Chung Min Jae, Lee Jae Hee, Moon Kyung Rye
Department of Pediatrics, Chosun University School of Medicine, Gwangju, Korea.
Pediatr Gastroenterol Hepatol Nutr. 2015 Dec;18(4):286-91. doi: 10.5223/pghn.2015.18.4.286. Epub 2015 Dec 23.
Ulcerative colitis (UC) is a chronic idiopathic inflammatory bowel disease. Mesalizine for the first-line therapy of UC has adverse effects include pancreatitis, pneumonia and pericarditis. UC complicated by two coexisting conditions, however, is very rare. Moreover, drug-related pulmonary toxicity is particularly rare. An 11-year-old male patient was hospitalized for recurring upper abdominal pain after meals with vomiting, hematochezia and exertional dyspnea developing at 2 weeks of mesalizine therapy for UC. The serum level of lipase was elevated. Chest X-ray and thorax computed tomography showed interstitial pneumonitis. Mesalizine was discontinued and steroid therapy was initiated. Five days after admission, symptoms were resolved and mesalizine was resumed after a drop in amylase and lipase level. Symptoms returned the following day, however, accompanied by increased the serum levels of amylase and lipase. Mesalizine was discontinued again and recurring symptoms rapidly improved.
溃疡性结肠炎（UC）是一种慢性特发性炎症性肠病。美沙拉嗪作为UC的一线治疗药物，其不良反应包括胰腺炎、肺炎和心包炎。然而，UC合并两种并存疾病的情况非常罕见。此外，药物相关的肺部毒性尤为罕见。一名11岁男性患者因在接受美沙拉嗪治疗UC 2周后出现餐后反复上腹痛伴呕吐、便血及劳力性呼吸困难而住院。血清脂肪酶水平升高。胸部X线和胸部计算机断层扫描显示间质性肺炎。停用美沙拉嗪并开始使用类固醇治疗。入院5天后，症状缓解，淀粉酶和脂肪酶水平下降后恢复使用美沙拉嗪。然而，第二天症状再次出现，同时血清淀粉酶和脂肪酶水平升高。再次停用美沙拉嗪，反复出现的症状迅速改善。
