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

Takahiro Arisaka; Mimari Kanazawa; Keiichi Tominaga; Fumiaki Takahashi; Kazuhiro Takenaka; Takeshi Sugaya; Osamu Arisaka; Atsushi Irisawa; Hideyuki Hiraishi

doi:10.2169/internalmedicine.1639-18

CASE REPORTS

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

Takahiro Arisaka, Mimari Kanazawa, Keiichi Tominaga, Fumiaki Takahashi, Kazuhiro Takenaka, Takeshi Sugaya, Osamu Arisaka, Atsushi Irisawa, Hideyuki Hiraishi

Author information

Takahiro Arisaka
Department of Gastroenterology, Dokkyo Medical University, Japan
Mimari Kanazawa
Department of Gastroenterology, Dokkyo Medical University, Japan
Keiichi Tominaga
Department of Gastroenterology, Dokkyo Medical University, Japan
Fumiaki Takahashi
Department of Gastroenterology, Dokkyo Medical University, Japan
Kazuhiro Takenaka
Department of Gastroenterology, Dokkyo Medical University, Japan
Takeshi Sugaya
Department of Gastroenterology, Dokkyo Medical University, Japan
Osamu Arisaka
Department of Pediatrics, Nasu Red Cross Hospital, Japan
Atsushi Irisawa
Department of Gastroenterology, Dokkyo Medical University, Japan
Hideyuki Hiraishi
Department of Gastroenterology, Dokkyo Medical University, Japan

Keywords: ulcerative colitis, prednisolone, drug allergy, hematemesis, drug lymphocyte stimulation test

JOURNAL OPEN ACCESS

2019 Volume 58 Issue 8 Pages 1093-1096

DOI https://doi.org/10.2169/internalmedicine.1639-18

Browse “Advance online publication” version

Details

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.

Corresponding author

Register with J-STAGE for free!