Document Detail

Can a drug-induced pulmonary hypersensitivity reaction be dose-dependent? A case with mesalamine.
MedLine Citation:
PMID:  11687867     Owner:  NLM     Status:  MEDLINE    
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.
P Sossai; M G Cappellato; S Stefani
Related Documents :
1788847 - Bullet pulmonary embolus and the role of surgery.
6307197 - Pulmonary metastatic leiomyosarcoma coexisting with pulmonary chondroma in carney's triad.
15302757 - Pulmonary sarcoidosis following stem cell transplantation: is it more than a chance occ...
12675767 - Pulmonary lymphangioleiomyomatosis and multiple hepatic angiomyolipomas in a man.
18476807 - A case of sterile endophthalmitis after repeated intravitreal bevacizumab injection.
19242907 - Dorsalis pedis artery pseudoaneurysm: an uncommon cause of soft tissue mass of the dors...
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    
Department of Medicine, Geral Hospital, Feltre, Italy.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Anti-Inflammatory Agents, Non-Steroidal / therapeutic use*
Colitis, Ulcerative / drug therapy*
Dose-Response Relationship, Drug
Drug Hypersensitivity / etiology*
Lung Diseases, Interstitial / etiology*,  radiography
Mesalamine / therapeutic use*
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

Previous Document:  Bronchiolitis obliterans in a patient with ulcerative colitis receiving mesalamine.
Next Document:  Pneumococcal vaccine failure in an HIV-infected patient with fatal pneumococcal sepsis and HCV-relat...