allopurinol / Generic mfg. - LARVOL DELTA

Mitochondrial ATP synthase deficiency and its relationship with the urea cycle (SSIEM 2023) - "Seven ATPAse6 pts showed persistent hypocitrullinemia (median 4 μmol/L; nv 10-35) with 4 identified at NBS (associating elevated C5OH, C3 carnitine) and 2 presented orotic aciduria after allopurinol loading test...Both disorders may present orotic aciduria, due to a secondary OTC deficiency instead of CPS1, as also supported by the bioinformatic tool STRING, showing a primary link between OTC, ATP6 and TMEM70 proteins. Positive ATP6 cases at NBS highlight the relevance of including this condition in the diagnostic algorithm."

CNS Disorders • Genetic Disorders • Metabolic Disorders

Mazdutide Inhibits p-ASK1 and SLC7A11-GPX4 Ferroptosis Axis to Improve Rat Uric Acid Nephropathy (OBESITY WEEK 2025) - "Eighty male SD rats were randomized into eight groups (n=10): CON (blank control), HFD (high-fat diet), UN (uric acid nephropathy), Mazdutide (0.025/0.05/0.075 mg·kg⁻¹), semaglutide (GLP-1RA), and allopurinol (25 mg·kg⁻¹). 1. Subcutaneous injection of Mazdutide every 3 days can improve uric acid nephropathy in SD rats.2. Administration of Mazdutide to HK-2 cells can improve cell viability reduced by uric acid administration and reduce cell apoptosis.3."

Preclinical • Fibrosis • Immunology • Renal Disease • ACSL4 • GPX4 • SLC7A11 • TGFB1

Mazdutide Lowers Uric Acid via GCGR-Dependent Hepatic Metabolic Reprogramming (OBESITY WEEK 2025) - "Single-nucleus RNA sequencing (snRNA-seq) examined transcriptional changes in hepatocyte subpopulations.In vitro, human hepatocyte THLE-2 cells were cultured under hyperuricemic conditions and treated with Mazdutide, Semaglutide, or Allopurinol. Mazdutide effectively lowers serum uric acid by reprogramming hepatic metabolism toward enhanced lipid utilization, reduced purine synthesis, and improved oxidative stress through GCGR-dependent mechanisms. Unlike Semaglutide, Mazdutide exhibits robust urate-lowering activity both in vivo and in vitro, highlighting its therapeutic potential for hyperuricemia and related metabolic disorders.These findings suggest that Mazdutide may offer therapeutic benefits for patients with hyperuricemia, particularly those with obesity-related metabolic disorders."

Genetic Disorders • Metabolic Disorders • Obesity

A Case of Drug Reaction With Eosinophilia And Systemic Symptoms Following Influenza Vaccination (ACAAI 2025) - "While most commonly triggered by medications such as antiepileptics and allopurinol, DRESS syndrome has rarely been associated with vaccinations...She was ultimately transitioned to mepolizumab for its steroid-sparing effect given her age and concern for systemic steroid side effects...Early detection and treatment with corticosteroids are crucial for favorable outcomes. With increasing vaccination efforts in older adults, clinicians should maintain a high index of suspicion for DRESS in patients presenting with systemic symptoms and rash following immunization."

Clinical • Anorexia • Eosinophilia • Fatigue • Immunology • Infectious Disease • Influenza • Pneumonia • Pulmonary Disease • Respiratory Diseases

Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS) Associated With RjPE Therapy: A Hidden Risk (ACAAI 2025) - "Isoniazid, rifampin, and pyrazinamide were held and his TB was treated with ethambutol, levofloxacin, and linezolid...He was treated with high dose dexamethasone and ultimately cyclosporine with resolution of his rash, eosinophilia, and respiratory distress. Discussion Common triggers of DRESS include antibiotics, anticonvulsants, and allopurinol. Rarely, RIPE therapy may incite DRESS with isoniazid and rifampin being the most common culprits. Mortality rate as high as 20% is attributable to kidney, liver, heart, and/or respiratory failure [1-3]."

Acute Respiratory Distress Syndrome • Cough • Eosinophilia • Immunology • Infectious Disease • Pulmonary Disease • Respiratory Diseases • Tuberculosis

Hypereosinophilic Syndrome Masquerading as a Drug Rash in the Primary Care Clinic (ACAAI 2025) - "Given the recent initiation of allopurinol, he was initially advised drug avoidance...He is currently undergoing successful treatment with Mepolizumab, a humanized monoclonal against Il-5...In fact, his rash had worsened despite drug avoidance. Furthermore, episodes of thrombosis could be further explained by a hypercoagulable state due to increased peripheral eosinophils."

