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December 1980

Possible Embryotoxicity of Sulfasalazine

Arch Intern Med. 1980;140(12):1674. doi:10.1001/archinte.1980.00330230120030

To the Editor.  —Sulfasalazine has been widely used as a maintenance treatment for chronic ulcerative colitis during pregnancy. To our knowledge, no untoward effect on its course or on the fetus has been reported, although a recent work by Azad-Kahn and Truelove1 showed that sulfasalazine and its sulfapyridine moiety are absorbed and reach the fetus in concentrations similar to those in the maternal serum. We have observed a case in which continuous treatment with sulfasalazine before and throughout pregnancy could be related to a severe fetal abnormality.

Report of a Case.  —A 28-year-old woman, gravida 1, para 1, with a regular menstrual history, was first seen by us in February 1978 because of a six-month history of bloody diarrhea. By endoscopic examination and biopsy specimens, her disease was diagnosed as active ulcerative colitis, limited to the left side of the colon. Therapy was begun with sulfasalazine, 3 g/day, resulting in