ACUTE-PANCREATITIS SECONDARY TO 5-AMINOSALICYLIC ACID IN A CHILD WITH ULCERATIVE-COLITIS

Pancreatitis has long been recognized as an uncommon adverse reaction to sulfasalazine, one of the principal medications used in the treatment of inflammatory bowel disease. Sulfasalazine comprises 5-aminosalicylic acid linked by an azo bond to sulfapyridine. Recognition that the adverse ef-fects of sulfasalazine were most commonly caused by the sulfa, rather than the anti-inflammatory moiety, 5-AS A, prompted the development of alternative systems to deliver 5-ASA to the site of intestinal inflammation. Although both clinical experience and scientific studies appear to indicate that side effects are fewer with these preparations, there are now several published reports of pancreatitis in adult patients taking the more recently developed 5-ASA preparations for management of inflamma-tory bowel disease. We report a case of pancreatitis secondary to 5-ASA in a child with ulcerative colitis, and review the literature documenting previous cases. © 1993 Raven Press, Ltd., New York.