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The authors believed quinidine caused Henoch-Schonlein purpura in this patient based on a chronologic association and lack of allopurinol-associated problems following chronic therapy. The mechanism is unknown and pharmacokinetic studies with hydrochlorothiazide have not demonstrated any effects on the disposition of allopurinol or oxipurinol (its major metabolite). The product of methylation, 2-amino-6-methylthiopurine, is also substantially less active and less toxic than Thioguanine and its formation is likewise unaffected by the presence of allopurinol. Allopurinol will not relieve a gout attack that has already started. {07} {35} {36} Both allopurinol and the uricosuric antigout agents are effective in patients whose 24-hour renal excretion of uric acid is 800 mg (4. MetabolicKrasinger and colleagues suggest that it may be reasonable to add allopurinol to the pancreatic enzyme treatment regimen in CF patients that have a urine pH of less than 6 and also excrete large amounts of uric acid.
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