Case Report
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World J Gastroenterol. Feb 21, 2013; 19(7): 1147-1149
Published online Feb 21, 2013. doi: 10.3748/wjg.v19.i7.1147
Isolated fever induced by mesalamine treatment
Rita Slim, Joseph Amara, Roy Nasnas, Khalil Honein, Joseph Bou Jaoude, Cesar Yaghi, Fady Daniel, Raymond Sayegh
Rita Slim, Joseph Amara, Khalil Honein, Joseph Bou Jaoude, Cesar Yaghi, Fady Daniel, Raymond Sayegh, Department of Gastroenterology, Hotel Dieu de France University Hospital, Saint Joseph University, Beirut 94010, Lebanon
Roy Nasnas, Department of Infectious Diseases, Hotel Dieu de France University Hospital, Saint Joseph University, Beirut 94010, Lebanon
Author contributions: Slim R and Amara J designed the paper; Nasnas R, Honein K, Jaoude JB, Yaghi C, Daniel F and Sayegh R revised the paper.
Correspondence to: Rita Slim, MD, Department of Gastroenterology, Hotel Dieu de France University Hospital, Saint Joseph University, Beirut 94010, Lebanon. rslimkaram@hotmail.com
Telephone: +961-1-615300 Fax: +961-1-615300
Received: September 23, 2012
Revised: December 17, 2012
Accepted: December 22, 2012
Published online: February 21, 2013
Processing time: 151 Days and 11.4 Hours
Abstract

Adverse reactions to mesalamine, a treatment used to induce and maintain remission in inflammatory bowel diseases, particularly ulcerative colitis, have been described in the literature as case reports. This case illustrates an unusual adverse reaction. Our patient developed an isolated fever of unexplained etiology, which was found to be related to mesalamine treatment. A 22-year-old patient diagnosed with ulcerative colitis developed a fever with rigors and anorexia 10 d after starting oral mesalamine while his colitis was clinically resolving. Testing revealed no infection. A mesalamine-induced fever was considered, and treatment was stopped, which led to spontaneous resolution of the fever. The diagnosis was confirmed by reintroducing the mesalamine. One year later, this side effect was noticed again in the same patient after he was administered topical mesalamine. This reaction to mesalamine seems to be idiosyncratic, and the mechanism that induces fever remains unclear. Fever encountered in the course of a mesalamine treatment in ulcerative colitis must be considered a mesalamine-induced fever when it cannot be explained by the disease activity, an associated extraintestinal manifestation, or an infectious etiology.

Keywords: Mesalamine; 5-aminosalicylic acid; Side effects; Adverse reactions; Fever