Latent pulmonary function abnormalities in children with Crohn's disease

Abstract

Recently, latent pulmonary involvement has been described in adult patients with inflammatory bowel disease. It is unknown, however, whether this also occurs in children, and whether the pulmonary abnormalities differ between the acute phase and remission. The incidence of pulmonary abnormalities has been investigated in 26 children with acute or quiescent Crohn's disease in terms of the following parameters: clinical pulmonary symptoms, chest roentgenograms and pulmonary function tests, including lung transfer factor for carbon monoxide (TLCO). One child had a severe digital clubbing. Chest radiographs were normal in all subjects. No significant differences were found between acute and quiescent phase for pulmonary volumes and expiratory flows, but TLCO (% predicted) was significantly decreased during the active phase of the disease as compared to remission (53 +/- 15 vs 81 +/- 19% predicted). These data suggest that latent pulmonary involvement is also present in a paediatric population with active Crohn's disease, despite a short disease history and absence of smoking. Although the nature of this abnormality remains unclear, this extradigestive epiphenomenon should be taken into account with respect to the aetiopathogenesis of Crohn's disease.

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

“…Latent pulmonary involvement has been reported in a pediatric population with Crohn's disease, despite a short duration of the disease and absence of smoking (22). An increased bronchial hyperresponsiveness in patients with inflammatory bowel disease with no bronchopulmonary symptoms and with normal baseline lung function has been reported (23).…”

“…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).…”

Review article: the eosinophil as a therapeutic target in gastrointestinal disease

“…1,3,7,8 The bronchopulmonary abnormalities can include 'asthmalike' clinical manifestations such as obstruction of the upper airways, small airways dysfunction, pulmonary vasculitis, eosinophilic inflammation and non-specific BHR. [56][57][58][59][60] While the airways are not generally considered as a common site of involvement, immunological and bronchopulmonary abnormalities may be present in 10-20% of patients with these disorders. 61 Despite this common association, the mechanism of this phenomenon has been an enigma until recently.…”

Pulmonary necrobiotic nodules: a rare extraintestinal manifestation of Crohn's disease

“…Lung function abnormalities are significantly more common in patients with inflammatory bowel disease (IBD) than controls [14] with reduced transfer factor being demonstrated in Crohn's disease in a number of studies [14][15][16][17]. Patients with IBD have bronchial hyperresponsiveness to methacholine [18] and impaired small airway function [17].…”