Mesalazine-associated lung fibrosis: case report and literature review

IF 0.7 Q4 RESPIRATORY SYSTEM

Respiratory Medicine Case Reports Pub Date : 2025-01-01 DOI:10.1016/j.rmcr.2025.102284

Nazlı Zeynep Uslu , Mustafa Hasan Adleh , Ebru Bilir , Fahad al-deen Kata , Merih Kalamanoğlu Balcı

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Abstract

Background

Even though uncommon, drug-induced interstitial lung disease (DIILD) represents a serious adverse drug reaction. We report a case of a patient with a history of ulcerative colitis who was receiving mesalazine.

Presentation

The patient developed dyspnea, hypoxemia, and respiratory failure accompanied by resting oxygen desaturation. Initial CT imaging revealed bilateral perihilar ground-glass opacities along with focal areas of consolidation. Inflammatory markers were elevated, but procalcitonin levels remained persistently low; sputum cultures and multiplex PCR ruled against an infectious origin. Mesalazine was discontinued, and the patient's respiratory status improved dramatically. Follow-up CT revealed interval resolution of the pulmonary lesions, and a diagnosis of DIILD was clinically established.

Conclusion

This case emphasizes the importance of balancing clinical suspicion between steroid-related infectious risk and an uncommon drug reaction. We also identified similar Mesalazine-associated DIILD cases in the literature to demonstrate similar radiologic patterns, onset time, and outcomes.

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美沙拉嗪相关性肺纤维化：病例报告及文献复习

尽管不常见，但药物性间质性肺疾病（DIILD）是一种严重的药物不良反应。我们报告一例患者的历史溃疡性结肠炎谁是接受美沙拉嗪。患者出现呼吸困难、低氧血症、呼吸衰竭伴静息氧饱和度降低。最初的CT成像显示双侧门静脉周围毛玻璃影伴病灶实变区。炎症标志物升高，但降钙素原水平持续偏低；痰培养和多重聚合酶链反应排除了传染源。停用美沙拉嗪后，患者的呼吸状况显著改善。随访CT显示肺病变间期消退，临床诊断为DIILD。结论本病例强调了在类固醇相关感染风险和罕见药物反应之间权衡临床怀疑的重要性。我们还在文献中发现了类似的美沙拉嗪相关DIILD病例，以证明相似的放射学模式、发病时间和结果。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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