Lemann M, Messing B, D'Agay F, Modigliani R
Service de gastroentérologie, Hôpital Saint-Lazare, Paris, France.
Gut. 1987 Dec;28(12):1669-72. doi: 10.1136/gut.28.12.1669.
Symptomatic respiratory tract involvement with granulomatous bronchial lesions has not yet been described in Crohn's disease. We report two patients with colonic Crohn's disease and severe respiratory symptoms (dyspnoea associated in one of the patients with voicelessness); erythema, aphthoid and superficial ulcerations were found in the colon and whitish granulations in the bronchi at endoscopy. Non-caseating tuberculoid granulomas were found in the colonic mucosa of both patients, as well as in the bronchial mucosa of one of them; in the second a diffuse inflammatory infiltrate including epithelioid cells was found underneath an erosion of bronchial epithelium. Both patients improved on oral prednisone. These two patients probably had bronchial involvement by Crohn's disease.
克罗恩病中尚未有关于伴有肉芽肿性支气管病变的症状性呼吸道受累的描述。我们报告了两名患有结肠克罗恩病且有严重呼吸道症状的患者(其中一名患者伴有呼吸困难及失音);内镜检查发现结肠有红斑、口疮样及浅表溃疡,支气管有白色颗粒。两名患者的结肠黏膜均发现非干酪样结核样肉芽肿,其中一名患者的支气管黏膜也发现了此类肉芽肿;另一名患者在支气管上皮糜烂下方发现包括上皮样细胞的弥漫性炎性浸润。两名患者口服泼尼松后病情均有改善。这两名患者可能患有克罗恩病累及支气管。