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Pleural Effusion Overview
A pleural effusion is the abnormal collection of fluid between the parietal and visceral pleura layers of tissue that form the lining of the lungs and chest cavity. It can occur independently or due to surrounding parenchymal diseases, such as infection, malignancy, or inflammatory conditions.
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Mesalamine-induced eosinophilic pleural effusion.

Abdullah Al-Abcha1, Fazal Raziq2, Shouq Kherallah2

  • 1Internal Medicine, Michigan State University, East Lansing, Michigan, USA alabchaa@msu.edu.

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Summary

Mesalamine, used for ulcerative colitis, can cause eosinophilic pleural effusion, a rare side effect. Stopping the medication resolved the breathing difficulty and fluid buildup in the lungs.

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drugs: gastrointestinal systemrespiratory medicineulcerative colitisunwanted effects / adverse reactions

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Area of Science:

  • Pulmonology
  • Gastroenterology
  • Pharmacology

Background:

  • A 45-year-old woman with newly diagnosed ulcerative colitis (UC) presented with dyspnea.
  • The patient was undergoing treatment with mesalamine suppositories for UC.

Observation:

  • Chest imaging revealed bilateral pleural effusion.
  • Thoracentesis confirmed exudative pleural effusion with eosinophilia.
  • Symptomatic improvement occurred post-thoracentesis.

Findings:

  • Pleural effusion resolved after discontinuation of mesalamine.
  • The Naranjo score indicated a probable adverse drug reaction to mesalamine.
  • This case highlights a rare but significant side effect of mesalamine treatment.

Implications:

  • Clinicians should consider mesalamine-induced eosinophilic pleural effusion in UC patients with unexplained pleural effusions.
  • Prompt recognition and drug withdrawal are crucial for patient recovery.
  • Further research into the mechanisms of mesalamine-induced pleural effusions is warranted.