Myocarditis Associated with Mesalazine: A Case Report

Öz

Acute myocarditis is a life-threatening inflammatory disease of the heart muscle. It usually occurs after a viral infection and it is often asymptomatic. Mesalazine is commonly used for the treatment of inflammatory bowel disease. Mesalazine rarely causes acute myocarditis, but the exact mechanism is unclear. A 32-year-old female patient using mesalazine with a diagnosis inflammatory bowel disease was admitted to the emergency department with shortness of breath. The patient showed signs of acute decompansated heart failure. Bedside echocardiography examination showed a reduced left ventricular systolic function. The patient was followed with a diagnosis of fulminant myocarditis and mechanical ventilation and inotropic support was started. The patient has dramatically improved after stopping treatment of mesalazine. Myocarditis due to any drug use should be taken into consideration in patients receiving mesalazine therapy.

Key Words: Mesalazine; Myocarditis; Crohn’s Disease.

Anahtar Kelimeler

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Journal of Turgut Ozal Medical Center

Öz

Akut miyokardit hayatı tehdit edebilen kalp kasının inflamatuar bir hastalığıdır. Genellikle viral enfeksiyon sonrası gelişir ve sıklıkla asemptomatik seyreder. İnflamatuar barsak hastalıklarında mesalazin yaygın olarak kullanılmaktadır. Mekanizması tam olarak bilinmemekle birlikte mesalazinin akut miyokardite neden olduğu bilinmektedir. İnflamatuar barsak hastalığı tanısıyla mesalazin kullanan 32 yaşındaki bayan hasta, nefes darlığı şikayetiyle acil servise başvurdu. Hastada akut dekompanse kalp yetmezliği bulguları mevcuttu. Yatak başı ekokardiografide azalmış sol ventrikül sistolik fonksiyonları izlendi. Hasta fulminan miyokardit tanısıyla takip edildi, mekanik ventilator ve inotropik destek tedavisi verildi. Hasta mesalazin tedavisi stoplandıktan sonra dramatik bir şekilde iyileşti. Mesalazin tedavisi alan hastalarda ilaç ile ilişkili miyokardit tanısı göz önünde bulundurulması gerekmektedir

Anahtar Kelimeler

• Mesalazin, Miyokardit, Crohn Hastalığı

Kaynakça

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