H. Ogawa, M. Fujimura, A. Nakashima
2003
Citations
0
Influential Citations
2
Citations
Quality indicators
Journal
Allergology International
Abstract
ABSTRACT Sulfasalazine (salazosulfapyridine) has been used increasingly and successfully for the treatment of rheumatoid arthritis. Azulfidine®EN (salazosulfapyridine; Pharmacia KK Diagnostics, Tokyo, Japan), which dissolves in the intestine, is an improvement over sulfasalazine in terms of diminishing adverse gastrointestinal effects. We report herein on a case treated with salazosulfapyridine for rheumatoid arthritis who developed mild dyspnea on exertion, high fever and diffuse pulmonary infiltrates, reversible on discontinuation of the drug. A histologic diagnosis of acute organizing interstitial pneumonia was made by transbronchial lung biopsy. Because the results of a lymphocyte stimulation test against Azulfidine®EN were negative, we allowed the patient to resume Azulfidine®EN for pain in his elbows under informed consent. However, the patient developed symptoms of fever, dry cough and stomatitis and mild renal dysfunction after two doses. Salazosulfapyridine was permanently discontinued and the patient's symptoms subsided. Laboratory findings returned to normal within 2 weeks. Azulfidine®EN should be added to the list of pharmacologic agents causing infiltrative pulmonary disease and renal dysfunction.