Agranulocytosis and acute suppurative tonsillitis induced by sulfasalazine
10.3760/cma.j.issn.1008-5734.2018.05.013
- VernacularTitle:柳氮磺吡啶致中性粒细胞缺乏症及急性化脓性扁桃体炎
- Author:
Yi ZHAO
1
;
Xu HUANG
1
;
Qiuju LIAO
1
;
Zhen TIAN
1
;
Xuemei LI
1
;
Xiaoxia LI
1
Author Information
1. 首都医科大学宣武医院风湿免疫科,北京,100053
- Publication Type:Journal Article
- Keywords:
Sulfasalazine;
Agranulocytosis;
Arthritis,rheumatoid;
Tonsillitis
- From:
Adverse Drug Reactions Journal
2018;20(5):380-381
- CountryChina
- Language:Chinese
-
Abstract:
A 25-year-old woman with rheumatoid arthritis was treated with prednisone,leflunomide,hydroxychloroquine,and calcium carbonate vitamin D.Her condition was controlled well.Because of her fertility requirement,the therapeutic regimen was changed to sulfasalazine 1.0 g and hydroxychloroquine 0.2 g twice daily orally.About 2 months later,the patient developed fever,sore throat,swelling of bilateral tonsils (degree Ⅱ) with purulent exudates on the surface,and bilateral cervical lymph nodes swelling.Laboratory tests showed white blood cell count 0.6 × 109/L and neutrophil count 0.01 × 109/L.The patient was diagnosed as having agranulocytosis induced by sulfasalazine accompanied by acute suppurative tonsillitis.Sulfasalazine and hydroxychloroquine were stopped and subcutaneous injection of recombinant human granulocyte colony stimulating factor 150 μg once daily were given for 6 consecutive days.Meanwhile,anti-infectious and symptomatic support treatments were given.Three weeks later,her white blood cell count and neutrophil count were returned to normal,and the clinical symptoms disappeared.Hydroxychloroquine and calcium carbonate vitamin D were given again.At 6 months of follow-up,the blood routine test results were normal and the condition of rheumatoid arthritis was stable.
