2014
DOI: 10.5603/piap.2014.0047
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Pulmonary Pathology in Patients with Ulcerative Colitis Treated with Mesalazine—A Challenging and Complex Diagnostic Problem. Case Series and Literature Review

Abstract: Pulmonary involvement in the course of inflammatory bowel disease has been a subject of interest to clinicians for long time, but despite this, its epidemiology and potential pathomechanisms remain obscured. Equally unclear is the role of medications used for bowel disease treatment in lung disease development. We present three patients with ulcerative colitis, all treated with mesalazine, in whom unexplained lung disease developed. Due to different clinical and radiological presentation, different conditions … Show more

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Cited by 9 publications
(12 citation statements)
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References 47 publications
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“…However, the incidence of adverse effects in general is low, and in some trials respiratory symptoms have not even been reported [ 94 ]. There is a variety of pulmonary changes induced by 5-ASA, all of them practically indistinguishable from IBD-related lung pathology [ 95 ]. The most commonly reported clinico-pathological entities include eosinophilic exudative pleuritis [ 96 – 98 ] and interstitial pneumonitis with the predominance of lymphocytes or eosinophils [ 93 , 97 106 ].…”
Section: Drug-related Lung Pathology In Inflammatory Bowel Disease Pamentioning
confidence: 99%
“…However, the incidence of adverse effects in general is low, and in some trials respiratory symptoms have not even been reported [ 94 ]. There is a variety of pulmonary changes induced by 5-ASA, all of them practically indistinguishable from IBD-related lung pathology [ 95 ]. The most commonly reported clinico-pathological entities include eosinophilic exudative pleuritis [ 96 – 98 ] and interstitial pneumonitis with the predominance of lymphocytes or eosinophils [ 93 , 97 106 ].…”
Section: Drug-related Lung Pathology In Inflammatory Bowel Disease Pamentioning
confidence: 99%
“…We present a case of mesalazine-induced lung injury with severe respiratory failure and a confirmed histological pattern of organizing pneumonia that was successfully treated with discontinuation of mesalazine and provision of steroid pulse therapy and NPPV. Almost all UC patients with mesalazine-induced lung injury in the literature review showed mild or no respiratory failure, which was improved only by discontinuation of the drug or administration of low-dose corticosteroids [ [1] , [2] , [3] , [4] , [5] , [6] , [7] , [8] , [9] , [10] , [11] , [12] , [13] , [14] , [15] , [16] , [17] , [18] , [19] , [20] , [21] , [22] , [23] , [24] ] ( Table 1 ).…”
Section: Discussionmentioning
confidence: 99%
“…Mesalazine, also known as 5-aminosalicylic acid (5-ASA), is the first-line treatment for patients with mild-to-moderate ulcerative colitis (UC), and it has been reported to be a causative agent for drug-induced lung injury (DLI) [ [1] , [2] , [3] , [4] , [5] , [6] , [7] , [8] , [9] , [10] , [11] , [12] , [13] , [14] , [15] , [16] , [17] , [18] , [19] , [20] , [21] , [22] , [23] , [24] ] ( Table 1 ). Although several cases of mesalazine-induced lung injury have been reported, only one case has so far been reported of severe respiratory failure in which mechanical ventilation was used [ 20 ].…”
Section: Introductionmentioning
confidence: 99%
“…All these medications, with the exception of glucocorticosteroids, are well known for their possible lung toxicity [62][63][64][65][66][67][68][69][70][71]. The assumed lung-toxicity manifests itself mostly as interstitial lung diseases such as eosinophilic pneumonia, organizing pneumonia, interstitial lung fibrosis, interstitial pneumonia with nonnecrotizing granulomas, not specified interstitial pneumonia, bronchiolitis [60][61][62][63][64][65][66][67][68][69].…”
Section: Drug-related Pulmonary Toxicitymentioning
confidence: 99%
“…Rarely drug--induced toxicity manifests itself as pleuritis [72][73][74]. There are no differences between symptoms and radiological features of the respiratory tract diseases appearing as a consequence of drug toxicity and in other circumstances [62][63][64][65][66][67][68][69][70][71].…”
Section: Drug-related Pulmonary Toxicitymentioning
confidence: 99%