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Maezawa Y, Okada K, Ariga H, Kashimura J, Okauchi S, Satoh H. Mesalazine-Induced Diffuse Lung Injury in a Patient Without Respiratory Signs and Symptoms. MAEDICA 2023; 18:718-721. [PMID: 38348085 PMCID: PMC10859214 DOI: 10.26574/maedica.2023.18.4.718] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Indexed: 02/15/2024]
Abstract
Mesalazine is a drug used to treat ulcerative colitis and Crohn's disease, and is known to rarely cause lung injury. We show herein a unique case who developed this drug-induced injury. A 17-year-old boy presented with fever and anorexia after administration of mesalazine. Computed tomography showed extensive ground-glass opacities with peripheral distribution in both lungs. He had general weakness, but had no respiratory symptoms such as cough and dyspnea. With prednisolone, which is primarily aimed at controlling ulcerative colitis, the extensive opacity in both lungs were improved. All patients with this drug-induced lung injury reported to date have had respiratory symptoms, but this patient had no subjective respiratory symptoms and had no abnormalities in respiratory rate and oxyhaemoglobin saturation. Although very rare, we do believe that this clinical course will provide some suggestive information on treatment for patients with similar course in the future.
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Affiliation(s)
- Yosuke Maezawa
- Division of General Medicine, Mito Medical Center, University of Tsukuba-Mito Kyodo General Hospital, Ibaraki, Japan
| | - Kenta Okada
- Division of Gastroenterology, Mito Medical Center, University of Tsukuba-Mito Kyodo General Hospital, Ibaraki, Japan
| | - Hiroyuki Ariga
- Division of Gastroenterology, Mito Medical Center, University of Tsukuba-Mito Kyodo General Hospital, Ibaraki, Japan
| | - Junya Kashimura
- Division of Gastroenterology, Mito Medical Center, University of Tsukuba-Mito Kyodo General Hospital, Ibaraki, Japan
| | - Shinichiro Okauchi
- Division of Respiratory Medicine, Mito Medical Center, University of Tsukuba-Mito Kyodo General Hospital, Ibaraki, Japan
| | - Hiroaki Satoh
- Division of Respiratory Medicine, Mito Medical Center, University of Tsukuba-Mito Kyodo General Hospital, Ibaraki, Japan
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Xu N, Chen X, Wu S, Ye M, Zhang M, Tong L, Zhu X, Liu J, Hu F, Bai C. Chronic pulmonary complications associated with toxic epidermal necrolysis: A case report and literature review. Exp Ther Med 2018; 16:2027-2031. [PMID: 30186435 DOI: 10.3892/etm.2018.6357] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2017] [Accepted: 09/01/2017] [Indexed: 01/31/2023] Open
Abstract
Patients with toxic epidermal necrolysis (TEN) are known to experience various complications. Although pulmonary complications are commonly observed, they typically manifest in an acute form. By contrast, chronic complications are quite rare, and little is known with regard to their incidences or clinical manifestations. The present study reports the case of a 29-year-old female patient who suffered from TEN. At the onset of the disease, the patient exhibited no pulmonary impairment; however, 1 month after recovering from TEN, the patient developed severe obstruction and a mild diffusion defect. A diagnosis of bronchiolitis obliterans was determined, and the patient was treated with antibiotics, inhaled corticosteroids, anticholinergic agents, and bronchodilators. At the last follow-up, the patient was alive, but with a stable airway obstruction.
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Affiliation(s)
- Nuo Xu
- Department of Pulmonary Medicine, Zhongshan Hospital, Fudan University, Shanghai 200032, P.R. China
| | - Xuehua Chen
- Department of Pulmonary Medicine, Zhongshan Hospital, Fudan University, Shanghai 200032, P.R. China
| | - Shengdi Wu
- Department of Gastroenterology and Hepatology, Zhongshan Hospital, Fudan University, Shanghai 200032, P.R. China
| | - Maosong Ye
- Department of Pulmonary Medicine, Zhongshan Hospital, Fudan University, Shanghai 200032, P.R. China
| | - Meiling Zhang
- Department of Pulmonary Medicine, Zhongshan Hospital, Fudan University, Shanghai 200032, P.R. China
| | - Lin Tong
- Department of Pulmonary Medicine, Zhongshan Hospital, Fudan University, Shanghai 200032, P.R. China
| | - Xiaodan Zhu
- Department of Pulmonary Medicine, Zhongshan Hospital, Fudan University, Shanghai 200032, P.R. China
| | - Jie Liu
- Department of Pulmonary Medicine, Zhongshan Hospital, Fudan University, Shanghai 200032, P.R. China
| | - Feifei Hu
- Department of Dermatology, Zhongshan Hospital, Fudan University, Shanghai 200032, P.R. China
| | - Chunxue Bai
- Department of Pulmonary Medicine, Zhongshan Hospital, Fudan University, Shanghai 200032, P.R. China
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Zhang Y, Luo L, Wang X, Liu X, Wang X, Ding Y. Mesalazine-induced eosinophilic pneumonia with bone marrow infiltration: a case report and literature review. Ther Clin Risk Manag 2016; 12:975-81. [PMID: 27366075 PMCID: PMC4913963 DOI: 10.2147/tcrm.s107012] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
Mesalazine-induced eosinophilic pneumonia has been rarely reported. We reported a case of mesalazine-induced eosinophilic pneumonia in a 56-year-old female who took mesalazine without a prescription for suspected ulcerative colitis. She had an elevated eosinophil count in peripheral blood and bronchoalveolar lavage fluid. Eosinophil infiltration was also noted in bone marrow aspirates. Chest radiograph and computed tomography demonstrated bilateral upper lung predominant infiltrates and spirometry showed a restrictive ventilatory defect with a reduced diffusion capacity. The patient recovered after cessation of mesalazine therapy. Mesalazine-induced lung damage should be considered in patients who develop unexplained respiratory symptoms while taking this agent.
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Affiliation(s)
- Yunjian Zhang
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Fourth Medical College of Peking University, Beijing, People's Republic of China
| | - Ling Luo
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Fourth Medical College of Peking University, Beijing, People's Republic of China
| | - Xiaofang Wang
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Fourth Medical College of Peking University, Beijing, People's Republic of China
| | - Xiaoyang Liu
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Fourth Medical College of Peking University, Beijing, People's Republic of China
| | - Xiaoyan Wang
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Fourth Medical College of Peking University, Beijing, People's Republic of China
| | - Yi Ding
- Department of Pathology, Jishuitan Hospital, Fourth Medical College of Peking University, Beijing, People's Republic of China
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