Tuberculosis and Respiratory Diseases

The Korean Academy of Tuberculosis and Respiratory Diseases (대한결핵및호흡기학회)
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A Case of Balsalazide-Induced Limited Form of Granulomatosis with Polyangiitis with Bronchiolitis Obliterans Organizing Pneumonia-like Variant in Ulcerative Colitis

  • Kang, Shin-Myung (Department of Pulmonary and Critical Care Medicine, Gachon University Gil Hospital) ;
  • Jang, Young-Rock (Department of Pulmonary and Critical Care Medicine, Gachon University Gil Hospital) ;
  • Yoon, Hyun-Hwa (Department of Pulmonary and Critical Care Medicine, Gachon University Gil Hospital) ;
  • Kim, Su-Ji (Department of Pulmonary and Critical Care Medicine, Gachon University Gil Hospital) ;
  • Kim, Eun-Young (Department of Radiology, Gachon University Gil Hospital) ;
  • Ha, Seung-Yeon (Department of Pathology, Gachon University Gil Hospital) ;
  • Park, Jeong-Woong (Department of Pulmonary and Critical Care Medicine, Gachon University Gil Hospital)
  • Received : 2012.01.09
  • Accepted : 2012.01.27
  • Published : 2012.03.30
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Abstract

5-Aminosalicylate agents are the main therapeutic agents for ulcerative colitis. Balsalazide is a prodrug of 5-aminosalicylate and has fewer side effects than the other 5-aminosalicylate agents. Pulmonary complications resembling granulomatosis with polyangiitis in ulcerative colitis are extremely rare. Here, we report a patient with ulcerative colitis on balsalazide presenting respiratory symptoms and multiple pulmonary nodules from a chest radiography that was pathologically diagnosed with a limited form of granulomatosis with polyangiitis with bronchiolitis obliterans organizing pneumonia-like variant. To our knowledge, this is the first report of a balsalazide-induced limited form of granulomatosis with polyangiitis with bronchiolitis obliterans organizing pneumonia-like variant.

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References

  1. Wiggins JB, Rajapakse R. Balsalazide: a novel 5-aminosalicylate prodrug for the treatment of active ulcerative colitis. Expert Opin Drug Metab Toxicol 2009;5:1279-84.
  2. Tursi A. Balsalazide in treating colonic diseases. Expert Opin Drug Metab Toxicol 2009;5:1555-63.
  3. Muzzi A, Ciani F, Bianchini D, Festini G, Volpe C. Adverse pulmonary effects of mesalamine. Chest 1995; 108:1181.
  4. Park JE, Hwangbo Y, Chang R, Chang YW, Jang JY, Kim BH, et al. Mesalazine-induced eosinophilic pneumonia in a patient with Crohn's disease. Korean J Gastroenterol 2009;53:116-20.
  5. Tanigawa K, Sugiyama K, Matsuyama H, Nakao H, Kohno K, Komuro Y, et al. Mesalazine-induced eosinophilic pneumonia. Respiration 1999;66:69-72.
  6. Bitton A, Peppercorn MA, Hanrahan JP, Upton MP. Mesalamine-induced lung toxicity. Am J Gastroenterol 1996;91:1039-40.
  7. Foster RA, Zander DS, Mergo PJ, Valentine JF. Mesalamine- related lung disease: clinical, radiographic, and pathologic manifestations. Inflamm Bowel Dis 2003;9: 308-15.
  8. Camus P, Piard F, Ashcroft T, Gal AA, Colby TV. The lung in inflammatory bowel disease. Medicine (Baltimore) 1993;72:151-83.
  9. Yano S, Kobayashi K, Kato K, Nishimura K. A limited form of Wegener's granulomatosis with bronchiolitis obliterans organizing pneumonitis-like variant in an ulcerative colitis patient. Intern Med 2002;41:1013-5.
  10. Kasuga A, Mandai Y, Katsuno T, Sato T, Yamaguchi T, Yokosuka O. Pulmonary complications resembling Wegener's granulomatosis in ulcerative colitis with elevated proteinase-3 anti-neutrophil cytoplasmic antibody. Intern Med 2008;47:1211-4.
  11. Salerno SM, Ormseth EJ, Roth BJ, Meyer CA, Christensen ED, Dillard TA. Sulfasalazine pulmonary toxicity in ulcerative colitis mimicking clinical features of Wegener's granulomatosis. Chest 1996;110:556-9.
  12. Stebbing J, Askin F, Fishman E, Stone J. Pulmonary manifestations of ulcerative colitis mimicking Wegener's granulomatosis. J Rheumatol 1999;26:1617-21.
  13. Meyer KC, Raghu G. Bronchoalveolar lavage for the evaluation of interstitial lung disease: is it clinically useful? Eur Respir J 2011;38:761-9.
  14. Khan A, Lawson CA, Quinn MA, Isdale AH, Green MJ. Successful treatment of ANCA-negative Wegener's granulomatosis with rituximab. Int J Rheumatol 2010; 2010:846063.

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  1. Balsalazide : Granulomatosis with polyangiitis with BOOP-like variant: case report vol.1431, pp.1, 2012, https://doi.org/10.1007/s40278-012-0032-2
  2. Febrile pleuropericarditis, a potentially life-threatening adverse event of balsalazide - case report and literature review of the side effects of 5-aminosalicylates vol.10, pp.5, 2014, https://doi.org/10.1586/1744666x.2014.902313
  3. Extracorporeal membrane oxygenation rescue in adolescent with bronchiolitis obliterans‐organizing pneumonia like Wegener's granulomatosis vol.5, pp.1, 2017, https://doi.org/10.1002/ccr3.752