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Case Reports
. 2019 Feb;10(1):59-62.
doi: 10.14740/cr820. Epub 2019 Feb 24.

Mesalamine-Induced Myopericarditis: A Case Report and Literature Review

Mohamed E Taha  1 , Abubaker Abdalla  1 , Jaafar Al-Khafaji  1 , Samira Malik  1
Affiliations
Case Reports

Mesalamine-Induced Myopericarditis: A Case Report and Literature Review

Mohamed E Taha et al. Cardiol Res. 2019 Feb.

Abstract

Inflammation of the myocardium (myocarditis) or pericardium (pericarditis) or both (myopericarditis) as side effects of mesalamine, a drug widely used in the treatment of inflammatory bowel disease, is a rare, but potentially lethal complication. We report a case of myopericarditis occurring in a young Caucasian woman 14 days following initiation of mesalamine therapy for treatment of a newly diagnosed ulcerative colitis (UC). She presented with pleuritic chest pain, elevated troponin levels and pre-syncope. The diagnosis of myopericarditis was made based on the clinical features, electrocardiogram (EKG) and cardiac magnetic resonance, which showed trace pericardial effusion. The patient's symptom and condition were dramatically improved upon discontinuing mesalamine, and a full recovery was achieved. Mesalamine-induced inflammation of the myocardium (myocarditis) or pericardium (pericarditis) or both (myopericarditis) is rare, but has fatal side effects. Early recognition of these side effects by clinicians and patients is important to prevent progression of the inflammation. Furthermore, patients should be educated to seek urgent medical attention if cardiac symptoms arise.

Keywords: CMR; Chest pain; Mesalamine; Myopericarditis; Ulcerative colitis.

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Conflict of interest statement

There is no conflict of interest to declare.

Figures

Figure 1
Figure 1
A 12-lead electrocardiogram showing borderline T-wave abnormalities in leads II, III and aVF.
Figure 2
Figure 2
Chest X-ray showing hazy bibasilar opacities suggestive of atelectasis.
Figure 3
Figure 3
Echocardiogram showing normal left ventricular ejection fraction (LVEF).
Figure 4
Figure 4
Cardiac magnetic resonance imaging showing trace pericardial effusion (Arrows) and bilateral pleural effusion (Stars).
See this image and copyright information in PMC

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