Sulfasalazine-Induced Pancytopenia Indicative of Bone Marrow Suppression: A Case Report

Abstract

Ulcerative colitis (UC) is a chronic disease characterized by the inflammation and ulceration of the colon mucosa. The present case report of pancytopenia associated with sulfasalazine treatment substantiates a few other published reports and further our knowledge of sulfasalazine tolerability. We report a case of sulfasalazine-induced pancytopenia indicative of bone marrow suppression in an 18 years old Saudi girl with UC. After two months of treatment with azathioprine, sulfasalazine and prednisolone, her hematological indicators declined to a greater extent. Initially, all medications except sulfasalazine were stopped but hematology did not improve so that sulfasalazine was also discontinued, but prednisolone was used for the next 30 days. Hematological indicators of the patient were improved and sulfasalazine was restarted at a dose of 500 mg t.i.d. However, within a month, hematological indicators declined drastically, which led to discontinuation of sulfasalazine re-treatment. The case of sulfasalazine-induced pancytopenia presented herein is suggestive of bone marrow suppression keeping in view the previous reports of UC patients regarding the development of sulfasalazine-induced bone marrow suppression and associated pancytopenia.




J Med Cases. 2014;5(5):289-291
doi: http://dx.doi.org/10.14740/jmc1767w