Allopurinol hypersensitivity in a patient with coexistent systemic lupus erythematosus and tophaceous gout

A patient with coexistent Klinefelter's syndrome, systemic lupus erythematosus (SLE) and chronic tophaceous gouty arthritis developed allopurinol hypersensitivity. The drug was reinstituted by a schedule of gradually increasing doses. Gout should be considered in the differential diagnosis of patients with SLE who present with acute arthritis and/or subcutaneous nodules particularly in those with longstanding stable nephritis who are receiving diuretics for concomitant hypertension.