Sulphasalazine induced selective IgA deficiency in rheumatoid arthritis

Abstract

Selective IgA deficiency (serum IgA concentration less than 0.4 g/l in the presence of normal or raised concentrations of IgG and IgM) can develop when sodium aurothiomalate or D-penicillamine are used in the treatment of rheumatoid arthritis. While recognised to be of major therapeutic importance in inflammatory bowel disease, sulphasalazine has recently been reported to have a disease modifying action in rheumatoid arthritis. We report three cases of rheumatoid arthritis in which sulphasalazine was associated with the onset of selective IgA deficiency.