MESALAZINE AND ACUTE-RENAL-FAILURE

We report a young woman who had Crohn's disease with ileocolic involve ment. The patient was treated with mesalazine during a period of 8 mon ths, developing oliguric acute renal failure (urea 166 mg/dl, creatini ne 8,3 mg/dl), that required several hemodialysis sessions. Several we eks later after receiving an increase in the mesalazine dose the patie nt showed features of an interstitial nephritis, suggesting a toxic ef fect rather than a hypersensitivity reaction. The patient's progress w as adequate once the medication was eliminated, regaining diuresis and exhibiting a slow and progressive improvement of renal function. Thre e months later, serum creatinine, level was lower than 1 mg/dl, protei nuria was undetectable though it had reached 1.2 g per day, and microh ematuria had disappeared. At the same time as the acute renal failure occurred, she presented an intense pancytopenia with hypoplastic bone marrow, showing no signs of hemolysis. The patient was treated with gr anulocytic colony stimulating factor, transfusions and erythropoietin. Three months later as renal function recovered these hematological ch anges were normalized. Due to the wide use of mesalazine, we suggest t he need to make frequent checks on hematological and renal function in patients receiving this type of treatment.