Mesalamine-induced granulomatous hepatitis

Braun, Marius; Fraser, Gerald; Kunin, Margareta; Salamon, F.; Kaspa, Ran Tur

doi:10.1016/s0002-9270(99)00301-9

Cited by 25 publications

(17 citation statements)

References 11 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Metoprolol has been associated with purpura. Mesalamine has been linked to the granulomatous Churg-Strauss syndrome 42 and also to granulomatous hepatitis, 43 making it further a potential contributor to our patient's granulomatous PPD. Mesalamine and balsalazide are aminosalicylates.…”

Section: Discussionmentioning

confidence: 90%

Granulomatous Pigmented Purpura: An Unusual Histological Variant

Kerns¹,

Mallatt²,

Shamma³

2009

The American Journal of Dermatopathology

View full text Add to dashboard Cite

Pigmented purpuric dermatoses (PPDs) tend to vary clinically, yet share a similar histology. Granulomas are only rarely seen, with 4 prior reported cases, designated granulomatous pigmented purpura. Historically, granulomatous pigmented purpura has been seen in Asians. In this article, we report the case of a 42-year-old, white female with granulomatous pigmented purpura, the fifth such reported case in the literature. Histopathological examination revealed a granulomatous dermatitis with eosinophils, extravasated erythrocytes, melanophages, and vascular proliferation. These findings were consistently reported on subsequent biopsy 6 months later. This case illustrates a rare histological finding in PPDs. Medications associated with PPD are reviewed and the patient's use of mesalamine and balsalazide for ulcerative colitis are deemed potential triggers, given their relative similarity to aspirin, a known trigger of PPD. Although other granulomatous processes must be excluded in such patients, one must consider the possibility of granulomatous pigmented purpura in the appropriate setting.

show abstract

Section: Discussionmentioning

confidence: 90%

Granulomatous Pigmented Purpura: An Unusual Histological Variant

Kerns¹,

Mallatt²,

Shamma³

2009

The American Journal of Dermatopathology

View full text Add to dashboard Cite

show abstract

“…The disease is most often asymptomatic but can manifest by fever or hepatosplenomegaly. It can also be induced by mesalazine and sulfasalazine therapy . Development of severe liver disease is unusual.…”

Section: Other Hepatic Manifestations Than Psc Affecting Ibd Patientsmentioning

confidence: 99%

Hepatic manifestations of inflammatory bowel diseases

Restellini

Chazouillères

Frossard

2016

Liver International

View full text Add to dashboard Cite

Inflammatory bowel diseases are associated with various hepatobiliary disorders, reported both in Crohn's disease and ulcerative colitis. They may occur at any moment in the natural course of the disease. The prevalence of liver dysfunction rises from 3% to 50% accordingly to definitions used in different studies. Fatty liver is considered as the most common hepatobiliary complication in inflammatory bowel diseases while primary sclerosing cholangitis is the most specific one. Less frequently, inflammatory bowel diseases-associated hepatobiliary disorders include: autoimmune hepatitis/ primary sclerosing cholangitis overlap syndrome, IgG4-associated cholangiopathy, primary biliary cholangitis, hepatic amyloidosis, granulomatous hepatitis, cholelithiasis, portal vein thrombosis and liver abscess. The spectrum of these manifestations varies according to the type of inflammatory bowel diseases. Treatments of inflammatory bowel diseases may cause liver toxicity, although incidence of serious complications remains low. However, early diagnosis of drug-induced liver injury is of major importance as it affects future clinical management. When facing abnormal liver tests, clinicians should undertake a full diagnostic work-up in order to determine whether the hepatic abnormalities are related to the inflammatory bowel diseases or not.Management of hepatic manifestations in inflammatory bowel diseases usually involves both hepatologists and gastroenterologists because of the complexity of some situations. K E Y W O R D Sdrug-induced liver injury, hepatotoxicity, inflammatory bowel disease, liver disease, primary sclerosing cholangitis

show abstract

“…In the above mentioned case report of mesalazine-induced granulomatous hepatitis,11 the fever disappeared within 3 days (both on initial cessation as well as after rechallenge). We noticed a faster decline, but this may have been a coincidence.…”

Section: Discussionmentioning

confidence: 92%

“…In 1999, the first case report was published describing biopsy-proven granulomatous hepatitis associated with mesalazine 11. Up until then, this condition was attributed only to sulfasalazine therapy, and withdrawal of the drug led to a total recovery—in most cases without additional measures 12–14…”

Section: Discussionmentioning

confidence: 99%

An unusual cause of febrile hepatitis

Stelzer

Köhler²,

Maggio

et al. 2015

BMJ Case Reports

View full text Add to dashboard Cite

SUMMARYWe describe the case of a 51-year-old man with recently diagnosed ulcerative colitis who developed fever and elevated liver enzymes as well as cholestasis a few weeks after starting treatment with mesalazine. As no obvious cause was found and fever persisted, liver biopsy was performed and revealed granulomatous hepatitis. The patient recovered completely after cessation of mesalazine, so that a drug-induced granulomatous hepatitis after exclusion of other differential diagnoses in an extensive work up was assumed. The present case demonstrates that even though drug-induced liver injury due to mesalazine is rare, it should be considered in unclear cases and lead to prompt discontinuation of mesalazine. BACKGROUND

show abstract

Mesalamine-induced granulomatous hepatitis

Cited by 25 publications

References 11 publications

Granulomatous Pigmented Purpura: An Unusual Histological Variant

Granulomatous Pigmented Purpura: An Unusual Histological Variant

Hepatic manifestations of inflammatory bowel diseases

An unusual cause of febrile hepatitis

Contact Info

Product

Resources

About