What is the clinical evidence from this study?

Study design: Case Report. Population: Ulcerative colitis (n=1). Intervention: Mesalazine. Primary outcome: Clinical and radiological resolution of effusions.

What question did this study set out to answer?

This case aims to highlight the challenges in diagnosing mesalazine-induced pleuropericarditis, particularly when corticosteroids are involved.

April 20, 2026European Journal of Case Reports in Internal MedicineOpen Access

Recurrent pleuropericarditis associated with mesalazine therapy masked by steroid use

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Key result

Mesalazine withdrawal linked to complete resolution of recurrent pleuropericarditis masked by corticosteroids.

Why the study?

Mesalazine is generally safe for ulcerative colitis, but it can cause rare, life-threatening cardiopulmonary complications such as pleuropericarditis.

Design

Case report

Follow-up

Two years

Authors

HDHakan DemirözOndokuz Mayıs University HEHasan EruzunSamsun University HÇHandan Doğan ÇakmakOndokuz Mayıs University

Discussion

Member takes

Implication

Clinicians should consider mesalazine withdrawal in recurrent pleuropericarditis masked by steroids; this case leaves open confirmation in prospective studies.

Key Points

This case aims to highlight the challenges in diagnosing mesalazine-induced pleuropericarditis, particularly when corticosteroids are involved.
Reported a case of a UC patient showing respiratory distress and effusions due to mesalazine therapy, with corticosteroid usage masking symptoms.
Analyzed pericardial fluid showing atypical neutrophilic features instead of the expected eosinophilic profile.
Patient initially misdiagnosed; discontinuation of mesalazine led to rapid clinical improvement.
Culture tests of pericardial fluid were negative, indicating drug-induced etiology rather than infection.

Study Design

Type

Case Report (n=1)

Structured PICO

Population

1 patient with a ulcerative colitis flare presenting with dyspnoea, concurrent pericardial and pleural effusions, and later recurrent massive pericardial effusion causing tamponade physiology

Intervention

Mesalazine therapy (with concomitant corticosteroid therapy)

Outcome

Resolution of pleuropericarditis upon mesalazine discontinuationsafety

Mesalazine-induced pleuropericarditis can be masked by corticosteroids and present with atypical neutrophilic features mimicking bacterial infection.

Limitations

Single case report
Re-challenge with the suspected drug was not performed due to ethical concerns

Cite This Study

Demiröz et al. (2026) conducted a case report in Ulcerative colitis (n=1). Mesalazine was evaluated on Clinical and radiological resolution of effusions. Mesalazine withdrawal resulted in complete clinical and radiological resolution of recurrent pleuropericarditis that had been masked by corticosteroid therapy for two years.

synapsesocial.com/papers/6a0a1d0200274e073d45d923 https://doi.org/10.12890/2026_006544

Topics

Pericardial disease

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Implication

Clinicians should consider mesalazine withdrawal in recurrent pleuropericarditis masked by steroids; this case leaves open confirmation in prospective studies.

Recurrent pleuropericarditis associated with mesalazine therapy masked by steroid use

Discussion

Member takes

Implication

Key Points

Study Design

Structured PICO

Limitations

Cite This Study

Topics

Recurrent pleuropericarditis associated with mesalazine therapy masked by steroid use

Discussion

Member takes

Implication

Key Points

Study Design

Structured PICO

Limitations

Cite This Study

Also Consider

Topics

Also Consider