Koh Youshin, Nagaya Tadanobu, Saegusa Hisanobu, Ikeuchi Hiroshi, Kodama Ryo, Ushimaru Hiroyasu
Department of Gastroenterology, JA Nagano Koseiren Shinonoi General Hospital.
Department of Gastroenterology, Shinshu University School of Medicine.
Nihon Shokakibyo Gakkai Zasshi. 2020;117(12):1093-1099. doi: 10.11405/nisshoshi.117.1093.
A 30-year-old man presented with constipation and abdominal pain. He was suspected of having ulcerative colitis, and administration of 2400mg/day of oral mesalazine was initiated. After 10 days of treatment, he experienced fever and chest pain. Blood examination, electrocardiography, and cardiac ultrasonography revealed elevated cardiac enzymes, ST-segment elevation, and diffuse hypokinesis, respectively. Mesalazine-induced acute myocarditis was diagnosed based on a positive drug-induced lymphocyte stimulation test and the absence of other myocarditis-causing conditions. Prompt cessation of mesalazine quickly improved his heart function and test results. Although rare, clinicians should consider the possibility of cardiac adverse events caused by mesalazine.
一名30岁男性因便秘和腹痛就诊。他被怀疑患有溃疡性结肠炎,开始口服美沙拉嗪,每日剂量为2400毫克。治疗10天后,他出现发热和胸痛。血液检查、心电图和心脏超声检查分别显示心肌酶升高、ST段抬高和弥漫性运动减弱。基于药物诱导淋巴细胞刺激试验阳性且不存在其他导致心肌炎的情况,诊断为美沙拉嗪诱发的急性心肌炎。迅速停用美沙拉嗪后,他的心脏功能和检查结果迅速改善。尽管罕见,但临床医生应考虑美沙拉嗪引起心脏不良事件的可能性。