Abu Shtaya Aasem, Cohen Shai, Kogan Yana, Shteinberg Michal, Sagool Ori
Department of Internal Medicine "B", Lady Davis Carmel Medical Center, Haifa, Israel.
Technion - Israel Institute of Technology, The B. Rappaport Faculty of Medicine, Haifa, Israel.
Eur J Case Rep Intern Med. 2021 Feb 19;8(3):002265. doi: 10.12890/2021_002265. eCollection 2021.
Crohn's disease is a chronic inflammatory bowel disease that can affect any part of the GI tract, which is frequently associated with extra-intestinal manifestations. Pulmonary parenchymal disease is very uncommon and usually considered to be debilitating and harder to diagnose. Pulmonary granulomas are rarely described in the literature as a complication of Crohn's disease. Here, we present a patient with Crohn's disease exacerbation who developed granulomatous lung disease under treatment with vedolizumab. Our case may add evidence to the emerging theory that gut-selective biologic agents could lead to upregulation of some pro-inflammatory factors leading to the evolution of pulmonary disease.
Pulmonary parenchymal diseases are rare in Crohn's disease but they can be debilitating and life-threatening as they are usually tardily diagnosed; awareness of this association is of high value and could potentially shorten the time to a definite diagnosis.Pulmonary manifestations of Crohn's disease could be subclinical without any respiratory complaints and not diagnosed with conventional imaging modalities such as chest x-ray.Gut-selective biologic agents could lead to the emergence of extra-intestinal manifestations due to upregulation of multiple pro-inflammatory cytokines.
克罗恩病是一种慢性炎症性肠病，可累及胃肠道的任何部位，常伴有肠外表现。肺实质疾病非常罕见，通常被认为是使人衰弱且更难诊断的疾病。肺肉芽肿作为克罗恩病的并发症在文献中很少被描述。在此，我们报告一例克罗恩病加重患者，在接受维多珠单抗治疗期间发生了肉芽肿性肺病。我们的病例可能为新出现的理论提供证据，即肠道选择性生物制剂可能导致一些促炎因子上调，从而导致肺部疾病的发展。
肺实质疾病在克罗恩病中罕见，但由于通常诊断延迟，它们可能使人衰弱并危及生命；认识到这种关联具有很高的价值，可能会缩短确诊时间。克罗恩病的肺部表现可能是亚临床的，没有任何呼吸道症状，并且不能通过胸部X光等传统影像学检查手段诊断出来。肠道选择性生物制剂可能由于多种促炎细胞因子上调而导致肠外表现的出现。
