Drug-induced pulmonary toxicity in a patient treated with mesalazine and azathioprine for ulcerative colitis.
We report a case of an 18-yr-old male with high-grade persistent fever, productive cough, malaise, diarrhea and associated abnormal findings on chest radiography. The patient suffered from ulcerative colitis receiving mesalazine and azathioprine. After a further and scrutinized work-up the diagnosis of drug-induced pulmonary toxicity was made. His condition was improved after discontinuing both drugs and the administration of corticosteroids. This is a rarely reported case of eosinophilic pneumonia. Although it has not been reported previously, the possibility of mesalazine and azathioprine synergism cannot be excluded. The clinical, aetiological, diagnostic and therapeutic aspects of the disease are discussed demonstrating the paramount importance of bronchoalveolar lavage in the diagnosis of this disorder. One should be aware of this entity in patients with inflammatory bowel disease.
Katsenos
Stamatis
S
Department of Pneumonology, Army General Hospital of Athens, Athens, Greece. skatsenos@yahoo.gr
Psathakis
Kostas
K
Kokkonouzis
Ioannis
I
Panagou
Panagiotis
P
Tsintiris
Kostas
K
Bouros
Demosthenes
D
D000293:Adolescent; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000009:adverse effects*; D001379:Azathioprine / Q000009:adverse effects*; D001992:Bronchoalveolar Lavage Fluid / Q000166:cytology; D003093:Colitis, Ulcerative / Q000188:drug therapy*; D003371:Cough / Q000139:chemically induced; D003967:Diarrhea / Q000139:chemically induced; D006801:Humans; D007091:Image Processing, Computer-Assisted; D007166:Immunosuppressive Agents / Q000009:adverse effects*; D008297:Male; D019804:Mesalamine / Q000009:adverse effects*; D011657:Pulmonary Eosinophilia / Q000139:chemically induced*; D014057:Tomography, X-Ray Computed
D000894:Anti-Inflammatory Agents, Non-Steroidal; D007166:Immunosuppressive Agents; D019804:Mesalamine; D001379:Azathioprine