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Axonal neuropathy with prolonged sulphasalazine use.

M Liedorp¹, A E Voskuyl, B W Van Oosten

¹Department of Neurology and the Department of Rheumatology, V.U. University Medical Centre, Amsterdam, The Netherlands. m.liedorp@vumc.nl

Clinical and Experimental Rheumatology

|September 19, 2008

Summary

Sulphasalazine, used for inflammatory conditions, can rarely cause peripheral neuropathy. This case highlights a patient developing axonal polyneuropathy after two years of sulphasalazine treatment.

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Area of Science:

Neuroscience
Pharmacology
Gastroenterology

Background:

Sulphasalazine is a 5-amino-salicylate medication commonly prescribed for inflammatory bowel diseases and arthritis.
Known adverse effects include blood dyscrasias and hepatic failure.
Peripheral neuropathy is a rare, documented adverse drug reaction to sulphasalazine.

Observation:

This report details a unique case of a patient experiencing neurological complications.
The patient presented with symptoms of axonal polyneuropathy.
The onset of symptoms occurred after a prolonged treatment period of two years with sulphasalazine.

Findings:

The patient developed axonal polyneuropathy.
The neuropathy manifested after two years of continuous sulphasalazine therapy.
This contrasts with most reported cases where symptoms appear within weeks of treatment initiation.

Implications:

This case expands the understanding of sulphasalazine's potential neurotoxic effects.
It suggests that prolonged sulphasalazine use may be associated with a delayed onset of peripheral neuropathy.
Clinicians should consider sulphasalazine-induced neuropathy in patients on long-term therapy presenting with neurological symptoms.