Pulmonary Vasculitis — An Uncommon Complication of Ulcerative Colitis

Isenberg, Jon I.; Goldstein, H. H.; Korn, Alexander R.; Ozeran, Robert S.; Rosen, Victor J.

doi:10.1056/nejm196812192792506

Cited by 82 publications

(31 citation statements)

References 5 publications

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“…On the other hand, there is a large number of case reports that suggest existence of the phenomenon. First such reports appeared in the second half of the 20 th century [13,14] and hundreds have been published since then [15][16][17][18]. It is believed that gut-lung communication is bidirectional, so two ways of approach to the subject can be found in the literature.…”

Section: Epidemiologymentioning

confidence: 99%

Respiratory System Involvement in Inflammatory Bowel Diseases

Kacprzak¹,

Szturmowicz²,

Kuś³

2017

Advances in Respiratory Medicine

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Section: Epidemiologymentioning

confidence: 99%

Respiratory System Involvement in Inflammatory Bowel Diseases

Kacprzak¹,

Szturmowicz²,

Kuś³

2017

Advances in Respiratory Medicine

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“…Pulmonary vasculitis is a rare complication of UC (Black et al, 2007;Forrest & Shearman, 1975;Hilling et al, 1994;Isenberg et al, 1968). Patients can present with fever, dyspnea, or cough with blood-tinged sputum (Forrest & Shearman, 1975;Hilling, Robertson et al, 1994).…”

Section: Vascular Diseasementioning

confidence: 99%

“…Nodular lung lesions can be seen in pulmonary vasculitis and Wegener's granulomatosis and are usually responsive to systemic steroids (Black, Mendoza et al, 2007;Forrest & Shearman, 1975;Hilling, Robertson et al, 1994;Isenberg, Goldstein et al, 1968;Stebbing et al, 1999).…”

Section: Vascular Diseasementioning

confidence: 99%

Extraintestinal Manifestations of Ulcerative Colitis

Huang¹,

Kwan²,

Shih³

2011

Ulcerative Colitis - Epidemiology, Pathogenesis and Complications

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“…The association between IBD and inflammatory lung disease is not well understood and pulmonary manifestations of IBD are still thought to be rare. In 1968, ISENBERG et al [72] suggested that pulmonary vasculitis was an uncommon complication of ulcerative colitis. In 1971 ROGERS et al [73] studied 1,400 patients with IBD and found 94 patients with pulmonary diagnoses.…”

Section: What Other Conditions May Mimic Sulphasalazine Lung Disease?mentioning

confidence: 99%

Sulphasalazine and lung toxicity

Parry¹,

Barbatzas²,

Peel³

et al. 2002

Eur Respir J

132

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Sulphasalazine prescribing is on the increase. Pulmonary toxicity and blood dyscrasias are rare side-effects. Numerous case reports have been published implicating sulphasalazine in pulmonary toxicity. The authors searched the literature for cases of sulphasalazine induced lung toxicity and the 50 cases identified are discussed here.All published case reports/letters referring to sulphasalazine and lung toxicity were studied. The search terms "sulphasalazine" and "sulfasalazine" were combined with the terms "lung", "pulmonary disease", "pneumonitis" and "pleuritis" using Medline and PubMed databases.Typical presentation of sulphasalazine-induced lung disease was with new onset dyspnoea and infiltrates on chest radiography. Common symptoms were cough and fever. Crepitations on auscultation and peripheral eosinophilia were noted in half of the cases. Sputum production, allergy history, rash, chest pain and weight loss were inconsistent findings. Pulmonary pathology was variable, the commonest being eosinophilic pneumonia with peripheral eosinophilia and interstitial inflammation with or without fibrosis. Fatal reports were infrequent. Most patients were managed by drug withdrawal with 40% prescribed corticosteroids.In conclusion, sulphasalazine lung disease should be distinguished from interstitial lung disease due to underlying primary disease. Despite the increase in sulphasalazine prescribing, pulmonary toxicity remains rare. The majority of patients with suspected sulphasalazine-induced lung disease improved within weeks of drug withdrawal and the need for corticosteroids is debatable. Sulphasalazine has been used worldwide since the 19409s when it was first prescribed for ulcerative colitis. Its use in the management of inflammatory bowel disease (IBD) is declining with the availability of newer nonsulphur containing aminosalicylates. Conversely, its use as a disease-modifying antirheumatoid drug (DMARD) in the treatment of rheumatoid arthritis is well known [1], its pattern of prescribing by rheumatologists is changing with the development of combination therapies and earlier prescribing of DMARD9s in the course of the disease [2,3]. Overall prescribing of sulphasalazine is on the increase. Information provided from the statistics division 1E of the Department of Health shows that in the decade 1980-1990 there were 4.3 million prescriptions for sulphasalazine with 652 million tablets prescribed. In the last decade to 1998 there were 4.6 million prescriptions with 698 million tablets prescribed.Sulphasalazine has clinically important side-effects in up to one-fifth of patients but these are mostly nausea and vomiting, skin rashes, arthralgia, fever and hepatic dysfunction. More serious side-effects include pulmonary toxicity and blood dyscrasias. Early case reports of adverse effects were published in the 19609s [4] and knowledge of adverse pulmonary effects is not new [5][6][7]. Numerous case reports have been published in the last 30 yrs implicating sulphasalazine in pulmonary toxicity. The presen...

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Pulmonary Vasculitis — An Uncommon Complication of Ulcerative Colitis

Cited by 82 publications

References 5 publications

Respiratory System Involvement in Inflammatory Bowel Diseases

Respiratory System Involvement in Inflammatory Bowel Diseases

Extraintestinal Manifestations of Ulcerative Colitis

Sulphasalazine and lung toxicity

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