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[Pericarditis during inflammatory bowel diseases. Extra-intestinal or iatrogenic complication?]
D Heresbach1, A Rabot, N Génetet
1Service d'Hépato-Gastroentérologie, CHRU Pontchaillou, Rennes.
Gastroenterologie Clinique Et Biologique
|January 1, 1994
Summary
Acute pericarditis can be a rare side effect of mesalazine treatment in patients with ulcerative colitis. Discontinuing the medication led to symptom resolution, suggesting an adverse drug reaction.
Area of Science:
- Gastroenterology
- Cardiology
- Pharmacology
Background:
- Acute pericarditis is infrequently linked to inflammatory bowel disease (IBD).
- Pericarditis in IBD patients, after excluding other causes, is often viewed as an extraintestinal manifestation or a drug-related effect.
- Identifying specific drug-induced pericarditis is crucial for patient management.
Observation:
- A 17-year-old patient with ulcerative colitis developed acute pericarditis after 15 days of mesalazine treatment.
- Symptoms resolved spontaneously upon mesalazine discontinuation.
- Extensive investigations ruled out other common causes of pericarditis.
Findings:
- A lymphoblastic transformation test for mesalazine was positive at concentrations >= 10 micrograms/mL in the patient.
- The same test was negative in control patients on mesalazine without adverse effects.
- This suggests a specific hypersensitivity reaction to mesalazine.
Implications:
- Mesalazine should be considered a potential cause of acute pericarditis in ulcerative colitis patients.
- This case highlights the importance of considering drug-induced adverse reactions in IBD management.
- Further research into drug-induced pericarditis in IBD is warranted.