Crohn's disease affecting the nasal mucosa

Abstract

Crohn's disease is a chronic inflammatory disease of the gastrointestinal tract, associated with disorders of cell mediated and humoral immunity. The incidence of the disease is increasing, and it is commonest in young women. Any part of the gastrointestinal tract may be affected, and 9% of cases have oral lesions which are usually painful and coincide with periods of active intestinal disease. These oral lesions are areas of cobblestoned mucosa with deep ulcers and fissures; on histological examination there is perivascular inflammation with lymphocytic infiltration and in 10% non-caseating granulomas are seen. In the absence of any clinically detectable lesion, biopsies of buccal mucosa from patients with Crohn's disease show focal inflammation around salivary glands, and immunofluorescent studies have demonstrated antibodies to buccal mucosa in their serum. Involvement of the lower respiratory tract by Crohn's disease is rare, and although laryngeal involvement leading to upper airway obstruction has been described, involvement of the nose has not been previously reported.