Mesalamine-Induced Hypersensitivity Pneumonitis

Sviri, Sigal; Gafanovich, Inna; Kramer, Mordechai R.; Tsvang, E.; Ben-Chétrit, Eldad

doi:10.1097/00004836-199701000-00007

Cited by 34 publications

(15 citation statements)

References 18 publications

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“…The pathogenesis of mesalazine-induced lung injury is unknown, but four mechanisms are considered as a causes of drug induced lung injury; 1) oxidant injury by a drug, such as nitrofurantoin ingestion; 2) direct cytotoxic effect on alveolar capillary endothelial cells; 3) injury mediated by deposition of phospholipids within the cell; and 4) immune-mediated injury causing clinical symptoms of systemic lupus erythematosus. Currently, it is postulated that mesalazine causes immune-mediated alveolitis as evidenced by lymphocyte stimulation [2, 5, 8]. …”

Section: Discussionmentioning

confidence: 99%

Acute eosinophilic pneumonia related to a mesalazine suppository

Kim

Lee

Koh

et al. 2013

Asia Pacific Allergy

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It has been well known that mesalazine can cause the interstitial lung disease, such as Bronchiolitis obliterans with organizing pneumonia (BOOP), Non-Specific Interstitial Pneumonia (NSIP), or eosinophilic pneumonia. 5-Aminosalicylic acid (5-ASA), mesalazine, and sulfasalazine are important drugs for treating inflammatory bowel disease. Topical products of these limited systemic absorption and have less frequent side effects, therefore suppository form of these drugs have been used more than systemic drug. Most cases of measalzine-induced lung toxicity develop from systemic use of the drug. A 30-year-old woman had an interstitial lung disease after using mesalazine suppository because of ulcerative colitis. The lung biopsy demonstrated eosinophilic pneumonia combined with BOOP. She was recovered after stopping of mesalazine suppository and treatment with systemic steroid.

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Section: Discussionmentioning

confidence: 99%

Acute eosinophilic pneumonia related to a mesalazine suppository

Kim

Lee

Koh

et al. 2013

Asia Pacific Allergy

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“…İlaç kesildikten günler ve haftalar içerisinde tablo düzelmektedir. Steroid iyileşmeyi hızlandırmaktadır [10][11][12]. Mesalazin'e bağlı akciğer hasarının mekanizması net olarak belli değildir.…”

Section: Discussionunclassified

Mesalazine - Induced Lung Injury

Kararmaz¹,

Yalnız²,

Özden³

et al. 2011

Tur Toraks Der

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Lung injury related to mesalazine (5-aminosalicylic acid) has rarely been reported in patients with inflammatory bowel diseases. Patients present with progressive respiratory symptoms and radiographic abnormalities whose genesis may occur from days to years after initiation of therapy. A 42 year old man with a diagnosis of ulcerative colitis who had been treated by mesalazine for 6 months was admitted to our clinic with shortness of breath. There were bilateral inspiratory crackles in the inferior zones on physical examination. Reticulonodulary infiltrations in the middle and lower zones on chest roentgenogram and bilateral diffuse ground-glass opacities and irregular peribronchovascular consolidation areas were seen on thorax CT. A restrictive pattern in the pulmonary functional tests and decreased diffusion capacity were found. Because we considered mesalazine-induced lung injury, we stopped the treatment of mesalazine and gave steroid. The patient's clinical findings and all investigations then reselved. As mesalazine-induced lung injury is a rare entity, we wished to present this case with literature reviews. ( GİRİŞİnflamatuar barsak hastalığı tanısı almış ve mesalazin kullanan hastalarda, mesalazine bağlı akciğer hasarı nadir olarak rapor edilmiştir. Hastalar tedavi başlangıcın-dan günler ya da aylar sonra ortaya çıkabilen ilerleyici respiratuar semptomlar ve daha çok interstisyel alanın tutulduğu anormal radyolojik bulgular ile başvurabilmek-tedir [1,2]. Bu bulgularla başvuran hastalarda interstisyel akciğer hastalığının ayırıcı tanısında ilaca bağlı akciğer hasarıda göz önünde bulundurulmalıdır.

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“…The incidence of mesalamine‐associated lung disease is unknown but appears to be lower than that of sulfasalazine. The most common side effects of mesalamine include headaches, diarrhea, nausea, and worsening of colitis (1,11). Over the past decade, a small number of reports of lung disease related to mesalamine have been published.…”

Section: Discussionmentioning

confidence: 99%

“…Currently, four mechanisms are recognized as a cause of drug‐induced lung injury: 1) oxidant injury by a drug, such as nitrofurantoin ingestion; 2) direct cytotoxic effect on alveolar capillary endothelial cells; 3) injury mediated by deposition of phospholipids within the cell, such as seen with amiodarone pulmonary toxicity; and 4) immune‐mediated injury causing clinical symptoms of systemic lupus erythematosus. Currently, it is postulated that mesalamine causes immune‐mediated alveolitis as evidenced by lymphocyte stimulation (11,19). Another possibility is direct drug toxicity to the alveolar capillary bed.…”

Section: Discussionmentioning

confidence: 99%

“…The 5‐aminosalicyclic acid component is responsible for the drug's anti‐inflammatory activity and is now used without the sulfa moiety to avoid systemic toxicity. Nonetheless, scattered reports of mesalamine‐related lung injury have appeared, and it is evident that pulmonary complications represent uncommon and perhaps underdiagnosed sequelae of mesalamine therapy (7–11). In this report, we describe the clinical, radiographic, and pathologic features of three patients with mesalamine‐related lung disease.…”

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confidence: 99%

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Mesalamine-Related Lung Disease: Clinical, Radiographic, and Pathologic Manifestations

Foster¹,

Zander

Mergo

et al. 2003

Inflammatory Bowel Diseases

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Lung injury related to mesalamine (5-aminosalicylic acid) has rarely been reported in patients with inflammatory bowel diseases. Patients present with progressive respiratory symptoms and radiographic abnormalities whose genesis may occur from days to years after initiation of therapy. Although pathologic features overlap with other pulmonary disorders, findings of chronic interstitial pneumonia and poorly formed nonnecrotizing granulomas should prompt consideration of mesalamine-related lung disease in a patient receiving this medication. The authors describe the clinical, radiographic, and pathologic manifestations of mesalamine-related lung disease in three patients and review the literature related to this topic.

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Mesalamine-Induced Hypersensitivity Pneumonitis

Cited by 34 publications

References 18 publications

Acute eosinophilic pneumonia related to a mesalazine suppository

Acute eosinophilic pneumonia related to a mesalazine suppository

Mesalazine - Induced Lung Injury

Mesalamine-Related Lung Disease: Clinical, Radiographic, and Pathologic Manifestations

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