Allopurinol hypersensitivity syndrome as a cause of hepatic centrilobular hemorrhagic necrosis.
Extensive and severe hepatic centrilobular hemorrhagic necrosis is a common finding in hepatic vein obstruction and Budd-Chiari syndrome. Some drugs, including allopurinol, can also cause this histopathologic appearance but to our knowledge in this setting the lesions are not so massive. Here we report a case of a 41-year-old female who developed fever, pruritic skin rash, jaundice, eosinophilia, abnormal liver function tests, and acute renal failure 3 weeks after the beginning of allopurinol treatment, complicated with severe hepatocyte necrosis around most terminal hepatic venules suggesting Budd-Chiari syndrome.
Mete
N
N
Department of Internal Medicine, Division of Immunology and Allergy, Ege University School of Medicine Bornova, Izmir, Turkey. nihal_mete@hotmail.com
Yilmaz
F
F
Gulbahar
O
O
Aydin
A
A
Sin
A
A
Kokuludag
A
A
Yuce
G
G
Sebik
F
F
D058186:Acute Kidney Injury / Q000139:chemically induced; D000328:Adult; D000493:Allopurinol / Q000009:adverse effects*; D000959:Antihypertensive Agents / Q000009:adverse effects*; D056486:Chemical and Drug Induced Liver Injury; D005260:Female; D006470:Hemorrhage / Q000139:chemically induced* / Q000473:pathology; D006801:Humans; D006973:Hypertension / Q000188:drug therapy; D008107:Liver Diseases / Q000473:pathology; D009336:Necrosis
D000959:Antihypertensive Agents; D000493:Allopurinol