Clinical • Cardiomyopathy • Cardiovascular • Chronic Kidney Disease • Dermatology • Eosinophilia • Gastrointestinal Disorder • Hematological Malignancies • Hypereosinophilic Syndrome • Immunology • Nephrology • Pruritus • Renal Disease • Urticaria • FIP1L1 • IL5 • PDGFRA

Evaluation Of A Newborn With Unexpected Reason For Positive SCID Screen (ACAAI 2025) - "Case Description A 7-day-old male born to a female with Crohn's disease on Allopurinol and Azathioprine presented with TREC count of zero on NBS. With increasing use of immune-modulating agents, there must be discussion on whether to include these specific drugs to the list of non-SCID conditions. This would allow providers to quickly assess, provide care, and broaden differentials for infants with T-cell lymphopenia of unknown cause."

Crohn's disease • Gastroenterology • Genetic Disorders • Hematological Disorders • Immunology • Inflammatory Bowel Disease • Leukopenia • Primary Immunodeficiency

DOAC-Induced DRESS In A Patient With CLL Factor V Leiden And Extensive Anticoagulant Intolerance (ACAAI 2025) - "While commonly associated with anticonvulsants, allopurinol, and antibiotics, DRESS due to direct oral anticoagulants (DOACs) is rarely reported...He has a complex anticoagulation history: He developed a prior rash to apixaban and was switched to dabigatran. He sustained clots on dabigatran, so he was transitioned to rivaroxaban...Although cross-reactivity among DOACs has not been well-established, this case raises concern for potential class effect among factor Xa inhibitors. The patient’s immunocompromised state from CLL may have contributed to his susceptibility to DRESS."

Clinical • Chronic Lymphocytic Leukemia • Dermatology • Dermatopathology • Eosinophilia • Immunology • Venous Thromboembolism

Stevens-Johnson syndrome or toxic epidermal necrolysis from antihypertensive medications: A systematic review of cases. (PubMed, Medicine (Baltimore)) - "Early recognition by clinicians is vital to achieving a favorable outcome, but identification of culprit medications can be difficult. Future studies should seek larger sample sizes and try to prove causation by further understanding the underlying pathophysiology."

Journal • Review • Cardiovascular • Hypertension • Infectious Disease • Renal Disease • Septic Shock • Steven-Johnson Syndrome

Long-read whole genome sequencing improves clinical management in acute leukemia (ASH 2025) - "patient diagnosed withAML, both epigenomic and genomic data confirmed NPM1 mutation, pharmacogenomic profilingidentified a poor function phenotype of the ABCG2 (BCRP) transporter, which had not been tested priorto the prescription of allopurinol at a dose of 300 mg daily, administered for 7 days on two separateoccasions...Our findings underscore the value of~20x long-read whole genomic and epigenomic profiling for refined diagnosis, risk stratification, andsupportive care management in hematology/oncology. Overall, we show the strength of a rapid long-readsequencing to provide in a single run methylation data that can assist in preliminary diagnostic andprognostic calls and DNA sequencing data for actionable genetic and pharmacogenomic calls to promotepersonalized treatment strategy."

Clinical • Whole genome sequencing • Hematological Malignancies • Leukemia • Myelodysplastic Syndrome • Pediatrics • ABCG2 • ARG1 • IDH1 • NPM1

Evaluation of ventoclax initiation prophylaxis and monitoring outcomes at each dose level and time point in patients with chronic lymphocytic leukemia: A real-world experience (ASH 2025) - "Background : Venetoclax (VEN)+obinutuzumab (VO) is an effective therapy for CLL/SLL requiring regularmonitoring for tumor lysis syndrome (TLS) during VEN ramp-up...Adult pts with CLL/SLL were eligible if they: (1) startedVO per-label outside of a clinical trial in 1L, or immediately after exposure in 1L to agents with differentmechanisms of action (i.e., BTKi, anti-CD20 only) of <30 days; (2) prior to VEN start, had either (i) lowphysician-determined tumor burden (TB) (i.e., all lymph nodes [LN] <5 cm and ALC <25 x 109/L), or (ii)medium physician-determined TB (i.e., any LN ≥5-<10 cm or ALC ≥25 x 109/L) with creatinine clearance≥80 mL/min; (3) had no strong CYP3A inhibitors or prophylactic rasburicase from 3 days prior to VENstart until end of VEN ramp-up; and (4) had VEN ramp-up in an outpatient setting.TB-related labs/imaging was assessed from 2 months prior to obinutuzumab initiation (i.e., index date)until VEN start...Prior to VEN ramp-up, all pts..."

