Sulfasalazine
- PDF / 141,883 Bytes
- 1 Pages / 595.245 x 841.846 pts (A4) Page_size
- 25 Downloads / 147 Views
1
S
Toxic epidermal necrolysis: case report A 40-year-old woman developed toxic epidermal necrolysis (TEN) during treatment with sulfasalazine for suspected rheumatoid arthritis (RA). The woman started sulfasalazine therapy [dosage and route not stated] 3 weeks prior to hospital admission. Symptoms preceding admission included fever, weakness, dry cough, lacrimation, photophobia and pain in the oral cavity and throat complicating breathing and swallowing of food [time to reaction onset not clearly stated]. Physical examination revealed widespread erythemaous cutaneous lesions involving the feet, cheeks, palms, conjunctiva and mucous membranes which evolved postadmission with the emergence of haemorrhagic blisters. The time from the onset of initial symptoms to the appearance of haemorrhagic blisters was approximately 10 days. During hospitalisation leukopenia and neutropenia were observed. Differential diagnoses included sulfasalazine-induced TEN in a patient with lupus erythematosus (LE), TEN secondary to LE, and TEN and sulfasalazine-induced LE in a patient with RA. Sulfasalazine was discontinued and antibiotic, steroid and antihistaminic therapy initiated. The patient was discharged after 15 days. She was hospitalised again 42 days after the onset of her initial symptoms. Visual complications due to TEN had developed causing photophobia, burning, and vision disorders. Repeat laboratory tests were suggestive of systemic lupus erythematosus and methylprednisolone was initiated [outcome not stated]. Author comment: "[I]n the clinical case we describe, sulfasalazine may have caused the drug-induced lupus and also activated the latent lupus. Further observations of the patient may add significant observations in resolving diagnostic uncertainties". Rachwal-Siek K, et al. [Toxic epidermal necrolysis during therapy with sulphasalazine in a patient with arthritis. Case report]. Wiadomosci Lekarskie (Warsaw, Poland: 1960) 64: 283-7, No. 4, 2011 [Polish; summarised from a 803075526 translation] - Poland
0114-9954/10/1416-0001/$14.95 Adis © 2010 Springer International Publishing AG. All rights reserved
Reactions 25 Aug 2012 No. 1416
Data Loading...
