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Sulfasalazine induced seizures and dysphasia
M E Hill1, C Gordon, R D Situnayake
1Department of Medicine, Queen Elizabeth Hospital, Birmingham, UK.
The Journal of Rheumatology
|April 1, 1994
Summary
A woman with rheumatoid arthritis experienced severe sulfasalazine side effects, including speech difficulty and seizures, with positive perinuclear antineutrophil cytoplasmic antibodies (pANCA). Symptoms resolved after stopping the medication, highlighting a potential new adverse reaction.
Area of Science:
- Rheumatology
- Clinical Pharmacology
- Neurology
Background:
- Rheumatoid arthritis (RA) is a chronic autoimmune disease.
- Sulfasalazine is a disease-modifying antirheumatic drug (DMARD) used in RA treatment.
- Adverse drug reactions require careful monitoring and reporting.
Observation:
- A 46-year-old female RA patient presented with severe adverse events.
- The patient developed dysphasia, seizures, and rash.
- Laboratory tests revealed strongly positive perinuclear antineutrophil cytoplasmic antibodies (pANCA).
Findings:
- The patient's symptoms significantly improved upon sulfasalazine withdrawal.
- Dysphasia was not previously documented as a sulfasalazine side effect.
- The pANCA positivity correlated with the observed adverse reaction.
Implications:
- This case suggests a potential new severe adverse drug reaction to sulfasalazine.
- Increased awareness of this reaction may aid in early diagnosis and management.
- Further investigation into the mechanism of sulfasalazine-induced autoimmunity is warranted.