Clinical • Real-world • Real-world evidence • Anemia • Chronic Lymphocytic Leukemia • Diabetes • Hematological Disorders • Hematological Malignancies • Leukemia • Neutropenia • IGH • TP53

An Interventional study on the impact of hyperuricaemia on the prognosis of patients with heart failure with preserved ejection fraction. (ChiCTR) - P4 | N=327 | Not yet recruiting | Sponsor: The Third People's Hospital of Chengdu; The Third People's Hospital of Chengdu

New P4 trial • Cardiovascular • Congestive Heart Failure • Heart Failure

Allopurinol Therapy in Cirrhotic Patients: Impact on Uric Acid and Liver Enzymes (ACG 2025) - "After matching, 5358 patients were included in each group. Allopurinol use was associated with greater reductions in serum uric acid (−2.1 mg/dL vs −0.4 mg/dL, p < 0.01), ALT (−14.2 U/L vs −6.5 U/L), and AST (−12.3 U/L vs −4.8 U/L) compared to controls. Albumin levels increased and total bilirubin decreased in the allopurinol group, though these changes were not statistically significant."

Clinical • Fibrosis • Hepatology • Immunology • Inflammation • Liver Cirrhosis

When Newly Diagnosed Cirrhosis Conceals Cancer: Diagnosing CLL in a Patient With Alcohol Use Disorder, Lymphocytic Ascites, and Exudative Pleural Effusions (ACG 2025) - "Peripheral smear revealed reactive lymphocytes, and lymph node biopsy confirmed Rai stage IV CLL/SLL.Given his decompensated cirrhosis, which precluded standard CLL induction regimens, and concurrent AKI with hyperuricemia concerning for spontaneous tumor lysis, he was started on weekly rituximab monotherapy for disease debulking, along with allopurinol and rasburicase. Prominent paraesophageal, mesenteric, retroperitoneal, bilateral pelvic sidewall, and inguinal lymphadenopathy. Additional findings include mild omental stranding concerning for a neoplastic process, diffuse soft tissue anasarca, and a moderate right-sided pleural effusion with associated passive lung collapse."

Clinical • Pleural effusion • Addiction (Opioid and Alcohol) • Chronic Lymphocytic Leukemia • CNS Disorders • Fibrosis • Hematological Malignancies • Hepatology • Hodgkin Lymphoma • Immunology • Infectious Disease • Leukemia • Liver Failure • Lymphoma • Metabolic Disorders • Non-Hodgkin’s Lymphoma • Oncology • Portal Hypertension • Respiratory Diseases • Small Lymphocytic Lymphoma • Tuberculosis

Allopurinol Use Is Associated With Decreased Incidence of Hepatic Decompensation and Overall Mortality Among Adults With Compensated Cirrhosis: A Population-Based Propensity-Matched Cohort Study of 10,716 Individuals (ACG 2025) - "After propensity-score matching, each group in the any dose exposure included 5358 patients, 2124 in each group for 100 mg, and 1020 in each group for 300 mg. At 18 months, statistically significantly lower incidence of hepatic decompensation was seen in the overall allopurinol exposure cohort (OR: 0.77; 95% CI: 0.70-0.84), the 100 mg cohort (OR: 0.66; 95% CI: 0.57 to 0.76), and 300 mg cohort (OR: 0.76, 95% CI: 0.62 to 0.94). Allopurinol exposure was associated with a decreased incidence of esophageal variceal bleeding (OR: 0.71 95% CI: 0.55 to 0.92), ascites (OR: 0.77 95% CI: 0.69 to 0.84), HE (OR: 0.76 95% CI: 0.63 to 0.92), SBP (OR: 0.61 95% CI: 0.46 to 0.80), and overall mortality (OR: 0.86 95%% CI: 0.77 to 0.96) compared to the control group (Figure). In a propensity-score matched analysis of a large national database, individuals with compensated cirrhosis and allopurinol use had significantly lower risk of hepatic decompensation and overall mortality."

