Cardiac MRI-confirmed mesalamine-induced myocarditis.
A 38-year-old Caucasian man with a medical history significant for inflammatory bowel disease (IBD) and mesalamine use presented to the emergency department with stabbing, pleuritic, substernal chest pain over the previous 2 days. Findings of leucocytosis, elevated cardiac enzymes and inflammatory markers, T-wave or ST-segment abnormalities and left ventricular systolic dysfunction suggested mesalamine-induced myocarditis. However, a cardiac MRI confirmed the diagnosis. Signs and symptoms improved within days of withdrawal of mesalamine, and initiation of corticosteroids and follow-up studies within the next year were unremarkable. Importantly, the diagnosis of mesalamine-induced myocarditis confirmed via cardiac MRI is a step rarely performed in published cases.
Department of Pharmacy Practice, University of Connecticut School of Pharmacy, Storrs, Connecticut, USA.
William L
WL
Baker
Department of Pharmacy Practice, University of Connecticut School of Pharmacy, Storrs, Connecticut, USA.
Whitney J
WJ
Saulsberry
Department of Pharmacy Practice, University of Connecticut School of Pharmacy, Storrs, Connecticut, USA.
Kaitlyn
K
Elliott
Department of Cardiology, Hartford Hospital, Hartford, Connecticut, USA.
Matthew W
MW
Parker
D000305:Adrenal Cortex Hormones / Q000008:administration & dosage*; D000328:Adult; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000008:administration & dosage / Q000009:adverse effects*; D002637:Chest Pain / Q000139:chemically induced*; D004417:Dyspnea / Q000139:chemically induced; D005500:Follow-Up Studies; D006801:Humans; D015212:Inflammatory Bowel Diseases / Q000188:drug therapy*; D008279:Magnetic Resonance Imaging; D008297:Male; D019804:Mesalamine / Q000008:administration & dosage / Q000009:adverse effects*; D009205:Myocarditis / Q000139:chemically induced* / Q000175:diagnosis / Q000188:drug therapy; D009325:Nausea / Q000139:chemically induced; D016896:Treatment Outcome; D014839:Vomiting / Q000139:chemically induced
D000305:Adrenal Cortex Hormones; D000894:Anti-Inflammatory Agents, Non-Steroidal; D019804:Mesalamine