Allopurinol-induced hepatitis. Report of a case and review of the literature
Ramond, M.J.; Nouel, O.; Degott, C.; Lebrec, D.; Benhamou, J.P.
Gastroenterologie Clinique et Biologique 6(2): 138-142
1982
ISSN/ISBN: 0399-8320 PMID: 7060857 Document Number: 189339
The case of a 74-yr-old female patient treated with allopurinol for 1 mo. and who presented with granulomatous hepatitis is reported. The main manifestations of the liver lesion were jaundice, mild ascites and increase in serum transaminases and alkaline phosphatases. The gradient between wedged and free hepatic venous pressures was 6 mm Hg, which indicated mild portal hypertension. The manifestations of liver involvement were associated with fever, rash, eosinophilia and renal failure. The patient recovered after cessation of allopurinol administration. From the analysis of this and 13 other cases, the features of allopurinol-induced hepatitis can be outlined: an interval of 3-6 wk between the beginning of the treatment and the onset of hepatitis; fever and/or rash preceding jaundice; frequent liver enlargement; increase in serum transaminases and alkaline phosphatases; frequent eosinophilia; frequent association with renal failure; histologically, inflammatory infiltration with granulomas in half of the cases; and recovery after cessation of allopurinol administration.