Clinical • CNS Disorders • Fibrosis • Hepatic Encephalopathy • Hepatocellular Cancer • Hepatology • Immunology • Liver Failure • Nephrology • Renal Disease • Solid Tumor

TUMOR LYSIS SYNDROME MANAGEMENT IN A RESOURCE-LIMITED SETTING WITH NO ACCESS TO RASBURICASE (SIOP 2025) - "Allopurinol was used in 15 (64%) patients. TLS, an unexpectedly frequent complication in ALL in our setting, can be effectively treated without Rasburicase despite a high frequency of hyperuricemia, with low mortality."

Acute Kidney Injury • Cardiovascular • CNS Disorders • Endocrine Disorders • Epilepsy • Metabolic Disorders • Nephrology • Oncology • Renal Disease

ORAL METRONOMIC THERAPY IN A CHILD WITH ACUTE MYELOID LEUKEMIA: A CASE REPORT FROM A RESOURCE-LIMITED SETTING (SIOP 2025) - "Metronomic oral therapy with steroids, etoposide, and 6-mercaptopurine has been reported to prolong survival and serve as a bridge to curative treatment...Hyperleukocytosis resolved within four days using hydroxyurea, fluids, steroids, and allopurinol... Oral metronomic therapy offers a feasible strategy for stabilizing frail children with AML before curative treatment and may serve as palliative strategy in resource-limited settings. Further studies are needed to assess its long-term efficacy."

Case report • Clinical • Acute Myelogenous Leukemia • Hematological Malignancies • Infectious Disease • Leukemia • Palliative care • Pediatrics

PHARMACOGENOMICS IMPLEMENTATION IN PAEDIATRIC ONCOLOGY: UTILISING THE MARVEL-PIC TRIAL TO GENERATE EVIDENCE FOR PRE-EMPTIVE TESTING (SIOP 2025) - "Paired medications include allopurinol, sertraline, omeprazole, voriconazole, ondansetron, flucloxacillin, amikacin and mercaptopurine...Ondansetron, mercaptopurine, omeprazole, pantoprazole and voriconazole were commonly prescribed medications with PGx prescribing recommendations, with highest actionability rates for the latter three... Our analysis reveals a high prevalence of clinically relevant PGx phenotypes across this cohort, highlighting the utility of PGx testing in paediatric oncology patients across a range of genes and commonly prescribed medications. Study findings provide evidence that broad, pre-emptive PGx testing in oncology patients could improve treatment safety and efficacy of both chemotherapeutics and supportive care. The MARVEL-PIC primary endpoints will validate this new approach to treatment protocols in children with cancer."

Biomarker • Pediatrics • ABCG2 • CYP2C19 • HLA-B • NUDT15

Tailored Management of Chronic Lymphocytic Leukemia-Related Monoclonal Gammopathy of Renal Significance in an Elderly Patient with Severe Kidney Impairment (KIDNEY WEEK 2025) - "Pre-phase prednisolone and rituximab (375mg/m2 over 2 days) was started to reduce tumor burden prior to initiating venetoclax and obinutuzumab (VEN+OBI) therapy. TLS prophylaxis with allopurinol and judicious hydration was instituted...Toxicities in this patient were managed with timely modifications, enabling continued therapy and clinical benefit. This case highlights the feasibility of effective, individualised treatment in a high-risk population."

Clinical • Chronic Kidney Disease • Chronic Lymphocytic Leukemia • Fibrosis • Glomerulonephritis • Hematological Disorders • Hematological Malignancies • Immunology • Leukemia • Lupus Nephritis • Monoclonal Gammopathy • Nephrology • Renal Disease

STEVENS-JOHNSON SYNDROME AND THE CONSEQUENCES OF PLACEMENT (CHEST 2025) - "Drug intolerance causes>50% of cases, including sulfa antibiotics, allopurinol, lamotrigine, NSAIDs, and some chemotherapy agents (4)...Treatment involves stopping the offending medication, providing supportive care, and treating with cyclosporine or plasmapheresis...She began adjuvant chemotherapy with gemcitabine and capecitabine and three weeks later developed oral ulcers, truncal rash, and diarrhea... This case highlights the need for appropriate clinical decision-making to play a more significant role in determining which patients clinically fit the profile of a severe case of SJS. Comorbidities like chemotherapy exposure should considered when deciding how to triage patients' care appropriately."

