title: Acute respiratory failure secondary to mesalamine-induced interstitial pneumonitis.
abstract: Interstitial pneumonitis as an adverse effect of mesalamine therapy is a rare but potentially serious complication. Patients typically have a mild disease course with no documented cases of respiratory failure in published literature. Given its variable latent period and non-specific signs and symptoms, it may be difficult to diagnose. We present the case of a 65-year-old man who presented with symptoms of fever, shortness of breath and a non-productive cough, 2 weeks after initiation of therapy with mesalamine. His hospital course was complicated by acute respiratory failure requiring intubation and mechanical ventilation. Radiographic studies revealed bilateral lower lobe infiltrates and bronchosopy with bronchoalveolar lavage and transbronchial biopsy were consistent with a diagnosis of drug-induced interstitial pneumonitis. The aim of this paper is to highlight the importance of considering a diagnosis of mesalamine-induced lung injury in patients presenting with respiratory symptoms while on mesalamine therapy and to review relevant literature.
authors: Nassau University Medical Center, East Meadow, New York, USA.
authors: Albin
authors: A
authors: Abraham
authors: Ali
authors: A
authors: Karakurum
mesh_terms: D055371:Acute Lung Injury / Q000139:chemically induced* / Q000150:complications; D000368:Aged; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000009:adverse effects*; D003093:Colitis, Ulcerative / Q000188:drug therapy; D006801:Humans; D017563:Lung Diseases, Interstitial / Q000139:chemically induced* / Q000150:complications; D008297:Male; D019804:Mesalamine / Q000009:adverse effects*; D012131:Respiratory Insufficiency / Q000209:etiology*
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D019804:Mesalamine
references: Respir Res. 2012 May 31;13:39
references: 22651223
references: Expert Opin Drug Saf. 2007 Mar;6(2):99-107
references: 17367256
references: Gastroenterology. 2004 May;126(6):1504-17
references: 15168363
references: World J Gastroenterol. 2011 Jul 21;17(27):3204-12
references: 21912469
references: BMJ Case Rep. 2009;2009:
references: 21686567
references: Inflamm Bowel Dis. 2003 Sep;9(5):308-15
references: 14555914
references: Medicine (Baltimore). 1993 May;72(3):151-83
references: 8502168
references: Gut. 2002 Oct;51(4):536-9
references: 12235076
references: Scand J Gastroenterol Suppl. 1990;172:66
references: 1972297
references: Inflamm Bowel Dis. 2004 May;10(3):207-14
references: 15290913
references: Conn Med. 2010 May;74(5):265-7
references: 20509416
references: Inflamm Bowel Dis. 2007 Mar;13(3):254-61
references: 17206702
references: J Crohns Colitis. 2007 Dec;1(2):61-9
references: 21172186
references: Chest. 1992 May;101(5):1469-71
references: 1582327
references: Clin Pharmacol. 2012;4:41-50
references: 22888278
references: Am J Gastroenterol. 1996 May;91(5):1039-40
references: 8633548
references: Mt Sinai J Med. 2001 Nov;68(6):389-95
references: 11687867