Department of Internal Medicine and Digestive Disease Research Institute, Wonkwang University School of Medicine, Iksan, Korea.
Korean J Gastroenterol. 2022 Jan 25;79(1):31-34. doi: 10.4166/kjg.2021.152.
5-aminosalicylic acid (5-ASA) is used widely to treat ulcerative colitis. The common side effects of 5-ASA include nausea, vomiting, abdominal pain, headache, and skin rash. 5-ASA-induced myocarditis is a rare side effect, and few cases have been reported. 5-ASA-induced myocarditis usually occurs within 2-4 weeks of drug use and causes chest pain and dyspnea. This paper reports 5-ASA-induced myocarditis in a 31-year-old male patient who took 5-ASA for 20 days prior. The patient was hospitalized with dyspnea that worsened when lying down, with chest pain radiating to the left neck, fever, and vomiting. Myocarditis was suspected. The work-up included electrocardiogram, transthoracic echocardiogram, cardiac MRI, and laboratory investigations. The patient's signs and symptoms improved within a few days after withdrawing 5-ASA. This case shows that an evaluation including the possibility of myocarditis should be performed when patients with ulcerative colitis receiving 5-ASA present with cardiac problems, such as dyspnea and chest pain.
5-氨基水杨酸(5-ASA)被广泛用于治疗溃疡性结肠炎。5-ASA 的常见副作用包括恶心、呕吐、腹痛、头痛和皮疹。5-ASA 诱导的心肌炎是一种罕见的副作用,仅有少数病例报告。5-ASA 诱导的心肌炎通常发生在用药后 2-4 周内,引起胸痛和呼吸困难。本文报告了 1 例 31 岁男性患者,因溃疡性结肠炎使用 5-ASA 20 天后发生心肌炎。该患者以平卧时呼吸困难加重、左侧颈部放射痛、发热和呕吐起病。疑诊心肌炎。检查包括心电图、经胸超声心动图、心脏 MRI 和实验室检查。停用 5-ASA 几天后,患者的症状和体征改善。该病例提示,对于接受 5-ASA 治疗的溃疡性结肠炎患者出现呼吸困难和胸痛等心脏问题时,应评估是否存在心肌炎。