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Possible mesalamine-induced pericarditis: case report and literature review
Robert A Waite1, Jennifer M Malinowski
1Department of Pharmacy Practice, Nesbitt School of Pharmacy, Wilkes University, Wilkes-Barre, Pennsylvania 18766, USA.
Abstract:
Pericarditis should be considered in any patient complaining of chest pain and/or dyspnea who is taking a product that contains mesalamine or sulfasalazine. A 41-year-old woman was taking mesalamine 800 mg 3 times/day for 3 weeks before hospital admission. She complained of sharp, pleuritic chest pain that radiated down both arms and increased in intensity when lying down. She was diagnosed with pericarditis based on clinical presentation and electrocardiogram findings. Differential diagnoses for myocardial infarction, systemic lupus erythematosus, and viral or bacterial causes were ruled out based on subjective and objective data. Mesalamine-induced pericarditis was considered on hospital day 2, and the drug was discontinued at discharge on day 3. Clinicians should be aware of this potential drug-related complication, as the relationship between mesalamine or sulfasalazine and pericarditis has been reported rarely in the literature.
Insights
Mesalamine can rarely cause pericarditis, a chest pain condition. Patients taking mesalamine or sulfasalazine with chest pain should be evaluated for this rare drug complication.
Area of Science:
- Cardiology
- Pharmacology
Background:
- Pericarditis is an inflammation of the pericardium, often presenting with chest pain and dyspnea.
- Mesalamine and sulfasalazine are commonly prescribed medications for inflammatory bowel disease.
Observation:
- A 41-year-old woman developed sharp, pleuritic chest pain radiating down both arms, exacerbated by lying down.
- The patient was taking mesalamine 800 mg three times daily for three weeks prior to admission.
Findings:
- Clinical presentation and electrocardiogram findings confirmed pericarditis.
- Myocardial infarction, systemic lupus erythematosus, and infectious causes were ruled out.
- Mesalamine-induced pericarditis was suspected, and the drug was discontinued.
Implications:
- Clinicians should consider mesalamine or sulfasalazine as potential causes of pericarditis in patients presenting with relevant symptoms.
- Awareness of this rare drug-induced complication is crucial for accurate diagnosis and patient management.