Tolerance of 4-aminosalicylic acid enemas in patients with inflammatory bowel disease and 5-aminosalicylic-induced acute pancreatitis.
Derivatives of 5-aminosalicylic acid (5-ASA) used for the treatment of inflammatory bowel disease may induce acute pancreatitis of immunoallergic origin. 4-aminosalicylic acid (4-ASA) differs from its 5-ASA counterpart by the position of the NH2 group and has shown efficacy in ulcerative colitis. The risk of cross intolerance reaction between 5-ASA and 4-ASA has currently never been evaluated. We report three cases of 5-ASA-induced pancreatitis, with no recurrence of pancreatitis during subsequent treatment with 4-ASA enemas. We conclude that 4-ASA enemas are a safe and well-tolerated therapeutic alternative whenever 5-ASA-induced pancreatitis occurs.
Département d'Hepato-Gastroentŕologie, Hôpital Européen Georges Pompidou, AP-HP, Paris, France.
Fady
F
Daniel
Philippe
P
Seksik
Wulfran
W
Cacheux
Raymond
R
Jian
Philippe
P
Marteau
D000328:Adult; D010131:Aminosalicylic Acid / Q000008:administration & dosage / Q000009:adverse effects; D004361:Drug Tolerance; D004733:Enema; D005260:Female; D006801:Humans; D015212:Inflammatory Bowel Diseases / Q000188:drug therapy*; D008297:Male; D019804:Mesalamine / Q000008:administration & dosage / Q000009:adverse effects*; D019283:Pancreatitis, Acute Necrotizing / Q000139:chemically induced*; D016896:Treatment Outcome
D019804:Mesalamine; D010131:Aminosalicylic Acid