rspНаучно-практическая ревматологияRheumatology Science and Practice1995-44841995-4492IMA-PRESS, LLC10.14412/1995-4484-2002-757rsp-894Research ArticleСтатьиArticlesТОКСИЧЕСКОЕ ПОРАЖЕНИЕ ПЕЧЕНИ СУЛЬФАСАЛАЗИНОМSULFASALAZINE INDUCED TOXIC HEPATIC INJURYKorenevaI NKorenevaI N-MouravievJu VMouravievJu V-YevsikovaM DYevsikovaM D-200215022002401№1 (2002)7374Copyright © Koreneva I.N., Mouraviev J.V., Yevsikova M.D., 20022002Koreneva I.N., Mouraviev J.V., Yevsikova M.D.Koreneva I.N., Mouraviev J.V., Yevsikova M.D.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://rsp.mediar-press.net/rsp/article/view/894

Описана 31 -летняя больная РА, у которой на 10-15 день лечение сульфасалазином в дозе 1.5 г/кг развилась лекарственная реакция в виде лихорадки, лимфаденопатии, миалгий, расширенных геморрагических высыпаний и клиники токсического гепатита с резким повышением печёночных ферментов. Отмена препарата и применение ГКС в/в и пер ос в течение месяца привело к ликвидации всех признаков тяжёлой лекарственной реакции.

