Title:Hypersensitivity to Febuxostat in a Patient with a Previous Allopurinolinduced
Steven-Johnson Syndrome: A Case Report of Treatment with a
Slow Desensitization Protocol
Volume: 22
Issue: 8
Author(s): Gianfranco Calogiuri*, Maurizio Congedo, Eustachio Nettism, Luigi Macchia, Caterina Foti and Angelo Vacca
Affiliation:
- Department of Pneumology, Civil Hospital Vito Fazzi, Lecce, Italy
Keywords:
Allopurinol, drug desensitization, febuxostat, hypersensitivity, skin rash, Steven-Johnson syndrome.
Abstract:
Background: We report the case of a 43-year-old Chinese male with Tophaceous gout
who had been living in Italy for some years.
Case Presentation: Previous treatments with allopurinol had induced Steven Johnson syndrome,
dictating a switch to febuxostat 80 mg daily. After two years of treatment with febuxostat, he
developed a diffuse maculopapular rash with severe itching. Rheumatologists stopped febuxostat;
however, gout worsened over the following years despite treatment with kalnicitrate and
colchicine. Therefore, an allergy consultation was called for. A slow desensitization protocol with
febuxostat was started, with a low oral dosage scheme to be increased up to 80 mg/day. Febuxostat
was prepared in a solid formulation by the consultation pharmacist as pills instead of the more
frequently used liquid suspension.
Conclusion: The patient is currently receiving febuxostat 80 mg, and he has shown no side effects
as of now, while his gout has improved. This is the first reported example and he has shown no
side effect till now, while his gout improved of a successful desensitization protocol using a solid
preparation of diluted febuxostat given as pills.
