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A Novel Procedure for Evaluating the Reinforcing Properties of Tastants in Laboratory Rats: Operant Intraoral Self-administration
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Allopurinol-induced Sweet's syndrome.

G Polimeni1, R Cardillo2, E Garaffo2

  • 1Sicilian Regional Centre of Pharmacovigilance, Clinical Pharmacology Unit - AOU Policlinico "G. Martino", Messina, Italy.

International Journal of Immunopathology and Pharmacology
|December 20, 2015
PubMed
Summary

This case report details a rare instance of Sweet's syndrome (acute febrile neutrophilic dermatosis) potentially triggered by allopurinol medication. Prompt treatment with corticosteroids led to rapid symptom resolution.

Keywords:
acute febrile neutrophilic dermatosisadverse drug reactionsallopurinolcutaneous manifestationdrug-induced Sweet’s syndrome

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Area of Science:

  • Dermatology
  • Rheumatology
  • Internal Medicine

Background:

  • Sweet's syndrome, or acute febrile neutrophilic dermatosis, is an uncommon but severe cutaneous condition.
  • It has not been previously associated with allopurinol therapy.

Observation:

  • An 87-year-old woman with hyperuricemia developed symptoms of Sweet's syndrome 8 days after initiating allopurinol therapy.
  • Symptoms included fever, painful edema, erythematous plaques with pustules, conjunctivitis, splenomegaly, and joint pain.
  • Initial blood tests revealed neutrophilic leukocytosis, inflammation, and abnormal liver function.

Findings:

  • The patient's condition did not improve with broad-spectrum antibiotics (ceftriaxone, levofloxacin).
  • Intravenous methylprednisolone therapy resulted in rapid clinical improvement, pain reduction, fever resolution, and normalization of blood values.
  • The Naranjo scale suggested a probable association between allopurinol use and the development of Sweet's syndrome.

Implications:

  • This case suggests a potential, previously unreported association between allopurinol and Sweet's syndrome.
  • The similar presentation of Sweet's syndrome to infections can lead to diagnostic delays and inappropriate antibiotic use.
  • Early recognition and consideration of drug-induced causes, such as allopurinol, are crucial for timely and effective glucocorticoid treatment.