Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0042109 (urticaria)
 6,569 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Standard prophylaxis and treatment of malignancy-associated hyperuricemia in the USA has been allopurinol with vigorous hydration, urinary alkalinization and osmotic diuresis. Urate oxidase, the enzyme that converts uric acid to allantoin (a readily excreted metabolite that has 5- to 10-fold higher solubility than uric acid), is an alternative therapy; however, few published findings support this practice. Between February 1994 and December 1996, we administered non-recombinant urate oxidase (Uricozyme) to 126 children with newly diagnosed non-B cell acute lymphoblastic leukemia (ALL) during the first 5 days of chemotherapy with methotrexate, 6-mercaptopurine or both. Their blood levels of uric acid and other indicators of tumor lysis were measured at diagnosis and during treatment and then compared with findings in 129 similarly treated historical controls who had received allopurinol to control hyperuricemia. Clinical responses to urate oxidase were also determined in eight patients with newly diagnosed B cell ALL or advanced-stage non-Hodgkin lymphoma. Patients treated with urate oxidase had rapid and significantly greater decreases in their blood uric acid levels than did the historical controls (median maximal level during treatment, 2.3 vs 3.9 mg/dl, P < 0.001). They also had lower creatinine (0.6 vs 0.7 mg/dl, P = 0.01) and blood urea nitrogen (11 vs 24 mg/dl, P < 0.001) levels. Similar findings were made in the eight cases of B cell ALL or non-Hodgkin lymphoma. None of the patients required dialysis for acute renal failure. Six (4.5%) of the 134 children given urate oxidase had allergic reactions, manifested primarily by urticaria, bronchospasm and hypoxemia. Thus, non-recombinant urate oxidase is a more effective uricolytic agent than allopurinol but is associated with acute hypersensitivity reactions, even in patients without a history of allergy.
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PMID:Urate oxidase in prevention and treatment of hyperuricemia associated with lymphoid malignancies. 936 11

Allopurinol is often prescribed for the treatment of hyperuricemia. It inhibits the uric acid production binding tightly to xanthine oxidase. Although it is generally well tolerated, an almost 10% prevalence of adverse reactions has been reported, particularly gastrointestinal and neurological effects. Some hypersensitivity syndromes have also been described (rash, vasculitis or exfoliative dermatitis). In these cases, if a substitute treatment is not available, a desensitization procedure to the drug must be considered. We present three patients with cutaneous hypersensitivity to allopurinol, two who developed urticaria and other one who had a fixed drug eruption. Skin test were all negatives with positive oral challenge test. An out- patient desensitization procedure to allopurinol was initiated, repeating the last tolerated doses for 4 or 5 days, and reaching maintenance therapeutic drug doses without any significant adverse effect (only one case of cutaneous pruritus). These experiences and the previously reported in the literature, show that the desensitization to allopurinol is a good therapeutic alternative in hypersensitivity reactions to the drug.
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PMID:[Hypersensitivity to allopurinol. Efficacy of a desensitizing protocol in 3 cases]. 1138 41

Allopurinol is an FDA -Approved xanthine oxidase inhibitor, which is effective in the treatment of gout, hyperuricemia and uremic kidney stones in patients with an increased level of uric acid excretion. Xanthine oxidase acts by converting hypoxanthine and xanthine into uric acid, and therefore its inhibition results in decreased production of uric acid. The most common side effects of this medication are as follows: maculopapular rashes, hives, itching, headache, dizziness, abnormal hair loss, fever and hypersensitivity reaction. Case Presentation: This report represents a case of drug-induced meningitis of a senile man who ended up in the ICU due to the remarkably reduced state of consciousness.
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PMID:Allopurinol and Loss of Consciousness in a 78-old Year Man Suffering from Gout. 3068 65