Lymphoproliferative disorder due to sulphasalazine.
1Heart of England NHS Trust, Department of Rheumatology, Netherwood, Solihull Hospital, Lode Lane, Solihull B91 2JL, UK.
BMJ Case Reports
|June 21, 2011
Summary
A 57-year-old man developed a lymphoproliferative disorder after 20 years of sulphasalazine treatment for rheumatoid arthritis. The disorder resolved upon drug cessation, highlighting sulphasalazine as a potential cause.
Area of Science:
- Rheumatology
- Oncology
- Pharmacology
Background:
- Rheumatoid arthritis (RA) is a chronic autoimmune disease.
- Long-term immunosuppressive therapies for RA include methotrexate and cyclosporine.
- Lymphoproliferative disorders are known complications of some RA medications.
Purpose of the Study:
- To report the first case of lymphoproliferative disorder secondary to sulphasalazine.
- To emphasize the importance of recognizing drug-induced lymphoproliferative disorders.
- To discuss differential diagnoses for such conditions.
Main Methods:
- Case presentation of a 57-year-old male RA patient.
- Review of literature on drug-induced lymphoproliferative disorders.
- Analysis of differential diagnoses including DRESS syndrome.
Main Results:
- The patient developed a lymphoproliferative disorder after 20 years of sulphasalazine use.
- Complete resolution of the lymphoproliferative disorder was observed after discontinuing sulphasalazine.
- This suggests a causal link between sulphasalazine and the observed disorder.
Conclusions:
- Sulphasalazine can induce lymphoproliferative disorders, a rare but significant adverse effect.
- Discontinuation of sulphasalazine may lead to complete remission of the disorder.
- Awareness of this potential complication is crucial for managing RA patients on long-term sulphasalazine therapy.
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