[Acute pancreatitis--adverse effect of 5-aminosalicylic acid (mesalazine) in various galenic dosage forms].
METHODS
A 34-year-old woman, being treated with oral mesalazine for colitis, developed upper abdominal pain radiating to the back one week after the drug was started, but the symptoms quickly regressed after mesalazine had been discontinued. The patient was admitted about 15 months later because of watery diarrhoea and lower abdominal pain. Physical examination revealed dehydration and pain on pressure over the lower abdomen.


METHODS
Coloscopy demonstrated Crohn's disease of the colon, more marked on the left. Laboratory tests indicated inflammatory disease.


METHODS
During treatment with oral prednisone and mesalazine enema the diarrhoea and laboratory parameters of inflammatory disease regressed. But 10 days after the start of treatment the patient complained of upper abdominal pain radiating to the back. Amylase and lipase levels were, respectively, four and twelve times normal. Ultrasound demonstrated an enlarged head of the pancreas, while endoscopy of the oesophagus, stomach and duodenum was unremarkable. 3 days after prednisone and mesalazine had been discontinued the symptoms had regressed and laboratory tests were normal. The symptoms did not recur when prednisone was administered again.


CONCLUSIONS
Mesalazine may cause an acute pancreatitis when given either orally or by rectal infusion.
Schwörer
H
H
Zentrum Innere Medizin, Abteilung Gastroenterologie und Endokrinologie, Universitätsklinik Göttingen.
Ramadori
G
G
D000208:Acute Disease; D000284:Administration, Oral; D000285:Administration, Rectal; D000328:Adult; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000009:adverse effects* / Q000627:therapeutic use; D001706:Biopsy; D003113:Colonoscopy; D003424:Crohn Disease / Q000188:drug therapy* / Q000473:pathology; D005260:Female; D006801:Humans; D007413:Intestinal Mucosa / Q000473:pathology; D019804:Mesalamine / Q000009:adverse effects* / Q000627:therapeutic use; D010195:Pancreatitis / Q000139:chemically induced* / Q000175:diagnosis; D012008:Recurrence; D019233:Retreatment
D000894:Anti-Inflammatory Agents, Non-Steroidal; D019804:Mesalamine