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Desensitization for Sulfasalazine Skin Rash

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Grant support: in part by grant AM-07072 from the National Institutes of Health.

▸Requests for reprints should be addressed to R. W. Summers, M.D.; Division of Gastroenterology-Hepatology, Department of Internal Medicine, University of Iowa Hospitals and Clinics; Iowa City, IA 52242.

Iowa City, Iowa

© 1984 American College of PhysiciansAmerican College of Physicians

Ann Intern Med. 1984;100(4):512-514. doi:10.7326/0003-4819-100-4-512
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Thirteen patients with inflammatory bowel disease and a documented allergy to sulfasalazine, manifested by skin rash with or without fever, were enrolled in a sulfasalazine-desensitization protocol. Twelve patients were successfully densensitized by using two concentrations of a liquid suspension of sulfasalazine. Four of thirteen patients developed a rash during the protocol. Although one patient refused further attempts at desensitization, the remainder completed the regimen successfully, despite recurrence of the rash on two occasions in one patient. No predilection to either fast or slow acetylator phenotype was found. This simple and convenient tolerance induction regimen may be used safely to desensitize most patients with sulfasalazine allergy manifested by skin rash with or without fever, despite recurrence of the rash during tolerance induction. Patients with serious reactions to sulfasalazine, such as agranulocytosis, toxic epidermal necrolysis, or fibrosing alveolitis, are not candidates for desensitization.





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