[Diffuse alopecia as side effect of mesalazine therapy in Crohn's disease]

Within the scope of the participation at the VI. European Crohn's Disease Study we observed under therapy with 4 g/day Mesalazine (Pentasa) a strong diffuse hair loss on two female patients which disappeared again after discontinuation of therapy. A repeated positive exposure in both patients confirmed the causality. One patient had thereafter a recurrence of Crohn's disease so she was given a reduced dose of Mesalazine (2 g/d). The hair loss began again but on an acceptable level for the patient. Thus, it looks like a dose-dependent side-effect as it is known in the medical literature. These are so far the first two cases of hair loss in connection with Pentasa recorded by the Swiss Drug Monitoring Center. In the medical literature there are reports about this side-effect from all producers known in Switzerland (Asacol, Pentasa, Salofalk), which suggests a Mesalazine specific side-effect. Since recently higher doses of Mesalazine (2-4 g/d) are used in Crohn's disease, a reversible and probably dose-dependent hair loss must be expected in 1-2% of these patients.