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Toxicity Of Trimethoprim-Sulphamethoxazole In Patients With Megaloblastic Haemopoiesis
I. Chanarin and J. M. England
The British Medical Journal
Vol. 1, No. 5801 (Mar. 11, 1972), pp. 651-653
Published by: BMJ
Stable URL: http://www.jstor.org/stable/25417981
Page Count: 3
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Four consecutive patients with megaloblastic anaemia who also received therapy with trimethoprim-sulphamethoxazole all showed poor responses to specific haematinic therapy. This was attributed to trimethoprim, which suppressed reticulocyte responses in three cases and produced a pancytopenia in two and a falling haemoglobin with neutropenia in a third. A fourth patient, with pernicious anaemia, had a satisfactory reticulocyte response but experienced no clinical benefit until after withdrawal of trimethoprim. Trimethoprim seems not to be a safe form of therapy in patients with a megaloblastic process; many of the toxic reactions reported with this drug may be on the basis of an unrecognized megaloblastic form of haemopoiesis.
The British Medical Journal © 1972 BMJ