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Recurrent Pericarditis: A Rare Adverse Effect of Mesalamine

Inflammation of the myocardium (myocarditis), pericardium (pericarditis), or both (myopericarditis) is a rare but potentially lethal side effect of mesalamine, a drug widely used in the treatment of inflammatory bowel disease (IBD). A 64-year-old female with a history of ulcerative colitis on mesala...

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Autores principales: Karki, Pratul, Kunwar, Ariya, Sharma, Nitish, Dogra, Megha
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Cureus 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9915855/
https://www.ncbi.nlm.nih.gov/pubmed/36788872
http://dx.doi.org/10.7759/cureus.33661
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author Karki, Pratul
Kunwar, Ariya
Sharma, Nitish
Dogra, Megha
author_facet Karki, Pratul
Kunwar, Ariya
Sharma, Nitish
Dogra, Megha
author_sort Karki, Pratul
collection PubMed
description Inflammation of the myocardium (myocarditis), pericardium (pericarditis), or both (myopericarditis) is a rare but potentially lethal side effect of mesalamine, a drug widely used in the treatment of inflammatory bowel disease (IBD). A 64-year-old female with a history of ulcerative colitis on mesalamine presented with dyspnea and chest pain. The patient was found to have mild to moderate pericardial effusion with signs of pericarditis. Further workup revealed positive rheumatoid factor, antineutrophil cytoplasmic autoantibody, cytoplasmic (c-ANCA), and antinuclear antibodies (ANA), raising suspicion for rheumatoid-associated pericarditis. She was discharged with a prednisone taper and an outpatient rheumatology follow-up. However, the patient presented again in three months with similar complaints and was found to have recurrent pericarditis. On this admission, mesalamine-induced pericarditis was considered in the differential diagnosis, and it was stopped on discharge. On a three-month follow-up, the patient showed complete resolution. Mesalamine-induced pericarditis is a rare side effect of this drug, and prompt recognition and appropriate intervention are important to prevent the progression of the inflammation and avoid adverse cardiovascular outcomes. The association of IBD with extra-intestinal cardiac manifestations can delay early diagnosis and treatment. 
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spelling pubmed-99158552023-02-13 Recurrent Pericarditis: A Rare Adverse Effect of Mesalamine Karki, Pratul Kunwar, Ariya Sharma, Nitish Dogra, Megha Cureus Cardiology Inflammation of the myocardium (myocarditis), pericardium (pericarditis), or both (myopericarditis) is a rare but potentially lethal side effect of mesalamine, a drug widely used in the treatment of inflammatory bowel disease (IBD). A 64-year-old female with a history of ulcerative colitis on mesalamine presented with dyspnea and chest pain. The patient was found to have mild to moderate pericardial effusion with signs of pericarditis. Further workup revealed positive rheumatoid factor, antineutrophil cytoplasmic autoantibody, cytoplasmic (c-ANCA), and antinuclear antibodies (ANA), raising suspicion for rheumatoid-associated pericarditis. She was discharged with a prednisone taper and an outpatient rheumatology follow-up. However, the patient presented again in three months with similar complaints and was found to have recurrent pericarditis. On this admission, mesalamine-induced pericarditis was considered in the differential diagnosis, and it was stopped on discharge. On a three-month follow-up, the patient showed complete resolution. Mesalamine-induced pericarditis is a rare side effect of this drug, and prompt recognition and appropriate intervention are important to prevent the progression of the inflammation and avoid adverse cardiovascular outcomes. The association of IBD with extra-intestinal cardiac manifestations can delay early diagnosis and treatment.  Cureus 2023-01-11 /pmc/articles/PMC9915855/ /pubmed/36788872 http://dx.doi.org/10.7759/cureus.33661 Text en Copyright © 2023, Karki et al. https://creativecommons.org/licenses/by/3.0/This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Cardiology
Karki, Pratul
Kunwar, Ariya
Sharma, Nitish
Dogra, Megha
Recurrent Pericarditis: A Rare Adverse Effect of Mesalamine
title Recurrent Pericarditis: A Rare Adverse Effect of Mesalamine
title_full Recurrent Pericarditis: A Rare Adverse Effect of Mesalamine
title_fullStr Recurrent Pericarditis: A Rare Adverse Effect of Mesalamine
title_full_unstemmed Recurrent Pericarditis: A Rare Adverse Effect of Mesalamine
title_short Recurrent Pericarditis: A Rare Adverse Effect of Mesalamine
title_sort recurrent pericarditis: a rare adverse effect of mesalamine
topic Cardiology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9915855/
https://www.ncbi.nlm.nih.gov/pubmed/36788872
http://dx.doi.org/10.7759/cureus.33661
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