Can sulfonamides cause sarcoidosis?

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Sulfonamides, also called sulfa drugs, are used to treat bacterial infections and some fungal infections. They prevent the growth of bacteria by interfering with cell metabolism. Sulfonamides were the wonder drug before they were largely replaced by antibiotics such as penicillin, which are generally safer and more effective. The most common use for sulfonamides in adults today is to treat urinary infections.

The following sulfonamides are still in use: Sulfisoxazole is used to treat urinary tract infections and can be used in combination with erythromycin to treat ear infections in children. It can also be used prophylactically to prevent ear infections and meningococcal infections. Trimethoprim and sulfamethoxazole are used in tandem to treat urinary tract infections and other infections that cannot be treated with antibiotics. Sulfadiazine may be used to protect people with rheumatic fever from infections, and to treat toxoplasmosis. An ointment containing silver sulfadiazine is widely used to treat burns. Sulfasalazine is used to treat infections of the colon and intestine.

Although sulfonamides generally do not produce side effects, in rare cases patients have suffered severe and life-threatening reactions. These include sudden, severe lung damage, serious blood problems, breakdown of the outer skin layer and a condition called Stevens-Johnson syndrome, in which patients get blisters around the mouth, eyes and other parts of the body. Consequently, they are used with extreme care in patients with liver problems, kidney problems and some times of anemia.

Sarcoidosis is a disease resulting from a certain type of inflammation of bodily tissues. It can appear in almost any organ, but usually starts in the lungs or lymph nodes. As the disease progresses, microscopic lumps called granulomas begin to appear in the affected tissue. These granulomas usually clear up with or without treatment. In the few cases where they do not heal and disappear, the affected tissue remains inflamed and becomes scarred (fibrotic).

Sarcoidosis was once considered a rare disease, but it is now recognized as a common chronic illness that appears all over the world. It is the most common scarring lung disorder, occurring in all races and in both sexes. Nevertheless, the risk is greater to young black adults (women in particular), Puerto Ricans and people of German, Scandinavian and Irish origin. Why this is so is unknown. The disease mainly affects people between the ages of 20 and 40.

Although much is unknown about the disease, it is usually not crippling, and often disappears by itself within 24 to 36 months. Most patients can go about their normal lives. Sarcoidosis is not a cancer and is not contagious. Although it has been known to occur in families, there is no evidence that it is passed from parents to their children.

In most cases, sarcoidosis presents briefly and heals itself, without the intervention or even the knowledge of the patient. Some permanent lung damage occurs in one out of every four cases, and one out of ten the disease can become chronic. In five to ten percent of sarcoidosis cases, the resulting granulomas or fibrosis cause serious damage to vital organs such as the heart, lungs, liver or nervous system. In such cases, the disease can be fatal.

Nobody knows what causes sarcoidosis. It is currently thought to be associated with an abnormal immune response; however, it has not been determined whether this immune disturbance is triggered by a foreign substance such as a chemical, virus or drug. Consequently, there is no evidence that sulfonamides are a causal factor in sarcoidosis. If such an assumption exists, it is likely due to the association of sulfonamides with erythema nodosum, a condition that is sometimes associated with sarcoidosis and presents similar symptoms.

Resource by Will

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