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
Kaynakça
- Kounis NG, Zavras GM, Soufras GD, Kitrou MP. Hypersensitivity myocarditis. Ann Allergy 1989;62:71-4.
- Kristensen KS, Hoegholm A, Bohr L, Friis S. Fatal myocarditis associated with mesalazin. Lancet 1990;335:605.
- Kounis GN, Kouni SA, Chiladakis JA, Kounis NG. Comment: Mesalamine-associated hypersensitivity myocarditis in ulcerative colitis and the kounis sydrome. Ann Pharmacoter 2009;43:393-94.
- Stelts S, Taylor MH, Nappi J, Van Bakel AB. Mesalamine associated hypersensivity myocarditis ulserative colitis. Ann Pharmacoter 2008;42:904-05.
- Galiuto L, Enriquez S, Reeder GS, Tazelaar HD, Li JT, Miller FA, et al. Eosinophilic myocarditis, manifesting as myocardial infarction: early diagnosis, and succesful treatment. Mayo clin proc 1997;72:603-10.
- Nash CL, Panaccione R, Sutherland LR, Meddings JB. Giant cell myocarditis in a patient with Crohn disease treated with etanercept-a tumour necrosis factor-alfa antagonist. Can J Gastroenterol 2001;15:607-11.
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
Kaynakça
- Kounis NG, Zavras GM, Soufras GD, Kitrou MP. Hypersensitivity myocarditis. Ann Allergy 1989;62:71-4.
- Kristensen KS, Hoegholm A, Bohr L, Friis S. Fatal myocarditis associated with mesalazin. Lancet 1990;335:605.
- Kounis GN, Kouni SA, Chiladakis JA, Kounis NG. Comment: Mesalamine-associated hypersensitivity myocarditis in ulcerative colitis and the kounis sydrome. Ann Pharmacoter 2009;43:393-94.
- Stelts S, Taylor MH, Nappi J, Van Bakel AB. Mesalamine associated hypersensivity myocarditis ulserative colitis. Ann Pharmacoter 2008;42:904-05.
- Galiuto L, Enriquez S, Reeder GS, Tazelaar HD, Li JT, Miller FA, et al. Eosinophilic myocarditis, manifesting as myocardial infarction: early diagnosis, and succesful treatment. Mayo clin proc 1997;72:603-10.
- Nash CL, Panaccione R, Sutherland LR, Meddings JB. Giant cell myocarditis in a patient with Crohn disease treated with etanercept-a tumour necrosis factor-alfa antagonist. Can J Gastroenterol 2001;15:607-11.
Ayrıntılar
| Birincil Dil | Tr |
|---|---|
| Bölüm | Makaleler |
| Yazarlar | |
| Yayımlanma Tarihi | 14 Aralık 2015 |
| Yayımlandığı Sayı | Yıl 2015 Cilt: 22 Sayı: 3 |
