Extreme lymphoplasmacytosis and hepatic failure associated with sulfasalazine hypersensitivity reaction and a concurrent EBV infection - Case report and review of the literature

Balazs Halmos, H. T. Anastopoulos, L. E. Schnipper, E. Ballesteros

Research output: Contribution to journalArticle

10 Citations (Scopus)

Abstract

We present an unusual case of a patient with extreme lymphoplasmacytosis and hepatic failure in association with a reaction to sulfasalazine and a concurrent Epstein-Barr virus (EBV) infection. Sulfa drugs can cause a wide range of allergic and hypersensitivity reactions and occasionally can lead to a fulminant illness. In the case under discussion the patient had hepatotoxicity, skin rash, fever, and peripheral blood atypical lymphocytosis. Initial impressions suggested the possibility of a malignant lymphoproliferative disorder. Flow cytometry of peripheral blood and a bone marrow biopsy provided clear evidence for a reactive, polyclonal process as opposed to a malignant disorder. Cessation of the offending drug and administration of steroids led to dramatic improvement. This case illustrates that drug hypersensitivity reactions can be manifested by an extreme lymphocytoid leukemoid reaction.

Original languageEnglish (US)
Pages (from-to)242-246
Number of pages5
JournalAnnals of Hematology
Volume83
Issue number4
DOIs
StatePublished - Apr 2004
Externally publishedYes

Fingerprint

Sulfasalazine
Epstein-Barr Virus Infections
Liver Failure
Hypersensitivity
Leukemoid Reaction
Drug Hypersensitivity
Lymphocytosis
Lymphoproliferative Disorders
Exanthema
Pharmaceutical Preparations
Flow Cytometry
Fever
Bone Marrow
Steroids
Biopsy

Keywords

  • Crohn's disease
  • Epstein-Barr virus
  • Hypersensitivity
  • Lymphocytes
  • Sulfasalazine

ASJC Scopus subject areas

  • Hematology

Cite this

Extreme lymphoplasmacytosis and hepatic failure associated with sulfasalazine hypersensitivity reaction and a concurrent EBV infection - Case report and review of the literature. / Halmos, Balazs; Anastopoulos, H. T.; Schnipper, L. E.; Ballesteros, E.

In: Annals of Hematology, Vol. 83, No. 4, 04.2004, p. 242-246.

Research output: Contribution to journalArticle

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