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Postgrad Med J. 1986 April; 62(726): 307–308.
PMCID: PMC2418663

Megaloblastic anaemia due to sulphasalazine responding to drug withdrawal alone.


A 60 year old man with ulcerative colitis since 1975 and treated with sulphasalazine, presented with severe megaloblastic anaemia caused by folate deficiency. The drug was stopped, and the anaemia recovered promptly. There was no relapse one year later.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.
  • Franklin JL, Rosenberg HH. Impaired folic acid absorption in inflammatory bowel disease: effects of salicylazosulfapyridine (Azulfidine). Gastroenterology. 1973 Apr;64(4):517–525. [PubMed]
  • Halsted CH, Gandhi G, Tamura T. Sulfasalazine inhibits the absorption of folates in ulcerative colitis. N Engl J Med. 1981 Dec 17;305(25):1513–1517. [PubMed]
  • Kane SP, Boots MA. Megaloblastic anaemia associated with sulphasalazine treatment. Br Med J. 1977 Nov 12;2(6097):1287–1288. [PMC free article] [PubMed]
  • Pounder RE, Craven ER, Henthorn JS, Bannatyne JM. Red cell abnormalities associated with sulphasalazine maintenance therapy for ulcerative colitis. Gut. 1975 Mar;16(3):181–185. [PMC free article] [PubMed]
  • Schneider RE, Beeley L. Megaloblastic anaemia associated with sulphasalazine treatment. Br Med J. 1977 Jun 25;1(6077):1638–1639. [PMC free article] [PubMed]
  • Selhub J, Dhar GJ, Rosenberg IH. Inhibition of folate enzymes by sulfasalazine. J Clin Invest. 1978 Jan;61(1):221–224. [PMC free article] [PubMed]
  • Swinson CM, Perry J, Lumb M, Levi AJ. Role of sulphasalazine in the aetiology of folate deficiency in ulcerative colitis. Gut. 1981 Jun;22(6):456–461. [PMC free article] [PubMed]
  • Taffet SL, Das KM. Sulfasalazine. Adverse effects and desensitization. Dig Dis Sci. 1983 Sep;28(9):833–842. [PubMed]

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