Interstitial and Granulomatous Lung Disease in Inflammatory Bowel Disease Patients

Eliadou, Elena; Moleiro, Joana; Ribaldone, Davide Giuseppe; Astegiano, Marco; Rothfuss, Katja; Taxonera, Carlos; Ghalim, Fahd; Carbonnel, Franck; Verstockt, Bram; Festa, Stefano; Maia, Luís; Berrozpe, Ana; Zagórowicz, Edyta; Savarino, Edoardo; Ellul, Pierre; Vavricka, Stephan R.; Calvo, Marta; Koutroubakis, Ioannis Ε.; Hoentjen, Frank; Salazar, Luis Fernández; Callela, F.; Pizarro, Fiorella Cañete; Soufleris, Konstantinos; Sonnenberg, Elena; Cavicchi, Maryan; Wypych, Joanna; Hommel, Christophe; Ghiani, Alessandro; Fiorino, Gionata

doi:10.1093/ecco-jcc/jjz165

Cited by 26 publications

(21 citation statements)

References 69 publications

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“…Bronchopulmonary manifestations are rare but increasingly recognized. 123 There is high variability and all segments of the bronchopulmonary tract can be affected. Besides airway affections, interstitial lung disease and granulomatous lung disease have been described as EIMs of IBD.…”

Section: Vascular Extraintestinal Manifestations In Inflammatory Bowel Diseasementioning

confidence: 99%

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Extraintestinal Manifestations of Inflammatory Bowel Disease: Current Concepts, Treatment, and Implications for Disease Management

et al. 2021

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Inflammatory bowel diseases (IBDs) are systemic diseases that manifest not only in the gut and gastrointestinal tract, but also in the extraintestinal organs in many patients. The quality of life for patients with IBD can be substantially affected by these extraintestinal manifestations (EIMs). It is important to have knowledge of the prevalence, pathophysiology, and clinical presentation of EIMs in order to adapt therapeutic options to cover all aspects of IBD. EIMs can occur in up to 24% of patients with IBD before the onset of intestinal symptoms, and need to be recognized to initiate appropriate diagnostic procedures. EIMs most frequently affect joints, skin, or eyes, but can also affect other organs, such as the liver, lung, and pancreas. It is a frequent misconception that a successful therapy of the intestinal inflammation will be sufficient to treat EIMs satisfactorily in most patients with IBD. In general, peripheral arthritis, oral aphthous ulcers, episcleritis, or erythema nodosum can be associated with active intestinal inflammation and can improve on standard treatment of the intestinal inflammation. However, anterior uveitis, ankylosing spondylitis, and primary sclerosing cholangitis usually occur independent of disease flares. This review provides a comprehensive overview of epidemiology, pathophysiology, clinical presentation, and treatment of EIMs in IBD.

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Section: Vascular Extraintestinal Manifestations In Inflammatory Bowel Diseasementioning

confidence: 99%

“…Although interstitial lung disease seems to be associated mainly with UC, granulomatous lung disease has been associated with CD. 123 Bronchopulmonary EIMs can occur even after colectomy in some patients with UC (Figure 4).…”

Section: Vascular Extraintestinal Manifestations In Inflammatory Bowel Diseasementioning

confidence: 99%

Extraintestinal Manifestations of Inflammatory Bowel Disease: Current Concepts, Treatment, and Implications for Disease Management

et al. 2021

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“…Strictly speaking, drug-induced pulmonary toxicity is not an extraintestinal manifestation of IBD[ 9 , 12 ]. Even so, over half of interstitial lung disease and granulomatous lung disease cases in IBD patients are drug-related; therefore, more differential diagnoses are necessary[ 13 ]. On that basis, we also reviewed 3 case reports of patients with CD.…”

Section: Discussionmentioning

confidence: 99%

Vedolizumab-associated diffuse interstitial lung disease in patients with ulcerative colitis: A case report

Zhang¹,

Liu²,

Gao³

et al. 2022

WJCC

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BACKGROUND Vedolizumab, a newer class of integrin antagonist biological agents, has been applied to treat patients with moderate-to-severe Crohn’s disease (CD) and ulcerative colitis (UC), especially for patients who are refractory to traditional therapies and tumor necrosis factor antagonists. However, some rare but life-threatening adverse effects warrant pharmacovigilance. We describe the first fatal case of vedolizumab-associated severe diffuse interstitial lung disease in China. CASE SUMMARY We present a case of new-onset diffuse parenchymal lung disease developing under treatment with vedolizumab in a patient with UC. After two doses of vedolizumab, he developed persistent fever and progressively worsening dyspnea. Extensive workups, including bronchoalveolar lavage, transbronchial lung biopsy and metagenomic next-generation sequencing, identified no infectious causes, and other potential causes (such as tumors and cardiogenic pulmonary edema) were also excluded. As a result, a diagnosis of vedolizumab-related interstitial lung disease was established. Unfortunately, although corticosteroids and empiric antibiotics were administered, the patient eventually died of respiratory failure. CONCLUSION Vedolizumab-related interstitial lung disease in patients with UC is rare but potentially lethal. Gastroenterologists and pulmonologists should be aware of vedolizumab-related adverse drug reactions.

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“…interstitial lung diseases [ILD]) which can be drug or non-drug related. 1 Although extremely rare, case-series did associate drug-related lung diseases with several approved IBD therapies.…”

Section: Accepted Manuscriptmentioning

confidence: 99%

Tofacitinib and Subacute Pneumonitis: Don’t Hold Your Breath

Verstockt

Pouillon

Bossuyt

2020

Journal of Crohn's and Colitis

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Interstitial and Granulomatous Lung Disease in Inflammatory Bowel Disease Patients

Cited by 26 publications

References 69 publications

Extraintestinal Manifestations of Inflammatory Bowel Disease: Current Concepts, Treatment, and Implications for Disease Management

Extraintestinal Manifestations of Inflammatory Bowel Disease: Current Concepts, Treatment, and Implications for Disease Management

Vedolizumab-associated diffuse interstitial lung disease in patients with ulcerative colitis: A case report

Tofacitinib and Subacute Pneumonitis: Don’t Hold Your Breath

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