Crohn's disease with pulmonary manifestations in children: 2 case reports and review of the literature

Vadlamudi, Narendra B.; Navaneethan, Udayakumar; Thame, Kirk A.; Kelly, David R.; Dimmitt, Reed A.; Harris, William T.

doi:10.1016/j.crohns.2012.05.007

Cited by 16 publications

(22 citation statements)

References 36 publications

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“…The incidence of symptomatic bronchopulmonary involvement in children suffering from IBD seems to be much lower than in adults [ 13 ]. The spectrum of lung pathologies is quite similar, and available reports comprise nodules consisting of non-caseating granulomas [ 36 , 51 ], cavitating lesions [ 82 ], pleuritis [ 82 ], lymphocytic infiltrations [ 15 ] and organizing pneumonia (OP) in patients with CD [ 51 ] and UC [ 72 ].…”

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%

“…Exudative pleuritis, usually eosinophilic, may accompany other lung pathologies [ 64 , 82 , 85 – 89 ]. Exudative pericarditis with possible life-threatening tamponade may also be present in these patients [ 87 – 89 ].…”

Section: Other Forms Of Respiratory Involvementmentioning

confidence: 99%

Pulmonary manifestations of inflammatory bowel disease

Majewski¹,

Piotrowski²

2015

aoms

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“…In children with IBD, pulmonary involvement is generally much more uncommon than in adults and has been more frequently described in CD . Bronchiectasis has been described in up to 66% of IBD adults with airway disease, whereas chronic bronchitis and suppurative large airway disease without airway dilation represent less common manifestations .…”

Section: Bronchiectasis and Coexisting Ibd In Childrenmentioning

confidence: 99%

Paediatric and adult bronchiectasis: Specific management with coexisting asthma, COPD, rheumatological disease and inflammatory bowel disease

2019

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Bronchiectasis, conventionally defined as irreversible dilatation of the bronchial tree, is generally suspected on a clinical basis and confirmed by means of chest high-resolution computed tomography. Clinical manifestations, including chronic productive cough and endobronchial suppuration with persistent chest infection and inflammation, may deeply affect quality of life, both in children/adolescents and adults. Despite many cases being idiopathic or post-infectious, a number of specific aetiologies have been traditionally associated with bronchiectasis, such as cystic fibrosis (CF), primary ciliary dyskinesia or immunodeficiencies. Nevertheless, bronchiectasis may also develop in patients with bronchial asthma; chronic obstructive pulmonary disease; and, less commonly, rheumatological disorders and inflammatory bowel diseases. Available literature on the development of bronchiectasis in these conditions and on its management is limited, particularly in children. However, bronchiectasis may complicate the clinical course of the underlying condition at any age, and appropriate management requires an integration of multiple skills in a team of complementary experts to provide the most appropriate care to affected children and adolescents. The present review aims at summarizing the current knowledge and available evidence on the management of bronchiectasis in the other conditions mentioned and focuses on the new therapeutic strategies that are emerging as promising tools for improving patients' quality of life.

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“…Pulmonary involvement in CD is well described, and though it is rarely reported in pediatric patients, it may be more common than previously reported [ 4 ]. Pulmonary CD can be latent or symptomatic, with symptoms manifesting before, during or after the diagnosis of CD.…”

Section: Introductionmentioning

confidence: 99%

Pulmonary Crohn's Disease in Down Syndrome: A Link or Linkage Problem

Thaver

Beg

2016

Case Rep Gastroenterol

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Crohn’s disease (CD) is an autoimmune inflammatory disorder that primarily affects the gastrointestinal tract. It may have pulmonary involvement, which has been rarely reported in pediatric patients. Down syndrome (DS) has been associated with increased frequency of autoimmune diseases. However, associations between CD and DS have been rarely reported. We present the case of a 5-year-old girl with known DS and a history of chronic intermittent abdominal pain who presented with persistent pneumonia. Her workup included a chest computed tomography (CT) scan that showed multiple noncalcified pulmonary nodules. An extensive infectious workup was done that was negative. CT-guided needle biopsy of the lung nodules showed necrotizing granulomas. This raised concern for primary CD with extraintestinal pulmonary manifestation. An esophagogastroduodenoscopy and colonoscopy were performed, and colon biopsies showed scattered epithelioid granulomas. Based on this information, there was consensus that her lung nodules were secondary to CD. She was started on standard therapy for CD, and her abdominal and respiratory symptoms gradually improved. However, she continues to have mild residual lung calcification and fibrosis. To our knowledge, this is the first reported case of pulmonary CD in a child with DS. The natural history of pulmonary CD in the pediatric population is not very well studied. Furthermore, since DS has been well known to be associated with increased frequency of malignancies and autoimmune conditions due to immune dysregulation, it is difficult to predict the severity and possible complications in this patient.

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Crohn's disease with pulmonary manifestations in children: 2 case reports and review of the literature

Cited by 16 publications

References 36 publications

Pulmonary manifestations of inflammatory bowel disease

Pulmonary manifestations of inflammatory bowel disease

Paediatric and adult bronchiectasis: Specific management with coexisting asthma, COPD, rheumatological disease and inflammatory bowel disease

Pulmonary Crohn's Disease in Down Syndrome: A Link or Linkage Problem

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