INCREASED UROBILINOGEN EXCRETION AND ACUTE HEMOLYTIC ANEMIA IN PATIENTS TREATED WITH SULFAPYRIDINE 1

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Abstract
The excretion of urobilinogen in feces and urine was measured in 26 patients with pneumonia, 20 of whom received sulfapyridine. The pneumonic process itself is apparently not responsible for increased erythrocyte destruction, since in 18 patients the excretion of urobilinogen was within normal limits. 8 patients who received sulfapyridine excreted increased amts. of urobilinogen and in 3 of these acute hemolytic anemia occurred. 2 patients in whom urobilinogen excretion was increased during drug therapy later excreted normal amts. when sulfapyridine was discontinued, even though the acute febrile disease persisted. No correlation existed between the increased excretion of urobilinogen and the dosage or blood levels of sulfapyridine. Certain patients vary in their susceptibility either to the sulfonamide comp''d. itself or to one of the derivatives formed within the body. Certain patients may convert more of the sulfonamide cmp''d. into hemolytic products than others, or else fail to detoxify and eliminate these products rapidly enough to prevent increased hemolysis.