Recurrent Eosinophilic Pneumonia Associated with Mesalazine Suppository in a Patient with Ulcerative Colitis

Korean J Gastroenterol. 2019 Apr 25;73(4):225-229. doi: 10.4166/kjg.2019.73.4.225.

Abstract

Mesalazine suppositories are widely used to treat ulcerative colitis and have a guaranteed safety profile, but although rare, they can cause pulmonary toxicity. A 35-year-old woman with ulcerative colitis was diagnosed to have acute eosinophilic pneumonia after 29 days of oral mesalazine use and improved after mesalazine and corticosteroid were withdrawn. Reintroduction of mesalazine suppositories resulted in acute eosinophilic pneumonia recurrence after 28 days. Mesalazine re-administration (even via a different route) in patients with a history of mesalazine-induced eosinophilic pneumonia should be undertaken cautiously, because eosinophilic pneumonia may recurrence.

Keywords: Eosinophilic pneumonia; Mesalamine; Mesalazine; Pulmonary eosinophilia; Suppositories.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Anti-Inflammatory Agents / therapeutic use
  • Budesonide / therapeutic use
  • Colitis, Ulcerative / drug therapy
  • Colitis, Ulcerative / pathology
  • Colonoscopy
  • Female
  • Humans
  • Mesalamine / adverse effects*
  • Mesalamine / therapeutic use
  • Methylprednisolone / therapeutic use
  • Pneumonia / diagnosis*
  • Pneumonia / drug therapy
  • Pneumonia / etiology
  • Probiotics / therapeutic use
  • Pulmonary Eosinophilia / diagnosis*
  • Pulmonary Eosinophilia / etiology
  • Recurrence
  • Thorax / diagnostic imaging
  • Tomography, X-Ray Computed

Substances

  • Anti-Inflammatory Agents
  • Mesalamine
  • Budesonide
  • Methylprednisolone