Evidence of Lymphocyte Alveolitis in Crohn's Disease

Wallaert, B.; Colombel, J.F.; Tonnel, A.-B.; Bonnière, P; Cortot, Antoine; Paris, J; Voisin, C

doi:10.1378/chest.87.3.363

Cited by 99 publications

(52 citation statements)

References 8 publications

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“…Wallaert et al (19) reported a high proportion of increased alveolar lymphocytosis in patients with Crohn's disease free of clinical symptoms and with normal chest roentgenograms. The significance of the increased percentage of lymphocytes is not clear.…”

Section: Discussionmentioning

confidence: 99%

“…Therefore, the association of Crohn's disease and lymphocyte alveolitis might be the result of an immunologic mechanism. The lymphocytes sensitized to antigens at one mucosal site could circulate and populate the mucosal surfaces of the lung (19). Muller et al (34) showed that CD4 were vigorously activated in the intestinal mucosa of patients with active Crohn's disease.…”

Section: Discussionmentioning

confidence: 99%

“…Although the overall prevalence of concomitant bronchopulmonary manifestations is only 0.4% (16), subclinical alterations in at least half of the adults with Crohn's disease have been demonstrated (17,18) suggesting underlying bronchial inflammation. This pulmonary involvement can be reflected by an increased lymphocyte count in the bronchoalveolar lavage fluid (19,20) and/or lung function abnormalities (21,22).…”

Section: Introductionmentioning

confidence: 99%

“…An increased frequency of asymptomatic bronchial hyperresponsiveness has been reported in patients with Crohn's disease, and a subclinical accumulation of activated T lymphocytes has been demonstrated in the lung of patients with Crohn's disease without respiratory symptoms (19,25). No study has demonstrated thus far the simultaneous presence of alveolar lymphocytosis and bronchial hyperresponsiveness to methacholine in respiratory asymptomatic patients with Crohn's disease.…”

Section: Introductionmentioning

confidence: 99%

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Bronchial hyperresponsiveness and analysis of induced sputum cells in Crohn's disease

Bártholo

Zaltman

Elia

et al. 2005

Braz J Med Biol Res

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With the aim of investigating the presence of latent inflammatory process in the lungs of patients with Crohn's disease, 15 patients with Crohn's disease were evaluated by spirometry, the methacholine challenge test, induced sputum, and skin tests for inhaled antigens. Serum IgE, erythrocyte sedimentation rate and hematocrit were also determined. The patients were compared with 20 healthy controls by the Mann-Whitney and Fisher exact tests. Their respiratory physical examination was normal. None had a personal or family history of clinical atopy. None had a previous history of pulmonary disease, smoking or toxic bronchopulmonary exposure. None had sinusitis, migraine, diabetes mellitus, or cardiac failure. Four (26.6%) of the patients with Crohn's disease had a positive methacholine challenge test whereas none of the 20 controls had a positive methacholine test (P = 0.026, Fisher exact test). Patients with Crohn's disease had a higher level of lymphocytes in induced sputum than controls (mean 14.59%, range 3.2-50 vs 5.46%, 0-26.92%, respectively; P = 0.011, Mann-Whitney test). Patients with Crohn's disease and a positive methacholine challenge test had an even higher percentage of lymphocytes in induced sputum compared with patients with Crohn's disease and a negative methacholine test (mean 24.88%, range 12.87-50 vs 10.48%, 3.2-21.69%; P = 0.047, Mann-Whitney test). The simultaneous findings of bronchopulmonary lymphocytosis and bronchial hyperresponsiveness in patients with Crohn's disease were not reported up to now. These results suggest that patients with Crohn's disease present a subclinical inflammatory process despite the absence of pulmonary symptoms.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Bronchial hyperresponsiveness and analysis of induced sputum cells in Crohn's disease

Bártholo

Zaltman

Elia

et al. 2005

Braz J Med Biol Res

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“…However, the frequency of pulmonary involvement in SS remains a subject of controversy, and varies according to whether clinical, radiologic, functional, or pathologic criteria are used to diagnose the lung disease (2,3,%14). There is evidence that chronic interstitial pulmonary diseases are associated with the recruitment of immune and inflammatory cells into the alveolar spaces, resulting in alveolitis (15,16 BAL, may be present in patients who are asymptomatic and who have various disorders (19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29), including connective tissue diseases and SS (30)(31)(32). Those findings support the view that inflammatory alveolitis does not necessarily lead to a clinically significant interstitial pulmonary process, per se.…”

mentioning

confidence: 99%

Subclinical lung inflammation in primary sjögren's syndrome. relationship between bronchoalveolar lavage cellular analysis findings and characteristics of the disease

Hatron

Wallaert

Gosset

et al. 1987

Arthritis & Rheumatism

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To directly evaluate whether a subclinical alveolar inflammation is associated with primary Sjögren's syndrome (SS), we evaluated the distribution of cells obtained by bronchoalveolar lavage (BAL) from the lower respiratory tract in 29 patients who had primary SS, but who were free of clinical pulmonary symptoms and had normal findings on chest roentgenograms. There was no difference in total cell counts of specimens from patients versus those of controls. An abnormal differential cell count was noted in 16 patients (55%). Two patterns of alveolitis were observed: a pure lymphocyte alveolitis (>18% lymphocytes, present in 11 patients) and a neutrophil alveolitis (>4% neutrophils, present in 5 patients). There was associated lymphocytosis in 4 of the patients with neutrophil alveolitis. All patients had normal results on pulmonary function tests. Patients with abnormal BAL findings showed clinical and biologic indexes of more severe disease than did those with normal BAL results, as demonstrated by greater extraglandular extension of the disease, higher mean values of serum gamma globulins and serum β2‐microglobulin, and higher prevalence of rheumatoid factor and of antinuclear antibody. Thus, our data demonstrate that BAL permitted the detection of subclinical inflammatory alveolitis in 55% of our patients with primary SS. A long‐term followup is required to determine whether these patients will develop obvious pulmonary involvement.

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Severe pulmonary disease in association with Crohn's disease in a 13-year-old girl

et al. 2000

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Evidence of Lymphocyte Alveolitis in Crohn's Disease

Cited by 99 publications

References 8 publications

Bronchial hyperresponsiveness and analysis of induced sputum cells in Crohn's disease

Bronchial hyperresponsiveness and analysis of induced sputum cells in Crohn's disease

Subclinical lung inflammation in primary sjögren's syndrome. relationship between bronchoalveolar lavage cellular analysis findings and characteristics of the disease

Severe pulmonary disease in association with Crohn's disease in a 13-year-old girl

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