别嘌醇致重症药疹和迟发型过敏性休克

1例74岁男性因尿酸增高口服别嘌醇0．1g,2次／d。用药第16天出现全身瘙瘁，第21天胸部及背部皮肤出现针尖样红色皮疹，停药并给予对症处理2d无效，皮疹加重，且出现头昏、胸闷，遂入院。入院后检查心率73次／min，血压70／46mmHg（1mm Hg=0．133kPa），血清丙氨酸转氨酶124U／L，天冬氨酸转氨酶80U／L，尿素氮22．6mmol／L，肌酐151μmol／L，尿酸738tzmol／L。入院后心率一度降至42次／min。给予对症、支持治疗21d后，患者皮疹基本消退，血压、心率及肾功能正常，肝功能仍异常。

Serious drug eruption and delayed anaphylactic shock due to allopurinol

A 74-year-old man with high uric acid received oral allopurinol 0.1 g twice daily. On day 16, the patient presented with generalized itching and, on day 21, pin tip-like red rash on his skin of chest and back appeared. No improvement occurred despite the drug was discontinued and a 2-day symptomatic therapy was given. Aggravated rash, dizziness, and chest tightness appeared in the patient and then he was admitted to hospital. After admission, examinations showed the following levels and values： heart rate 73 beats / min, blood pressure 70/46 mm Hg. alanine aminotransferase 124 U/L. asoartate aminotransferase 80 U/L. Mood urea nitrogen 22.6 mmol/L, serum creatinine 151 μmol/L, and uric acid 738 μmol/L. After admission, his heart rate decreased to 42 beats/min on one occasion. After a 21-day symptomatic and supportive treatment, his rash disappeared basically and blood pressure, heart rate and renal function normalized, while liver function remained abnormal.