title: Unusual Case of an Alcoholic with Liver Injury from Sulfasalazine Use.
abstract: A 57-year-old male with a history of alcoholism presented to the emergency room with abdominal pain, jaundice, transaminitis, and hyperbilirubinemia. Due to the history of alcoholism, it was initially presumed that the patient had alcoholic hepatitis but further investigation revealed that he was recently started on sulfasalazine for the treatment of rheumatoid arthritis. Upon cessation of the drug, the patient's liver function tests significantly improved over a few days and eventually normalized within weeks. This case was interesting as the patient's history of alcoholism disguised the actual diagnosis. Furthermore, the late presentation of sulfasalazine-induced liver injury is uncommon as it commonly presents 2-4 weeks after initiation of therapy.
authors.affiliation: Department of Internal Medicine, SUNY Upstate Medical University, Syracuse, NY, USA.
authors.forename: Umair
authors.initials: U
authors.lastname: Masood
authors.affiliation: Department of Internal Medicine, SUNY Upstate Medical University, Syracuse, NY, USA.
authors.forename: Anuj
authors.initials: A
authors.lastname: Sharma
authors.affiliation: Department of Internal Medicine, SUNY Upstate Medical University, Syracuse, NY, USA.
authors.forename: Sonny
authors.initials: S
authors.lastname: Nijjar
authors.affiliation: Department of Internal Medicine, SUNY Upstate Medical University, Syracuse, NY, USA.
authors.forename: Barbara
authors.initials: B
authors.lastname: Krenzer
keywords: Adverse effect; hepatitis; liver toxicity; sulfasalazine