Tracheobronchitis in a Patient With Crohn's Disease

Abstract

We report a 63-year-old woman who presented with 1 month of non-productive cough and non-bloody diarrhea. She was on maintenance therapy for a 15-year history of Crohn's disease. Treatment with systemic corticosteroids resulted in rapid improvement of both her diarrhea and respiratory symptoms. Our patient is unique in that she presented with tracheobronchitis during an acute flare of her Crohn's without obvious lung pathology on chest imaging. Tracheobronchitis is a rare manifestation of inflammatory bowel disease that should be considered in Crohn's disease patients presenting with persistent non-infectious cough.

Tracheobronchitis and laryngitis associated with Crohn's disease

“…Tracheobronchial diseases dose not correlate with inflammatory bowel disease activity and can occur after cololectomy [ 8 ]. Usually, the bronchoscopic findings of tracheobronchial involvement in CD involve mucosal inflammation with exuberant pseudo-tumoral lesion, deformities, whitish lesions and luminal narrowing [ [9] , [10] , [11] , [12] , [13] ]. Tracheal ulcerations and stenosis have also been reported [ 14 , 15 ].…”

“…Some patients show marked and longstanding responses to administered of inhaled corticosteroids [ 9 , 10 ]. These suggestions have been drawn from case reports [ [4] , [5] , [6] , [7] , [11] , [12] , [13] , [14] , [15] ]. It has been estimated that fewer than 25% of patients with oropharyngeal CD have spontaneous resolution of disease [ 16 ].…”

Tracheobronchitis in ulcerative colitis: a case report of therapeutic response with infliximab and review of the literature

“…Our patient did not progress to methacholine testing; negative reversibility testing can be instrumental in excluding the differential of asthma. Radiological findings of IBD-related tracheobronchitis have included the variable presence of thickening of the bronchial and trachea wall [24–26] reinforcing the diagnostic benefit of bronchoscopy. In keeping with previously recorded cases of tracheobronchitis in IBD [14, 20, 27] our patient had evidence of mucosal oedema and hyperaemia on bronchoscopy.…”