Document Detail

Severe chest pain in a pediatric ulcerative colitis patient after 5-aminosalicylic acid therapy.
MedLine Citation:
PMID:  18666333     Owner:  NLM     Status:  MEDLINE    
Severe reactions to mesalamine products are rarely seen in pediatric patients. We report a case of a 12-year-old boy who had a severe cardiac reaction to a mesalamine product Asacol. Past medical history is significant for ulcerative colitis (UC) diagnosed at 9 years of age. Colonoscopy one week prior to admission revealed pancolitis. He was treated with Asacol 800 mg three times per day and prednisone 20 mg/d. He was subsequently admitted to the hospital for an exacerbation of his UC and started on intravenous solumedrol. He had improvement of his abdominal pain and diarrhea. The patient complained of new onset of chest pain upon initiating Asacol therapy. Electrocardiogram (ECG) revealed non-specific ST-T wave changes with T-wave inversion in the lateral leads. Echocardiogram (ECHO) revealed low-normal to mildly depressed left ventricular systolic function. The left main coronary artery and left anterior descending artery were mildly prominent measuring 5 mm and 4.7 mm, respectively. His chest pain completely resolved within 24-36 h of discontinuing Asacol. A repeat echocardiogram performed two days later revealed normal left ventricular function with normal coronary arteries (< 3.5 mm). Onset of chest pain after Asacol and immediate improvement of chest pain, as well as improvement of echocardiogram and ECG findings after discontinuing Asacol suggests that our patient suffered from a rare drug-hypersensitivity reaction to Asacol.
Orhan Atay; Kadakkal Radhakrishnan; Janine Arruda; Robert Wyllie
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  World journal of gastroenterology : WJG     Volume:  14     ISSN:  1007-9327     ISO Abbreviation:  World J. Gastroenterol.     Publication Date:  2008 Jul 
Date Detail:
Created Date:  2008-07-30     Completed Date:  2008-11-13     Revised Date:  2009-11-18    
Medline Journal Info:
Nlm Unique ID:  100883448     Medline TA:  World J Gastroenterol     Country:  China    
Other Details:
Languages:  eng     Pagination:  4400-2     Citation Subset:  IM    
Department of Pediatric Gastroenterology and Nutrition, The Children's Hospital, Cleveland Clinic, 9500 Euclid Avenue/A111, Cleveland Ohio 44195, United States.
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MeSH Terms
Anti-Inflammatory Agents, Non-Steroidal / adverse effects
Chest Pain / chemically induced,  diagnosis*
Colitis, Ulcerative / drug therapy*
Drug Hypersensitivity
Echocardiography / methods
Electrocardiography / methods
Mesalamine / adverse effects*
Pericardial Effusion
Time Factors
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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