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Subsequently, he presented with mucocutaneous jaundice, prompting a comprehensive evaluation, including a liver biopsy, the results of which suggested drug-induced hepatotoxicity, with mesalazine identified as the most likely cause. The temporal sequence, hepatic histopathological findings and respiratory improvement following mesalazine withdrawal and corticosteroid therapy supported the diagnosis of pulmonary toxicity without the need for additional invasive tests. This case, together with a review of the literature on mesalazine toxicity, suggests that drug-induced lung and hepatotoxicity may be more common than previously thought, emphasising the need to consider these conditions in extraintestinal manifestations of inflammatory bowel disease.<\/jats:p>","DOI":"10.1136\/bcr-2025-266199","type":"journal-article","created":{"date-parts":[[2025,7,1]],"date-time":"2025-07-01T21:30:22Z","timestamp":1751405422000},"page":"e266199","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["Concurrent interstitial pneumonia and acute hepatitis induced by mesalazine"],"prefix":"10.1136","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-1105-5077","authenticated-orcid":false,"given":"Daniel","family":"Wang","sequence":"first","affiliation":[{"name":"Clinical Pharmacology, Hospital Vall d\u2019Hebron, Barcelona, Spain"},{"name":"Clinical Pharmacology, Hospital del Mar, Hospital del Mar Research Institute, Barcelona, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dolores","family":"Vela Serrano","sequence":"additional","affiliation":[{"name":"Internal Medicine, Hospital Vall d\u2019Hebron, Barcelona, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9609-0394","authenticated-orcid":false,"given":"Lina","family":"Camacho-Arteaga","sequence":"additional","affiliation":[{"name":"Clinical Pharmacology, Hospital Vall d\u2019Hebron, Barcelona, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2025,7,1]]},"reference":[{"key":"2025082709235102000_18.7.e266199.1","doi-asserted-by":"crossref","first-page":"302","DOI":"10.1016\/j.gastrohep.2014.09.002","article-title":"Hepatitis aguda secundaria a mesalazina","volume":"38","author":"Dom\u00ednguez Jim\u00e9nez","year":"2015","journal-title":"Gastroenterolog\u00eda y Hepatolog\u00eda"},{"key":"2025082709235102000_18.7.e266199.2","doi-asserted-by":"publisher","DOI":"10.1136\/gut.44.6.886"},{"key":"2025082709235102000_18.7.e266199.3","first-page":"55","article-title":"Neumonitis intersticial por mesalazina en paciente con colitis ulcerosa","volume":"40","author":"Prado Mel","year":"2016","journal-title":"Farm Hosp"},{"key":"2025082709235102000_18.7.e266199.4","doi-asserted-by":"publisher","DOI":"10.1016\/S0168-8278(97)80061-X"},{"key":"2025082709235102000_18.7.e266199.5","unstructured":"Katsenos S , Psathakis K , Kokkonouzis I , et al . Drug-induced pulmonary toxicity in a patient treated with mesalazine and azathioprine for ulcerative colitis. 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Revisi\u00f3n Diagn\u00f3stico diferencial de las hepatitis agudas."},{"key":"2025082709235102000_18.7.e266199.11","unstructured":"LiverTox . 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