A case of interstitial pneumonitis in a patient with ulcerative colitis treated with azathioprine.
The early hypersensitivity reaction and late bone marrow depression are well-known side-effects of azathioprine, whereas interstitial pneumonia is a rare complication. A 40-year old male patient had been treated with azathioprine in consequence of extensive ulcerative colitis for 10 years. He then complained of 7 d of fever, cough and catarrhal signs, without symptoms of active colitis. Opportunistic infections were ruled out. The chest X-ray, CT and lung biopsy demonstrated the presence of interstitial inflammation. Azathioprine therapy was discontinued as a potential source of the pulmonary infiltrate. In response to steroid therapy, and intensive care, the pulmonary infiltrate gradually decreased within 4 wk. Three months later, his ulcerative colitis relapsed, and ileo-anal pouch surgery was performed. In cases of atypical pneumonia, without a proven infection, azathioprine-associated interstitial pneumonitis may be present, which heals after withdrawal of the drug.
Nagy
Ferenc
F
First Department of Medicine, Faculty of Medicine, University of Szeged, Koranyi fasor 8, H-6701, Szeged, POB 427, Hungary. agyferi@in1st.szote.u-szeged.hu
Molnar
Tamas
T
Makula
Eva
E
Kiss
Ildiko
I
Milassin
Peter
P
Zollei
Eva
E
Tiszlavicz
Laszlo
L
Lonovics
Janos
J
D000328:Adult; D001379:Azathioprine / Q000008:administration & dosage / Q000009:adverse effects*; D003093:Colitis, Ulcerative / Q000188:drug therapy*; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage / Q000009:adverse effects*; D017563:Lung Diseases, Interstitial / Q000139:chemically induced* / Q000175:diagnosis* / Q000473:pathology; D008297:Male; D013902:Radiography, Thoracic
D007166:Immunosuppressive Agents; D001379:Azathioprine