title: Mesalamine-induced myocarditis following diagnosis of Crohn's disease: a case report.
abstract: Mesalamine is a common treatment for Crohn's disease, and can be rarely associated with myocarditis through a mechanism of drug hypersensitivity. We present the case of a 19-year-old male who developed chest pain two weeks after beginning mesalamine therapy. The electrocardiogram showed slight ST-segment elevation with upward concavity in the inferolateral leads; blood tests demonstrated elevated troponin I and the echocardiogram revealed moderately depressed left ventricular systolic function with global hypocontractility. Cardiac magnetic resonance imaging confirmed the diagnosis of myocarditis, revealing multiple areas of subepicardial fibrosis. The onset of symptoms after mesalamine, and improvement of chest pain, cardiac biomarkers and left ventricular systolic function after discontinuing the drug, suggest that our patient suffered from a rare drug-hypersensitivity reaction to mesalamine.
authors.affiliation: Serviço de Cardiologia, Hospital de Braga, Braga, Portugal. Electronic address: carlos.galvaobraga@gmail.com.
authors.forename: Carlos
authors.initials: C
authors.lastname: Galvão Braga
authors.forename: Juliana
authors.initials: J
authors.lastname: Martins
authors.forename: Carina
authors.initials: C
authors.lastname: Arantes
authors.forename: Vítor
authors.initials: V
authors.lastname: Ramos
authors.forename: Catarina
authors.initials: C
authors.lastname: Vieira
authors.forename: Alberto
authors.initials: A
authors.lastname: Salgado
authors.forename: Sónia
authors.initials: S
authors.lastname: Magalhães
authors.forename: Adelino
authors.initials: A
authors.lastname: Correia
mesh_terms: D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000009:adverse effects* / Q000627:therapeutic use; D003424:Crohn Disease / Q000188:drug therapy*; D006801:Humans; D008297:Male; D019804:Mesalamine / Q000009:adverse effects* / Q000627:therapeutic use; D009205:Myocarditis / Q000139:chemically induced*; D055815:Young Adult
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D019804:Mesalamine
keywords: Cardiac magnetic resonance imaging; Ecocardiografia transtorácica; Mesalamina; Mesalamine; Miocardite; Myocarditis; Ressonância magnética cardíaca; Transthoracic echocardiography