Methods: PBMC from 2 patients with severe hypersensitivity syndrome to sulfasalazine, 3 patients with sulfamethoxazole allergy and 5 healthy donors were isolated and incubated with medium only (negative control), 2 concentrations (10, 100 μg/ml) of sulfapyridine, 2 concentrations (100, 200 μg/ml) of sulfamethoxazole, and tetanus toxoid (10 μg/ml) as a positive control. JAFerro
Hypersensitivity reactions have been reported in patients taking sulfasalazine. Eighteen days after sulfasalazine therapy was initiated, the patient developed a sore throat, nausea, chills, and high fever. Sulfasalazine-induced hypersensitivity syndrome (SIHS) is a serious systemic delayed adverse drug reaction that is associated with significant morbidity and mortality. Drug-induced pseudolymphoma and hypersensitivity syndrome. Patients with a known hypersensitivity to sulfasalazine, its metabolites or any of the excipients as well as sufonamides or salicylates. RL Sulfasalazine toxic reactions. Many drugs may cause allergic reactions via T-cell activation, but the reactions do not always develop into hypersensitivity syndrome. Salazopyrin is used to treat and manage ulcerative colitis and Crohn's disease which are inflammatory bowel diseases. Hernández N, Borrego L, Soler E, Hernández J. Actas Dermosifiliogr. PD
et al. Chou
Human herpesvirus 6 was isolated from PBMCs obtained on the eighth hospital day and identified as HHV-6 variant B by PCR (Figure 3). The expected product was 776 base pairs (bp). HHS Currently, this drug is approved by the US Food and Drug Administration (FDA) for the treatment of ulcerative colitis and rheumatoid arthritis. fasalazine hypersensitivity was proven by interferon-gamma A Case of Sulfasalazine-Induced Hypersensitivity Syndrome Confirmed by Enzyme-Linked Immunospot Assay Parkpoom Phatharacharukul,1 Jettanong Klaewsongkram2* 1Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand A severe adverse reaction to sulfasalazine therapy has been associated with hypersensitivity syndrome, the clinical features of which are similar to infectious mononucleosis. We report 2 cases of hypersensitivity syndrome induced by the use of sulfasalazine. Methylprednisolone pulse therapy (1 g/d for 3 days) was administered, and the patient's general condition and liver function improved markedly. Treatment with 1.5 g/d of sulfasalazine and 1 mg/d of betamethasone suppository was commenced, and the patient's symptoms resolved 2 weeks later. worsening of these symptoms while on treatment. Reprints: Mikiko Tohyama, MD, Department of Dermatology, Ehime University School of Medicine, Shitsukawa, Shigenobucho, Onsengun, Ehime 791-0295, Japan (e-mail: email@example.com). These drugs have a variety of uses and can be classified into antibiotics and non-antibiotic drugs. Oral sulfasalazine inhibits the absorption and metabolism of folic acid and may cause folic acid deficiency, potentially resulting in serious blood disorders (e.g. In conclusion, we demonstrate that a drug-induced hypersensitivity syndrome due to sulfasalazine use is associated with reactivation of HHV-6 and an infectious mononucleosislike illness. Here, we report the first case, to our knowledge, of a patient with previously unidentified SIHS who developed a significantly more rapid and extreme recurrence on re-exposure to sulfasalazine. Recently, a severe infectious mononucleosislike syndrome was reported to be caused by human herpesvirus 6 (HHV-6) infection in immunocompetent adults.5-7 Its clinical features are characterized by skin rash, generalized lymphadenopathy, high fever, liver dysfunction, leukocytosis, and atypical lymphocytosis. We would like to suggest possible treatment with an antiviral drug such as ganciclovir for hypersensitivity syndrome, since our observations indicate that HHV-6 infection occurs in a late stage of hypersensitivity syndrome.31. Then, HHV-6 latently infects monocytes and salivary glands. Isolated virus was identified with immunofluorescence assay using anti–HHV-6 monoclonal antibody and polymerase chain reaction (PCR) assay. Sobue
It should be noted that the patients' clinical conditions improved with the use of systemic corticosteroids. Leukocytosis, atypical lymphocytes, liver dysfunction, and renal disturbance were also observed. Medium-to-long-term follow-up is required even after complete resolution of the condition. Jarrett
• In patients with intestinal and urinary obstructions. TShiraki
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