Al-Abcha Abdullah, Raziq Fazal, Kherallah Shouq, Alratroot Ahmad
Internal Medicine, Michigan State University, East Lansing, Michigan, USA
Internal Medicine, Michigan State University, East Lansing, Michigan, USA.
BMJ Case Rep. 2020 Apr 16;13(4):e233886. doi: 10.1136/bcr-2019-233886.
A 45-year-old woman with a medical history of ulcerative colitis (UC) presented with difficulty in breathing. The patient was diagnosed with UC a month prior to presentation and was started on mesalamine suppository. Chest x-ray (CXR) on presentation showed bilateral pleural effusion, which was confirmed on CT angiogram of the chest. Diagnostic and therapeutic thoracentesis was performed and 0.7 L of pleural fluid was removed from the left side. The pleural fluid analysis was consistent with exudative pleural effusion with eosinophilia. Symptomatic improvement was noted after thoracentesis. Mesalamine was stopped and repeat CXR was obtained on the follow-up visit, which showed no pleural effusion. The Naranjo score was calculated to be 7, indicating that the eosinophilic pleural effusion was most probably secondary to adverse reaction from mesalamine.
一名有溃疡性结肠炎（UC）病史的45岁女性出现呼吸困难。该患者在就诊前一个月被诊断为UC，并开始使用美沙拉嗪栓剂。就诊时胸部X线（CXR）显示双侧胸腔积液，胸部CT血管造影证实了这一点。进行了诊断性和治疗性胸腔穿刺术，从左侧抽出了0.7升胸腔积液。胸腔积液分析与伴有嗜酸性粒细胞增多的渗出性胸腔积液一致。胸腔穿刺术后症状有所改善。停用美沙拉嗪，随访时复查CXR，显示无胸腔积液。计算得出的纳兰霍评分是7分，表明嗜酸性胸腔积液很可能继发于美沙拉嗪的不良反应。
