Published online Sep 26, 2020. doi: 10.12998/wjcc.v8.i18.4162
Peer-review started: June 25, 2020
First decision: July 24, 2020
Revised: August 6, 2020
Accepted: August 29, 2020
Article in press: August 29, 2020
Published online: September 26, 2020
Processing time: 88 Days and 4.6 Hours
Lung and airway involvement in inflammatory bowel disease are increasingly frequently reported either as an extraintestinal manifestation or as an adverse effect of therapy.
We report a case of a patient with ulcerative colitis controlled under mesalazine treatment who presented with chronic cough and hemoptysis. Chest computed tomography and bronchoscopy findings supported tracheal involvement in ulcerative colitis; pathology examination demonstrated an unusual eosinophil-rich inflammatory pattern, and together with clinical data, a nonasthmatic eosinophilic bronchitis diagnosis was formulated. Full recovery was observed within days of mesalazine discontinuation.
Mesalazine-induced eosinophilic respiratory disorders have been previously reported, generally involving the lung parenchyma. To the best of our knowledge, this is the first report of mesalamine-induced eosinophilic involvement in the upper airway.
Core Tip: Respiratory involvement is sometimes reported in inflammatory bowel disease patients, either as extradigestive lesions or as therapy adverse effects. Mesalazine, a common therapeutic option in mild forms of ulcerative colitis, has been associated to eosinophilic respiratory and cardiovascular disorders. We report a patient exhibiting symptoms suggestive for nonasthmatic eosinophilic bronchitis. Available data supports the hypothesis of a previously unreported mesalazine adverse effect.