Salazosulfapyridine-induced angioimmunoblastic lymphadenopathy

Area of Science:

• Immunology
• Oncology
• Pharmacology

Background:

• Ulcerative colitis (UC) management often involves medications like sulfasalazine.
• Angioimmunoblastic lymphadenopathy (AIL) is a rare T-cell mediated disorder.
• Drug-induced AIL is an uncommon but significant differential diagnosis.

Observation:

• A 20-year-old male patient with UC presented with fever, rash, and swollen lymph nodes.
• The patient had recently initiated salazosulfapyridine therapy.
• Lymph node biopsy confirmed angioimmunoblastic lymphadenopathy.

Findings:

• Autoantibody and viral titers were negative, ruling out common autoimmune and infectious causes.
• T-cell receptor beta gene rearrangement and chromosomal aberrations were absent, excluding peripheral T-cell lymphoma.
• The clinical presentation and biopsy results strongly suggested salazosulfapyridine-induced AIL.

Implications:

• This case underscores the potential for salazosulfapyridine to induce AIL, a condition that can be mistaken for lymphoma.
• Accurate diagnosis requires careful consideration of medication history and exclusion of other causes.
• This is the second reported case of drug-induced AIL linked to salazosulfapyridine in English literature.