Sulfasalazine-induced mononucleosis-like-illness and haemolysis

Sahm, Julian; Groot, Kirsten de; Schreiber, J

doi:10.1080/03009742.2020.1747533

Cited by 3 publications

(2 citation statements)

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“…After this the clinical conditions with features like that seen in sulfone syndrome was described as a "Mononucleosis like syndrome" characterized by exfoliative dermatitis, jaundice, hepato-splenomegaly, lymphadenopathy, and a predominance of peripheral blood lymphocytosis in patients with leprosy and tuberculosis treated with dapsone. 17 . Lastly is DRESS syndrome which is almost indistinguishable from the sulfone syndrome as they both shear the same clinical and pathological features.…”

Section: Discussionmentioning

confidence: 99%

“…The management of sulfone syndrome and sulfasalazine induced hepatitis involves mainly the cessation of the medication and use of steroid. 14,17 But as some patients who develop this syndrome is already on steroid it appears not to prevent it development. The index case like that reported by Barnard, Scharf & Dagher 20 was on prednisolone before starting the sulfasalazine and subsequently developed the sulfone syndrome.…”

Section: Discussionmentioning

confidence: 99%

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Sulfone syndrome due to sulfasalazine use in treatment of Rheumatoid Arthritis: A case report and a review of literature

Ibrahim¹

2022

World J. Adv. Res. Rev.

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Background: Sulfone syndrome has been reported in patients treated with sulfur containing agents such as dapsone and carbamazepine for almost a century. But not much as being discuss about it in recent literature. I present a case of sulfone syndrome which occurred. Clinical Case: I present the rare case of a 76-year-old female with rheumatoid arthritis who two weeks after starting sulfasalazine developed systemic symptoms of fever with chills and rigors, headache, and maculopapular skin rash. She had severe mixed picture deranged hepatic function (Hepatocellular and cholestatic picture) and pancytopenia. Microbiological investigations revealed no microbial etiology. The patient was treated with prednisolone and supportive therapy including discontinuation of the sulfasalazine. Her symptoms improved and resolved within 5 days. The pancytopenia resolved in a week and liver function test gradually improved and normalized by 90 days. Conclusion: Although sulfone syndrome can resolve once the offending sulfur agent is discontinued it can cause severe morbidity and mortality. Therefore. I urge physician starting patients on sulfur containing agents such as sulfasalazine to always watch out for sulfone syndrome as a possible adverse reaction.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%