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Severe skeletal muscle damage following the administration of mesalazine to a patient with ulcerative colitis

Mesalazine, also known as 5-aminosalicylic acid (5-ASA), is an anti-inflammatory drug used to treat ulcerative colitis. The main adverse effects commonly observed during 5-ASA treatment include diarrhea, nausea, vomiting, abdominal pain, exacerbation of symptoms of inflammatory bowel disease, headache, and hypersensitivity reactions. Some patients develop serious sideeffects such as acute pancreatitis, hepatitis, nephrotic syndrome, allergic lung reactions, or allergic myocarditis. To our knowledge, however, skeletal muscle damage caused by 5-ASA has not been described in the literature. Herein we report an unusual case of severe skeletal muscle damage during administration of 5-ASA for ulcerative colitis. The specific pathogenesis of this muscle damage is unknown. Additionally a hypersensitive reaction to 5-ASA was also suggested.