sulindac and Lupus-Erythematosus--Systemic

We present a case of a severe reaction to sulindac. A 30-year-old woman with quiescent systemic lupus erythematosus received sulindac for nonspecific migrating chest pain. An initial course of therapy produced an unrecognized sensitization to the drug with a febrile illness and rash. Readministration of the drug caused an anaphylactoid reaction as well as evidence of cardiovascular, hepatic, pulmonary, and hematologic dysfunction. The patient's illness had evidence of types I, II, and III hypersensitivity reactions.

Topics: Adult; Anaphylaxis; Chest Pain; Drug Hypersensitivity; Female; Humans; Lupus Erythematosus, Systemic; Sulindac

A 22-year-old woman with systemic lupus erythematosus experienced generalized pruritus, shortness of breath, pleuritic chest pain, visual blurring, severe photophobia, a stiff neck, an occipital headache, and a temperature of 39.4 degrees C within one hour after taking sulindac (Clinoril). Findings from a CSF examination disclosed a notable elevation of protein and a polymorphonuclear pleocytosis. All symptoms disappeared within 24 hours. Inhibition of prostaglandin synthesis did not seem to be the mechanism of this adverse reaction, since the patient tolerated aspirin.

Topics: Adult; Drug Hypersensitivity; Female; Humans; Indenes; Lupus Erythematosus, Systemic; Meningitis; Meningitis, Aseptic; Sulindac

A patient with Sulindac-induced hepatitis is presented. Sulindac was confirmed as the cause of the patient's liver disease when hepatic dysfunction abruptly recurred after an inadvertent reexposure to Sulindac and quickly resolved when the drug was withdrawn. The prompt reappearance of fever, chills, pruritus, rash, tender hepatomegaly, and abnormal liver tests after only two doses of Sulindac suggested a hypersensitivity reaction.

Topics: Adult; Chemical and Drug Induced Liver Injury; Female; Humans; Indenes; Lupus Erythematosus, Systemic; Sulindac