Acute myopericarditis in a patient recently started on mesalazine for Crohn disease

Downton, Teesha; Willcocks, Briony; Boutlis, Craig S.

doi:10.1111/imj.14273

Cited by 4 publications

(2 citation statements)

References 3 publications

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“…Cardiovascular manifestations are rare and can include pericarditis, pericardial effusions, myocarditis, arterial and venous thromboembolism, and heart failure, with pericarditis being the most common cardiovascular manifestation (70%) 1 . There are a few case reports in adults implicating some of the drug therapies used for treatment of CD, such as 5‐ASA products (sulfasalazine) and adalimumab, which typically begin within a few weeks of starting the medication, and are usually reversible after discontinuation 2‐5 . Our patient did not receive adalimumab; however, she did receive a 5‐ASA product for 2 years prior to diagnosis of DCM and it was discontinued for 6–8 weeks after diagnosis of DCM, without any improvement in ventricular function.…”

Section: Discussionmentioning

confidence: 86%

Crohn’s disease with dilated cardiomyopathy in a child: An experience with heart transplantation

Konduri

Blake

Aggarwal

2021

Pediatric Transplantation

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Background DCM has rarely been reported in children with CD, but is a recognized complication in adults. DCM with uncontrolled heart failure may need heart transplantation, which could be challenging in CD. Case Description We present a 9‐year‐old female with CD who was diagnosed with DCM and a measured Ejection fraction ~25.8%. She was initiated on heart failure treatment, but continued to have progressive symptoms and underwent bicaval OHT three months after her initial presentation. Her post‐operative course was complicated by perforation of the rectosigmoid junction requiring exploratory laparotomy and primary repair of the perforation. This was believed to be secondary to her underlying CD and possibly reperfusion injury after heart transplant. During the first‐year post heart transplant, she had 4 episodes of acute cellular rejection. These episodes were treated with high dose steroids with good results. The patient has been in remission from CD since transplantation. For the last two years she is doing well, with no further rejection episodes on current immunosuppression. Conclusion DCM, though rare, can occur in patients with CD, whether active or in remission. The development of DCM could be insidious and keeping a high index of suspicion is important and subtle signs suggestive of cardiac involvement should warrant further investigation. The post‐transplant management can be challenging with early morbidity in the first post‐transplant year but overall good median survival and quality of life for our patient to date.

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Section: Discussionmentioning

confidence: 86%

Crohn’s disease with dilated cardiomyopathy in a child: An experience with heart transplantation

Konduri

Blake

Aggarwal

2021

Pediatric Transplantation

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“…The British Medical Journal obituary for Dr Parkinson, our very own Antipodean Plague Doctor, perhaps sums it up best: He lost his life striving in the interests of others, doing a man's work as a man should. 41…”

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confidence: 99%

The Plague Doctor of Venice

Mussap

2019

Internal Medicine Journal

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There is a distinctive Venetian carnival mask with sinister overtones and historical significance to physicians because it belongs to the ‘Doctor of the Plague’. The costume features a beaked white mask, black hat and waxed gown. This was worn by mediaeval Plague Doctors as protection according to the Miasma Theory of disease propagation. The plague (or Black Death), ravaged Europe over several centuries with each pandemic leaving millions of people dead. The cause of the contagion was not known, nor was there a cure, which added to the widespread desperation and fear. Venice was a major seaport, and each visitation of the plague (beginning in 1348) devastated the local population. In response, Venetians were among the first to establish the principles of quarantine and ‘Lazarets’ which we still use today. Plague outbreaks have occurred in Australia, notably in Sydney (1900–1925), and continue to flare up in poorer communities, most recently in Madagascar (2017). Antibiotics are the mainstay of treatment, but there are concerns regarding the emergence of resistant pathogenic strains of Yersinia pestis, and their potential use in bio‐terrorism.

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Mesalazine

2019

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Acute myopericarditis in a patient recently started on mesalazine for Crohn disease

Cited by 4 publications

References 3 publications

Crohn’s disease with dilated cardiomyopathy in a child: An experience with heart transplantation

Crohn’s disease with dilated cardiomyopathy in a child: An experience with heart transplantation

The Plague Doctor of Venice

Mesalazine

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