сульфасалазин. гепатитРАSulphasalazinehenatitisRAReferences<div><p>Машковский М.Д. Лекарственные средства: В 2-х томах, Т.2.-10-е изд.стер. М., Медицина. 1987. 576.</p><p>МКБ - Международная статистическая классификация болезнен и проблем, связанных со здоровьем: 10-и пересмотр. T.I. ВОЗ. Женева, 1995. 3- Barraso N. Leo Е„ Guil A. el al. Non-immunoallergic hepatotoxicity due mesalazine. Gaslroenterol.Hepatol., 1999, 22. 4,176-179</p><p>Besuard М. Debray D. Durand P. et al. Fulminant hepatitis in two children treated with sulfasalazine for Crohn disease Arch.Pediatr. 1999. 6. 6. 643-646.</p><p>Boyer D.L., Li B.U. Fyda J.N., Friedman R.A. Sulfasalazine- induced hepatotoxicity in children with inflammatory bowel disease. J. Pediater. Gastroenterol, Nutr., 1989, 8, 4. 528-532,</p><p>Callen J.P., Soderstorm R.M., Granulematous hepatitis associated with salicylazosulfapyridine therapy. South. Med. J., 1978, 71, 9. 1159-1160.</p><p>Chester A.C. Diamond L.H., Schreiner G.E. Hypersensitivity to salicylazosulfapyridine renal and hepatic toxic reactions. Arch.Intern.Med., 1978. 138. 7. 1138-1139.</p><p>Farr М., Simmons D.P. Bacon P.A. Raised serum alkaline phosphatase and aspartate transaminase levels in two rheumatoid patiens treated with sulphasalazine. Ann.Rhcum.Dis., 1985. 44. II. 798-800.</p><p>Gremse D.A., Bancroft J., Moyer M.S. Sulfasalazine hypersensitivity with hepatotoxicity. trombocytopenia.and ervtroid hyperplasia. J. Pediatr. Gaslroenterol. Nutr. 1989. 9. 2, 261 - 263.</p><p>Gulley R.M., Mirza A-, Kelley C.E. Hepatotoxicity of salicy- lazosulfapyridine: a case report and review of the literature. Am.J.Gastrointestinal., 1979. 75, 5. 561-564.</p><p>Haines J.DJr. Hepatotoxicity after treatment with sulfasalazine. Postgrad. Med., 1986. 79. 6. 193-4. 197-198.</p><p>Kanner R.S., Tedesco F.J. Kaiser M.H. Azulfidine (sulfasalazine) induced hepatic injury. Am. J. Dig. Dis. 1978,.23, 10, 956-958.</p><p>Mihas A.A. Goldenberg D.J. Slaughter R.l. Sulfasalazine toxic reactions, hepatitis, fever and skin rash with hypoconiplemenl- mia and immune complexes. JAMA. 1978. 239. 24. 25902591.</p><p>Ribe J., Benkov K.J. Thung S.N. et al. Fatal massive hepatic necrosis:a probable hypersensitivity reaction to sulfasalazine. Am.J.Gastroenterol., 1986, 81. 3. 205-208.</p><p>Rubin R. Sulfasalazine-induced fulminant hepatic failure and necrotizing pancreatitis. Am.J.Gastroenlerol. 1994. 89. 5, 789791.</p><p>Schoonjans R. Mast A., Van den Abeelc G- et al. Sulfasalazine-associated encephalopathy in a patient with Crohn's disease, Am.J.Gastroenterol., 1993, 88. 10, 1759-1763.</p><p>Senturk Т. Aydintung A.O., Durzun N. Tokgoz G. Sezures and hepatotoxicity following sulphasalazine administration. Rheumatol.Int., 1997. 17. 2. 75-77, IS. Smith M.D., Gibson G.E. Rowland R. Combined hepatotoxic- ity and neurotoxicity following sulfasalazine administration. Aust. N. Z. J. Med., 1982. 12, 1. 76-80.</p><p>Sotolongo R.P., Neebe L.I., Rudzki C„ Ishak k.G. Hypersensitivity reaction to sulfasalazine with severe hepatotoxicity. Gastroenterol., 1978. 75, I, 95-99.</p><p>Tohyama M„ Yahata Y. Yasukawa M. el al. Severe hypersensitivity syndrome due to sulfasalazine associated with reactivation of human herpesvirus 6. Arch. Dermatol. 1998, 134, 9. 1113-1117.</p></div><br /><div><p>Машковский М.Д. Лекарственные средства: В 2-х томах, Т.2.-10-е изд.стер. М., Медицина. 1987. 576.</p><p>МКБ - Международная статистическая классификация болезнен и проблем, связанных со здоровьем: 10-и пересмотр. T.I. ВОЗ. Женева, 1995. 3- Barraso N. Leo Е„ Guil A. el al. Non-immunoallergic hepatotoxicity due mesalazine. Gaslroenterol.Hepatol., 1999, 22. 4,176-179</p><p>Besuard М. Debray D. Durand P. et al. Fulminant hepatitis in two children treated with sulfasalazine for Crohn disease Arch.Pediatr. 1999. 6. 6. 643-646.</p><p>Boyer D.L., Li B.U. Fyda J.N., Friedman R.A. Sulfasalazine- induced hepatotoxicity in children with inflammatory bowel disease. J. Pediater. Gastroenterol, Nutr., 1989, 8, 4. 528-532,</p><p>Callen J.P., Soderstorm R.M., Granulematous hepatitis associated with salicylazosulfapyridine therapy. South. Med. J., 1978, 71, 9. 1159-1160.</p><p>Chester A.C. Diamond L.H., Schreiner G.E. Hypersensitivity to salicylazosulfapyridine renal and hepatic toxic reactions. Arch.Intern.Med., 1978. 138. 7. 1138-1139.</p><p>Farr М., Simmons D.P. Bacon P.A. Raised serum alkaline phosphatase and aspartate transaminase levels in two rheumatoid patiens treated with sulphasalazine. Ann.Rhcum.Dis., 1985. 44. II. 798-800.</p><p>Gremse D.A., Bancroft J., Moyer M.S. Sulfasalazine hypersensitivity with hepatotoxicity. trombocytopenia.and ervtroid hyperplasia. J. Pediatr. Gaslroenterol. Nutr. 1989. 9. 2, 261 - 263.</p><p>Gulley R.M., Mirza A-, Kelley C.E. Hepatotoxicity of salicy- lazosulfapyridine: a case report and review of the literature. Am.J.Gastrointestinal., 1979. 75, 5. 561-564.</p><p>Haines J.DJr. Hepatotoxicity after treatment with sulfasalazine. Postgrad. Med., 1986. 79. 6. 193-4. 197-198.</p><p>Kanner R.S., Tedesco F.J. Kaiser M.H. Azulfidine (sulfasalazine) induced hepatic injury. Am. J. Dig. Dis. 1978,.23, 10, 956-958.</p><p>Mihas A.A. Goldenberg D.J. Slaughter R.l. Sulfasalazine toxic reactions, hepatitis, fever and skin rash with hypoconiplemenl- mia and immune complexes. JAMA. 1978. 239. 24. 25902591.</p><p>Ribe J., Benkov K.J. Thung S.N. et al. Fatal massive hepatic necrosis:a probable hypersensitivity reaction to sulfasalazine. Am.J.Gastroenterol., 1986, 81. 3. 205-208.</p><p>Rubin R. Sulfasalazine-induced fulminant hepatic failure and necrotizing pancreatitis. Am.J.Gastroenlerol. 1994. 89. 5, 789791.</p><p>Schoonjans R. Mast A., Van den Abeelc G- et al. Sulfasalazine-associated encephalopathy in a patient with Crohn's disease, Am.J.Gastroenterol., 1993, 88. 10, 1759-1763.</p><p>Senturk Т. Aydintung A.O., Durzun N. Tokgoz G. Sezures and hepatotoxicity following sulphasalazine administration. Rheumatol.Int., 1997. 17. 2. 75-77, IS. Smith M.D., Gibson G.E. Rowland R. Combined hepatotoxic- ity and neurotoxicity following sulfasalazine administration. Aust. N. Z. J. Med., 1982. 12, 1. 76-80.</p><p>Sotolongo R.P., Neebe L.I., Rudzki C„ Ishak k.G. Hypersensitivity reaction to sulfasalazine with severe hepatotoxicity. Gastroenterol., 1978. 75, I, 95-99.</p><p>Tohyama M„ Yahata Y. Yasukawa M. el al. Severe hypersensitivity syndrome due to sulfasalazine associated with reactivation of human herpesvirus 6. Arch. Dermatol. 1998, 134, 9. 1113-1117.</p></div><br />

The authors declare that there are no conflicts of interest present.