Perimyocarditis in a Patient with Ulcerative Colitis Treated with 5-Aminosalicylic Acid.

Hye Young Lee, Dong Hoon Baek
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Abstract

5-Aminosalicylic acid (5-ASA) is recommended for managing ulcerative colitis. Common adverse effects associated with 5-ASA include gastrointestinal disorders, headaches, and skin rashes. Perimyocarditis induced by 5-ASA is a rare adverse effect, with only a limited number of cases reported. This paper presents a case of 5-ASA-induced perimyocarditis in a 29-year-old female who had been taking 5-ASA for three weeks. The patient was admitted to the emergency department with dyspnea, chest discomfort, and fever. She subsequently underwent laboratory investigations, including electrocardiography, transthoracic echocardiography, chest computed tomographic angiography, cardiac magnetic resonance imaging, and heart biopsy. Intravenous steroid was administered, and 5-ASA was discontinued. The patient's signs and symptoms improved significantly within a few days of discontinuing 5-ASA, leading to her subsequent discharge. This case highlights the importance of considering perimyocarditis in patients exhibiting cardiac symptoms during 5-ASA therapy, despite it being a rare adverse effect. Drug withdrawal in such cases may lead to rapid clinical improvement.

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用 5-氨基水杨酸治疗溃疡性结肠炎患者的心包炎
5-氨基水杨酸(5-ASA)被推荐用于治疗溃疡性结肠炎。5-ASA 常见的不良反应包括胃肠功能紊乱、头痛和皮疹。5-ASA 诱发的心包炎是一种罕见的不良反应,仅有少量病例报道。本文介绍了一例由 5-ASA 诱发的心包炎病例,患者是一名 29 岁的女性,服用 5-ASA 已达三周。患者因呼吸困难、胸部不适和发热被送入急诊科。随后,她接受了实验室检查,包括心电图、经胸超声心动图、胸部计算机断层扫描血管造影、心脏磁共振成像和心脏活检。静脉注射了类固醇,并停用了 5-ASA。停用 5-ASA 几天后,患者的体征和症状明显改善,随后出院。本病例强调了在 5-ASA 治疗期间出现心脏症状的患者考虑心包炎的重要性,尽管这是一种罕见的不良反应。在这种情况下停药可使临床症状迅速好转。
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