Mesalazine
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Reactions 1357 - 25 Jun 2011 S Mesalazine Acute pancreatitis and inferior vena cava thrombosis: case report A 21-year-old man developed acute pancreatitis and inferior vena cava thrombosis following treatment with mesalazine for ulcerative colitis. The man, who also had multiple sclerosis treated with interferon β-1b, began receiving mesalazine [route and dosage not stated] and prednisolone. Two months later, he presented with severe, sudden-onset epigastric pain and nausea. Upon admission, he had a temperature of 38.1°C and a pulse rate of 109 beats/min. Laboratory investigations included the following: WBC count 19 120/mm 3 , platelet count 456 000/mm 3 , haemoglobin 11.5 g/dL, ESR 41 mm/h, amylase 377 IU/L and lipase 816 IU/L. An abdominal CT revealed pancreatic swelling, with fluid in and around the organ. Magnetic resonance cholangiopancreatography and endoscopic ultrasound revealed acute pancreatitis and inferior vena cava thrombosis. Mesalazine was discontinued, and the man received anticoagulants. Over the next few days, his amylase and lipase levels normalised, and his abdominal pain and fever resolved. A positive drug provocation test with mesalazine confirmed the diagnosis of mesalazine-induced acute pancreatitis. After 3 months of anticoagulant therapy, the inferior vena cava thrombosis had resolved completely. A follow-up Doppler test 9 months later showed no signs of thrombosis. Author comment: Pancreatitis caused by mesalazine was confirmed through provocation test. It was believed that local peritoneal inflammation caused by pancreatitis in a hypercoagulable state by ulcerative colitis contributed to the development of the interior vena cava thrombosis. Shin DH, et al. A case of inferior vena cava thrombosis and acute pancreatitis in a patient with ulcerative colitis. Korean Journal of Gastroenterology 56: 255-9, No. 4, Oct 2010 [Korean; summarised from a translation] - South Korea 803055905 1 Reactions 25 Jun 2011 No. 1357 0114-9954/10/1357-0001/$14.95 © 2010 Adis Data Information BV. All rights reserved
Transcript of Mesalazine
Reactions 1357 - 25 Jun 2011
SMesalazine
Acute pancreatitis and inferior vena cavathrombosis: case report
A 21-year-old man developed acute pancreatitis andinferior vena cava thrombosis following treatment withmesalazine for ulcerative colitis.
The man, who also had multiple sclerosis treated withinterferon β-1b, began receiving mesalazine [route anddosage not stated] and prednisolone. Two months later, hepresented with severe, sudden-onset epigastric pain andnausea. Upon admission, he had a temperature of 38.1°Cand a pulse rate of 109 beats/min. Laboratory investigationsincluded the following: WBC count 19 120/mm3, plateletcount 456 000/mm3, haemoglobin 11.5 g/dL, ESR 41 mm/h,amylase 377 IU/L and lipase 816 IU/L. An abdominal CTrevealed pancreatic swelling, with fluid in and around theorgan. Magnetic resonance cholangiopancreatography andendoscopic ultrasound revealed acute pancreatitis andinferior vena cava thrombosis.
Mesalazine was discontinued, and the man receivedanticoagulants. Over the next few days, his amylase andlipase levels normalised, and his abdominal pain and feverresolved. A positive drug provocation test with mesalazineconfirmed the diagnosis of mesalazine-induced acutepancreatitis. After 3 months of anticoagulant therapy, theinferior vena cava thrombosis had resolved completely. Afollow-up Doppler test 9 months later showed no signs ofthrombosis.
Author comment: Pancreatitis caused by mesalazine wasconfirmed through provocation test. It was believed that localperitoneal inflammation caused by pancreatitis in ahypercoagulable state by ulcerative colitis contributed to thedevelopment of the interior vena cava thrombosis.Shin DH, et al. A case of inferior vena cava thrombosis and acute pancreatitis in apatient with ulcerative colitis. Korean Journal of Gastroenterology 56: 255-9, No.4, Oct 2010 [Korean; summarised from a translation] - South Korea 803055905
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Reactions 25 Jun 2011 No. 13570114-9954/10/1357-0001/$14.95 © 2010 Adis Data Information BV. All rights reserved
