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Mesalamine-related lung disease: clinical, radiographic, and pathologic manifestations

Runi A Foster1, Dani S Zander, Patricia J Mergo

  • 1Department of Medicine, University of Florida College of Medicine, Gainesville, Florida 32610, USA. fostera@medicine.ufl.edu

Inflammatory Bowel Diseases
|October 14, 2003
PubMed

Insights

Mesalamine (5-aminosalicylic acid) can cause rare lung injury in inflammatory bowel disease patients. Progressive respiratory symptoms and specific lung pathology warrant consideration of this medication as a cause.

Area of Science:

  • Pulmonology
  • Gastroenterology
  • Pharmacology

Background:

  • Mesalamine (5-aminosalicylic acid) is a common treatment for inflammatory bowel diseases.
  • Rare instances of lung injury associated with mesalamine therapy have been documented.
  • Understanding these adverse pulmonary events is crucial for patient management.

Observation:

  • Patients may develop progressive respiratory symptoms, including cough and dyspnea.
  • Radiographic findings can include interstitial pneumonia and granulomas.
  • Symptom onset can range from days to years after starting mesalamine.

Findings:

  • Pathologic features may include chronic interstitial pneumonia and nonnecrotizing granulomas.
  • These findings, while overlapping with other lung diseases, are suggestive of mesalamine-induced lung injury.
  • The study details three cases of mesalamine-related lung disease.

Implications:

  • Clinicians should consider mesalamine-induced lung disease in IBD patients with unexplained pulmonary symptoms.
  • Early recognition and discontinuation of mesalamine may be critical for patient outcomes.
  • Further research into the mechanisms and prevalence of mesalamine lung toxicity is warranted.

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