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Stephen J. Derbes, MD
Tulane University Medical Center New Orleans

JAMA. 1985;253(15):2192.

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In Reply.—

I have several comments to make concerning the observations of Dr de la Monte and colleagues.

While sulfonamides are a frequent cause of untoward immunologic reactions, the association of some with the trimethoprim-sulfamethoxazole combination may be due, in certain instances, to the trimethoprim component. This was suggested in my report by the observation that, on one occasion, meningitis was associated with the ingestion of trimethoprim alone. It may therefore be erroneous to conclude that this patient had a "sensitivity to sulfa drugs."

While my report acknowledges the occurrence of aseptic meningitis in Sjögren's syndrome,¹ the clinical picture of meningitis appears to be rather uncommon in this disease. Most publications dealing with Sjögren's syndrome (including a recently published reference text²) make no direct mention of it. The report by de la Monte et al³ suggests that meningeal inflammation may be common in Sjögren's syndrome. Their patients . . . [Full Text PDF of this Article]

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