Abstract
A patient with ulcerative colitis developed a sulfasalazine-induced skin allergy manifested by a urticaria rash. The patient underwent drug desensitization. The first desensitization, done according to Holdsworth's protocol, resulted in eruption with itching at a dose of 800 mg. The second desensitization, with Das's protocol, failed to reintroduce the drug because of urticarial eruptions. The third challenge, with a more gradual increase in sulfasalazine dose than that use in Holdsworth's protocol, successfully desensitized the patient. The relationship between the drug and various adverse reactions is reviewed and the desensitization to sulfasalazine is discussed.
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References
Baron JH, Connell AM, Lennard-Jones JE, et al. Sulphasalazine and salicylazosulphamidine in ulcerative colitis. Lancet 1962;I:1094–1096.
Khan AKA, Howes DT, Piris J, et al. Optimum dose of sulfasalazine for maintenance of remission in ulcerative colitis. Gut 1980;21:232–240.
Holdsworth CD. Sulphasalazine desensitisation. Br Med J (Clin Res) 1981;282:110–111.
Taffet SL, Das KM. Desensitization of patients with inflammatory bowel disease to sulfasalazine Am J Med 1982;73:520–524.
Taffet SL, Das KM Sulfasalazine: Adverse effects and desensitization. Dig Dis Sci 1983;28:833–842.
Korelitz BI, Present DH, Rubin PH et al. Desensitization to sulfasalazine in allergic patients with IBD: An important therapeutic modality (abstract). Gastroenterology 1982;82:1104.
Sachar DB. The safety of sulfasalazine: The gastroenterologist's experience. J Rheumatol 1988;15:14–16.
Dick AP, Grayson MJ, Carpenter RG, et al. Controlled trial of sulphasalazine in the treatment of ulcerative colitis. Gut 1964;5:437–442.
Misiewicz JJ, Lennard-Jones JE, Connell AM et al. Controlled trial of sulphasalazine in maintenance therapy for ulcerative colitis. Lancet 1965;I:185–188.
Bargen JA. Ulcerative colitis. I. Medical management. Am Surg 1962;28:630–635.
Svartz N. The treatment of 124 cases of ulcerative colitis with salazopyrine and attempts at desensibilization in cases of hypersensitiveness to sulfa. Acta Med Scand (Suppl) 1948;206:465–472.
Purdy BH, Philips DM, Summurs RW. Desensitization for sulfasalazine skin rash. Ann Intern Med 1984;100:512–514.
Chiba A, Murata M, Ihzuka M et al. Desefisitization to salicylazosulfapyridine (salazopyrine) in a patient with ulcerative colitis (in Japanese). Jpn J Gastroenterol 1986;83:113–116.
Tolia V. Sulfasalazine desensitization in children and adolescents with chronic inflammatory bowel disease. Am J Gastroenterol 1992;87:1029–1032.
Averbuch M, Halpern Z, Hallak A, et al. Sulfasalazine pneumonitis. Am J Gastroenterol 1985;80:343–345.
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Akahoshi, K., Chijiiwa, Y., Kabemura, T. et al. Desensitization for sulfasalazine-induced skin rash in a patient with ulcerative colitis. J Gastroenterol 29, 772–775 (1994). https://doi.org/10.1007/BF02349286
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DOI: https://doi.org/10.1007/BF02349286