CHOLESTASIS ASSOCIATED WITH MESALAZINE THERAPY IN A PATIENT WITH CROHNS-DISEASE

Background/Aims: Mesalazine is a widely prescribed medication, develop ed as an alternative to sulfasalazine in the treatment of inflammatory bowel disease. In contrast to sulfasalazine, there are only a few cas e reports on its causing hepatic injury. We here report on a patient w ith cholestasis after mesalazine therapy for Crohn's disease of the il eum. Methods/Results: The patient, a 30-year-old man, developed clinic al signs of severe hepatic injury 4 months after treatment with mesala zine (4 g/day) including biopsy-proven hepatocellular cholestasis with minimal focal mononuclear inflammatory infiltration. Contrary to prev ious reports, no symptoms of generalized hypersensitivity were seen. T he patient's illness was resolved by discontinuing the mesalazine trea tment and he recovered completely in 40 days. Conclusions: This case r einforces the possibility of a causal relationship between mesalazine treatment and toxic hepatic injury without systemic hypersensitivity.