Allergy Asthma Immunol Res.  2013 Nov;5(6):415-417. 10.4168/aair.2013.5.6.415.

A Case of Sulfasalazine-Induced Hypersensitivity Syndrome Confirmed by Enzyme-Linked Immunospot Assay

• Phatharacharukul P
• Klaewsongkram J

• KMID: 2260287
• DOI: http://doi.org/10.4168/aair.2013.5.6.415

Abstract

A 24-year-old male with a history of spondyloarthropathy presented with high fever, cervical lymphadenopathy and generalized maculopapular rash. He was treated with prednisolone for chronic uveitis before being switched to sulfasalazine 3 weeks prior to admission. Laboratory findings revealed marked leukocytosis with frequent atypical lymphocytes. Sulfasalazine was discontinued and the etiology of mononucleosis syndrome explored. During admission, he developed acalculous cholecystitis and hypotension. All symptoms quickly improved following administration of systemic corticosteroids. The investigation for infectious mononucleosis yielded negative results and a diagnosis of sulfasalazine-induced hypersensitivity syndrome was confirmed using enzyme-linked immunospot assays.

Keyword

Drug hypersensitivity; enzyme-linked immunospot assay; sulfasalazine

MeSH Terms

Acalculous Cholecystitis
Adrenal Cortex Hormones
Drug Hypersensitivity
Enzyme-Linked Immunospot Assay
Exanthema
Fever
Humans
Hypersensitivity
Hypotension
Infectious Mononucleosis
Leukocytosis
Lymphatic Diseases
Lymphocytes
Male
Prednisolone
Spondylarthropathies
Sulfasalazine
Uveitis
Young Adult
Adrenal Cortex Hormones
Prednisolone
Sulfasalazine

Figure

• 

  Fig. 1 Acalculous cholecystitis with pericholecystic fluid collection as demonstrated by abdominal computed tomography scans. G, gallbladder.

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  Fig. 2 Sulfasalazine-specific interferon-gamma responses as demonstrated by enzyme-linked immunospot assay.

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