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Unexpected outcome (positive or negative) including adverse drug reactions
Case report
Mesalamine-induced eosinophilic pleural effusion
  1. Abdullah Al-abcha,
  2. Fazal Raziq,
  3. Shouq Kherallah and
  4. Ahmad Alratroot
  1. Internal Medicine, Michigan State University, East Lansing, Michigan, USA
  1. Correspondence to Dr Abdullah Al-abcha; alabchaa{at}msu.edu

Abstract

A 45-year-old woman with a medical history of ulcerative colitis (UC) presented with difficulty in breathing. The patient was diagnosed with UC a month prior to presentation and was started on mesalamine suppository. Chest x-ray (CXR) on presentation showed bilateral pleural effusion, which was confirmed on CT angiogram of the chest. Diagnostic and therapeutic thoracentesis was performed and 0.7 L of pleural fluid was removed from the left side. The pleural fluid analysis was consistent with exudative pleural effusion with eosinophilia. Symptomatic improvement was noted after thoracentesis. Mesalamine was stopped and repeat CXR was obtained on the follow-up visit, which showed no pleural effusion. The Naranjo score was calculated to be 7, indicating that the eosinophilic pleural effusion was most probably secondary to adverse reaction from mesalamine.

  • unwanted effects / adverse reactions
  • respiratory medicine
  • drugs: gastrointestinal system
  • ulcerative colitis

http://dx.doi.org/10.1136/bcr-2019-233886

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    Footnotes

    • Contributors AA has significantly contributed to the planning, reporting, conception and design of the work. FR has significantly contributed to the reporting, design and conception of the work. SK has significantly contributed to the reporting, design, and acquisition of data of the work. AA has significantly contributed to the reporting, conception and acquisition of data of the work.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Patient consent for publication Obtained.

    • Provenance and peer review Not commissioned; externally peer reviewed.