Journal article
Republished: Case of relapsing sulfasalazine-induced hypersensitivity syndrome upon re-exposure
Drug and therapeutics bulletin, Vol.59(11), pp.174-175
05/24/2021
DOI: 10.1136/dtb.2021.235803rep
PMID: 34031176
Abstract
Summary
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.
Background
Sulfasalazine is an immune-modulating medication that is used in the treatment of various autoimmune diseases. While it is generally well tolerated, sulfasalazine has been known to cause sulfasalazine-induced hypersensitivity syndrome (SIHS)1 2—a drug-specific version of the syndrome also known as drug reaction with eosinophilia and systemic symptoms (DRESS). SIHS is a systemic adverse drug reaction that typically manifests between 2 and 6 weeks after initiation of the drug and can be fatal
Details
- Title: Subtitle
- Republished: Case of relapsing sulfasalazine-induced hypersensitivity syndrome upon re-exposure
- Creators
- Jason Winward - Roy J. and Lucille A. Carver College of MedicineLaurel Lyckholm - Roy J. and Lucille A. Carver College of MedicineSamuel M Brown - Intermountain Medical CenterMohamad Mokadem - Roy J. and Lucille A. Carver College of Medicine
- Resource Type
- Journal article
- Publication Details
- Drug and therapeutics bulletin, Vol.59(11), pp.174-175
- DOI
- 10.1136/dtb.2021.235803rep
- PMID
- 34031176
- ISSN
- 0012-6543
- eISSN
- 1755-5248
- Language
- English
- Date published
- 05/24/2021
- Academic Unit
- Gastroenterology and Hepatology; Internal Medicine
- Record Identifier
- 9984359691502771
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