Complications of Immunomodulator and Mesalazine Therapy in Crohn’s Disease

Abstract

As a chronic granulomatous disease, Crohn’s disease (CD) poses a significant insinuation on morbidity and low quality of life. In order to control the disease activity, long term treatment is needed. Observation and evaluation of disease activity are principal practice in treating CD that sometimes clinicians tend to overlook the adverse effect of therapy that may occur and resemble disease progression.

Hereby we presented a 76-year-old female with a-10-year-history of Crohn’s disease who came to our emergency room with general weakness one week prior to admission. She complained hematochezia and abdominal pain in the last 1 month. She had been taking mesalazine 2 x 500 mg PO and azathioprine 2 x 50 mg PO in the last 3 years. She was diagnosed with lung cancer 6 months before admission and had been prescribed erlotinib 1 x 150 mg PO in the last 6 weeks. Upon admission, pancytopenia was found from the blood study. Hematochezia along with anemia and abdominal pain might occur due to either disease activity or the adverse effects of the medication.

Thorough observation and clinical evaluation regarding disease activity and side effects are required in the comprehensive management of Crohn’s disease.