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Review
. 2015 Mar 30:13:Doc03.
doi: 10.3205/000207. eCollection 2015.

Tracheal and bronchial involvement in colitis ulcerosa - a colo-bronchitic syndrome? A case report and some additional considerations

Peter von Wichert  1 , Peter Barth  2 , Goetz von Wichert  3
Affiliations
Review

Tracheal and bronchial involvement in colitis ulcerosa - a colo-bronchitic syndrome? A case report and some additional considerations

Peter von Wichert et al. Ger Med Sci. .

Abstract
in English, German

Systemic involvement is well known in patients with inflammatory bowel diseases (IBD), but there are only few data looking to Crohn's disease (CD) and ulcerative colitis (UC) separately instead of lumping together both entities to IBD. The frequency of bronchial involvement in UC is not yet exactly analysed but reported to be rare. We asked 100 patients with UC for bronchial complaints, and found in 13 patients a bronchial affection. From reports in the literature it is known that sometimes a bronchial involvement in patients with UC can affect the whole bronchial tree including small bronchi. The involvement of bronchial system in UC is obviously more prominent than previously thought and may fulfil the criteria for a separate syndrome. These relations may have consequences for pathogenetic understanding of UC as well as bronchitis and also consequences for treatment regimes.

Beteiligungen systemischer Organe sind bei entzündlichen Darmerkrankungen bekannt, bisher wurden aber Morbus Crohn und Colitis kaum separat bezüglich ihrer Systembeteiligung betrachtet. So ist die Häufigkeit bronchialer Beteiligung speziell bei Colitis ulcerosa unbekannt, wird in der Literatur als selten angesehen. Wir fragten 100 Patienten mit Colitis ulcerosa nach bronchialen Beschwerden und fanden bei 13 Patienten eine floride Bronchitis. Die bronchiale Beteiligung ist offensichtlich häufiger als bisher angenommen und könnte die Kriterien eines Syndroms erfüllen. Für pathogenetisches Verständnis und therapeutische Konsequenzen sowohl von Colitis wie Bronchitis würde das bedeutsam sein.

Keywords: Crohn’s disease; bronchiectasis; bronchitis; inflammatory bowel disease; ulcerative colitis.

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Figures

Table 1
Table 1. Analysis of 100 patients with ulcerative colitis (UC)
Table 2
Table 2. Overview of some previous publications on lung involvement in ulcerative colitis (UC)
Figure 1
Figure 1. Thorax CT shows cylindrical bronchiectasis and thick bronchial walls. Lung parenchyma is mostly unchanged. (Department of Radiology of Philipps-University Marburg)
Figure 2
Figure 2. Bronchial mucosa shows a patchy interstitial lymphocytic infiltrate. The epithelium is hyperplastic and discloses few intraepithelial lymphocytes.
Figure 3
Figure 3. Colonic mucosa biopsies reveal a diffuse interstitial infiltrate mainly composed of lymphocytes with admixed plasma cells and eosinophils, few intraepithelial granulocytes and crypt abscesses. There is slight mucosal architectural distortion.
See this image and copyright information in PMC

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