Mesalazine-induced bronchiolitis obliterans organizing pneumonia (BOOP) in a patient with ulcerative colitis and primary sclerosing cholangitis

Kevans, David; Greene, John; Galvin, Leanne; Morgan, Ross; Murray, Frank E.

doi:10.1002/ibd.21819

Cited by 15 publications

(10 citation statements)

References 5 publications

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“…These span from interstitial pneumonitis, interstitial pneumonia, Wegener's granulomatosis and eosinophilic pneumonia . Development of bronchiolitis obliterans with organising pneumonia has also been reported, with improvement noted once the drug has been discontinued and patient has received corticosteroids …”

Section: Resultsmentioning

confidence: 99%

Systematic review: safety of mesalazine in ulcerative colitis

Sehgal

Colombel

Aboubakr

et al. 2018

Aliment Pharmacol Ther

103

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Patients on mesalazine should be monitored for worsening of ulcerative colitis and development of new onset organ dysfunction. High-dose mesalazine appears to have similar safety profile as low dose, and is not associated with greater risk of adverse events. Prior to placing a patient on mesalazine, baseline liver and renal function should be evaluated. Renal function should be periodically assessed, whereas other testing should be performed depending on development of symptoms.

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Section: Resultsmentioning

confidence: 99%

Systematic review: safety of mesalazine in ulcerative colitis

Sehgal

Colombel

Aboubakr

et al. 2018

Aliment Pharmacol Ther

103

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“…In different cases the domination of neutrophils [23], lymphocytes [20] or eosinophils [22] could be seen, but most frequently a mixed pattern was present. Not all patients with blood eosinophilia had high eosinophil counts in BAL fluid [22,30,31], and some patients with increased eosinophils in BAL fluid had normal eosinophil counts in the blood [17][18][19][20]. The results of histological examination of lung biopsy were available for 15 of 27 reviewed patients.…”

Section: Discussionmentioning

confidence: 99%

“…As our review of the literature showed, pulmonary disease in IBD patients responded well to GCs, but spontaneous regression was seen in numerous patients as well. Most commonly mesalazine cessation and treatment with GCs were applied resulting in a rapid improvement [12,23,26,[31][32][33]. This approach was applied in Patient 2, in whom mesalazine was stopped and GC was commenced.…”

Section: Discussionmentioning

confidence: 99%

Pulmonary Pathology in Patients with Ulcerative Colitis Treated with Mesalazine—A Challenging and Complex Diagnostic Problem. Case Series and Literature Review

Kacprzak¹,

Szcześniak²,

Szturmowicz³

et al. 2014

Advances in Respiratory Medicine

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Pulmonary involvement in the course of inflammatory bowel disease has been a subject of interest to clinicians for long time, but despite this, its epidemiology and potential pathomechanisms remain obscured. Equally unclear is the role of medications used for bowel disease treatment in lung disease development. We present three patients with ulcerative colitis, all treated with mesalazine, in whom unexplained lung disease developed. Due to different clinical and radiological presentation, different conditions were initially placed on the top of the differential list in each of them. The outcome was favourable in all patients despite differences in management. We compared our patients with similar cases from literature. We show the level of difficulty and complexity in the issue of lung disease in patients with inflammatory bowel disease.

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“…BOOP may be classified into three categories according to its etiology: organizing pneumonia of determined cause, organizing pneumonia of undetermined cause but occurring in a specific and relevant context, and cryptogenic (idiopathic) organizing pneumonia (9). BOOP can be seen in UC due for several reasons, such as reaction to viral, bacterial and fungal infections, the IBD itself, or drug reactions (10)(11)(12)(13). Persistent airway inflammation can result in airway narrowing, dependent on the localization, resulting in tracheal stenosis, bronchiectasis or bronchiolitis obliterans.…”

Section: Discussionmentioning

confidence: 99%