji-Garin S, Fouchard N, Bertocchi M, et al. SCORTEN: a severity-of-illness score for toxic epidermal necrolysis. J Invest Dermatol. 2000;115:149–153.
  13. Heuer R, Paulmann M, Annecke T, et al. S3 guideline: Diagnosis and treatment of epidermal necrolysis (Stevens-Johnson syndrome and toxic epidermal necrolysis) - Part 1: Diagnosis, initial management, and immunomodulating systemic therapy. J Dtsch Dermatol Ges. 2024;22(10):1448-1466.