Recurrent Interstitial Pneumonitis in a Patient with Entero-Behçet’s Disease Initially Treated with Mesalazine
A 65-year-old man with entero-Behçet’s disease (BD) being treated with mesalazine was presented to our hospital complaining of dyspnea. Computed tomography (CT) of the chest showed ground-glass opacities and he was initially diagnosed with mesalazine-induced interstitial pneumonitis (IP). Besides th...
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| Format: | Article |
| Language: | English |
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Wiley
2016-01-01
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| Series: | Case Reports in Rheumatology |
| Online Access: | http://dx.doi.org/10.1155/2016/5636489 |
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| author | Akihiro Nakamura Tomoya Miyamura Brian Wu Eiichi Suematsu |
| author_facet | Akihiro Nakamura Tomoya Miyamura Brian Wu Eiichi Suematsu |
| author_sort | Akihiro Nakamura |
| collection | DOAJ |
| description | A 65-year-old man with entero-Behçet’s disease (BD) being treated with mesalazine was presented to our hospital complaining of dyspnea. Computed tomography (CT) of the chest showed ground-glass opacities and he was initially diagnosed with mesalazine-induced interstitial pneumonitis (IP). Besides the discontinuation of mesalazine, a high dose of oral prednisolone was administered and the patient seemed to recover. However, four months later, dyspnea recurred and repeated CT revealed more extensive pulmonary infiltration despite steroid therapy. After the exclusion of infections, we suspected either a recurrence of mesalazine-induced IP or BD-related IP as a clinical manifestation of BD. The patient was treated with intravenous methylprednisolone and cyclophosphamide, followed by orally administered azathioprine, based on the assumption of underlying vasculitis. Thereafter, his condition improved. BD-related IP is an extremely rare condition with limited reports in the literature. Mesalazine-induced IP is also uncommon but the prognosis is generally good after discontinuation of mesalazine with or without steroid therapy. We discuss an extremely rare case, especially focusing on BD-related IP and mesalazine-induced IP as a potential cause of recurrent IP in a patient with entero-BD. |
| format | Article |
| id | doaj-art-648389eefa8649258ee113f36481b971 |
| institution | Kabale University |
| issn | 2090-6889 2090-6897 |
| language | English |
| publishDate | 2016-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Case Reports in Rheumatology |
| spelling | doaj-art-648389eefa8649258ee113f36481b9712025-02-03T06:47:56ZengWileyCase Reports in Rheumatology2090-68892090-68972016-01-01201610.1155/2016/56364895636489Recurrent Interstitial Pneumonitis in a Patient with Entero-Behçet’s Disease Initially Treated with MesalazineAkihiro Nakamura0Tomoya Miyamura1Brian Wu2Eiichi Suematsu3Department of Internal Medicine and Rheumatology, Clinical Research Institute, National Hospital Organization, Kyushu Medical Center, 1-8-1 Jigyohama, Chuo-ku, Fukuoka 810-8563, JapanDepartment of Internal Medicine and Rheumatology, Clinical Research Institute, National Hospital Organization, Kyushu Medical Center, 1-8-1 Jigyohama, Chuo-ku, Fukuoka 810-8563, JapanDepartment of Genetics and Development, Krembil Research Institute, Toronto Western Hospital, 60 Leonard Avenue, Toronto, ON, M5T 2S8, CanadaDepartment of Internal Medicine and Rheumatology, Clinical Research Institute, National Hospital Organization, Kyushu Medical Center, 1-8-1 Jigyohama, Chuo-ku, Fukuoka 810-8563, JapanA 65-year-old man with entero-Behçet’s disease (BD) being treated with mesalazine was presented to our hospital complaining of dyspnea. Computed tomography (CT) of the chest showed ground-glass opacities and he was initially diagnosed with mesalazine-induced interstitial pneumonitis (IP). Besides the discontinuation of mesalazine, a high dose of oral prednisolone was administered and the patient seemed to recover. However, four months later, dyspnea recurred and repeated CT revealed more extensive pulmonary infiltration despite steroid therapy. After the exclusion of infections, we suspected either a recurrence of mesalazine-induced IP or BD-related IP as a clinical manifestation of BD. The patient was treated with intravenous methylprednisolone and cyclophosphamide, followed by orally administered azathioprine, based on the assumption of underlying vasculitis. Thereafter, his condition improved. BD-related IP is an extremely rare condition with limited reports in the literature. Mesalazine-induced IP is also uncommon but the prognosis is generally good after discontinuation of mesalazine with or without steroid therapy. We discuss an extremely rare case, especially focusing on BD-related IP and mesalazine-induced IP as a potential cause of recurrent IP in a patient with entero-BD.http://dx.doi.org/10.1155/2016/5636489 |
| spellingShingle | Akihiro Nakamura Tomoya Miyamura Brian Wu Eiichi Suematsu Recurrent Interstitial Pneumonitis in a Patient with Entero-Behçet’s Disease Initially Treated with Mesalazine Case Reports in Rheumatology |
| title | Recurrent Interstitial Pneumonitis in a Patient with Entero-Behçet’s Disease Initially Treated with Mesalazine |
| title_full | Recurrent Interstitial Pneumonitis in a Patient with Entero-Behçet’s Disease Initially Treated with Mesalazine |
| title_fullStr | Recurrent Interstitial Pneumonitis in a Patient with Entero-Behçet’s Disease Initially Treated with Mesalazine |
| title_full_unstemmed | Recurrent Interstitial Pneumonitis in a Patient with Entero-Behçet’s Disease Initially Treated with Mesalazine |
| title_short | Recurrent Interstitial Pneumonitis in a Patient with Entero-Behçet’s Disease Initially Treated with Mesalazine |
| title_sort | recurrent interstitial pneumonitis in a patient with entero behcet s disease initially treated with mesalazine |
| url | http://dx.doi.org/10.1155/2016/5636489 |
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