Document Detail

Megaloblastic anemia associated with salazosulfapyridine treatment for rheumatoid arthritis
MedLine Citation:
PMID:  19110522     Owner:  NLM     Status:  MEDLINE    
A 70-year-old man was diagnosed as having rheumatoid arthritis (RA) in 2005. He was treated with 1 g salazosulfapyridine (SASP) daily for two years. Hematological investigations conducted since 2005 demonstrated hemoglobin concentrations of 8 approximately 9 g/dl, which then dropped to 4.9 g/dl on November 21, 2007, following which he was admitted to our hospital. Megaloblastic anemia associated with SASP treatment and anemia of chronic disorders were diagnosed on the basis of folate deficiency and bone marrow examination. This report describes a case of megaloblastic anemia, which developed two years after starting SASP and promptly recovered after its withdrawal and treatment with folic acid and prednisolone. The doses of SASP prescribed for RA in Japan are less than those prescribed abroad. Megaloblastic anemia associated with SASP treatment for RA is not usually detected in Japan. Currently, SASP is widely used and one of the key drugs in the treatment of RA. This case suggests that SASP therapy in RA might result in megaloblastic anemia.
Shoko Nakayama; Taiji Yokote; Kichinosuke Kobayashi; Yuji Hirata; Satoshi Hara; Toshikazu Akioka; Takuji Miyoshi; Motomu Tsuji; Takayuki Takubo; Toshiaki Hanafusa
Publication Detail:
Type:  Case Reports; English Abstract; Journal Article    
Journal Detail:
Title:  [Rinshō ketsueki] The Japanese journal of clinical hematology     Volume:  49     ISSN:  0485-1439     ISO Abbreviation:  Rinsho Ketsueki     Publication Date:  2008 Dec 
Date Detail:
Created Date:  2008-12-26     Completed Date:  2009-06-30     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  2984782R     Medline TA:  Rinsho Ketsueki     Country:  Japan    
Other Details:
Languages:  jpn     Pagination:  1609-13     Citation Subset:  IM    
Depatment of Internal Medicine (I), Osaka Medical College, Japan.
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MeSH Terms
Anemia, Megaloblastic / chemically induced*,  drug therapy
Antirheumatic Agents / administration & dosage,  adverse effects*
Arthritis, Rheumatoid / drug therapy*
Folic Acid / therapeutic use
Folic Acid Deficiency / chemically induced*,  drug therapy
Prednisolone / therapeutic use
Sulfasalazine / administration & dosage,  adverse effects*
Treatment Outcome
Reg. No./Substance:
0/Antirheumatic Agents; 50-24-8/Prednisolone; 59-30-3/Folic Acid; 599-79-1/Sulfasalazine

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