Pancreatitis and pancreatic necrosis during sulfasalazine therapy

Two patients with inflammatory bowel disease and no history of bilio-pancreatic disorders or alcoholism developed acute pancreatitis after therapy with sulfasalazine. The treatment lasted two months in the first case and four days in the second. The onset of pancreatic complications was heralded by jaundice; abdominal pain was a late symptom. The clinical course was dramatic in both cases, and one patient died. These findings agree with the hypothesis that sulfasalazine like other sulfonamidic compounds is a potentially pancreotoxic drug.