Journal article
Case of relapsing sulfasalazine-induced hypersensitivity syndrome upon re-exposure
BMJ case reports, Vol.13(9), p.e235803
09/15/2020
DOI: 10.1136/bcr-2020-235803
PMCID: PMC7493089
PMID: 32933910
Abstract
Sulfasalazine-induced hypersensitivity syndrome (SIHS) is a serious systemic delayed adverse drug reaction that is associated with significant morbidity and mortality. Here, we report the first case, to our knowledge, of a patient with previously unidentified SIHS who developed a significantly more rapid and extreme recurrence on re-exposure to sulfasalazine. The patient is a 58-year-old woman with asymptomatic Crohn's disease who, 10 days after initiating sulfasalazine, developed fevers, diffuse rash, pancytopenia, hypotension and hepatitis without a definitive source of infection. Sixteen days after her first hospitalisation, she was restarted on sulfasalazine and was readmitted within 10 hours with a similar but more serious presentation, requiring vasopressors. She did recover completely without any further recurrence to date, after definitively discontinuing sulfasalazine. This case demonstrates the importance of recognising SIHS early in patients to prevent re-exposure to sulfasalazine and to ensure timely initiation of appropriate treatment.
Details
- Title: Subtitle
- Case of relapsing sulfasalazine-induced hypersensitivity syndrome upon re-exposure
- Creators
- Jason Winward - Roy J. and Lucille A. Carver College of MedicineLaurel Lyckholm - University of IowaSamuel M Brown - Intermountain Medical CenterMohamad Mokadem - Roy J. and Lucille A. Carver College of Medicine
- Resource Type
- Journal article
- Publication Details
- BMJ case reports, Vol.13(9), p.e235803
- DOI
- 10.1136/bcr-2020-235803
- PMID
- 32933910
- PMCID
- PMC7493089
- ISSN
- 1757-790X
- eISSN
- 1757-790X
- Language
- English
- Date published
- 09/15/2020
- Academic Unit
- Gastroenterology and Hepatology; Internal Medicine
- Record Identifier
- 9984359850502771
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