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[Pancreatitis associated with 5-aminosalicylic acid]
V F Eckardt1, G Kanzler, H Rieder
1Gastroenterologische Fachpraxis Wiesbaden, Universität Mainz.
Deutsche Medizinische Wochenschrift (1946)
|April 5, 1991
Summary
5-aminosalicylic acid (mesalazine) may cause acute pancreatitis in patients with inflammatory bowel disease. Symptoms resolved upon drug discontinuation and recurred upon re-challenge, suggesting an allergic reaction.
Area of Science:
- Gastroenterology
- Clinical Pharmacology
Background:
- 5-aminosalicylic acid (mesalazine) is a common treatment for inflammatory bowel diseases like ulcerative colitis and Crohn's disease.
- Acute pancreatitis is a serious condition characterized by severe upper abdominal pain.
Observation:
- Three patients with inflammatory bowel disease developed acute pancreatitis within 1-4 weeks of initiating mesalazine therapy.
- Elevated lipase and amylase levels were observed in all affected patients.
- Symptoms rapidly improved after mesalazine was discontinued.
Findings:
- Pancreatitis recurred in two patients upon readministration of mesalazine, even at a lower dose.
- These findings strongly suggest a causal link between mesalazine and acute pancreatitis.
- The pattern of recurrence points towards a potential hypersensitivity or allergic mechanism.
Implications:
- Clinicians should consider mesalazine as a potential cause of acute pancreatitis in patients with inflammatory bowel disease.
- Discontinuation of mesalazine should be considered in patients presenting with symptoms suggestive of pancreatitis.
- Further investigation into the immunological mechanisms underlying mesalazine-induced pancreatitis is warranted.