Hideto Nakao

Mesalazine-Induced Eosinophilic Pneumonia

A 35-year-old woman with a 6-month history of ulcerative colitis and treatment with oral mesalazine (5-aminosalicylic acid) developed dry cough, low-grade fever and bilaterally wandering pulmonary infiltrates. Improvement in clinical symptoms and radiological abnormalities occured spontaneously after discontinuation of mesalazine. The transbronchial lung biopsy demonstrated the organizing stage of eosinophilic pneumonia. Drug lymphocyte stimulation test was positive for mesalazine and negative for sulfasalazine and sulfapyridine. The present case indicates that although mesalazine-induced eosinophilic pneumonia is an extremely rare entity, its possibility should be fully considered in patients developing unexplained respiratory symptoms while on mesalazine therapy.

Cytokine regulation of HLA on thyroid epithelial cells

The regulation of class I and class II HLA expression in human thyroid follicular cells was studied in vitro. Tumour necrosis factor‐alpha (TNF‐α) enhanced the expression of class I antigen on thyrocytes, but these cytokines had little effect on the expression of class II antigen. Interleukin‐lβ (IL‐ lβ) and interleukin‐6(IL‐6) did not affect class I and class II antigen expression. The combination of interferon‐gamma (IFN‐γ) with TNF‐α or IL‐1β enhanced the induction of class I and class II antigens, compared with the effect of IFN‐β alone. Neither class I nor class II expression was induced by lL‐6 alone or in combination with IFN‐γ. These findings suggest that TNF‐α and IL‐1β may have an important role in inappropriate expression of HLA antigens on thyrocytes in thyroid gland.