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Fatal Hepatic Necrosis Due to Pyrimethamine-Sulfadoxine (Fansidar)
- BASIL J. ZITELLI, M.D.;
- JEFFREY ALEXANDER, M.D.;
- SUZANNE TAYLOR, M.D., Ph.D.;
- KIRK D. MILLER, M.D.;
- DENISE L. HOWRIE, Pharm.D.;
- JOEL N. KURITSKY, M.D.;
- THOMAS H. PEREZ, R.Ph.; and
- DAVID H. VAN THIEL, M.D.
Abstract
Pyrimethamine-sulfadoxine has been associated with severe and fatal cutaneous reactions as well as transient liver damage. We report the case of a patient who died of progressive hepatic failure caused by pyrimethamine-sulfadoxine administration. In addition, we summarize reports made to the Food and Drug Administration since 1982 that focus on hepatotoxic reactions to pyrimethamine-sulfadoxine. We suggest that fatal hepatic injury can occur after treatment with pyrimethamine-sulfadoxine and that physicians who prescribe the drug should be aware of this possibility.
Article and Author Information
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▸From the Departments of Pediatrics, Medicine, and Pathology, University of Pittsburgh Health Center Schools of Medicine and Pharmacy, Pittsburgh, Pennsylvania; Malaria Branch, Centers for Disease Control, Atlanta, Georgia; and the Food and Drug Administration, Department of Health and Human Services, Rockville, Maryland.
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▸Requests for reprints should be addressed to Basil J. Zitelli, M.D.; Children's Hospital of Pittsburgh, 3705 Fifth Avenue at DeSoto Street; Pittsburgh, PA 15213.
- © 1987 American College of Physicians
