Sulphasalazine-related life-threatening side effects: is N-acetylcysteine of therapeutic value?
This report is on a patient with a spondylarthropathy with peripheral joint involvement treated with sulphasalazine who developed severe hepatitis, disseminated intravascular coagulation, high spiking fever, a mononucleosis-like syndrome and a diffuse cutaneous rash. All these features resolved rapidly after drug withdrawal and intravenous N-acetylcysteine. Serious sulphasalazine-related adverse reactions are rare and their outcome is generally favourable within a few weeks after drug withdrawal. However, certain cases with life-threatening side effects may need additional treatment. The course in our patient suggests that N-acetylcysteine may be useful for treating sulphasalazine-induced side effects.
Gabay
C
C
Clinique de Rhumatologie, CHU Bichat, Claude-Bernard, Paris, France.
De Bandt
M
M
Palazzo
E
E
D000111:Acetylcysteine / Q000008:administration & dosage / Q000627:therapeutic use*; D000328:Adult; D056486:Chemical and Drug Induced Liver Injury / Q000188:drug therapy / Q000209:etiology; D004211:Disseminated Intravascular Coagulation / Q000139:chemically induced / Q000188:drug therapy; D003875:Drug Eruptions / Q000188:drug therapy / Q000209:etiology; D005260:Female; D006801:Humans; D007262:Infusions, Intravenous; D007592:Joint Diseases / Q000188:drug therapy; D012460:Sulfasalazine / Q000009:adverse effects* / Q000037:antagonists & inhibitors
D012460:Sulfasalazine; D000111:Acetylcysteine