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Related Experiment Videos

Mesalamine-induced granulomatous hepatitis.

M Braun1, G M Fraser, M Kunin

  • 1Department of Internal Medicine "D" and Gastroenterology, Rabin Medical Centre, Petach Tikva, Israel.

The American Journal of Gastroenterology
|July 16, 1999
PubMed
Summary

Mesalamine therapy for ulcerative colitis can cause drug-induced granulomatous hepatitis. This rare side effect presents with prolonged fever and abnormal liver tests, resolving upon drug cessation.

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Area of Science:

  • Hepatology
  • Gastroenterology
  • Pharmacology

Background:

  • Inflammatory bowel disease (IBD) management often involves mesalamine.
  • Fever and abnormal liver function tests can occur in IBD patients.
  • Differential diagnosis for hepatitis in IBD is broad.

Observation:

  • A 42-year-old man with ulcerative colitis presented with prolonged fever and cholestatic liver tests.
  • Endoscopic retrograde cholangiopancreatography revealed a normal biliary tree.
  • Liver biopsy demonstrated granulomata.

Findings:

  • A diagnosis of drug-induced granulomatous hepatitis was established.
  • Symptoms resolved after discontinuing mesalamine.
  • Symptoms recurred upon rechallenge with mesalamine, confirming causality.

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Implications:

  • Mesalamine is a potential cause of drug-induced granulomatous hepatitis in ulcerative colitis patients.
  • Clinicians should consider mesalamine-induced liver injury in IBD patients with unexplained hepatitis.
  • Prompt recognition and drug cessation are crucial for patient recovery.