Brooks Carolyn, Calderon Lucie, Mosunjac Marina, Qayed Emad
Department of Internal Medicine, Emory University School of Medicine, Atlanta, USA.
Division of Digestive Diseases, Department of Internal Medicine, Emory University School of Medicine, Atlanta, USA.
Hepatol Forum. 2025 Jan 14;6(2):65-68. doi: 10.14744/hf.2024.2024.0027. eCollection 2025.
Acute immunoallergic hepatitis presents as acute liver injury, often accompanied by nonspecific findings of fever, rash, and abdominal pain, and is often induced by drug ingestion. Allopurinol has been implicated in multiple cases of acute immunoallergic hepatitis. We present the case of a young East Asian male with gout who experienced acute immunoallergic hepatitis, complicated by DRESS syndrome with a severe cutaneous reaction, as a result of allopurinol intake. The patient was positive for the HLA-B58*01 gene, a significant risk factor for developing allopurinol-induced liver injury. The patient's liver injury and skin reaction improved with the administration of IV methylprednisolone, followed by a course of oral prednisone. Our case prompts clinicians to prescribe allopurinol with caution in certain high-risk populations and emphasizes the importance of administering corticosteroids early in such a presentation to avoid long-term liver damage.
急性免疫过敏性肝炎表现为急性肝损伤，常伴有发热、皮疹和腹痛等非特异性表现，且常由药物摄入诱发。别嘌醇已被证实与多例急性免疫过敏性肝炎有关。我们报告了一例患有痛风的年轻东亚男性病例，该患者因服用别嘌醇而发生急性免疫过敏性肝炎，并并发伴有严重皮肤反应的药物超敏反应综合征（DRESS）。患者的HLA - B58*01基因呈阳性，这是发生别嘌醇诱导肝损伤的一个重要危险因素。给予静脉注射甲泼尼龙，随后口服泼尼松疗程后，患者的肝损伤和皮肤反应得到改善。我们的病例提示临床医生在某些高危人群中谨慎使用别嘌醇，并强调在此类病症中早期使用糖皮质激素以避免长期肝损伤的重要性。
