Pneumothorax as a presenting feature of granulomatous disease of the lung in a patient with Crohnʼs disease

Smith, Paul A.; Crampton, J. R.; Pritchard, Sheila; Li, Cheng

doi:10.1097/meg.0b013e328304e0cc

Cited by 5 publications

(2 citation statements)

References 25 publications

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“…Good responses to steroids have been reported in all cases of pleuritis or pleuropericarditis. Pneumothorax is a rare complication, and was described in a patient suffering from CD-related granulomatous lung disease [ 90 ]. An air-leak syndrome (pneumothorax, pneumomediastinum and subcutaneous emphysema) associated with organizing pneumonia pattern was described as an unusual presentation of UC-related bronchopulmonary involvement [ 91 ].…”

Section: Other Forms Of Respiratory Involvementmentioning

confidence: 99%

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: Other Forms Of Respiratory Involvementmentioning

confidence: 99%

Pulmonary manifestations of inflammatory bowel disease

Majewski¹,

Piotrowski²

2015

aoms

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“…Such reports with sequential sarcoidosis–Crohn’s-associated forms are rare. This is the case of a pneumothorax arising from a peripheral parenchymal necrotic granulomatous lesion, in which simultaneous Crohn’s disease was identified by colonoscopy [ 38 ]. Montembault et al [ 39 ] also reported the case of a woman in whom the first episode of Crohn’s disease was accompanied by sarcoidosis.…”

Section: Discussionmentioning

confidence: 99%

Pulmonary Crohn’s Disease or Crohn’s Disease with Lung Sarcoidosis? A Case Report and Literature Review

et al. 2022

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Background: Crohn’s disease and ulcerative hemorrhagic colitis are forms of granulomatous inflammatory intestinal disease, which usually affects the gastrointestinal tract. There are also reported rare localizations at the skin, kidney, joints, liver and eye level. Pulmonary involvement is relatively rare, and it is most commonly reported in suppuration with bronchiectasis. On the other hand, sarcoidosis is, in principle, a thoracic localization of a granulomatosis disease, although bowel, skin and intestinal disorders are described. There is not a clear line to separate Crohn’s disease from sarcoidosis with, possibly because they are, in fact, considered to have the same inflammatory granulomatosis disease pathology. The diagnoses of the two entities, sarcoidosis and Crohn’s disease, are based on non-pathognomonic, inclusive clinical and paraclinical criteria, without elements of the mutual exclusion of typical locations. Case Report: We present a very rare case of a young male, already diagnosed with small-bowel Crohn’s disease. Granulomatous lung disease with major hemoptysis requires emergency surgery. An intraoperative assessment revealed a necrotic hemorrhagic lesion located in the left lower lobe and a lobectomy was performed. The final pathological report showed the presence of non-caseous granulomatous inflammation, with the identification of specific multinucleated giant cells. Conclusions: The identical diagnostic principles of Crohn’s disease and sarcoidosis, Crohn’s disease as a predecessor to pulmonary lesions, the clinical picture and the necrotico-hemorrhagic appearance of the unilateral pulmonary lesion, which are similar to aggressive necrotico-hemorrhagic or perforating intestinal forms, are arguments in favor of the diagnosis of pulmonary Crohn’s disease and not pulmonary sarcoidosis. At the same time, in general, the two diseases have overlapping elements, suggesting they are, in fact, not the same disease with different facets.

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