Multiple Hematologic Abnormalities Associated with Sulfasalazine

Brief Reports1 November 1982Multiple Hematologic Abnormalities Associated with SulfasalazineKEVIN R. WHEELAN, M.D., BARRY COOPER, M.D., MARVIN J. STONE, M.D.KEVIN R. WHEELAN, M.D.Search for more papers by this author, BARRY COOPER, M.D.Search for more papers by this author, MARVIN J. STONE, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-97-5-726 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptVarious adverse reactions to sulfa drugs have been documented by numerous reports (1). Several distinct hematologic abnormalities associated with the use of sulfasalazine (Azulfidine; Pharmacia Laboratories, Piscataway, New Jersey) have been reported including hemolytic anemia, thrombocytopenia, and fatal agranulocytosis. We describe a patient with Crohn's disease who presented with agranulocytosis, erythroid hypoplasia, and marked marrow plasmacytosis. All these findings resolved promptly after sulfasalazine treatment was discontinued.A 28-year-old black man developed bloody diarrhea in December 1980. Findings on physical examination were normal. Laboratory data included a leukocyte count of 12 900/mm3with normal differential, and a hematocrit of 29%. Findings...References1. COLLINS J. Adverse reactions to salicylazosulfapyridine (Azulfidine) in the treatment of ulcerative colitis. South Med J. 1968;61:354-8. CrossrefMedlineGoogle Scholar2. GULLEYMIRZAKELLY RAC. Hepatotoxicity of salicylazo-sulfapyridine: a case report and review of the literature. Am J Gastroenterol. 1979;72:561-4. MedlineGoogle Scholar3. JAMSHIDIARLANDERGARCIAWINDSCHITLSWAIM KTMHW. Azalfidine agranulocytosis with bone marrow megakaryocytosis, histiocytosis and plasmacytosis. Minn Med. 1972;55:545-8. MedlineGoogle Scholar4. POUNDERCRAVENHENTHORNBANNATYNE REJJ. Red cell abnormalities associated with sulphasalazine maintenance therapy for ulcerative colitis. Gut. 1975;16:181-5. CrossrefMedlineGoogle Scholar5. WOLFWORKEN JB. Atypical amyloidosis and bone marrow plasmacytosis in a case of hypersensitivity to sulfonamides. Am J Med. 1954;16:746-55. CrossrefMedlineGoogle Scholar6. OSSERMANTAKATSUKI EK. Considerations regarding the pathogenesis of the plasmacytic dyscrasias. Scand J Haematol [Suppl]. 1965;4:28-49. Google Scholar7. HANCHAWLASOKAL TPJ. Sulfapyridine-induced serum-sickness-like syndrome associated with plasmacytosis, lymphocytosis and multiclonal gamma-globulinopathy. N Engl J Med. 1969;280:547-8. CrossrefMedlineGoogle Scholar8. DASEASTWOODMCMANUSSIRCUS KMJW. Adverse reactions during salicylazosulfapyridine therapy and the relation with drug metabolism and acetylator phenotype. N Engl J Med. 1973;289:491-5. CrossrefMedlineGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAuthors: KEVIN R. WHEELAN, M.D.; BARRY COOPER, M.D.; MARVIN J. STONE, M.D.Affiliations: Charles A. Sammons Cancer Center Baylor University Medical Center Dallas, Texas PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited bySulfonamidesSulphasalazine induced aplastic anaemiaThe use of sulphasalazine as a disease modifying antirheumatic drugDrug Metabolism by Leukocytes and Its Role in Drug-Induced Lupus and Other Idiosyncratic Drug ReactionsSulfasalazine in the rheumatic diseaseAgranulocytosis Associated with SulfasalazineA double-blind, placebo-controlled trialHépatite et syndrome mononucléosique liés à la prise de salazosulfapyridineSulfasalazine 1 November 1982Volume 97, Issue 5Page: 726-727KeywordsAdverse reactionsBone marrowCrohn's diseaseDiarrheaHematocritHemolytic anemiaResearch funding ePublished: 1 December 2008 Issue Published: 1 November 1982 PDF downloadLoading ...