NATHAN L. KOBRINSKY, M.D.; NORMA K. C. RAMSAY, M.D.
Trimethoprim-sulfamethoxazole is used in a wide range of bacterial infections and is the preferred treatment for pneumocystis pneumonia. Despite the theoretical potential for inducing an acute megaloblastic state by synergistic inhibition of tetrahydrofolate synthesis, hematologic toxicities are rarely described after oral administration because of specificity for bacterial and protozoan systems (1). The development of pancytopenia after treatment with high-dose trimethoprim-sulfamethoxazole (20 and 100 mg/kg of body weight) in a patient with low folate stores illustrates the importance of recognizing high-risk situations in preventing toxicity from this drug.
A 22-year-old white woman was admitted to the University of Minnesota Hospitals because
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KOBRINSKY NL, RAMSAY NKC. Acute Megaloblastic Anemia Induced by High-Dose Trimethoprim-Sulfamethoxazole. Ann Intern Med. 1981;94:780-781. doi: 10.7326/0003-4819-94-6-780
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Published: Ann Intern Med. 1981;94(6):780-781.
Hematology/Oncology, Red Cell Disorders.
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Print ISSN: 0003-4819 | Online ISSN: 1539-3704
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