Gregory C. Kane, MD

Allopurinol, commonly used to treat patients with gout, has been known to cause hypersensitivity reactions. We report a case of drug-induced delayed multiorgan hypersensitivity syndrome secondary to allopurinol use. To the best of our knowledge, this is the first reported case of diffuse alveolar hemorrhage in a patient presenting with allopurinol-induced rash with eosinophilia and systemic symptoms.

The patient was a 40-year-old African American woman, with no significant past medical history, who presented to our medical center with a 4-week history of shortness of breath and lower extremity edema. The onset was progressive and initially occurred only with moderate exertion until about 2 weeks before presentation; at that time, her symptoms had worsened to the point where she experienced shortness of breath at rest. Orthopnea also developed at this time. The patient also reported intermittent palpitations, wheezing, and a dry cough of unknown duration.