Background: Mesalazine is the first-line inflammatory bowel disease (IBD) treatment. However, it can cause fatal cardiotoxicity. We aimed to analyze the clinical characteristics of mesalazine-induced cardiotoxicity and provide evidence for clinical diagnosis, treatment, and prevention. Methods: We collected Chinese and English literature on mesalazine-induced cardiotoxicity from 1970 to 2021 for retrospective analysis. Results: A total of 52 patients (40 males and 12 females) were included, with a median age of 24.5 years (range 9-62) and a median onset time of 14 days (range 2-2880). Cardiotoxicity manifested as myocarditis, pericarditis, and cardiac pericarditis. The main clinical manifestations are chest pain (82.7%), fever (46.2%), and respiratory symptoms such as dyspnea and cough (40.4%). The levels of troponin T, creatine kinase, C-reactive protein, leukocyte count, erythrocyte sedimentation rate, and other biochemical markers were significantly increased. Cardiac imaging often suggests myocardial infarction, pericardial effusion, myocardial necrosis, and other symptoms of cardiac injury. It is essential to discontinue mesalamine immediately in patients with cardiotoxicity. Although corticosteroids are a standard treatment option, the benefits remain to be determined. Re-challenge of mesalamine should be carefully considered as cardiotoxic symptoms may reoccur. Conclusion: Mesalazine may cause cardiotoxicity in patients with inflammatory bowel disease, which should be comprehensively diagnosed based on clinical manifestations, biochemical indicators, and cardiac function imaging examinations. Mesalazine should be immediately discontinued, and corticosteroids may be an effective treatment for cardiotoxicity.

中文翻译：

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美沙拉秦致心脏毒性临床特征分析。

背景：美沙拉嗪是炎症性肠病 (IBD) 的一线治疗药物。但是，它会导致致命的心脏毒性。我们旨在分析美沙拉嗪所致心脏毒性的临床特征，为临床诊断、治疗和预防提供依据。方法：收集1970-2021年美沙拉秦致心脏毒性的中英文文献进行回顾性分析。结果：共纳入 52 名患者（40 名男性和 12 名女性），中位年龄为 24.5 岁（范围 9-62 岁），中位发病时间为 14 天（范围 2-2880）。心脏毒性表现为心肌炎、心包炎和心包炎。主要临床表现为胸痛（82.7%）、发热（46.2%）、呼吸困难、咳嗽等呼吸道症状（40.4%）。肌钙蛋白 T、肌酸激酶的水平，C反应蛋白、白细胞计数、血沉等生化指标明显升高。心脏影像学常提示心肌梗死、心包积液、心肌坏死和其他心脏损伤症状。有心脏毒性的患者必须立即停用美沙拉嗪。尽管皮质类固醇是标准的治疗选择，但其益处仍有待确定。应仔细考虑再次服用美沙拉嗪，因为可能会再次出现心脏毒性症状。结论：美沙拉嗪可能引起炎症性肠病患者的心脏毒性，应根据临床表现、生化指标、心功能影像学检查等综合诊断。应立即停用美沙拉嗪，