Mesalazine-induced eosinophilic variant of Wegener's granulomatosis in an ulcerative colitis patient.

A 24-year-old woman presented with two weeks history of progressive shortness of breath associated with sharp chest pain. She had been on mesalazine for two years for Ulcerative Colitis. Chest X-ray showed bilateral pulmonary infiltrates with left sided pleural effusion. Blood investigations revealed, positive pANCA, negative cANCA and peripheral eosinophillia. Video assisted thoracoscopic lung biopsy specimen was consistent with eosinophillic variant of Wegener's granulomatosis. She responded to combination of withdrawal of mesalazine and high dose steroids. To our knowledge this is the first reported case of mesalazine induced eosinophilic variant of Wegener's granulomatosis.