title: Allopurinol-induced aplastic anemia in a patient with chronic kidney disease.
abstract: Aplastic anemia is a rare complication of allopurinol use. We report an unusual case of aplastic anemia associated with allopurinol therapy for hyperuricemia in a patient with chronic kidney disease. A 37-year-old female patient diagnosed with Stage III chronic kidney disease was admitted with pancytopenia. She had a history of taking allopurinol for 5 months. Her bone marrow showed extremely decreased cellularity (< 20%) and there was no malignant cell infiltration. She was free of infections, including parvovirus B19, cytomegalovirus and Epstein-Barr virus. These results suggested a diagnosis of aplastic anemia. Allopurinol was discontinued immediately and treatment with blood transfusions and prednisolone was begun. After 6 months, the bone marrow cellularity improved to approximately 70%. Recently, it was suggested that decreased activity of multidrug resistance P-glycoprotein may play a role in acquired aplastic anemia. So we measured the inhibitory effect of allopurinol and oxypurinol on P-glycoprotein activity. But neither allopurinol nor oxypurinol inhibited P-glycoprotein activity.
authors.affiliation: Department of Internal Medicine, School of Medicine, Inje University, Busan, South Korea. kyw8625@chollian.net
authors.forename: Y W
authors.initials: YW
authors.lastname: Kim
authors.forename: B S
authors.initials: BS
authors.lastname: Park
authors.forename: C H
authors.initials: CH
authors.lastname: Ryu
authors.forename: S J
authors.initials: SJ
authors.lastname: Park
authors.forename: S W
authors.initials: SW
authors.lastname: Kang
authors.forename: Y H
authors.initials: YH
authors.lastname: Kim
authors.forename: I S
authors.initials: IS
authors.lastname: Song
authors.forename: J H
authors.initials: JH
authors.lastname: Shon
mesh_terms: D000328:Adult; D000493:Allopurinol / Q000009:adverse effects*; D000741:Anemia, Aplastic / Q000139:chemically induced* / Q000628:therapy; D004791:Enzyme Inhibitors / Q000009:adverse effects*; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000150:complications*
chemical_list: D004791:Enzyme Inhibitors; D000493:Allopurinol