STANLEY L. WALLACE, M.D.
To the editor: The case report by Gelbart, Weinstein, and Fajardo (Ann Intern Med 86:196-198, 1977) describes the clinical course and biopsy information in a patient who, after 1 month of allopurinol therapy, developed exfoliative dermatitis, fever, eosinophilia, and acute renal shutdown. Skin biopsy showed subacute small vessel angiitis and renal biopsy a severe acute interstitial nephritis.
However, one crucial question was neither asked nor answered in this report. Why was the patient given allopurinol at all? According to the letter, allopurinol and small doses of colchicine were given in the treatment of an acute attack of presumed gout. But
WALLACE SL. Allopurinol Use. Ann Intern Med. ;87:116–117. doi: 10.7326/0003-4819-87-1-116_2
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Published: Ann Intern Med. 1977;87(1):116-117.
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