Hematemesis due to Drug Allergy to Oral Prednisolone in a Patient with Ulcerative Colitis.

Abstract

The patient was diagnosed with ulcerative colitis and received remission induction therapy with prednisolone. While they developed muscle pain in the lower extremities after starting prednisolone, they ultimately achieved clinical remission. After discharge, hematemesis and gastric discomfort developed. Esophagogastroduodenoscopy showed mucosal edema, redness, and oozing bleeding in the gastric body. In addition, the patient had bloody stool and was considered to have a relapse of ulcerative colitis. They therefore received remission induction therapy with tacrolimus. The patient achieved clinical remission again; however, gastric discomfort and muscle pain remained. A drug lymphocyte stimulation test revealed positivity for prednisolone; therefore, the patient was diagnosed with an allergy to prednisolone.

• Authors: Takahiro Arisaka, Mimari Kanazawa, Keiichi Tominaga, Fumiaki Takahashi, Kazuhiro Takenaka, Takeshi Sugaya, Osamu Arisaka, Atsushi Irisawa, Hideyuki Hiraishi
• Journal: Internal medicine (Tokyo, Japan) (Intern Med) Vol. 58 Issue 8 Pg. 1093-1096 (Apr 15 2019) ISSN: 1349-7235 [Electronic] Japan
• PMID: 30568137 (Publication Type: Case Reports, Journal Article)

Chemical References

• Anti-Inflammatory Agents
• Mesalamine
• Prednisolone
• Tacrolimus

Topics

• Administration, Oral
• Adult
• Anti-Inflammatory Agents (adverse effects, therapeutic use)
• Colitis, Ulcerative (drug therapy)
• Drug Hypersensitivity (physiopathology)
• Hematemesis (chemically induced)
• Humans
• Male
• Mesalamine (therapeutic use)
• Prednisolone (adverse effects, therapeutic use)
• Remission Induction
• Tacrolimus (therapeutic use)
• Treatment Outcome