, Volume 58, Issue 8, pp 2148-2150
Date: 30 Jan 2013

5-ASA Induced Recurrent Myopericarditis and Cardiac Tamponade in a Patient with Ulcerative Colitis

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Case Presentation and Evolution

A 20-year-old woman with recently diagnosed moderate left-sided ulcerative colitis (UC) presented to the emergency department (ED) for chest pain. Two months earlier, she had been evaluated in gastroenterology clinic for bloody diarrhea and crampy left lower quadrant abdominal pain. Stool tests for infectious causes were negative. Colonoscopy demonstrated diffuse mucosal erythema, linear ulcerations, and friability that extended continuously from the rectum to the descending colon (Fig. 1), histologically reported as acute and chronic colitis with crypt architectural distortion, consistent with inflammatory bowel disease. No granulomas or viral inclusion bodies were seen. Institution of sulfasalazine 500 mg four times daily and mesalamine enemas significantly improved her symptoms.Fig. 1

Colonoscopy at time of diagnosis of ulcerative colitis. Images of the patient’s colonoscopy from the indicated regions of the colon demonstrate diffuse mucosal erythema, l