Lupus-like syndrome caused by 5-aminosalicylic acid in patients with inflammatory bowel disease

BACKGROUND: Although 5-aminosalicylic acid (5-ASA) preparations used to tre at inflammatory bowel disease are reported to have fewer side effects than sulphasalazine, increased clinical use of these compounds has resulted in i ncreased reports of significant: side effects. OBJECTIVE: To report four patients with antinuclear antibody-positive migra tory arthralgias and acute inflammation unrelated to the underlying inflamm atory bowel disease, fulfilling the criteria of a drug-induced lupus-like s yndrome. SETTING: A university-affiliate teaching hospital. INTERVENTION: Cessation of treatment with 5-ASA compounds. RESULTS: The cases described constitute a drug-induced lupus-like syndrome. All patients improved rapidly after discontinuation of 5-ASA. compounds. CONCLUSIONS: Reversible lupus-like syndrome appears to be a rare but signif icant side effect of 5-ASA compounds. Patients treated with 5-ASA compounds who experience acute inflammatory symptoms or clinical deterioration not r elated to their gastrointestinal disease should be screened to rule out a l upus-like reaction.