Document Detail


Can a drug-induced pulmonary hypersensitivity reaction be dose-dependent? A case with mesalamine.
MedLine Citation:
PMID:  11687867     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Mesalamine-induced pulmonary adverse drug reactions (ADRs) in the course of therapy for inflammatory bowel diseases are rare events, having been reported in only 21 cases. This response, resembling hypersensitivity pneumonitis, is considered to be immunologically mediated and thus dose-independent. We report the case of a 70-year-old woman with ulcerative colitis (UC) who developed biopsy-proven interstitial pulmonary disease (lymphocytic alveolitis and mild interstitial pulmonary fibrosis) three months after starting mesalamine therapy. The usual treatment in cases of ADR is cessation of the drug and initiation of corticosteroids. In this case, we continued the mesalamine therapy but halved the dose, and did not add corticosteroids. This approach led to a remission of the pulmonary manifestations without a resurgence of UC symptoms. Based on a review of the literature and our own observation, we challenge the concept that mesalamine-induced pulmonary injury is always due to a hypersensitivity reaction. The evidence suggests that in some cases pulmonary ADR is dose-related; in such instances the most accepted therapy is not necessarily the most appropriate one.
Authors:
P Sossai; M G Cappellato; S Stefani
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Publication Detail:
Type:  Case Reports; Journal Article; Review    
Journal Detail:
Title:  The Mount Sinai journal of medicine, New York     Volume:  68     ISSN:  0027-2507     ISO Abbreviation:  Mt. Sinai J. Med.     Publication Date:  2001 Nov 
Date Detail:
Created Date:  2001-11-05     Completed Date:  2001-12-07     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0241032     Medline TA:  Mt Sinai J Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  389-95     Citation Subset:  IM    
Affiliation:
Department of Medicine, Geral Hospital, Feltre, Italy.
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MeSH Terms
Descriptor/Qualifier:
Aged
Anti-Inflammatory Agents, Non-Steroidal / therapeutic use*
Colitis, Ulcerative / drug therapy*
Dose-Response Relationship, Drug
Drug Hypersensitivity / etiology*
Female
Humans
Lung Diseases, Interstitial / etiology*,  radiography
Mesalamine / therapeutic use*
Chemical
Reg. No./Substance:
0/Anti-Inflammatory Agents, Non-Steroidal; 89-57-6/Mesalamine

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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