Mesalamine-Induced Myocarditis and Coronary Vasculitis in a Pediatric Ulcerative Colitis Patient: A Case Report

Mesalamine-containing products are often a first-line treatment for ulcerative colitis. Severe adverse reactions to these products, including cardiovascular toxicity, are rarely seen in pediatric patients. We present a case of a 16-year-old boy with ulcerative colitis treated with Asacol, a mesalami...

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Main Authors: Elimarys Perez-Colon, Gul H. Dadlani, Ivan Wilmot, Michelle Miller
Format: Article
Language:English
Published: Wiley 2011-01-01
Series:Case Reports in Pediatrics
Online Access:http://dx.doi.org/10.1155/2011/524364
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author Elimarys Perez-Colon
Gul H. Dadlani
Ivan Wilmot
Michelle Miller
author_facet Elimarys Perez-Colon
Gul H. Dadlani
Ivan Wilmot
Michelle Miller
author_sort Elimarys Perez-Colon
collection DOAJ
description Mesalamine-containing products are often a first-line treatment for ulcerative colitis. Severe adverse reactions to these products, including cardiovascular toxicity, are rarely seen in pediatric patients. We present a case of a 16-year-old boy with ulcerative colitis treated with Asacol, a mesalamine-containing product, who developed sudden onset chest pain after four weeks on therapy. Serial electrocardiograms showed nonspecific ST segment changes, an echocardiogram showed mildly decreased left ventricular systolic function with mild to moderate left ventricular dilation and coronary ectasia, and his troponins were elevated. Following Asacol discontinuation, his chest pain resolved, troponins were trending towards normal, left ventricular systolic function normalized, and coronary ectasia improved within 24 hours suggesting an Asacol-associated severe drug reaction. Mesalamine-induced cardiovascular toxicity, although rare, may represent a life-threatening disorder. Therefore, every patient presenting with acute chest pain should receive a workup to rule out this rare drug-induced disorder.
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spelling doaj-art-86be151eb8804d42ab6194595e06d1d32025-08-20T03:37:53ZengWileyCase Reports in Pediatrics2090-68032090-68112011-01-01201110.1155/2011/524364524364Mesalamine-Induced Myocarditis and Coronary Vasculitis in a Pediatric Ulcerative Colitis Patient: A Case ReportElimarys Perez-Colon0Gul H. Dadlani1Ivan Wilmot2Michelle Miller3Department of Pediatrics, University of South Florida, 2 Tampa General Circle, Tampa, FL 33606, USADepartment of Pediatrics, University of South Florida, 2 Tampa General Circle, Tampa, FL 33606, USAAll Children’s Hospital Heart Institute, Outpatient Care Center, 2nd Floor, 501 6th Street South Saint. Petersburg, FL 33701, USAAll Children’s Hospital Heart Institute, Outpatient Care Center, 2nd Floor, 501 6th Street South Saint. Petersburg, FL 33701, USAMesalamine-containing products are often a first-line treatment for ulcerative colitis. Severe adverse reactions to these products, including cardiovascular toxicity, are rarely seen in pediatric patients. We present a case of a 16-year-old boy with ulcerative colitis treated with Asacol, a mesalamine-containing product, who developed sudden onset chest pain after four weeks on therapy. Serial electrocardiograms showed nonspecific ST segment changes, an echocardiogram showed mildly decreased left ventricular systolic function with mild to moderate left ventricular dilation and coronary ectasia, and his troponins were elevated. Following Asacol discontinuation, his chest pain resolved, troponins were trending towards normal, left ventricular systolic function normalized, and coronary ectasia improved within 24 hours suggesting an Asacol-associated severe drug reaction. Mesalamine-induced cardiovascular toxicity, although rare, may represent a life-threatening disorder. Therefore, every patient presenting with acute chest pain should receive a workup to rule out this rare drug-induced disorder.http://dx.doi.org/10.1155/2011/524364
spellingShingle Elimarys Perez-Colon
Gul H. Dadlani
Ivan Wilmot
Michelle Miller
Mesalamine-Induced Myocarditis and Coronary Vasculitis in a Pediatric Ulcerative Colitis Patient: A Case Report
Case Reports in Pediatrics
title Mesalamine-Induced Myocarditis and Coronary Vasculitis in a Pediatric Ulcerative Colitis Patient: A Case Report
title_full Mesalamine-Induced Myocarditis and Coronary Vasculitis in a Pediatric Ulcerative Colitis Patient: A Case Report
title_fullStr Mesalamine-Induced Myocarditis and Coronary Vasculitis in a Pediatric Ulcerative Colitis Patient: A Case Report
title_full_unstemmed Mesalamine-Induced Myocarditis and Coronary Vasculitis in a Pediatric Ulcerative Colitis Patient: A Case Report
title_short Mesalamine-Induced Myocarditis and Coronary Vasculitis in a Pediatric Ulcerative Colitis Patient: A Case Report
title_sort mesalamine induced myocarditis and coronary vasculitis in a pediatric ulcerative colitis patient a case report
url http://dx.doi.org/10.1155/2011/524364
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