Case Report
Copyright ©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Mar 21, 2015; 21(11): 3376-3379
Published online Mar 21, 2015. doi: 10.3748/wjg.v21.i11.3376
Proposed case of mesalazine-induced cardiomyopathy in severe ulcerative colitis
Kathryn Fleming, Andrew Ashcroft, Christopher Alexakis, Demitrios Tzias, Christopher Groves, Andrew Poullis
Kathryn Fleming, Andrew Ashcroft, Christopher Alexakis, Demitrios Tzias, Christopher Groves, Andrew Poullis, Department of Gastroenterology, St Georges Hospital, SW17 0QT London, United Kingdom
Author contributions: Fleming K and Alexakis C wrote the case presentation and acquired clinical data; Ashcroft A and Alexakis C wrote and referenced the case discussion; Tzias D wrote radiology section and selected appropriate image; Groves C and Poullis A contributed to the writing of all sections as well as the design of the report.
Supported by grants from NHS St Georges Hospital.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
Correspondence to: Kathryn Fleming, MD, Department of Gastroenterology, St Georges Hospital, Blackshaw Road, SW17 0QT London, United Kingdom.
Telephone: +44-20 86721255 Fax: +44-20-87253855
Received: July 25, 2014
Peer-review started: July 26, 2014
First decision: October 14, 2014
Revised: October 25, 2014
Accepted: December 1, 2014
Article in press: December 1, 2014
Published online: March 21, 2015

Five-amino salicylic acids are recommended for use in the management of inflammatory bowel disease, cardiac complications are a rare although recognised phenomenon. This report aims to highlight this serious but rare adverse reaction. We report here a case of a young man presenting with cardiogenic shock in the context of recent mesalazine treatment in severe ulcerative colitis.

Keywords: Ulcerative colitis, Mesalazine, Cardiomyopathy, Adverse reactions

Core tip: A rare but serious occurrence in ulcerative colitis is myocarditis which can often be life-threatening. Whether 5-amino salicylic acids induced (as proposed here), or an autoimmune phenomenon in acute disease flare-ups, prompt recognition and treatment will be of benefit in the clinical setting.