title: Acute Pancreatitis due to pH-Dependent Mesalazine That Occurred in the Course of Ulcerative Colitis.
abstract: We report the case of a 26-year-old male who presented with acute pancreatitis during the course of treatment for pancolitic ulcerative colitis (UC) with a time-dependent mesalazine formulation, prednisolone and azathioprine (AZA). Despite a review of his clinical history and various tests, the cause of pancreatitis could not be determined. Since drug-induced pancreatitis was considered possible, administration of the time-dependent mesalazine preparation and AZA was discontinued, and conservative treatment for acute pancreatitis was performed. The pancreatitis promptly improved with these treatments, but drug lymphocyte stimulation test (DLST) for both the time-dependent mesalazine formulation and AZA was negative. A pH-dependent mesalazine formulation was given for maintenance therapy of UC. Subsequently, as the pancreatitis relapsed, drug-induced pancreatitis was strongly suspected. Administration of mesalazine was discontinued, and pancreatitis was smoothly in remission by conservative treatment. According to the positive DLST result for the pH-dependent mesalazine formulation and the clinical course, a diagnosis of pH-dependent mesalazine-induced pancreatitis due to this formulation was made. During the clinical course of UC, occurrence of drug-induced pancreatitis must always be considered.
authors: Division of Gastroenterology and Hepatology, Department of Internal Medicine, Jikei University School of Medicine, Tokyo, Japan.
authors: Yoshinori
authors: Y
authors: Arai
authors: Seiji
authors: S
authors: Arihiro
authors: Daisuke
authors: D
authors: Ide
authors: Isao
authors: I
authors: Odagi
authors: Munenori
authors: M
authors: Itagaki
authors: Nobuhiko
authors: N
authors: Komoike
authors: Yutaka
authors: Y
authors: Nakao
authors: Kazuki
authors: K
authors: Takakura
authors: Masayuki
authors: M
authors: Saruta
authors: Mika
authors: M
authors: Matsuoka
authors: Tomohiro
authors: T
authors: Kato
authors: Hisao
authors: H
authors: Tajiri