Mesalamine-induced granulomatous hepatitis.
A 42-yr-old man with ulcerative colitis was admitted for investigation of prolonged fever associated with cholestatic liver tests. Endoscopic retrograde cholangiopancreatography demonstrated a normal biliary tree, and liver biopsy showed granulomata. A clinical diagnosis of drug-induced granulomatous hepatitis was established as the symptoms disappeared after cessation of mesalamine therapy and recurred on rechallenge. Although the differential diagnosis of fever and hepatitis in patients with inflammatory bowel disease is wide, in this case mesalamine is the most likely cause.
Department of Internal Medicine "D" and Gastroenterology, Rabin Medical Centre, Petach Tikva, Israel.
M
M
Braun
G M
GM
Fraser
M
M
Kunin
F
F
Salamon
R
R
Tur-Kaspa
D000328:Adult; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000009:adverse effects* / Q000627:therapeutic use; D056486:Chemical and Drug Induced Liver Injury / Q000175:diagnosis / Q000209:etiology* / Q000473:pathology; D003093:Colitis, Ulcerative / Q000188:drug therapy; D006099:Granuloma / Q000473:pathology; D006801:Humans; D008297:Male; D019804:Mesalamine / Q000009:adverse effects* / Q000627:therapeutic use
D000894:Anti-Inflammatory Agents, Non-Steroidal; D019804:Mesalamine