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Acute respiratory failure secondary to mesalamine-induced interstitial pneumonitis

Albin Abraham1, Ali Karakurum

  • 1Nassau University Medical Center, East Meadow, New York, USA.

BMJ Case Reports
|August 22, 2013
PubMed

Insights

Mesalamine therapy can rarely cause interstitial pneumonitis, a serious lung injury. This case highlights a severe presentation with respiratory failure, emphasizing the need for prompt diagnosis in patients with respiratory symptoms.

Area of Science:

  • Pulmonology
  • Pharmacology
  • Internal Medicine

Background:

  • Mesalamine (5-ASA) is a common treatment for inflammatory bowel disease.
  • Interstitial pneumonitis is a rare adverse effect of mesalamine therapy.
  • Diagnosis can be challenging due to variable latency and non-specific symptoms.

Observation:

  • A 65-year-old male developed fever, dyspnea, and cough two weeks after starting mesalamine.
  • The patient experienced acute respiratory failure requiring mechanical ventilation.
  • Radiographic and bronchoscopic findings confirmed drug-induced interstitial pneumonitis.

Findings:

  • Mesalamine-induced lung injury can lead to severe respiratory compromise.
  • This case represents a severe manifestation of a known but uncommon adverse effect.
  • Early recognition and cessation of mesalamine are crucial.

Implications:

  • Clinicians should consider mesalamine-induced lung injury in patients with unexplained respiratory symptoms.
  • Prompt diagnosis and management can prevent severe outcomes.
  • Further research into risk factors and early detection of mesalamine-induced lung injury is warranted.

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