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Pure white cell aplasia induced by mesalazine in a patient with ulcerative colitis

Francesco Frattini1, Silvia Crestani, Pier Paolo Vescovi

  • 1Department of Hematology and Transfusion Medicine, Azienda Ospedaliera, Mantova, Italy. francesco.frattini@aopoma.it

Hematology (Amsterdam, Netherlands)
|January 17, 2013
PubMed
Abstract

Insights

Mesalazine, used for inflammatory bowel disease, can rarely cause neutropenia. This case highlights the importance of monitoring blood counts during mesalazine treatment to detect and manage this rare side effect.

Area of Science:

  • Gastroenterology
  • Hematology
  • Pharmacology

Background:

  • Mesalazine is a cornerstone therapy for inflammatory bowel diseases (IBD).
  • It is generally considered safe with a favorable side effect profile.
  • Neutropenia is a rare but serious adverse event associated with mesalazine therapy.

Observation:

  • A patient with ulcerative colitis developed severe febrile neutropenia.
  • This occurred during treatment with mesalazine.
  • The neutropenia presented as a significant drop in neutrophil count.

Findings:

  • Discontinuation of mesalazine was initiated.
  • Treatment with granulocyte colony-stimulating factor (G-CSF) was administered.
  • Complete and durable remission of neutropenia was achieved.

Implications:

  • Periodic blood count monitoring is recommended for patients on mesalazine.
  • Early detection of neutropenia can prevent severe complications.
  • This case underscores the need for vigilance in mesalazine therapy for IBD.

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