en
Scientific article
Case report
English

Drug-induced hypersensitivity syndrome with lupus manifestations due to mesalazine in a patient with ulcerative colitis

Published inBMJ case reports, vol. 15, no. 2, e248229
Publication date2022-02-25
First online date2022-02-25
Abstract

Mesalazine is often used as first-line therapy for ulcerative colitis. Several reports have pointed to systemic adverse reactions associated with this drug. Most have evoked a drug-induced hypersensitivity syndrome, while some have described lupus syndromes but with limited clinical and varied biological features. A 75-year-old man presented with fever, dyspnoea, chest pain, polyarthralgia, and myalgia, following mesalazine introduction. Clinical symptoms and low-titre positive antihistone antibodies disappeared after mesalazine withdrawal without recourse to steroids. Pericardial effusion and 8F-fluorodeoxyglucose uptake on positron emission tomography/CT scan, and glomerular haematuria and proteinuria also disappeared. Cytokine-lymphocyte transformation tests showed a strong sensitisation pattern with interleukin-5 production. This case advances our knowledge of the mechanism of mesalazine-induced adverse effects, namely via drug-induced hypersensitivity with lupus manifestations, which we are the first to report.

eng
Keywords
  • Gastrointestinal system
  • Immunology
  • Ulcerative colitis
  • Unwanted effects / adverse reactions
  • Aged
  • Anti-Inflammatory Agents, Non-Steroidal / adverse effects
  • Colitis, Ulcerative / drug therapy
  • Drug Hypersensitivity Syndrome / diagnosis
  • Drug Hypersensitivity Syndrome / drug therapy
  • Drug Hypersensitivity Syndrome / etiology
  • Humans
  • Male
  • Mesalamine / adverse effects
  • Pharmaceutical Preparations
Citation (ISO format)
ZGHEIB, Omar et al. Drug-induced hypersensitivity syndrome with lupus manifestations due to mesalazine in a patient with ulcerative colitis. In: BMJ case reports, 2022, vol. 15, n° 2, p. e248229. doi: 10.1136/bcr-2021-248229
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Article (Published version)
Identifiers
ISSN of the journal1757-790X
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Creation03/15/2022 9:57:00 PM
First validation03/15/2022 9:57:00 PM
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