Agranulocytosis: an adverse effect of allopurinol treatment

Abstract

Introduction: Allopurinol is a xanthine oxidase inhibitor that is primarily used to treat hyperuricemia and its complications. The drug is rarely associated with adverse effects, but those that occur can be significant. Hematologic side effects, including bone marrow suppression, severe anemia, thrombocytopenia, and leukopenia, have been reported in 0.2-0.6% of treated patients. Materials and methods: We report a case of agranulocytosis associated with allopurinol therapy in a patient admitted for fever.

Anti-hyperuricemic and nephroprotective effects of Modified Simiao Decoction in hyperuricemic mice

“…Despite advances in the use of anti-hyperuricemic agents for the treatment of hyperuricaemia and gout, allopurinol as a frequently used xanthine oxidase (XOD) inhibitor could cause two percents of the users to induce severe hypersensitivity (such as a mild exanthema) and agranulocytosis, and aggravate renal toxicity by impairing pyrimidine metabolism (Chen et al, 2005;Horiuchi et al, 2000;Mari et al, 2011;Pluim et al, 1998). Therefore, it underlines much impetus for urgent need of available anti-hyperuricemic agents, especially herbal medicine (Ahmad et al, 2008;An et al, 2010).…”

Anti-Hyperuricemic and Nephroprotective Effects of Rhein in Hyperuricemic Mice

“…Nowadays, there are only a few drugs to treat hyperuricemia and nephropathy in clinics, including uricosuric agents and xanthine oxidase (XOD) inhibitors [4]. However, uricosuric drugs could lose their efficacy when kidney damage has already occurred and, on the other hand, as one of the most frequently prescribed agents, allopurinol could cause severe hypersensitivity, agranulocytosis, and aggravate renal toxicity by impairing pyrimidine metabolism [5][6][7]. Thus, the search for new compounds for concurrent therapy of hyperuricemia and nephropathy with the absence of toxic or side effects is highly warranted.…”

Utilization of Thiopurine Metabolites and Allopurinol in Pediatric Acute Lymphoblastic Leukemia: Consideration for an Algorithmic Approach

“…Similarly, a second patient had a drop in hemoglobin from a baseline of 12 g/dL to a low of 8.6 g/dL during the time of data collection. Both red cell aplasia and agranulocytosis have been reported with allopurinol, and therefore patients must be closely monitored for this side effect and 6MP not increased too aggressively while on allopurinol 24,25. Given the potential sensitivity of RBCs to 6TGNs, it is vital to monitor the hemoglobin closely while on allopurinol and especially if considering 6MP dose escalation.…”