Fatal reactions to administration of sulfonamide drugs

Abstract

Abstract Five deaths are reported following the administration of sulfonamide drugs, three from granulocytopenia, one from hemolytic anemia, and one from liver and kidney damage. In a patient receiving 101 Gm. of sulfanilamide for scarlet fever, and in another patient receiving 64 Gm. of sulfanilamide for streptococcal sore throat, fatal granulocytopenia developed. A third case of fatal granulocytopenia occurred in a patient who was given 88.5 Gm. of sulfapyridine in the treatment of bacterial endocarditis. In two of these patients the bone marrow was examined at autopsy and showed maturation arrest of the myeloid series at the myelocyte level. A typical acute hemolytic anemia developed within three days in a patient treated for erysipelas with 25 Gm. of sulfanilamide. Interference with renal tubular function by precipitated hemoglobin derivatives was thought to be a major factor leading to death in this patient. The fifth case showed clinical evidence of severe liver and kidney damage developing after the administration of 34 Gm. of sulfanilamide for gonorrheal arthritis. Degeneration of liver cells and necrosis of renal tubular epithelium were found at autopsy.