title: Mesalazine-induced multi-organ hypersensitivity.
abstract: Mesalazine therapy for ulcerative colitis has been reported to be effective and safe. Rare cases of mesalazine-induced renal, pancreatic, myo-pericardial, pleuro-pulmonary and haematological toxicity have been described separately. We report a case characterized by the simultaneous presence of fever, pericarditis, peripheral eosinophilia, eosinophilic pneumonia, anaemia and haematuria (together with proteinuria and leukocyturia) due to mesalazine treatment in a patient with ulcerative colitis. No clinical response had been obtained with corticosteroids and various antibacterial agents. When mesalazine treatment was suspended, all symptoms rapidly and totally disappeared, confirming the direct responsibility of this drug in causing these adverse events. We conclude that mesalazine can induce multi-organ hypersensitivity, which must always be considered as a possible adverse effect during treatment with this drug. To resolve this adverse event it is essential to discontinue mesalazine treatment.
authors.affiliation: Unità Operativa Pneumologia, Ospedale Misericordia Grosseto, Grosseto, Italy. bsposat@tin.it
authors.forename: Bruno
authors.initials: B
authors.lastname: Sposato
authors.forename: Maria Pia
authors.initials: MP
authors.lastname: Allegri
authors.forename: Maria Piera
authors.initials: MP
authors.lastname: Riccardi
authors.forename: Silvia
authors.initials: S
authors.lastname: Chigiotti
authors.forename: Cesira
authors.initials: C
authors.lastname: Nencioni
authors.forename: Barbara
authors.initials: B
authors.lastname: Ricciardi
authors.forename: Tiziana
authors.initials: T
authors.lastname: Carli
authors.forename: Alberto
authors.initials: A
authors.lastname: Cresti
authors.forename: Maria Grazia
authors.initials: MG
authors.lastname: Perari
authors.forename: Maria Giovanna
authors.initials: MG
authors.lastname: Migliorini
authors.forename: Mario
authors.initials: M
authors.lastname: Toti
mesh_terms: D000328:Adult; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000009:adverse effects* / Q000627:therapeutic use; D003093:Colitis, Ulcerative / Q000188:drug therapy; D004342:Drug Hypersensitivity / Q000209:etiology* / Q000503:physiopathology; D006801:Humans; D008297:Male; D019804:Mesalamine / Q000009:adverse effects* / Q000627:therapeutic use
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D019804:Mesalamine