Interstitial Pneumonia Accompanying Ulcerative Colitis.

Abstract

Wereport a patient with ulcerative colitis complicated with idiopatic interstitial pneumonia, in whomthe etiology of interstitial pneumonia was unknown, but immunological disturbance might have been involved. There are many complications with ulcerative colitis, but interstitial pneumonia is quite rare and its prognosis is quite poor. Antibiotic and steroid treatment were given under respiration supported therapy, but no response could be obtained. In the treatment of patients with ulcerative colitis, we must be mindful of interstitial pneumonia because the prognosis is quite poor. (Internal Medicine 40: 883-886, 2001)

Ulcerative colitis combined with acute interstitial lung disease and airway disease: A case report and literature review

“…Two patients with acute UC plus ILD reported in the literature succumbed due to ineffective glucocorticoid treatment (3,4). In the case of UC accompanied by acute ILD that was diagnosed and treated by the author, the disease remitted following administration of cyclophosphamide combined with γ globulin.…”

“…In eight cases the gender and age were not reported, including two cases with acute ILD insensitive to glucocorticoid therapy. Of these two cases, one patient with idiopathic interstitial pneumonia (4) succumbed 75 days after the disease onset due to opportunistic infections in the lungs, and one patient with the usual type of acute interstitial pneumonia and acute exacerbation (3) succumbed three months after the disease onset. The keywords ‘Colitis, Ulcerative/complications’ and ‘Bronchitis’, ‘Colitis, Ulcerative/complications’ and ‘Bronchiolitis’ and ‘Colitis, Ulcerative/complications’ and ‘Lung Diseases, Obstructive’ were then used to search PubMed.…”

“…Among the 24 cases, 10 (11–13) did not report the order of the ILD and UC incidences. In 12 cases (12/14, 85.71%) the ILD occurred 1–15 years after the diagnosis of UC (3,4,7–9,14–18); this included only five cases in which the ILD occurred during active UC (5/12, 41.67%) (3,4,14,15). In two cases it was reported that the ILD occurred prior to the UC (17,19); in one of these cases (19) the ILD occurred immediately subsequent to the UC relapse, indicating that UC activity may be associated with the incidence of ILD.…”

“…In the literature, there were 24 cases of UC accompanied by ILD and 33 cases accompanied by airway inflammation, in which there were 2 cases of UC accompanied by airway inflammation, fibrosis of bronchi and bronchiole, and bronchitis. Whilst UC accompanied by acute ILD is rare, two cases of acute UC plus ILD were reported by Marten et al (3) and Chikano et al (4), in which high-dose corticosteroid therapy was ineffective and the patients eventually succumbed. In the present study, a case of UC accompanied by acute ILD, airway disease, lung cysts and pleural adhesions was diagnosed by the author.…”

“…The rate of pulmonary complications caused by inflammatory bowel diseases is ~0.21% (2). UC can be complicated by numerous diseases, including interstitial lung disease (ILD) (3,4) airway inflammation, airway stenosis (5), pulmonary vasculitis (6), pulmonary embolism, pulmonary bullae, lung cysts (7) and pleural adhesions (8). In the literature, there were 24 cases of UC accompanied by ILD and 33 cases accompanied by airway inflammation, in which there were 2 cases of UC accompanied by airway inflammation, fibrosis of bronchi and bronchiole, and bronchitis.…”