Hypersensitivity with hepatotoxicity to mesalazine after hypersensitivity to sulfasalazine

Hautekèete, M.; Bourgeois, Nadine; Potvin, P; Duville, Lieve; Reynaert, H; Devis, Ghislain; Adler, Michaël; Klöppel, Günter

doi:10.1016/0016-5085(92)91453-b

Cited by 62 publications

(35 citation statements)

References 26 publications

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“…Since erythromycin, like other macrolide antibiotics, is known to cause hepatic disturbances, one could argue that the patient's symptoms might have been drug-related. However, hepatitis caused by erythromycin is ususally more pronounced and does not resolve before the drug is discontinued [9,10]. In our patient hepatitis had already regressed several days before erythromycin therapy was stopped.…”

Section: Discussionmentioning

confidence: 55%

Scarlet Fever Associated with Hepatitis – A Report of Two Cases

Girisch

Heininger

2000

Infection

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SummaryInfection with group A beta-hemolytic streptococci (GABHS) is the most common bacterial cause of acute pharyngitis and tonsillitis beyond infancy. We report on two patients with scarlet fever associated with hepatitis. The patients (boys aged 6 and 7 years) both presented with a scarlatiniform rash, dark urine and light-colored stools. Laboratory studies revealed elevated liver transaminases and negative antibody tests against hepatitis viruses A, B and C, cytomegalovirus and Epstein-Barr virus. Both patients were treated with antibiotics and recovered completely within a few days. Although the association between scarlet fever and hepatitis has been known for many decades, the pathogenesis is still unknown. Physicians treating patients with group A beta-hemolytic streptococcal infections should be aware of possible hepatic involvement.

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Section: Discussionmentioning

confidence: 55%

Scarlet Fever Associated with Hepatitis – A Report of Two Cases

Girisch

Heininger

2000

Infection

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“…Reações adversas são frequentes e aparecem em 5-55% dos pacientes com doença inflamatória intestinal 4 . Elas incluem efeitos dose-dependentes, tais como dispepsia, náuseas, vômitos, cefaleia, oligoespermia reversível e reações idiossincráti-cas, tais como descamação cutânea, febre, discrasias sanguíneas, nefrite intersticial, neutropenia, pneumonite, pancreatite, neurotoxicidade e hepatotoxicidade [3][4][5][6] . Esses efeitos colaterais são mais frequentes em pacientes recebendo SSZ na dose de quatro gramas ou mais diariamente 4,8 .…”

Section: Discussionunclassified

“…Hautekeete et al mostraram que 70-90% dos pacientes intolerantes a SSZ foram tolerantes a mesalazina ou olsalazina (formas isoladas do ácido 5-aminossalicílico), enquanto o restante apresentaram efeitos adversos semelhantes aos da SSZ. Assim, concluíram que, tanto o radical sulfapiridina, quanto o ácido 5-aminossalicílico, podem ser responsáveis pelos efeitos adversos 5 . As manifestações clínicas da hepatotoxicidade pela SSZ incluem febre, icterícia, exantema, linfadenopatia, eosinofilia, leucocitose com eosinofilia, elevação dos níveis de enzimas hepáticas e canaliculares, bilirrubinas e da proteína C reativa [2][3][4][5]8 .…”

Section: Discussionunclassified

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Hepatotoxicidade induzida por sulfassalazina: relato de caso

Batista

Pozzobon

Albuquerque

et al. 2011

Rev bras. colo-proctol.

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210BATISTA RR, POZZOBON BHZ, ALBUQUERQUE ICD, FORMIGA GJS. Hepatotoxicidade induzida por sulfassalazina: relato de caso. Rev bras Coloproct, 2011;31(2): 210-212. RESUMO:A sulfassalazina é ainda muito utilizada nas doenças inflamatórias intestinais, sobretudo na retocolite ulcerativa leve e moderada. Entretanto, seu uso é relacionado a vários efeitos colaterais, incluindo disfunção hepática grave.Este é um relato do caso de paciente masculino, 21 anos, portador de retocolite ulcerativa moderada, com queixa de inapetência, febre, artralgia e icterícia, há sete dias. Antecedente pessoal de uso de sulfassalazina 4 g/dia há seis semanas. Ao exame físico apresentava-se ictérico, com exantema em membros e edema de membros inferiores. Exames complementares mostravam aumento de bilirrubinas, enzimas hepáticas e canaliculares e da proteína C reativa. Com o diagnóstico de hepatotoxicidade por sulfassalazina, foi suspensa a medicação e introduzido prednisona 20 mg/dia e ciprofloxacino 1 g/dia. Recebeu alta no terceiro dia de internação após melhora clínica e laboratorial. Atualmente encontra-se assintomático e em uso de azatioprina 150 mg/dia.

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“…Directly toxicity from the 5-ASA component: This can lead to both acute or chronic hepatitis and has been shown to occur mostly between 6 days to 1 year of starting the drug Both 5-ASA and Sulfasalazine are equally responsible for the number of cases of drug induced hepatitis from Aminosalicylates [109][110][111][112][113]. Studies have reported liver enzyme abnormalities in up to 2% of patients on Mesalamine [114].…”

Section: Aminosalicylates: Sulfasalazine and Mesalaminementioning

confidence: 99%

A review of liver disorders in inflammatory bowel disease (IBD)

Shah¹,

Gupta²,

Borg³

2017

Clin Case Rep Rev

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Disorders of the liver and the biliary tract are frequently the extraintestinal manifestations of inflammatory bowel disease (IBD). The etiology of these hepato-biliary conditions is deemed secondary to their shared pathogenesis, the chronic effects of a long term, ongoing inflammation of the bowels, along with the medications used to manage IBD. For up to 30% of patients with IBD, abnormal liver biochemical tests are present. Other, selected patients with IBD are followed for reactivation of hepatitis B, through guidelines only relatively recently in place. The vast realm of related clinical conditions does not always correspond well with IBD severity, which can range from mild hepatic insult to end-stage liver disease, necessitating liver transplantation. Hence it is critical to follow its presence, clinical course and long term consequences. Moreover, the management of these disorders is necessarily individualized, with some patients requiring frequent monitoring and others a more multi-disciplinary approach. Studies aimed at improving the outcomes of patients with IBD who experience associated liver and biliary tract disorders are now needed to assess early identification, possible screening approaches and more effective systems of referral. This article covers the evidence-based literature on topics detailing the co-existence of liver conditions in inflammatory bowel disease with a focus on its epidemiology, clinical manifestations, diagnosis and management.

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Hypersensitivity with hepatotoxicity to mesalazine after hypersensitivity to sulfasalazine

Cited by 62 publications

References 26 publications

Scarlet Fever Associated with Hepatitis – A Report of Two Cases

Scarlet Fever Associated with Hepatitis – A Report of Two Cases

Hepatotoxicidade induzida por sulfassalazina: relato de caso

A review of liver disorders in inflammatory bowel disease (IBD)

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