Soma Kar1, S G Thomas. 1. Department of Respiratory Medicine, Calderdale Royal Hospital, Halifax, West Yorkshire, UK. drsomakar@hotmail.co.uk
Abstract
INTRODUCTION: Tracheobronchitis is a rare extraintestinal manifestation of ulcerative colitis (UC) and is often mis-diagnosed and treated as asthma. OBJECTIVE: We report a case of tracheobromchitis in a patient with long-standing UC, who had been treated for asthma for many years with a poor response to standard asthma management. Only very few cases are reported and in the majority of them tracheobronchitis developed after colectomy. METHODS: Subsequent investigations of unremitting respiratory symptoms in our patient revealed tracheobronchitis. His UC remained quiescent for more than 20 years on medical treatment having never required a bowel resection. RESULTS: On thoroughly investigating the aetiology for his pulmonary pathology, it was thought to be an extraintestinal manifestation of UC, which makes this case noteworthy. CONCLUSION: Pulmonary complications can develop many years after the diagnosis of inflammatory bowel disease, without any sign of disease activity. In such cases awareness and a high index of suspicion are important to ensure early diagnosis and treatment, and further investigations to detect large airway disease is warranted. The pulmonary manifestations tend to respond well to steroid therapy, which may prevent or ameliorate permanent lung damage.
INTRODUCTION: Tracheobronchitis is a rare extraintestinal manifestation of ulcerative colitis (UC) and is often mis-diagnosed and treated as asthma. OBJECTIVE: We report a case of tracheobromchitis in a patient with long-standing UC, who had been treated for asthma for many years with a poor response to standard asthma management. Only very few cases are reported and in the majority of them tracheobronchitis developed after colectomy. METHODS: Subsequent investigations of unremitting respiratory symptoms in our patient revealed tracheobronchitis. His UC remained quiescent for more than 20 years on medical treatment having never required a bowel resection. RESULTS: On thoroughly investigating the aetiology for his pulmonary pathology, it was thought to be an extraintestinal manifestation of UC, which makes this case noteworthy. CONCLUSION: Pulmonary complications can develop many years after the diagnosis of inflammatory bowel disease, without any sign of disease activity. In such cases awareness and a high index of suspicion are important to ensure early diagnosis and treatment, and further investigations to detect large airway disease is warranted. The pulmonary manifestations tend to respond well to steroid therapy, which may prevent or ameliorate permanent lung damage.