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Acute pancreatitis after long-term 5-aminosalicylic acid therapy
1Gastroenterology Department, Hospital Clínic i Provincial, University of Barcelona, Spain.
Abstract:
Acute pancreatitis is a known, although rare, complication of mesalamine treatment. This complication typically appears within the first days or weeks after initiation of therapy. We describe two cases of acute pancreatitis that occurred after long term mesalamine therapy for ulcerative colitis. A rechallenge, performed in both patients, confirmed the diagnosis of mesalamine-induced pancreatitis. These case reports provide evidence that 5-aminosalicylic acid may induce acute pancreatitis after long term treatment.
Insights
Mesalamine can rarely cause acute pancreatitis, even after long-term use for ulcerative colitis. Re-exposure confirmed this rare side effect, highlighting the need for vigilance in patients on this medication.
Area of Science:
- Gastroenterology
- Pharmacology
Background:
- Mesalamine (5-aminosalicylic acid) is a common treatment for ulcerative colitis.
- Acute pancreatitis is a recognized, though infrequent, adverse effect of mesalamine therapy.
Observation:
- Two patients with ulcerative colitis developed acute pancreatitis after prolonged mesalamine treatment.
- Both patients underwent rechallenge, which reconfirmed mesalamine as the causative agent.
Findings:
- This study provides evidence that mesalamine can induce acute pancreatitis even after long-term administration.
- The findings suggest a potential delayed-onset complication associated with mesalamine therapy.
Implications:
- Clinicians should consider mesalamine-induced pancreatitis in patients with ulcerative colitis presenting with acute pancreatitis.
- Awareness of this rare complication is crucial for patient safety and appropriate management of ulcerative colitis.