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Related Experiment Videos

The three week sulphasalazine syndrome.

H Brooks1, H G Taylor, F E Nichol

  • 1Department of Rheumatology, Leicester Royal Infirmary, United Kingdom.

Clinical Rheumatology
|December 1, 1992
PubMed
Summary

A rare sulphasalazine reaction can cause fever, rash, and hepatitis in rheumatoid arthritis patients. Prompt recognition and corticosteroid treatment are crucial for managing this potentially fatal adverse effect.

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Area of Science:

  • Rheumatology
  • Clinical Pharmacology

Background:

  • Rheumatoid arthritis (RA) is a chronic autoimmune disease.
  • Sulphasalazine is an established disease-modifying antirheumatic drug (DMARD) used in RA treatment.

Observation:

  • A 53-year-old male patient with sero-negative RA developed fever, rash, and hepatitis.
  • Symptoms appeared 3 weeks after initiating sulphasalazine therapy.

Findings:

  • The patient exhibited T cell lymphocytosis, eosinophilia, and classical complement pathway activation.
  • High-dose corticosteroids led to a favorable response.

Implications:

  • This case highlights a rare but characteristic adverse drug reaction to sulphasalazine.
  • Increased sulphasalazine use may lead to more frequent encounters with this reaction by rheumatologists.
  • Timely diagnosis is essential to prevent potentially fatal outcomes and misdiagnosis with other systemic conditions.

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