title: [Adverse effects of sulfasalazine: discussion of mechanism and role of sulfonamide structure].
abstract: Sulfasalazine is widely used in the treatment of chronic inflammatory bowel disease (IBD) and certain rheumatic diseases. However, its use is associated with a high rate of adverse effects (AEs) which can be cutaneous, hematological, renal, hepatic, gastrointestinal or neurological. The aim of our study was to collect all cases of AEs suspected to be associated with the use of sulfasalazine in patients hospitalized in the department of Gastroenterology from the Hospital Hedi Chaker of Sfax (Tunisia) for a period of 5 years and to search the incriminated fraction (sulfonamide or salicylate). Our study population included 69 patients who received sulfasalazine for the treatment of IBD. We collected, in 23 patients (33%), 25 AEs suspected to be related to sulfasalazine. Cutaneous and hematological reactions are the most common. The subsequent administration of mesalazine was performed in 15 patients. It was well tolerated in 14 patients. So we were suspecting probably the responsibility of sulfonamide fraction in these cases. The mechanism of sulfasalazine induced AEs may be toxic or immunoallergic with the possibility of a cross-reaction with the other antimicroacterial sulfonamides.
authors.affiliation: Laboratoire de Pharmacologie, Faculté de Médecine, Sfax, Tunisie.
authors.forename: Rim
authors.initials: R
authors.lastname: Atheymen
authors.affiliation: Laboratoire de Pharmacologie, Faculté de Médecine, Sfax, Tunisie.
authors.forename: Hanen
authors.initials: H
authors.lastname: Affes
authors.affiliation: Laboratoire de Pharmacologie, Faculté de Médecine, Sfax, Tunisie.
authors.forename: Kamilia
authors.initials: K
authors.lastname: Ksouda
authors.affiliation: Service de Gastroentérologie, Hôpital Hédi Chaker, Sfax, Tunisie.
authors.forename: Leila
authors.initials: L
authors.lastname: Mnif
authors.affiliation: Laboratoire de Pharmacologie, Faculté de Médecine, Sfax, Tunisie.
authors.forename: Zouheir
authors.initials: Z
authors.lastname: Sahnoun
authors.affiliation: Service de Gastroentérologie, Hôpital Hédi Chaker, Sfax, Tunisie.
authors.forename: Nabil
authors.initials: N
authors.lastname: Tahri
authors.affiliation: Laboratoire de Pharmacologie, Faculté de Médecine, Sfax, Tunisie.
authors.forename: Khaled Mounir
authors.initials: KM
authors.lastname: Zeghal
authors.affiliation: Laboratoire de Pharmacologie, Faculté de Médecine, Sfax, Tunisie.
authors.forename: Serria
authors.initials: S
authors.lastname: Hammami
mesh_terms: D000328:Adult; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000009:adverse effects* / Q000627:therapeutic use; D003429:Cross Reactions; D005260:Female; D006760:Hospitalization; D006801:Humans; D015212:Inflammatory Bowel Diseases / Q000188:drug therapy*; D008297:Male; D019804:Mesalamine / Q000009:adverse effects* / Q000627:therapeutic use; D008875:Middle Aged; D012189:Retrospective Studies; D012460:Sulfasalazine / Q000009:adverse effects* / Q000627:therapeutic use; D014416:Tunisia
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D012460:Sulfasalazine; D019804:Mesalamine