Chest
Volume 113, Issue 6, June 1998, Pages 1723-1726
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Selected Reports
Large Airway Disease Associated With Inflammatory Bowel Disease

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Lung disease is a rare complication of inflammatory bowel disease (IBD). Herein is a series of seven IBD patients who developed new, persistent and unexplained symptoms of respiratory disease, particularly chronic productive cough. Using a CT scan of the chest, a diagnosis of bronchiectasis was made in five patients, while the diagnosis of chronic bronchitis was made in two patients. Factors, other than IBD, that could account for pulmonary disease in these patients were absent. Several important clinical patterns for IBD-associated large airway disease were uncovered and are reviewed in light of earlier case reports in the medical literature. A discussion regarding the possible pathogenesis of IBD-associated airway disease follows.

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Patient 1

A 30-year-old male nonsmoker with regional enteritis (Crohn's disease) was referred to the study clinic in January 1993 with a 2-year history of chronic productive cough. The cough had begun 4 months after his diagnosis of regional enteritis in 1991, and it had been unresponsive to three separate courses of antibiotics. During that 2-year period, the patient had experienced episodic worsening of the chronic cough associated with exacerbations of the IBD. He had no prior history of childhood

DISCUSSION

We describe in detail seven IBD patients developing new, persistent and unexplained chronic productive cough. For five patients, a diagnosis of bronchiectasis was made with the use of a CT scan of the chest. For the remaining two patients, a diagnosis of chronic bronchitis was made since there was no evidence of bronchiectasis on a CT scan of the chest. In these patients, the association between IBD and their respiratory disease is strongly suggested by the absence of any other causes for

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