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Mesalazine blood dyscrasia monitoring — GPhC CRA MCQ

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HardGI TherapeuticsMesalazine blood dyscrasia monitoringGPhC CRA

A 36-year-old woman with ulcerative colitis takes mesalazine modified-release tablets. She reports new fever, sore throat and unexplained bruising. Her last blood tests were six months ago. What monitoring is required?

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Correct answer: E — Withhold mesalazine and arrange urgent FBC, renal tests and review

Fever, sore throat and unexplained bruising raise concern for a mesalazine-associated blood dyscrasia. SPS advises an urgent full blood count and immediate stopping when dyscrasia or toxicity is suspected; renal function also requires review because mesalazine can cause nephrotoxicity. Waiting for routine monitoring or simply reducing the dose could allow serious marrow toxicity to progress.

Reference: NHS SPS mesalazine monitoring: https://www.sps.nhs.uk/monitorings/mesalazine-monitoring/