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Rapidly progressive bronchiectasis complicating ulcerative colitis in a child
I Türktaş1, I Bostanci, B Altuntaş
1Department of Pediatric Allergy and Asthma, Gazi University Faculty of Medicine, Ankara, Turkey.
Insights
Extraintestinal manifestations like bronchiectasis are rare in pediatric ulcerative colitis. This case highlights a delayed diagnosis of bronchial involvement in a young patient, emphasizing the need for early recognition and treatment.
Area of Science:
- Pediatric Gastroenterology
- Pulmonology
Background:
- Ulcerative colitis (UC) can present with extraintestinal manifestations.
- Bronchiectasis is an uncommon manifestation, especially in pediatric UC patients.
Observation:
- A 13-year-old boy with UC developed an unexplained productive cough.
- Bronchial involvement and bronchiectasis were diagnosed two years after UC onset.
- Inhaled corticosteroid treatment showed no improvement, with rapid bronchial destruction.
Findings:
- The case illustrates a rare association between pediatric ulcerative colitis and bronchiectasis.
- Delayed recognition of chest symptoms potentially worsened the pulmonary outcome.
- Aggressive treatment may be required for significant pulmonary involvement in pediatric UC.
Implications:
- Highlights the importance of investigating pulmonary symptoms in pediatric UC.
- Suggests a potential need for earlier and more aggressive treatment of bronchiectasis in this population.
- Emphasizes the link between gastrointestinal and respiratory systems in pediatric inflammatory conditions.
Abstract:
Patients with ulcerative colitis may have a presentation dominated by extraintestinal manifestations. These manifestations, particularly bronchiectasis, are very rarely seen in pediatric patients. A 13-year-old boy with ulcerative colitis who was diagnosed by colonic mucosa biopsy is presented. He developed unexplained productive cough after the appearance of colonic disease. He was treated and followed up at his primary care hospital with the sole diagnosis of ulcerative colitis, with little attention given to the chest symptoms. The relation of the bronchial involvement to the ulcerative colitis was not established until two years after the onset of disease. Thoracal computed tomography (CT) examination after this period showed evidence of bronchiectasis and pulmonary involvement. Despite prophylactic inhaled corticosteroid treatment, no clinical or radiographic improvement was observed and widespread bronchial destruction developed very rapidly. More effective treatment with oral steroids was probably necessary in this patient, if the early chest symptoms were related to the ulcerative colitis.