Chest
Selected ReportsFibrosing Alveolitis, Bronchiolitis Obliterans, and Sulfasalazine Therapy
Section snippets
CASE REPORT
A 66-year-old male exsmoker had a diagnosis of ulcerative colitis and was given sulfasalazine, 8 g/day, and hydrocortisone enemas. His initial chest roentgenogram was normal. With symptomatic improvement, the sulfasalazine dosage was reduced to 2 g/day. Shortness of breath on exertion was first noted six months after initiation of treatment. Four months later, a fever with a dry cough developed, but he had no other symptoms suggestive of a viral illness. Sulfasalazine therapy was discontinued.
COMMENTS
To our knowledge, there have been eight reported cases of sulfasalazine-related lung disease.2, 3, 4, 5, 6, 7, 8, 9, 10 The daily dosage of sulfasalazine ranged from 1.5 to 6.0 g, and the length of exposure from 1.5 to 7.0 months. Symptoms described included dyspnea,2, 3, 4, 5, 6, 7, 8, 9, 10 fever,3, 4, 7, 8, 9Table 1—Pulmonary Function Tests cough,3, 4, 7 and wheeze.2 Pulmonary syndromes described were tracheal edema,2 pulmonary eosinophilia,3, 7, 8, 9 pulmonary infiltrates,4 and fibrosing
ACKNOWLEDGMENT
Our thanks to Dr. D. Chamberlain, Toronto General Hospital, for his most helpful comments on the pathology of this case.
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