A case presentation of a pulmonary complication of ulcerative colitis

Talwar, Ambika; Kunst, Heinke; Ngatchu, Theodore; Trotter, Simon

doi:10.1136/bcr-02-2012-5806

Cited by 8 publications

(6 citation statements)

References 5 publications

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“…His UC was active at the onset of LABD, presenting as a long-term flare-up with bloody diarrhea. The long course of the patient's bowel disease prior to the presentation of his skin lesions does not rule out UC as a trigger of LABD as other extraintestinal manifestations, such as primary sclerosing cholangitis [15], pyoderma gangrenosum [16] or pulmonary involvement [17], have been reported years after the first diagnosis of IBD. However, it appears more likely that the patient developed LABD as a consequence of the IFX infusions due to the chronology of the onset of skin lesions in tandem with the start of IFX therapy.…”

Section: Discussionmentioning

confidence: 99%

Linear IgA Bullous Dermatosis Secondary to Infliximab Therapy in a Patient with Ulcerative Colitis

Hoffmann

Hadaschik²,

Enk³

et al. 2015

Dermatology

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Linear IgA bullous disease (LABD) is a rare vesiculobullous autoimmune skin disorder whose etiology and pathogenesis are not completely understood. Its occurrence has been related to malignancies, inflammatory diseases and several drugs. This report describes a 49-year-old Caucasian male with a 14-year history of ulcerative colitis who received infliximab to treat the refractory course of his bowel disease. During induction therapy with infliximab, he developed LABD. Treatment with infliximab was discontinued, and the skin lesions were successfully treated with oral steroids and dapsone. Considering the close chronological relation between administration of the tumor necrosis factor-α inhibitor and onset of the skin disease, we hypothesize that this is the first reported case of infliximab-induced LABD. Similar to psoriasis, it may represent a ‘paradoxical' autoimmune reaction triggered by anti-tumor necrosis factor-α therapy.

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Section: Discussionmentioning

confidence: 99%

Linear IgA Bullous Dermatosis Secondary to Infliximab Therapy in a Patient with Ulcerative Colitis

Hoffmann

Hadaschik²,

Enk³

et al. 2015

Dermatology

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“…Small cavitations reflecting central necrosis may be present [ 34 ]. Tumors with central necrosis may resemble granulomatosis with polyangitis (GPA) and may require thorough differentiation with this disease, especially in cases of UC with positive anti-neutrophil cytoplasmic antibodies (ANCA) in the serum [ 52 – 57 ]. Overlapping of UC with GPA in such cases should be considered [ 58 ].…”

Section: Interstitial Lung Diseasementioning

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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“…These are known as extraintestinal manifestations. The musculoskeletal, dermatological, ocular, and hepatobiliary systems are the most frequently affected, while pulmonary involvement is uncommon [ 3 , 4 ]. The exact pathophysiological mechanisms underlying extraintestinal manifestations are still unknown [ 1 , 3 ].…”

Section: Introductionmentioning

confidence: 99%

Organizing Pneumonia and Ulcerative Colitis: A Relationship To Remember

Pereira¹,

Sousa²,

Esteves³

et al. 2023

Cureus

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Ulcerative colitis (UC) is a chronic inflammatory bowel disease characterised by relapsing and remitting mucosal inflammation of the colon. Despite primarily affecting the gastrointestinal tract, UC has various extraintestinal manifestations that often affect other organs and systems. Although pulmonary involvement is uncommon, organising pneumonia (OP), which affects the lung parenchyma, is one of the potential extraintestinal manifestations of UC. We report a case of OP in a 35-year-old male with a longstanding history of UC, well-medicated with sulfasalazine (SSZ). He presented to the emergency department (ED) with complaints of fatigue, coughing, myalgia, thoracalgia and dyspnoea. A chest X-ray showed parenchymal infiltrates and computed tomography revealed bilateral consolidation. Under a preliminary diagnosis of atypical pneumonia, he was treated with an empirical broad-spectrum antimicrobial agent, which did not lead to any clinical, laboratory or imaging improvement. Furthermore, the diagnostic work-up excluded any malignancy or infectious cause. A probable diagnostic hypothesis was OP as an extraintestinal manifestation of UC or as an adverse effect of SSZ therapy. Hence, SSZ was discontinued, and he was successfully treated with corticosteroids, exhibiting significant improvements and recovering completely during the follow-up period. Despite lung involvement in UC being rare, we present this case to emphasise the importance of a thorough differential diagnosis when treating acute respiratory illness in patients with UC, including extraintestinal manifestations of UC, especially OP, even during a period of remission. We also emphasise the importance of early initiation of corticosteroid therapy to prevent major complications and promote recovery.

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A case presentation of a pulmonary complication of ulcerative colitis

Cited by 8 publications

References 5 publications

Linear IgA Bullous Dermatosis Secondary to Infliximab Therapy in a Patient with Ulcerative Colitis

Linear IgA Bullous Dermatosis Secondary to Infliximab Therapy in a Patient with Ulcerative Colitis

Pulmonary manifestations of inflammatory bowel disease

Organizing Pneumonia and Ulcerative Colitis: A Relationship To Remember

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