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      Interstitial Lung Disease in a 70-Year-Old Man with Ulcerative Colitis

      case-report
      Author(s): , MD 1 , , , MD 1 , 2
      Publication date (Electronic):
      Journal: ACG Case Reports Journal
      Publisher: American College of Gastroenterology

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          Abstract

          Interstitial lung disease is a rare but increasingly recognized extraintestinal manifestation of inflammatory bowel disease that can have devastating consequences if left untreated. We report a case of ulcerative colitis–associated interstitial lung disease presenting with acute hypoxic respiratory failure during an ulcerative colitis flare. Gastroenterologists and pulmonologists should be aware of the numerous bronchopulmonary signs and symptoms that can suggest systemic illness in inflammatory bowel disease.

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          National Cooperative Crohn's Disease Study: extraintestinal manifestations and perianal complications.

          George Rankin, H.David Watts, Clifford S. Melnyk … (1979)
          Among 569 patients with Crohn's disease, 24% had a history of at least one extraintestinal manifestation and 36% had a history of perianal disease before randomization. Multiple extraintestinal manifestations occurred in the same patient more frequently than would be expected by chance. Seventy-six percent of patients with ileocolitis had perianal disease, extraintestinal manifestations, or both. This was significantly greater than the 58% incidence in patients with disease confined to the small bowel. Perianal complications alone were significantly more common in patients with colitis or ileocolitis than in those with disease of only the small bowel. This was true also of internal fistulization. There was a significant positive association between perianal disease and the presence of extraintestinal features. Perianal abscess appeared to respond to sulfasalazine and anal fissure to prednisone or azathioprine. These results require confirmation in larger series of patients.
          Article 0 comments Cited 45 times – based on 0 reviews     Review now
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            Extraintestinal manifestations of inflammatory bowel disease.

            Chinyu G Su, Thomas Judge, Gary Lichtenstein (2002)
            Numerous extraintestinal diseases have been associated with IBD. The role of the gastrointestinal tract in host response to the foreign antigens present in the gut makes the enteric immune system highly susceptible to any external perturbation to the system. Dysregulation of the enteric immune response results in pathology in various organs outside of the gut. The site-specific manifestations of this immune response are not understood fully. Better understanding of the pathogenesis of IBD and the complex interactions between the gut immune system and the extraintestinal systems would provide insights into the development of many of these extraintestinal manifestations. Much is unknown about the presence of cardiac, pulmonary, and hematologic diseases in patients with IBD. True association or coincidental presence of the diseases in these organ systems with IBD requires better delineation. An important consideration in all patients with IBD presenting with extraintestinal manifestations should be a careful search for medication-related complications.
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              Bronchial disease in ulcerative colitis.

              T Higenbottam, Gareth Turner, Christopher W Seymour … (1980)
              Ten patients with ulcerative colitis, all of whom were non-smokers, presented with a productive cough. In six, the chest radiography was normal and cough was the only symptom; three of these patients had a minor obstructive ventilatory defect on testing. Four patients complained of exertional dyspnoea and had both an abnormal chest radiograph with bilateral pulmonary shadows and a mixed obstructive and restrictive ventilatory defect. Bronchial epithelial biopsies from four patients (two with and two without pulmonary shadows) revealed basal reserve cell hyperplasia, basement membrane thickening, and submucosal inflammation, changes more usually associated with cigarette smoking. Inhaled beclomethasone diproprionate relieved cough in seven patients. The occurrence of airway epithelial disease in association with ulcerative colitis raises the possibility of a systemic mechanism affecting both bronchial and colonic epithelium. It does not seem likely that sulphasalazine was the cause of the pulmonary syndrome in these subjects.
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                Author and article information

                Journal
                Journal ID (nlm-ta): ACG Case Rep J
                Journal ID (iso-abbrev): ACG Case Rep J
                Journal ID (publisher-id): crj
                Title: ACG Case Reports Journal
                Publisher: American College of Gastroenterology
                ISSN (Electronic): 2326-3253
                Publication date Collection: 2018
                Publication date (Electronic): 11 April 2018
                Volume: 5
                Electronic Location Identifier: e28
                Affiliations
                [1 ]Department of Internal Medicine, University of Virginia, Charlottesville, VA
                [2 ]Division of Gastroenterology and Hepatology, University of Virginia, Charlottesville, VA
                Author notes
                Correspondence: Hampton W. Collins, University of Virginia, Department of Internal Medicine, 1215 Lee St, Charlottesville, VA 22908 ( hwc2f@ 123456virginia.edu ).
                Article
                Publisher ID: crj.2018.28
                DOI: 10.14309/crj.2018.28
                PMC ID: 5895464
                SO-VID: e2c7d8a5-4faa-43f6-8f50-214a3309c940
                Copyright © Copyright © Collins et al.
                License:

                This is an open-access article. This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License. To view a copy of this license, visit http://creativecommons.org/licenses/by-nc-nd/4.0/

                History
                Date received : 25 November 2017
                Date accepted : 25 January 2018
                Categories
                Subject: Case Report
                Subject: Inflammatory Bowel Disease

                Data availability:

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