Case Report
Copyright ©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Sep 26, 2020; 8(18): 4162-4168
Published online Sep 26, 2020. doi: 10.12998/wjcc.v8.i18.4162
Nonasthmatic eosinophilic bronchitis in an ulcerative colitis patient – a putative adverse reaction to mesalazine: A case report and review of literature
Andrei Tudor Cernomaz, Gabriela Bordeianu, Cristina Terinte, Cristina Maria Gavrilescu
Andrei Tudor Cernomaz, Cristina Maria Gavrilescu, Department of Internal Medicine, Grigore T. Popa University of Medicine and Pharmacy, Iasi 700115, Romania
Gabriela Bordeianu, Department of Biochemistry, Grigore T. Popa University of Medicine and Pharmacy, Iasi 700115, Romania
Cristina Terinte, Department of Pathology, Regional Oncology Institute, Iasi 700483, Romania
Author contributions: Cernomaz AT was the attending physician, collected initial and follow up data and drafted the manuscript; Bordeianu G and Gavrilescu CM reviewed the literature and participated in manuscript drafting; Terinte C contributed pathology data; all authors revised the manuscript.
Informed consent statement: Informed written consent was obtained from the patient prior to publication of this report and any accompanying images.
Conflict-of-interest statement: The authors declare no conflict of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (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: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Andrei Tudor Cernomaz, MD, PhD, Assistant Lecturer, Attending Doctor, Department of Internal Medicine, Grigore T. Popa University of Medicine and Pharmacy, Universitatii, 16, Iasi 700115, Romania. tudor.cernomaz@umfiasi.ro
Received: June 25, 2020
Peer-review started: June 25, 2020
First decision: July 24, 2020
Revised: August 6, 2020
Accepted: August 29, 2020
Article in press: August 29, 2020
Published online: September 26, 2020
Abstract
BACKGROUND

Lung and airway involvement in inflammatory bowel disease are increasingly frequently reported either as an extraintestinal manifestation or as an adverse effect of therapy.

CASE SUMMARY

We report a case of a patient with ulcerative colitis controlled under mesalazine treatment who presented with chronic cough and hemoptysis. Chest computed tomography and bronchoscopy findings supported tracheal involvement in ulcerative colitis; pathology examination demonstrated an unusual eosinophil-rich inflammatory pattern, and together with clinical data, a nonasthmatic eosinophilic bronchitis diagnosis was formulated. Full recovery was observed within days of mesalazine discontinuation.

CONCLUSION

Mesalazine-induced eosinophilic respiratory disorders have been previously reported, generally involving the lung parenchyma. To the best of our knowledge, this is the first report of mesalamine-induced eosinophilic involvement in the upper airway.

Keywords: Mesalamine, Ulcerative colitis, Hemoptysis, Bronchitis, Drug-related side effects, Case report

Core Tip: Respiratory involvement is sometimes reported in inflammatory bowel disease patients, either as extradigestive lesions or as therapy adverse effects. Mesalazine, a common therapeutic option in mild forms of ulcerative colitis, has been associated to eosinophilic respiratory and cardiovascular disorders. We report a patient exhibiting symptoms suggestive for nonasthmatic eosinophilic bronchitis. Available data supports the hypothesis of a previously unreported mesalazine adverse effect.