Allopurinol-hypersensitivity vasculitis and liver damage

Fever, skin rash, renal failure and liver disease developed in 3 patients 3 to 4 wk after treatment with allopurinol was begun. Two of the patients recovered following therapy with corticosteroids. After recovery from the initial illness, allopurinol was readministered to one patient and fever and skin rash recurred. Allopurinol hypersensitivity should be included in the differential diagnosis of hepatocellular necrosis and renal failure. Early diagnosis is essential because the continued administration of allopurinol may result in a protracted illness and increased mortality.