INDUCTION OF DOUBLE-STRANDED DNA ANTIBODI ES BY SULFASALAZINE TREATMENT - A PHENOMENON WITHOUT CLINICAL-SIGNIFICANCE

The induction of a lupus-like syndrome by treatment with sulphasalzine (SAS) is so far only reported in single cases. After observing this p henomenon in a few cases we investigated prospectively the value, inci dence and in some cases the long-term outcome of 103 patients receivin g SAS-treatment. 18 patients (17 %) developed new ds-DNS-antibodies. 1 7 (of 77) patients had SAS because of rheumatoid arthritis, only one p atient (of 26) suffered from a HLA-B27 associated spondarthropathy. Tw o of the patients developed a lupus-like syndrome (fever leukopenia, e rythema), which dissolved after discontinuing the treatment. The 18 pa tients who developed ds-DNA-antibodies could be followed for a longer period. In twelve cases SAS treatment was stopped because of the high antibody titre or because of insufficiency. In all these cases there w ere no more ds-DNA antibodies detectable after six months. Six of the patients received further treatment with SAS despite their development of antibodies without clinical consequences. Our results show a frequ ent development of ds-DNA antibodies by SAS treatment especially in pa tients with rheumatoid arthritis, only single cases in patients with H LA-B27 associated spondarthropathy. A lupus-like syndrome in neverthel ess very rare. Our experiences show that SAS-treatment doesn't have to be discontinued as soon as antibodies develop, but there has to be a close follow-up of these patients.