Intest Res  
Drug-induced eosinophilic pneumonia in a patient with Crohn’s disease: diagnosis and treatment using fraction of exhaled nitric oxide
Jina Yeo, Hyun Sun Woo, Sang Min Lee, Yoon Jae Kim, Kwang An Kwon, Dong Kyun Park, Jung Ho Kim, Kyoung Oh Kim, Jun-Won Chung
Department of Internal Medicine, Gachon University Gil Medical Center, Incheon, Korea
Correspondence to: Jun-Won Chung, Division of Gastroenterology, Department of Internal Medicine, Gachon University Gil Medical Center, 21 Namdong-daero 774 beon-gil, Nandong-gu, Incheon 21565, Korea. Tel: +82-32-460-3778, Fax: +82-32-460-3408, E-mail: junwonchung@hanmail.net
Received: August 4, 2016; Revised: November 6, 2016; Accepted: November 21, 2016; Published online: February 27, 2017.
© Korean Association for the Study of Intestinal Diseases. All rights reserved.

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
Oral 5-aminosalicylic acid agents (mesalazine and sulfasalazine) and azathioprine are the mainstays of treatment for inflammatory bowel disease. Reports of pulmonary toxicity induced by oral 5-aminosalicylic acid agents or azathioprine in patients with inflammatory bowel disease are very rare; to date, only 38 cases have been reported worldwide. We, herein, report a case involving a 26-year-old man who was diagnosed with eosinophilic pneumonia after using mesalazine and azathioprine for the treatment of Crohn’s disease and recovered after treatment. We also found that the fraction of exhaled nitric oxide level was elevated in this patient. After treatment, the fraction of exhaled nitric oxide level decreased and the symptoms improved. The present case shows that fraction of exhaled nitric oxide is related to the disease activity and treatment effectiveness of drug-induced eosinophilic pneumonia.
Keywords: Pulmonary eosinophilia; Mesalamine; Azathioprine; Crohn disease; Nitric oxide


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