Immune complex haemolytic anaemia associated with sulfasalazine.

Case 1 A 48 year old man had had symptoms of multiple sclerosis for three years, at first intermittent but eventually progressive, with mainly ataxia and spastic weakness of the legs. He also had disabling oscillopsia due to a multidirectional nystagmus. Two days after starting carbamazepine (100 mg three times daily) he was unable to walk because of increased weakness, but two days after stopping it he could walk unassisted. Carbamazepine (50 mg three times daily) was restarted one week later without any change in symptoms. When the dose was increased to 100 mg three times daily he developed a profound weakness of the legs, which disappeared two days after stopping treatment.