Myo-Pericarditis and Congestive Heart Failure Secondary to Mesalamine Use Associated With Completely Reversible Cardiac Dysfunction

Abstract

Mesalamine is a 5-ASA derivative commonly used to treat ulcerative colitis and mild to moderate crohns disease. Rarely, it has been associated with myocarditis or pericarditis. Several hypotheses have been proposed but the exact mechanism of cardiac injury is still unclear. We present a case of combined pericarditis and myocarditis in a young man on mesalamine therapy, with subsequent deterioration of cardiac function, EKG changes and signs of congestive heart failure. After the appropriate treatment, beginning with discontinuation of mesalamine, he had complete recovery of cardiac function to normal. This case exemplifies the importance of quick physician recognition of the disease association and immediate discontinuation of the drug for more successful outcomes in conjunction with appropriate management.




J Med Cases. 2012;3(3):214-216
doi: https://doi.org/10.4021/jmc617w