Recurrent Mesalazine-Induced Myopericarditis in a Patient with Ulcerative Colitis

Inflammatory bowel disease (IBD) is considered as a dysregulated immune mediated disease. Pericarditis in IBD is a very rare disease both as an extra-intestinal manifestation of IBD and an adverse reaction of therapeutic drug for IBD such as mesalazine or sulfasalazine. A 26-year-old IBD male patient who had been taking mesalazine regularly for about 1 month was referred to our hospital because of fever, chest discomfort, and abnormal electrocardiographic findings. The patients was diagnosed as acute myopericarditis, and recovered after cessation of mesalazine using steroid and aspirin. When mesalazine was re-medicated some days after discharge, he suffered from myopericarditis again. Subsequently, myopericarditis was resolved just after cessation of mesalazine again. These findings suggest that the development of myopericarditis is caused by mesalazine.

A Case of Polyarteritis Nodosa That Presented as Hemobilia / 대한소화기내시경학회지

Hemobilia is defined as hemorrhage into the biliary tract, and the patients with hemobilia present with abdominal pain, jaundice and gastrointestinal bleeding. The causes of hemobilia are traumatic or operative injury to the liver or bile ducts, intraductal rupture of the hepatic abscess or aneurysm of the hepatic artery. Cholecystitis can also develop in patients with hemobilia. Polyarteritis nodosa (PAN) is a multisystem, necrotizing vasculitis of the small and medium-sized muscular arteries and patients with this illness may present with fever, sweats, weight loss, severe arthralgia and myalgia. Mesentery artery involvement that can result in gastrointestinal hemorrhage, bowel infarction and perforation is rare, yet very serious in patients with PAN. We report here on a rare case of PAN that presented as hemobilia due to rupture of a hepatic arterial aneurysm.