title: Mesalazine-associated tubulo-interstitial nephritis in inflammatory bowel disease.
abstract: The 5-aminosalicylic acid (5-ASA) is currently the treatment of choice for patients with inflammatory bowel disease. It can be administered as sulfasalazine (5-ASA + sulfapyridine), mesalazine (5-ASA + resins or gels) and olsalazine (two molecules of 5-ASA). The recent trend has been to use formulations without sulfapyridine since they produce less side-effects although some cases of nephrotoxicity have been described. We report the case of a young female with Crohn's disease treated with mesalazine (400 mg every 8 hours) over a period of 12 months who developed acute interstitial nephritis. The characteristic features of renal function impairment were an insidious onset with non-specific laboratory data and progression towards a chronic state which partially improved with steroid treatment. In summary, it is important to bear this possibility in mind when confronted by any renal impairment which cannot be related to a relapse of inflammatory bowel disease. Renal function should be monitored routinely in patients receiving mesalazine at least during the first year of treatment and annually thereafter.
authors.affiliation: Nephrology Unit, Complejo Hospitalario Universitario de Santiago, Santiago de Compostela, Spain.
authors.forename: J
authors.initials: J
authors.lastname: Calviño
authors.forename: R
authors.initials: R
authors.lastname: Romero
authors.forename: E
authors.initials: E
authors.lastname: Pintos
authors.forename: E
authors.initials: E
authors.lastname: Losada
authors.forename: D
authors.initials: D
authors.lastname: Novoa
authors.forename: D
authors.initials: D
authors.lastname: Güimil
authors.forename: J
authors.initials: J
authors.lastname: Mardaras
authors.forename: D
authors.initials: D
authors.lastname: Sanchez-Guisande
mesh_terms: D000328:Adult; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000009:adverse effects*; D003424:Crohn Disease / Q000188:drug therapy*; D004334:Drug Administration Schedule; D005260:Female; D005938:Glucocorticoids / Q000627:therapeutic use; D006801:Humans; D007668:Kidney / Q000473:pathology; D019804:Mesalamine / Q000009:adverse effects*; D009395:Nephritis, Interstitial / Q000139:chemically induced* / Q000175:diagnosis / Q000188:drug therapy; D011241:Prednisone / Q000627:therapeutic use; D013997:Time Factors
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D005938:Glucocorticoids; D019804:Mesalamine; D011241:Prednisone