Sulfapyridine-Induced Serum-Sickness-Like Syndrome Associated with Plasmacytosis, Lymphocytosis and Multiclonal Gamma-Globulinopathy

W.B., a 38-year-old Negro, had previously been treated with sulfonamide ointment for dermatitis herpetiformis. On June 5, 1966, oral sulfapyridine, 2 gm daily, was started for a recurrence. Two weeks later, fever, abdominal pain, extreme weakness and generalized skin rash developed.On admission he was weak and lethargic, with hoarseness and somewhat labored respiration. The temperature was 102°F. The scleras were icteric. He had a generalized papular skin eruption, with exfoliation, moderate generalized lymphadenopathy, hepatomegaly and edema of the lips, tongue and fauces.The hemoglobin 1 week after onset of illness was 12.9 gm per 100 ml; subsequently, it fell . . .