Lupus-like syndrome caused by 5-aminosalicylic acid in patients with inflammatory bowel disease.
BACKGROUND
Although 5-aminosalicylic acid (5-ASA) preparations used to treat inflammatory bowel disease are reported to have fewer side effects than sulphasalazine, increased clinical use of these compounds has resulted in increased reports of significant side effects.


OBJECTIVE
To report four patients with antinuclear antibody-positive migratory arthralgias and acute inflammation unrelated to the underlying inflammatory bowel disease, fulfilling the criteria of a drug-induced lupus-like syndrome.


METHODS
A university-affiliated teaching hospital.


METHODS
Cessation of treatment with 5-ASA compounds.


RESULTS
The cases described constitute a drug-induced lupus-like syndrome. All patients improved rapidly after discontinuation of 5-ASA compounds.


CONCLUSIONS
Reversible lupus-like syndrome appears to be a rare but significant side effect of 5-ASA compounds. Patients treated with 5-ASA compounds who experience acute inflammatory symptoms or clinical deterioration not related to their gastrointestinal disease should be screened to rule out a lupus-like reaction.
Kirkpatrick
A W
AW
Vancouver Hospital and Health Sciences Centre, Vancouver, Canada.
Bookman
A A
AA
Habal
F
F
D000328:Adult; D000368:Aged; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000009:adverse effects* / Q000627:therapeutic use; D000974:Antibodies, Antinuclear / Q000032:analysis; D003240:Connective Tissue Diseases / Q000139:chemically induced*; D003424:Crohn Disease / Q000188:drug therapy*; D005260:Female; D006801:Humans; D008180:Lupus Erythematosus, Systemic / Q000139:chemically induced*; D008297:Male; D019804:Mesalamine / Q000009:adverse effects* / Q000627:therapeutic use; D008875:Middle Aged
D000894:Anti-Inflammatory Agents, Non-Steroidal; D000974:Antibodies, Antinuclear; D019804:Mesalamine