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Sulfasalazine Toxic Reactions
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1978
Year
Gastrointestinal PharmacologyAllergy MedicineImmunologyGastroenterologyChemical AgentDrug AllergyInflammatory ArthritisToxicological MechanismInflammationDrug HypersensitivityMedicinal ChemistrySulfasalazine Toxic ReactionsFood IntoleranceMinor Adverse EffectsToxicologyUlcerative ColitisRheumatoid ArthritisGeneralized Allergic ReactionRheumatologyAllergyAutoimmune DiseasePharmacologyDigestive System DiseasesClinical GastroenterologyGastrointestinal PathologyMedicine
SINCE its discovery in 1942, sulfasalazine (Azulfidine) has been the most commonly used sulfonamide for the treatment of inflammatory bowel disease. Its merit has been well established in ulcerative colitis, and it possibly has a place in the treatment of Crohn's disease. Although minor adverse effects (anorexia, nausea, vomiting) are recognized frequently, serious reactions are considered rare. In recent years, however, severe adverse reactions to sulfasalazine therapy have been reported with greater frequency.<sup>1,2</sup>We report a generalized allergic reaction with fever, skin rash, arthralgias, lymphadenopathy, and hepatitis coincident with the administration of this drug. This reaction was accompanied by decreased complement levels and circulating immune complexes. <h3>Report of a Case</h3> A 26-year-old man was seen because of a three-year history of intermittent cramping abdominal pain, diarrhea, and a 9-kg weight loss. A sigmoidoscopy, small bowel series, and barium enema examination showed Crohn's disease involving the terminal ileum and rectum.