Therapy with a drug containing 5-aminosalicylic acid (5-ASA) can rarely result in pulmonary toxicity.



(1) Mesalazine or Mesalamine (trade name for 5-ASA)

(2) Sulphasalazine or Sulfasalzine (SASP = 5-ASA with bound sulfapyridine)


Common indication: inflammatory bowel disease (Crohn's disease or ulcerative colitis)


Lung pathology:

(1) eosinophilic pneumonia (with eosinophilia in the peripheral blood and broncho-alveolar lavage)

(2) interstitial pneumonia

(3) interstitial fibrosis


Clinical findings:

(1) onset of respiratory symptoms (low-grade fever, cough, pulmonary infiltrates on chest X-ray) after starting drug therapy

(2) reversal of respiratory symptoms after drug discontinuation over several weeks

(3) variable need for corticosteroids with severe airway inflammation


Differential diagnosis:

(1) infectious pneumonia

(2) pulmonary complications of the inflammatory bowel disease

(3) other forms of interstitial or eosinophilic pneumonia


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