{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T01:37:40Z","timestamp":1787017060963,"version":"build-2736575974"},"reference-count":8,"publisher":"BMJ","issue":"4","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2021,3,21]]},"published-print":{"date-parts":[[2021,4]]},"abstract":"<jats:p>Ulcerative colitis often develops in the reproductive age women and can cause exacerbation by pregnancy. Mesalazine (5-aminosalicylic acid) is recommended as a safe anti-inflammatory drug during pregnancy. However, maternal mesalazine is transferred to the fetus through the placenta and may cause allergic events. A pregnant woman with severe ulcerative colitis was treated with a dose of mesalazine 4,000 mg\/day from early gestation to delivery. Immediately after birth, the preterm neonate vomited bloody contents and discharged massive gross haematochezia. Serum concentrations of mesalazine and its main metabolite were high in the mother and the umbilical cord. Faecal eosinophils and drug-induced lymphocyte stimulation test suggested possibility that sensitisation with mesalazine in utero caused allergic enterocolitis like food protein-induced allergic proctocolitis. Maternal mesalazine has a potential of fetal sensitisation and cause allergic disease.<\/jats:p>","DOI":"10.1136\/bcr-2020-238743","type":"journal-article","created":{"date-parts":[[2021,4,15]],"date-time":"2021-04-15T13:03:57Z","timestamp":1618491837000},"page":"e238743","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":3,"title":["Maternal mesalazine-induced neonatal gastrointestinal bleeding"],"prefix":"10.1136","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2519-1360","authenticated-orcid":false,"given":"Kohichiroh","family":"Nii","sequence":"first","affiliation":[{"name":"Department of Neonatology, Shikoku Medical Center for Children and Adults, Zentsuji, Kagawa, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kaoru","family":"Okazaki","sequence":"additional","affiliation":[{"name":"Division of Neonatology, Tokyo Metropolitan Children's Medical Center, Fuchu, Tokyo, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hitoshi","family":"Okada","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Kagawa University, Miki-cho, kitagun, Kagawa, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Toru","family":"Kuboi","sequence":"additional","affiliation":[{"name":"Department of Neonatology, Shikoku Medical Center for Children and Adults, Zentsuji, Kagawa, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2021,4,15]]},"reference":[{"key":"2025082701181625000_14.4.e238743.1","doi-asserted-by":"crossref","first-page":"1597","DOI":"10.1111\/apt.14688","article-title":"Systematic review: safety of mesalazine in ulcerative colitis","volume":"47","author":"Sehgal","year":"2018","journal-title":"Aliment Pharmacol Ther"},{"key":"2025082701181625000_14.4.e238743.2","doi-asserted-by":"crossref","first-page":"811","DOI":"10.1016\/j.crohns.2012.04.009","article-title":"Management of inflammatory bowel disease in pregnancy","volume":"6","author":"Vermeire","year":"2012","journal-title":"Journal of Crohn's and Colitis"},{"key":"2025082701181625000_14.4.e238743.3","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(94)92009-5"},{"key":"2025082701181625000_14.4.e238743.4","doi-asserted-by":"crossref","first-page":"433","DOI":"10.3109\/00016348709022049","article-title":"Salazosulfapyridine and metabolites in fetal and maternal body fluids with special reference to 5-aminosalicylic acid","volume":"66","author":"Ambrosius Christensen","year":"1987","journal-title":"Acta Obstet Gynecol Scand"},{"key":"2025082701181625000_14.4.e238743.5","doi-asserted-by":"crossref","first-page":"618","DOI":"10.1016\/0140-6736(93)91443-P","article-title":"Negligible excretion of 5-aminosalycylic acid in breast milk","volume":"346","author":"Klotz","year":"1993","journal-title":"Lancet"},{"key":"2025082701181625000_14.4.e238743.6","doi-asserted-by":"crossref","first-page":"273","DOI":"10.5217\/ir.2018.16.2.273","article-title":"Evaluation of the drug-induced lymphocyte stimulation test for diagnosing mesalazine allergy","volume":"16","author":"Saito","year":"2018","journal-title":"Intest Res"},{"key":"2025082701181625000_14.4.e238743.7","doi-asserted-by":"crossref","first-page":"394","DOI":"10.1111\/pai.12408","article-title":"Does allergy begin in utero?","volume":"26","author":"Lockett","year":"2015","journal-title":"Pediatr Allergy Immunol"},{"key":"2025082701181625000_14.4.e238743.8","doi-asserted-by":"crossref","DOI":"10.1186\/s13256-017-1318-z","article-title":"Hematochezia caused by eosinophilic proctocolitis in a newborn before oral feeding: a case report","volume":"11","author":"Debuf","year":"2017","journal-title":"J Med Case Rep"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2020-238743","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T08:18:22Z","timestamp":1756282702000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2020-238743"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,4]]},"references-count":8,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2021,4,15]]},"published-print":{"date-parts":[[2021,4]]}},"alternative-id":["10.1136\/bcr-2020-238743"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2020-238743","relation":{},"ISSN":["1757-790X"],"issn-type":[{"value":"1757-790X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,4]]}}}