Combined hepatotoxicity and neurotoxicity following sulphasalazine administration

Two cases of hepatotoxicity following sulphasalazine administration are reported. Each patient became ill after her initial exposure to sulphasalazine and after being re-exposed to the drug. In both instances there was an interval of three weeks between receiving the drug for the first time and the onset of the toxic reaction. In the first patient, hepatotoxicity occurred after initial exposure and following the second course of sulphasalazine. Mild neurotoxicity was seen following second exposure to sulphasalazine. In the second patient, hepatotoxicity occurred following the initial exposure to sulphasalazine but after reexposure the only abnormality in liver function tests present was a slight rise in the serum level of gamma glutamyl transpeptidase. In this patient, life-threatening neurotoxicity occurred each time that the patient received sulphasalazine.