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Pulmonary manifestations of inflammatory bowel disease.

Majewski S, Piotrowski W - Arch Med Sci (2015)

Bottom Line: Latent and asymptomatic pulmonary involvement is not unusual.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.

View Article: PubMed Central - PubMed

Affiliation: Department of Pneumology and Allergy, Medical University of Lodz, Lodz, Poland.

ABSTRACT
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.

No MeSH data available.


Related in: MedlinePlus

Chest X-ray of a young woman treated for CD with infliximab, showing consolidation in the left lower lobe (A) and a CT scan showing bilateral opacities predominantly in the left basal segments (B). She presented with productive cough and fever, non-responsive to empirical antibiotic treatment. The radiological picture and clinical context suggested IBD-related lung disease. Transbronchial lung biopsy was non-diagnostic and the patient refused surgical biopsy. Steroids were introduced but were withdrawn shortly after the bronchoalveolar aspirate appeared positive for Mycobacterium tuberculosis. Note the atypical location of TB lung infiltrations
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Figure 0003: Chest X-ray of a young woman treated for CD with infliximab, showing consolidation in the left lower lobe (A) and a CT scan showing bilateral opacities predominantly in the left basal segments (B). She presented with productive cough and fever, non-responsive to empirical antibiotic treatment. The radiological picture and clinical context suggested IBD-related lung disease. Transbronchial lung biopsy was non-diagnostic and the patient refused surgical biopsy. Steroids were introduced but were withdrawn shortly after the bronchoalveolar aspirate appeared positive for Mycobacterium tuberculosis. Note the atypical location of TB lung infiltrations

Mentions: Anti-tumor necrosis factor (anti-TNF) agents have become widely used for the treatment of IBD in recent years [117]. Infections and malignancies may occur in patients during such treatment [118]. A number of pulmonary infections have been reported in patients treated with anti-TNF agents, the most important being tuberculosis [119] (Figures 3 A and B). Less frequent ones include lung actinomycosis [120] and invasive aspergillosis [121]. Diffuse alveolar hemorrhage has been described after infusion of infliximab in patients with CD [122]. The number of reports on infliximab-induced lung complications may be growing, with the increasing acceptance of this therapeutic option for the treatment of IBD [123]. In the context of both UC and CD, non-specific interstitial pneumonia (NSIP) was described recently [124, 125].


Pulmonary manifestations of inflammatory bowel disease.

Majewski S, Piotrowski W - Arch Med Sci (2015)

Chest X-ray of a young woman treated for CD with infliximab, showing consolidation in the left lower lobe (A) and a CT scan showing bilateral opacities predominantly in the left basal segments (B). She presented with productive cough and fever, non-responsive to empirical antibiotic treatment. The radiological picture and clinical context suggested IBD-related lung disease. Transbronchial lung biopsy was non-diagnostic and the patient refused surgical biopsy. Steroids were introduced but were withdrawn shortly after the bronchoalveolar aspirate appeared positive for Mycobacterium tuberculosis. Note the atypical location of TB lung infiltrations
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4697051&req=5

Figure 0003: Chest X-ray of a young woman treated for CD with infliximab, showing consolidation in the left lower lobe (A) and a CT scan showing bilateral opacities predominantly in the left basal segments (B). She presented with productive cough and fever, non-responsive to empirical antibiotic treatment. The radiological picture and clinical context suggested IBD-related lung disease. Transbronchial lung biopsy was non-diagnostic and the patient refused surgical biopsy. Steroids were introduced but were withdrawn shortly after the bronchoalveolar aspirate appeared positive for Mycobacterium tuberculosis. Note the atypical location of TB lung infiltrations
Mentions: Anti-tumor necrosis factor (anti-TNF) agents have become widely used for the treatment of IBD in recent years [117]. Infections and malignancies may occur in patients during such treatment [118]. A number of pulmonary infections have been reported in patients treated with anti-TNF agents, the most important being tuberculosis [119] (Figures 3 A and B). Less frequent ones include lung actinomycosis [120] and invasive aspergillosis [121]. Diffuse alveolar hemorrhage has been described after infusion of infliximab in patients with CD [122]. The number of reports on infliximab-induced lung complications may be growing, with the increasing acceptance of this therapeutic option for the treatment of IBD [123]. In the context of both UC and CD, non-specific interstitial pneumonia (NSIP) was described recently [124, 125].

Bottom Line: Latent and asymptomatic pulmonary involvement is not unusual.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.

View Article: PubMed Central - PubMed

Affiliation: Department of Pneumology and Allergy, Medical University of Lodz, Lodz, Poland.

ABSTRACT
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.

No MeSH data available.


Related in: MedlinePlus