SESSION TYPE: ILD Posters
PRESENTED ON: Wednesday, October 24, 2012 at 01:30 PM - 02:30 PM
PURPOSE: Ulcerative colitis associated lung disease is a very rare condition. There is limited data regarding inflammatory bowel disease [IBD] related ling injury, there are no guidelines for surveillance of lung injury and its treatment in this patient population. . We report a case series of ulcerative colitis associated lung disease .
METHODS: We discuss four cases , in which the patients had significant respiratory symptoms, including cough and shortness of breath , who also had Ulcerative Colitis. Case 1: 42yr old lady which presented with sub acute respiratory failure with chest CT images and open lung biopsy results available showing lung fibrosis and inflammation. Case2:A 60 yr old male with nodular and fobrotic lung disease and lung biopsies, to accompany his dsypnea and cough.Case 3 and 4:65 and 66 yr old women who had unexplained fibrosis on there chest CT scans along with there ulcerative colitis. There symptoms could not be explained by other processes.
RESULTS: All these patients had ulcerative colitis and lung diseases. There lung parenchymal diseases after clinical evaluation could not be explained by the more common diagnosis. These lung findings seem to be related to Ulcerative Colitis.
CONCLUSIONS: The pathophysiology of IBD is not completely understood. Currently it is accepted that IBD and its gastrointestinal inflammation are the results of an inadequate activation of the innate immune system to a luminal factor (i.e. intestinal flora) occurring in genetically predisposed subjects14 . Altered mRNA has been studied in neoplastic processes extensively, but now it is also being studied in relation to altered immunity on a cellular level. It is thought that defective mRNA cause abnormal maturity of the intestinal immune cells causing uncontrolled activation and inflammation.It is possible that in a genetically predisposed individual this molecular defect is also present in the immune cells of the lung, the second biggest internal organ directly exposed to the atmosphere, which may also suffer from abnormal activation and may cause uncontrolled inflammation.
CLINICAL IMPLICATIONS: Further characterization of the lung disease associated with UC in terms of presentation, screening and specific diagnostic tools, modalities of treatment and response, recurrence and long term complications etc demands for study of a larger pool of patients similar to our described patients in observational and case control studies.
DISCLOSURE: The following authors have nothing to disclose: Sikandar Ansari, Pascal Kingah, Pooja Swamy, Domingo Franco, Lobelia Samavati
No Product/Research Disclosure InformationDetroit Medical Center/Wayne State University, Detroit, MI