Inflammatory bowel disease (thoracic manifestations)

Thoracic manifestations of both ulcerative colitis and Crohn disease can be variable and cannot be used to differentiate between these entities.

They can develop at any time with respect to the clinical onset of the underlying disease. Actually, they can also predate the colonic disease or develop after colectomy.

The spectrum includes:

• affecting large airways
  • tracheobroncheolitis - ulcerative tracheobronchiolitis 
  • upper airway stenosis - tracheal stenosis
  • bronchiectasis 
• affecting small airways
  • as a panbronchiolitis
  • as a bronchiolitis obliterans organizing pneumonia
• as lesions mimicking granulomatosis with polyangiitis
• pulmonary vasculitis
• necrobiotic nodules
• pulmonary eosinophilia
• pulmonary bullae
• apical fibrosis
• interstitial lung disease

Differential diagnosis

It is important to differentiate these from adverse drug reactions to medications given for the underlying disease (IBD).

Diagnosis is important, as pulmonary abnormalities in ulcerative colitis and Crohn disease can present years after the onset of the bowel disease and can - as stated above - affect any part of the lungs. Early recognition is of utmost importance as symptoms can be strikingly steroid-responsive .

Complexity is not decreased by the fact that several entities may coexist or be linked to IBD, e.g. sarcoidosis and IBD to mention just one.

See also

• ulcerative colitis
• Crohn disease
• inflammatory bowel disease

Siehe auch:

• Morbus Crohn des Ösophagus
• extraintestinale Manifestationen bei Morbus Crohn