J Korean Rheum Assoc.
2005 Sep;12(3):231-234.
Sulfasalazine-induced Megaloblastic Anemia in Normal Serum Folate Level
- Affiliations
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- 1Department of Internal Medicine, Gachon Medical School Gil Medical Center, Incheon, Korea. baekhj@gilhospital.com
- 2Department of Laboratory Medicine, Gachon Medical School Gil Medical Center, Incheon, Korea.
Abstract
- Sulfasalazine produces a varied spectrum of adverse reactions on the hematopoietic system. Sulfasalazine-induced megaloblastic anemia is very rare and a few cases have been reported in patients with inflammatory bowel disease. Most of them show a low serum folate level. The pathogenesis is known as folate deficiency by intestinal folate malabsorption, inhibition of folate enzyme, or hemolysis. We experienced a 43-year old female with Behcet's disease, who presented with megaloblastic anemia having normal serum folate level after treatement of sulfasalazine (2 g/day for 3 months). Megaloblastic anemia recovered after withdrawal of the drug only.
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