Sulfasalazine pulmonary toxicity in ulcerative colitis mimicking clinical features of Wegener's granulomatosis

Stephen M. Salerno, Eric J. Ormseth, Bernard J. Roth, Cristopher A. Meyer, Erik D. Christenseu, Thomas A Dillard

Research output: Contribution to journalArticle

54 Citations (Scopus)

Abstract

The centrally accentuated antineutrophil cytoplasmic antibody test (c- ANCA) is widely regarded as a sensitive and specific marker for Wegener's granulomatosis (WG). There are increasing reports, however, of false-positive c-ANCAs, usually in the setting of other vasculidities. We report a case of a 27-year-old man with ulcerative colitis who developed pulmonary symptoms, peripheral nodular lung infiltrates, and an elevated c-ANCA suggesting WG. Chest CT and open lung biopsy specimens were consistent with WG. The symptoms and pulmonary infiltrates resolved after discontinuation of sulfasalazine therapy. The c-ANCA remained elevated due to the occurrence of false-positive values in ulcerative colitis. We conclude sulfasalazine toxicity can mimic clinical aspects of WG and that c-ANCA testing should be interpreted with caution in patients with ulcerative colitis.

Original languageEnglish (US)
Pages (from-to)556-559
Number of pages4
JournalCHEST
Volume110
Issue number2
DOIs
StatePublished - Jan 1 1996
Externally publishedYes

Fingerprint

Sulfasalazine
Antineutrophil Cytoplasmic Antibodies
Granulomatosis with Polyangiitis
Ulcerative Colitis
Lung
Thorax
Biopsy

Keywords

  • Wegener's granulomatosis
  • antinuclear cytoplasmic antibody
  • sulfasalazine
  • ulcerative colitis

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine
  • Critical Care and Intensive Care Medicine
  • Cardiology and Cardiovascular Medicine

Cite this

Salerno, S. M., Ormseth, E. J., Roth, B. J., Meyer, C. A., Christenseu, E. D., & Dillard, T. A. (1996). Sulfasalazine pulmonary toxicity in ulcerative colitis mimicking clinical features of Wegener's granulomatosis. CHEST, 110(2), 556-559. https://doi.org/10.1378/chest.110.2.556

Sulfasalazine pulmonary toxicity in ulcerative colitis mimicking clinical features of Wegener's granulomatosis. / Salerno, Stephen M.; Ormseth, Eric J.; Roth, Bernard J.; Meyer, Cristopher A.; Christenseu, Erik D.; Dillard, Thomas A.

In: CHEST, Vol. 110, No. 2, 01.01.1996, p. 556-559.

Research output: Contribution to journalArticle

Salerno, SM, Ormseth, EJ, Roth, BJ, Meyer, CA, Christenseu, ED & Dillard, TA 1996, 'Sulfasalazine pulmonary toxicity in ulcerative colitis mimicking clinical features of Wegener's granulomatosis', CHEST, vol. 110, no. 2, pp. 556-559. https://doi.org/10.1378/chest.110.2.556
Salerno, Stephen M. ; Ormseth, Eric J. ; Roth, Bernard J. ; Meyer, Cristopher A. ; Christenseu, Erik D. ; Dillard, Thomas A. / Sulfasalazine pulmonary toxicity in ulcerative colitis mimicking clinical features of Wegener's granulomatosis. In: CHEST. 1996 ; Vol. 110, No. 2. pp. 556-559.
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