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Arq. gastroenterol ; 37(4): 224-6, out.-dez. 2000.
Artículo en Inglés | LILACS | ID: lil-286404

RESUMEN

Abstract: The authors describe the case of a young Brazilian woman who was treated of ileocolonic Crohn's disease sparing rectum, as confirmed by colonoscopy and histopathological examination. After a 4-years course of sulfasalazine treatment, she presented with skin facial lesions in vespertilio, fever, arthralgias and high titers of anti-ANA and LE cells. A sulfasalazine-induced lupus syndrome was diagnosed, because ofter sulfasalazine withdrawal and a short course of prednisone, the clinical symptoms disappeared and the laboratory tests returned to normal. Mesalazine 3 g/day was started and patient remained well for the next 3 years, when she was again admitted with fever, weakness, arthralgias, diplopy, strabismus and hypoaesthesia in both hands and feet, microhematuria, haematic casts, hypocomplementemia and high titers of autoimmune antibodies. A diagnosis of associated systemic lupus erythematosus was made. Although a pulsotherapy with methylprednisolone was started, no improvement was noticed. A cyclophosphamide trial was tried and again no positive results occurred. The patient envolved to severe clinical manifestation of general vasculitis affecting the central and peripheral nervous system and lungs, havaing a fatal evolution after 2 weeks. Although uncommon, the association of both disease may occur, and the authors call attention to this possibiliti, making a brief review of literature.


Asunto(s)
Humanos , Femenino , Adulto , Antiinflamatorios no Esteroideos/efectos adversos , Enfermedad de Crohn/tratamiento farmacológico , Lupus Eritematoso Sistémico/inducido químicamente , Mesalamina/efectos adversos , Sulfasalazina/efectos adversos , Antiinflamatorios no Esteroideos/uso terapéutico , Resultado Fatal , Mesalamina/uso terapéutico , Sulfasalazina/uso terapéutico
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