Nagy F, Molnar T, Makula E, Kiss I, Milassin P, Zollei E, Tiszlavicz L, Lonovics J. A case of interstitial pneumonitis in a patient with ulcerative colitis treated with azathioprine. World J Gastroenterol 2007; 13(2): 316-319 [PMID: 17226917 DOI: 10.3748/wjg.v13.i2.316]
Corresponding Author of This Article
Ferenc Nagy MD, PhD. First Department of Medicine, Faculty of Medicine, University of Szeged, Koranyi fasor 8, H-6701, Szeged, POB 427, Hungary. agyferi@in1st.szote.u-szeged.hu
Article-Type of This Article
Case Report
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World J Gastroenterol. Jan 14, 2007; 13(2): 316-319 Published online Jan 14, 2007. doi: 10.3748/wjg.v13.i2.316
A case of interstitial pneumonitis in a patient with ulcerative colitis treated with azathioprine
Ferenc Nagy, Tamas Molnar, Eva Makula, Ildiko Kiss, Peter Milassin, Eva Zollei, Laszlo Tiszlavicz, Janos Lonovics
Ferenc Nagy, Tamas Molnar, Janos Lonovics, First Department of Medicine, University of Szeged, Faculty of Medicine, Szeged, Hungary
Eva Makula, Ildiko Kiss, Peter Milassin, Department of Radiology, University of Szeged, Faculty of Medicine, Szeged, Hungary
Eva Zollei, Medical Intensive Care Unit, University of Szeged, Faculty of Medicine, Szeged, Hungary
Laszlo Tiszlavicz, Institute of Pathology, University of Szeged, Faculty of Medicine, Szeged, Hungary
Author contributions: All authors contributed equally to the work.
Correspondence to: Ferenc Nagy MD, PhD. First Department of Medicine, Faculty of Medicine, University of Szeged, Koranyi fasor 8, H-6701, Szeged, POB 427, Hungary. agyferi@in1st.szote.u-szeged.hu
Telephone: +36-62-545189 Fax: +36-62-545185
Received: September 20, 2006 Revised: October 8, 2006 Accepted: October 25, 2006 Published online: January 14, 2007
Abstract
The early hypersensitivity reaction and late bone marrow depression are well-known side-effects of azathioprine, whereas interstitial pneumonia is a rare complication. A 40-year old male patient had been treated with azathioprine in consequence of extensive ulcerative colitis for 10 years. He then complained of 7 d of fever, cough and catarrhal signs, without symptoms of active colitis. Opportunistic infections were ruled out. The chest X-ray, CT and lung biopsy demonstrated the presence of interstitial inflammation. Azathioprine therapy was discontinued as a potential source of the pulmonary infiltrate. In response to steroid therapy, and intensive care, the pulmonary infiltrate gradually decreased within 4 wk. Three months later, his ulcerative colitis relapsed, and ileo-anal pouch surgery was performed. In cases of atypical pneumonia, without a proven infection, azathioprine-associated interstitial pneumonitis may be present, which heals after withdrawal of the drug.
