title: An unusual cause of febrile hepatitis.
abstract: We describe the case of a 51-year-old man with recently diagnosed ulcerative colitis who developed fever and elevated liver enzymes as well as cholestasis a few weeks after starting treatment with mesalazine. As no obvious cause was found and fever persisted, liver biopsy was performed and revealed granulomatous hepatitis. The patient recovered completely after cessation of mesalazine, so that a drug-induced granulomatous hepatitis after exclusion of other differential diagnoses in an extensive work up was assumed. The present case demonstrates that even though drug-induced liver injury due to mesalazine is rare, it should be considered in unclear cases and lead to prompt discontinuation of mesalazine.
authors.affiliation: Department of Internal Medicine, Spital Zollikerberg, Zollikerberg, Switzerland.
authors.forename: Teresa
authors.initials: T
authors.lastname: Stelzer
authors.affiliation: Department of Endocrinology, University Hospital Zurich, Zurich, Switzerland.
authors.forename: Sibylle
authors.initials: S
authors.lastname: Kohler
authors.affiliation: Department of Pathology, University Hospital Zurich, Zurich, Switzerland.
authors.forename: Ewerton
authors.initials: E
authors.lastname: Marques Maggio
authors.affiliation: Department of Internal Medicine, Spital Zollikerberg, Zollikerberg, Switzerland.
authors.forename: Ludwig Theodor
authors.initials: LT
authors.lastname: Heuss
mesh_terms: D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000009:adverse effects* / Q000627:therapeutic use; D001706:Biopsy; D056486:Chemical and Drug Induced Liver Injury / Q000175:diagnosis / Q000209:etiology*; D002779:Cholestasis / Q000209:etiology; D003093:Colitis, Ulcerative / Q000188:drug therapy*; D005334:Fever / Q000175:diagnosis* / Q000209:etiology; D006505:Hepatitis / Q000175:diagnosis / Q000209:etiology*; D006801:Humans; D008099:Liver / Q000473:pathology*; D008297:Male; D019804:Mesalamine / Q000009:adverse effects* / Q000627:therapeutic use; D008875:Middle Aged
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D019804:Mesalamine