Mesalamine-Associated Hypersensitivity Myocarditis in Ulcerative Colitis

Stelts, Sundae; Taylor, Marian H; Nappi, Jean M.; Bakel, Adrian B. Van

doi:10.1345/aph.1k288

Cited by 30 publications

(18 citation statements)

References 4 publications

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“…6 The diagnosis of hypersensitivity myocarditis is supported by two facts: inflammation worsens if mesalamine is reintroduced during the acute phase, 1 and resolution of symptoms occurs within one week after drug discontinuation, as has been described in all reported cases. 1---4 Eosinophilic infiltration of the myocardium on endomyocardial biopsy has also been described, 7 which seems to confirm the link between mesalamine and hypersensitivity myocarditis.…”

Section: Discussionmentioning

confidence: 74%

Mesalamine-induced myocarditis following diagnosis of Crohn's disease: A case report

Braga

Martins

Arantes

et al. 2013

Revista Portuguesa de Cardiologia

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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. © 2012 Sociedade Portuguesa de Cardiologia. Published by Elsevier España, S.L. All rights reserved. PALAVRAS-CHAVEMiocardite; Mesalamina; Ecocardiografia transtorácica; Ressonância magnética cardíaca Miocardite induzida pela mesalamina após o diagnóstico de doença de Crohn ---relato de um caso clínico Resumo A mesalamina é um tratamento comum para a doença de Crohn, associando-se de forma rara à miocardite aguda, através de uma reação de hipersensibilidade ao fármaco. Os autores apresentam o caso clínico de um jovem de 19 anos com aparecimento de dor torá-cica duas semanas após ter iniciado tratamento com mesalamina para a doença de Crohn. O eletrocardiograma mostrou um discreto supradesnivelamento do segmento ST, de concavidade ascendente, nas derivações infero-laterais; as análises revelaram elevação da troponina I e o ecocardiograma exibiu uma depressão moderada da função sistólica do ventrículo esquerdo, por hipocontractilidade global. A ressonância magnética cardíaca confirmou o diagnóstico de miocardite, evidenciando múltiplas áreas de fibrose subepicárdica. O início dos sintomas após o começo da mesalamina e a melhoria da dor torácica, biomarcadores cardíacos e função sistólica * Corresponding author. E-mail address: carlos.galvaobraga@gmail.com (C. Galvão Braga).0870-2551/$ -see front matter © 2012 Sociedade Portuguesa de Cardiologia. Published by Elsevier España, S.L. All rights reserved. http://dx.doi.org/10.1016/j.repc.2012.12.018 Document downloaded from http://http://www.elsevier.pt, day 14/02/2014. This copy is for personal use. Any transmission of this document by any media or format is strictly prohibited. 718C. Galvão Braga et al. ventricular esquerda após a suspensão do medicamento, sugerem que o nosso paciente teve uma reação rara de hipersensibilidade à mesalamina.

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Section: Discussionmentioning

confidence: 74%

Mesalamine-induced myocarditis following diagnosis of Crohn's disease: A case report

Braga

Martins

Arantes

et al. 2013

Revista Portuguesa de Cardiologia

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“…The relationship between mesalazine and myocarditis is thought to be due to hypersensitivity reaction rather than cytotoxic effects (2,3). Previous studies showed eosinophilic infiltration of the myocard in mesalazine associated myocarditis in biopsy (4). Although patients with a hypersensitivity disease may develop arteritis, acute myocardial infarction rarely occurs (5).…”

Section: öZetmentioning

confidence: 99%

“…Mesalazine associated eosinophilic myocarditis or giant cell myocarditis was considered in our case. Because a provocative test with etiologic agent could lead fatal damage, it was not performed (2)(3)(4). Similarly, we did not perfom an endomyocardial biopsy because the patient refused to consent to the biopsy.…”

Section: öZetmentioning

confidence: 99%

Myocarditis Associated with Mesalazine: A Case Report

2015

J Turgut Ozal Med Cent

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Acute myocarditis is a life-threatening inflammatory disease of the heart muscle. It usually occurs after a viral infection and it is often asymptomatic. Mesalazine is commonly used for the treatment of inflammatory bowel disease. Mesalazine rarely causes acute myocarditis, but the exact mechanism is unclear. A 32-year-old female patient using mesalazine with a diagnosis inflammatory bowel disease was admitted to the emergency department with shortness of breath. The patient showed signs of acute decompansated heart failure. Bedside echocardiography examination showed a reduced left ventricular systolic function. The patient was followed with a diagnosis of fulminant myocarditis and mechanical ventilation and inotropic support was started. The patient has dramatically improved after stopping treatment of mesalazine. Myocarditis due to any drug use should be taken into consideration in patients receiving mesalazine therapy.

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“…O diagnóstico deve ser suspeitado na presença de eosinofilia no sangue periférico ou infiltrado eosinofílico miocárdico. Também podemos ter o desenvolvimento de miocardite eosinofílica linfocítica secundária a vacinação [13][14][15] . Doenças sistêmicas autoimunes como a síndrome de Churg-Strauss 16 , e a síndrome hipereosinofílica estão associadas à miocardite eosinofílica 17 .…”

Section: Etiologiaunclassified

“…Roque Figueira (7,8), João David de Souza Neto (9), Lídia Ana Zytynski Moura (10,11), Luiz Antônio de Almeida Campos (12,13), Marcelo Imbroinise Bittencourt (1,12), Márcia de Melo Barbosa (14), Maria da Consolação Vieira Moreira (15), Maria de Lourdes Higuchi (3), Pedro Schwartzmann (16), Ricardo Mourilhe Rocha (1,12), Sabrina Bernardez Pereira (2), Sandrigo Mangini (3,17), Silvia Marinho Martins (18), Solange Bordignon (19,20), Vitor Agueda Salles (21,22). …”

mentioning

confidence: 99%