• Am. J. Gastroenterol. · Dec 1989

    Case Reports

    Fulminant liver failure and pancreatitis associated with the use of sulfamethoxazole-trimethoprim.

    • J J Alberti-Flor, M E Hernandez, J P Ferrer, S Howell, and L Jeffers.
    • Department of Medicine, Mercy Hospital, Miami, Florida.
    • Am. J. Gastroenterol. 1989 Dec 1; 84 (12): 1577-9.

    AbstractWe report the case of a 26-yr-old patient with fulminant liver failure and acute hemorrhagic pancreatitis secondary to the use of trimethoprim-sulfamethoxazole (Bactrim DS). Our patient presented with skin rash and decreased C3 and C4 levels, which we believed was due to a hypersensitivity reaction secondary to the sulfonamide component (sulfamethoxazole). To our knowledge, this is the first case reported in which sulfamethoxazole-trimethoprim has been implicated as a cause of fulminant liver failure and acute hemorrhagic pancreatitis simultaneously, and emphasizes the need of discontinuing this medication as soon as there is evidence of liver and pancreatic dysfunction.

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