Atypical Lung Changes in a 19-Year-Old Woman with Crohn’s Disease

Piotrowski, Wojciech J.; Zieliński, Krzysztof; Kozłowska, Alicja; Górski, Paweł

doi:10.1007/s00408-007-9005-2

Cited by 6 publications

(12 citation statements)

References 5 publications

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“…Similarly to tracheobronchial signs and symptoms, interstitial disease may precede the first symptoms of bowel disease by years [ 41 ], but most commonly it appears in patients with long-lasting IBD. In addition, interstitial disease signs and symptoms are not related to bowel disease activity and may be present in patients with inactive IBD [ 42 – 45 ]. The clinical course is not characteristic.…”

Section: Interstitial Lung Diseasementioning

confidence: 99%

“…General symptoms are frequently reported, and may include malaise, fever or sub-febrile state, loss of weight and arthralgias [ 42 , 47 , 48 ]. The general symptoms seem to be especially frequent in patients with organizing pneumonia (OP) [ 42 , 47 ] and resemble those described in the course of cryptogenic organizing pneumonia (COP) [ 49 ]. Respiratory symptoms include dry cough, breathlessness on exertion or at rest and chest tightness.…”

Section: Interstitial Lung Diseasementioning

confidence: 99%

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Pulmonary manifestations of inflammatory bowel disease

Majewski¹,

Piotrowski²

2015

aoms

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Bronchopulmonary signs and symptoms are examples of variable extraintestinal manifestations of the inflammatory bowel diseases (IBD). These complications of Crohn's disease (CD) and ulcerative colitis (UC) seem to be underrecognized by both pulmonary physicians and gastroenterologists. The objective of the present review was to gather and summarize information on this particular matter, on the basis of available up-to-date literature. Tracheobronchial involvement is the most prevalent respiratory presentation, whereas IBD-related interstitial lung disease is less frequent. Latent and asymptomatic pulmonary involvement is not unusual. Differential diagnosis should always consider infections (mainly tuberculosis) and drug-induced lung pathology. The common link between intestinal disease and lung pathology is unknown, but many hypotheses have been proposed. It is speculated that environmental pollution, common immunological mechanisms and predisposing genetic factors may play a role.

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Section: Interstitial Lung Diseasementioning

confidence: 99%

Section: Interstitial Lung Diseasementioning

confidence: 99%

Pulmonary manifestations of inflammatory bowel disease

Majewski¹,

Piotrowski²

2015

aoms

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“…In our patient, GGO was seen nine years from the initial diagnosis of the CD. Besides, the signs and symptoms are not related to bowel disease activity and may be present in patients with inactive CD [9]. Asymptomatic lung involvement is possible.…”

Section: Bowel or Lung -Which Comes First?mentioning

confidence: 99%

“…Metastatic lung disease becomes a differential if the lesions are coin-shaped and bigger. Subpleural nodes and small nodules may be seen, which may mimic primary lung tumors [9]. Small cavitations reflecting central necrosis may be present.…”

Section: Imaging Patternsmentioning

confidence: 99%

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Extraintestinal Manifestations of Crohn’s Disease in the Form of Pulmonary Nodules: A Case Report

Garg

Shrimanker

Goel

et al. 2020

Cureus

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Crohn's disease is a systemic illness with a plethora of extraintestinal manifestations affecting various organs, of which the lungs are relatively rare. Pulmonary involvement may include airway diseases, lung parenchymal diseases, pleural diseases, or drug-related diseases. Tracheobronchial involvement is the most common respiratory presentation, whereas Crohn's disease-related interstitial lung disease is seen less frequently. A 41-year-old woman with a past medical history of Crohn's disease (status-post subtotal colectomy) presented to the hospital for an enlarging ground-glass opacity in her right middle lobe detected on routine computed tomography of the abdomen six months earlier. The opacity had increased in size from 21 x 18 mm to 28 x 18 mm and another ground-glass opacity in the right lower lobe increased in size from 5 mm to 12.4 mm. A robotic right middle lobectomy with lymph node dissection was done and bronchoscopy showed benign nodular lymphoid hyperplasia and a single perivascular epithelioid granuloma. A year later, her relapsing episodes of cough and shortness of breath were managed with prednisone, 20 mg, for a probable pulmonary manifestation of Crohn's disease. A non-contrast computed tomography of the chest showed interval resolution of the right lower lobe ground-glass opacity. A year after that, she presented to the hospital with increasing cough, shortness of breath, and a new right lower lobe ground-glass opacity (14 x 14 mm) on non-contrast computed tomography of the chest and has been managed with steroids with consideration of immunosuppression. In conclusion, pulmonary manifestations of Crohn's disease present in a myriad of varieties and often present confounding diagnostic problems necessitating an extensive work-up. Thus, Crohn's disease should be kept in the differential list in case of unusual clinical symptoms and radiological signs of idiopathic pulmonary presentations. These infrequent, and sometimes life-threatening, extraintestinal manifestations need to be considered when dealing with Crohn's disease to avoid further impairment of health status and alleviate patient symptoms by prompt recognition and treatment.

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