Inflammatory bowel disease and the lung in paediatric patients

Jochmann, Anja; Trachsel, Daniel; Hammer, Jürg

doi:10.1183/20734735.0269-2020

Cited by 3 publications

(3 citation statements)

References 63 publications

(106 reference statements)

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“…If upper airway inflammation is refractory to steroid treatment, interventional bronchoscopy can be performed (i.e., laser beam, balloon dilatation or stent placement) [16]. Furthermore, when PM is noticed, the escalation of IBD therapy is recommended [188]. In bronchiectasis, rare in children, antibiotic regimes and bronchial toilet should be applied [16].…”

Section: Treatmentmentioning

confidence: 99%

Pathophysiological Concepts and Management of Pulmonary Manifestation of Pediatric Inflammatory Bowel Disease

Schmid

Chao

Däbritz

2022

IJMS

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Pulmonary manifestation (PM) of inflammatory bowel disease (IBD) in children is a rare condition. The exact pathogenesis is still unclear, but several explanatory concepts were postulated and several case reports in children were published. We performed a systematic Medline search between April 1976 and April 2022. Different pathophysiological concepts were identified, including the shared embryological origin, “miss-homing” of intestinal based neutrophils and T lymphocytes, inflammatory triggering via certain molecules (tripeptide proline-glycine-proline, interleukin 25), genetic factors and alterations in the microbiome. Most pediatric IBD patients with PM are asymptomatic, but can show alterations in pulmonary function tests and breathing tests. In children, the pulmonary parenchyma is more affected than the airways, leading histologically mainly to organizing pneumonia. Medication-associated lung injury has to be considered in pulmonary symptomatic pediatric IBD patients treated with certain agents (i.e., mesalamine, sulfasalazine or infliximab). Furthermore, the risk of pulmonary embolism is generally increased in pediatric IBD patients. The initial treatment of PM is based on corticosteroids, either inhaled for the larger airways or systemic for smaller airways and parenchymal disease. In summary, this review article summarizes the current knowledge about PM in pediatric IBD patients, focusing on pathophysiological and clinical aspects.

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Section: Treatmentmentioning

confidence: 99%

Pathophysiological Concepts and Management of Pulmonary Manifestation of Pediatric Inflammatory Bowel Disease

Schmid

Chao

Däbritz

2022

IJMS

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“…The common embryonic origin of both colonic and respiratory epithelia from the primitive foregut and the similarity of the mucosal immune system may be responsible for similar pathological changes. Thus an injury to the intestinal barrier due to the circulating immune complexes in IBD, may result in an entry of antigens that may induce both local and systemic inflammations [ 1 , 2 , 3 , 4 ]. There is a wide array of lung manifestations, ranging from subclinical alterations, via airway and parenchymal lung disease, to pleural and drug-related conditions [ 1 , 4 ].…”

Section: Introductionmentioning

confidence: 99%

“…Thus an injury to the intestinal barrier due to the circulating immune complexes in IBD, may result in an entry of antigens that may induce both local and systemic inflammations [ 1 , 2 , 3 , 4 ]. There is a wide array of lung manifestations, ranging from subclinical alterations, via airway and parenchymal lung disease, to pleural and drug-related conditions [ 1 , 4 ].…”

Section: Introductionmentioning

confidence: 99%

Pulmonary Function in Paediatric Patients with Inflammatory Bowel Disease

Bąk-Drabik

Malik²,

Gwoździewicz³

et al. 2022

JCM

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Background: Among the extraintestinal manifestations of inflammatory bowel disease (IBD), those involving the lungs are relatively rare and often overlooked. There are only scarce data on the prevalence of IBD-associated lung involvement in children. Objectives: The aim of our study was to assess pulmonary function in IBD children by different methods and to evaluate the influence of immunosuppressive therapy on disease severity. Methods: Seventy-two children with IBD (mean age of 14.45 ± 2.27 years) and 40 age-matched healthy controls (mean age of 14.17 ± 2.82) were included in the study. Pulmonary function tests (PFTs) were carried out by means of spirometry, oscillometry (IOS) and fractional exhaled nitric oxide (FeNO) to assess the pulmonary involvement. Results: Certain differences were observed between the study group and the control group, regarding the spirometric and oscillometry parameters. The fractions of exhaled nitric oxide did not differ between the group with IBD patients and the control group with regards to disease activity, the duration of illness and the administered immunosuppressive treatment. Conclusions: The mean spirometry results were significantly different in the study group compared to the controls, although they were still within the normal limits. The pulmonary function abnormalities did not depend on either the disease activity or the immunosuppressive therapy. Oscillometry could be a supplementary method to assess pulmonary resistance. In turn, FeNO does not appear to be useful either in screening IBD children for pulmonary involvement or for the evaluation of disease activity. It appears then that only general screening of asymptomatic patients is a suitable method and a necessary recommendation in this population, prompting a revision of the current diagnostic approach.

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Pulmonary Manifestations of IBD: Case Report and Review of the Literature

Herling,

Perluk,

Freund

et al. 2024

JCM

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This article explores the pulmonary complications associated with inflammatory bowel disease (IBD). It presents a detailed case study of a 22-year-old male with Crohn’s disease exhibiting pulmonary symptoms. The review delves into the spectrum of pulmonary involvement in IBD, covering clinical presentations, diagnostic challenges, underlying pathophysiology, and management strategies. It highlights the significance of these extraintestinal manifestations on patient outcomes and quality of life. The article underscores the need for heightened clinical awareness and a systematic approach to diagnosis and management, integrating the expertise of multiple specialists. The review identifies gaps in current research, suggesting avenues for future investigation to enhance the understanding and treatment of these complex manifestations.

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Inflammatory bowel disease and the lung in paediatric patients

Cited by 3 publications

References 63 publications

Pathophysiological Concepts and Management of Pulmonary Manifestation of Pediatric Inflammatory Bowel Disease

Pathophysiological Concepts and Management of Pulmonary Manifestation of Pediatric Inflammatory Bowel Disease

Pulmonary Function in Paediatric Patients with Inflammatory Bowel Disease

Pulmonary Manifestations of IBD: Case Report and Review of the Literature

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