Cardiovascular • Cerebral Hemorrhage • CNS Disorders • Conjunctivitis • Dry Eye Disease • Gallbladder Cancer • Hematological Disorders • Ocular Infections • Ocular Inflammation • Ophthalmology • Solid Tumor • Steven-Johnson Syndrome • Thermal Injury • CCL22

A RARE ADVERSE EFFECT OF DASATINIB THERAPY IN A CASE OF CHRONIC MYELOGENOUS LEUKEMIA (CML) (CHEST 2025) - "She was treated with allopurinol. This case highlights a rare presentation of bilateral chylothoraces, which is a relatively rare complication dasatinib therapy. The patient was taking the lowest dose of dasatinib and subsequently developed chylothoraces. The patient was discontinued off of the drug, which led to resolution of symptoms and chylothoraces."

Adverse events • Clinical • Chronic Myeloid Leukemia • Hematological Malignancies • Immunology • Inflammatory Arthritis • Leukemia • Oncology • Respiratory Diseases • Rheumatology

FROM UNCOMMON TO RARE: PRIMARY PERICARDIAL EFFUSION LYMPHOMA IN NONIMMUNOCOMPROMISED PATIENT (CHEST 2025) - "Given its rarity, clinical trials investigating optimal treatment regimens are not robust, and cyclophosphamide, doxorubicin, vincristine, prednisone-based chemotherapy have been the mainstay of treatment...Treatment with colchicine was initiated, and the patient was transferred to the ICU for close monitoring...Allopurinol was recommended to prevent tumor lysis syndrome... PEL often presents in immunocompromised/AIDS patients. Having said that, this case highlights that PEL should not be dismissed in patients living with HIV long-term, even well-controlled. Early detection, prompt interventions such as pericardiocentesis, and interdisciplinary collaboration are vital for enhancing patient outcomes."

Clinical • B Cell Lymphoma • Cardiovascular • Diffuse Large B Cell Lymphoma • Hematological Malignancies • Human Immunodeficiency Virus • Infectious Disease • Kaposi Sarcoma • Lymphoma • Non-Hodgkin’s Lymphoma • Oncology • Respiratory Diseases • Sarcoma • Solid Tumor • CD4

DUAL CRISIS: ACUTE RESPIRATORY FAILURE IN CLL WITH INFLUENZA A (CHEST 2025) - "The management strategy involved initiating Rituximab along with pulse-dose corticosteroids to address potential organizing pneumonia and leukemic infiltration. Empiric antibiotics (cefepime and vancomycin) were started, while oseltamivir was administered for the Influenza A infection. IV voriconazole was included for fungal prophylaxis...Prophylaxis for TLS with allopurinol was also implemented, with careful monitoring of metabolic parameters to prevent complications... This case underscores the importance of early recognition and aggressive management of acute respiratory failure in immunocompromised patients, especially those with hematologic malignancies like CLL. Multidisciplinary collaboration and timely interventions, including antiviral treatment and supportive care, are crucial to improving outcomes. Preventive measures such as influenza vaccination and early initiation of antiviral therapy should be prioritized in patients with CLL to reduce the risk of severe..."

Acute Respiratory Distress Syndrome • Anesthesia • Chronic Lymphocytic Leukemia • Infectious Disease • Influenza • Pneumonia • Pulmonary Embolism • Respiratory Diseases

DROWNING IN BLASTS: A CASE OF ACUTE MYELOID LEUKEMIA PRESENTING WITH PULMONARY LEUKOSTASIS (CHEST 2025) - "A chest X-ray showed basilar atelectasis concerning for pneumonia, and he was prescribed doxycycline and azithromycin...Oncology initiated treatment with allopurinol, rasburicase, and hydroxyurea... Pulmonary leukostasis is a life-threatening but potentially reversible complication of AML that requires early recognition and prompt intervention. This case highlights the diagnostic challenge posed by its overlap with other pulmonary conditions, underscoring the importance of maintaining a high index of suspicion in AML patients presenting with respiratory distress. Despite aggressive management, delayed diagnosis and rapid disease progression can lead to poor outcomes."

Clinical • Acute Myelogenous Leukemia • Cough • Fatigue • Hematological Malignancies • Hypotension • Infectious Disease • Leukemia • Metabolic Disorders • Nephrology • Oncology • Pneumonia • Pulmonary Disease • Respiratory Diseases • Thrombosis

Allopurinol-Associated Bullous Fixed Drug Eruption With Cross-Reaction to Febuxostat. (PubMed, Am J Ther) - No abstract available

Journal