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Sulfasalazine-induced Pancytopenia Indicating Bone Marrow Suppression: A Rare Pediatric Case Report from Pakistan

Shayan Marsia1, Samar Mahmood1, Mohammad Raza2

  • 1Internal Medicine, Dow University of Health Sciences (DUHS), Karachi, PAK.

Cureus
|June 29, 2019
PubMed

Insights

Juvenile idiopathic arthritis (JIA) is a common childhood rheumatic disease. This case report details rare sulfasalazine-induced bone marrow suppression in a five-year-old child with JIA.

Area of Science:

  • Pediatric Rheumatology
  • Pharmacology
  • Hematology

Background:

  • Juvenile idiopathic arthritis (JIA) is the most prevalent chronic rheumatic condition in children.
  • Current JIA management relies on pharmacotherapy, including NSAIDs, corticosteroids, and disease-modifying antirheumatic drugs (DMARDs).
  • Sulfasalazine serves as a second-line DMARD, generally considered safe and effective.

Observation:

  • This study presents a rare case of JIA in a five-year-old child.
  • The child experienced bone marrow suppression.
  • This adverse event was linked to sulfasalazine treatment.

Findings:

  • Sulfasalazine, a commonly used DMARD for JIA, can induce bone marrow suppression.
  • This specific adverse effect is infrequently documented in pediatric JIA patients.
  • The case highlights a rare but serious complication of sulfasalazine therapy in children.

Implications:

  • Clinicians should be vigilant for potential hematologic side effects of sulfasalazine in pediatric JIA patients.
  • Early recognition and management of bone marrow suppression are crucial for patient outcomes.
  • This case underscores the importance of monitoring and reporting rare adverse drug reactions in pediatric populations.

Keywords:
bone marrow suppressiondmardjoint painjuvenile idiopathic arthritisoligoarthritispakistanpancytopeniapediatricsrheumatologysulfasalazine

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