To the Editor:
Allopurinol is the major drug used in the treatment of gout and hyperuricemia. Generally, the drug is well tolerated, although a minority of people, about 2%, develop a hypersensitivity reaction with rash or, less frequently, Stevens-Johnson syndrome (SJS)1. A multinational study reported that allopurinol is the most common drug associated with SJS and toxic epidermal necrolysis2. Genomic studies have shown that the HLA-B*5801 allele is a strong risk factor (OR 34–348) for developing allopurinol-induced SJS3,4,5,6,7,8. However, the clinical utility of HLA-B*5801 is unclear.
We conducted an observational study in the immediate family members of a male patient who experienced allopurinol-induced SJS in 1997 (index case). The patient, now 72 years old, was diagnosed with SJS by a dermatologist when he developed a generalized blistering rash, fever, and internal organ failure …
Address correspondence to Dr. R.O. Day, Clinical Pharmacology, St. Vincent’s Hospital Sydney, Darlinghurst, New South Wales 2010, Australia. E-mail: R.Day{at}unsw.edu.au