Sulfonamides aplastic anemia with

Severe reactions Severe reactions including deaths caused by sulfonamides have been associated with hypersensitivity reactions, agranulocytosis, aplastic anemia, other blood dyscrasias, and renal and hepatic damage. Irreversible neuromuscular and CNS changes and fibrosing alveolitis may occur. 

Sulfonamides can cause hemolytic or aplastic anemia, granulocytopenia, thrombocytopenia, or leukemoid reactions. Sulfonamides may provoke hemolytic reactions in patients with glucose-6-phosphate dehydrogenase deficiency. Sulfonamides taken near the end of pregnancy increase the risk of kernicterus in newborns. 

Some ADRs are caused by most or all medications in a class, while others are agent specific. Nausea, vomiting, and diarrhea have been observed with most antibiotics, yet only chloramphenicol and certain sulfonamide antibiotics have been consistently implicated as causes of aplastic anemia. Some pharmacological effects, such as sedation from an antihistamine, may be considered adverse effects when they are... 

Most hematological adverse effects associated with trimethoprim have been reported with co-trimoxazole. These include macrocytic and megaloblastic anemia, aplastic anemia, neutropenia, hypersegmentation of leukocytes, thrombocytopenia, and pancytopenia (12,61-63,75-79). Sulfonamides alone have not been associated with folate deficiency, but in combination with trimethoprim they can deplete folate stores in patients with preexisting deficiency of folate or vitamin B12 (80). Treatment with co-trimoxazole can impair the function of mobilized autologous peripheral blood stem cells (81). 

Hematotoxicity Though such effects are rare, sulfonamides can cause granulocytopenia, thromboc3Topenia, and aplastic anemia. Acute hemolysis may occur in persons with glu-cose-6-phosphate dehydrogenase deficiency. 

Agranulocytosis occurs in 0.1 % of cases after sulfadiazine and also occurs after other sulfonamides. The myelotoxic effect is demonstrated as impaired development of the myeloblasts. Granulocytopenia is not related to the applied dosage and as a rule appears after 10 days treatment. Slight passing thrombocytopenia is frequent, but serious thrombocytopenia and aplastic anemia are rare. Isolated peripheral eosinophilia can be observed, disappearing rapidly after cessation of sulfonamides. It can also appear in combination with other signs of hypersensitivity (Thirkettle et al. 1963 Johnson and Korst 1961). 

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