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Published on: August 7, 2017
Low prevalence of pulmonary involvement in children with inflammatory bowel disease
Joanna Peradzyńska1, Katarzyna Krenke, Joanna Lange
1Medical University of Warsaw, Department of Pediatric Pneumonology and Allergy, Działdowska 1, 01-184 Warsaw, Poland. jperadzynska@gmail.com
Insights
Pulmonary involvement in pediatric inflammatory bowel disease (IBD) is uncommon, with no significant differences in lung function tests. However, elevated fractional exhaled nitric oxide (FeNO) may indicate airway issues in some young patients.
Area of Science:
- Pediatric Pulmonology
- Gastroenterology
- Systemic Inflammatory Diseases
Background:
- Inflammatory bowel disease (IBD), including Crohn's disease (CD) and ulcerative colitis (UC), is recognized as a systemic disorder with extraintestinal manifestations.
- Data on pediatric IBD-associated lung involvement are limited.
Purpose of the Study:
- To investigate the prevalence and characteristics of pulmonary involvement in pediatric patients diagnosed with IBD.
- To assess functional and structural lung changes in children with CD and UC.
Main Methods:
- Study included 50 pediatric IBD patients (25 UC, 25 CD) and 39 healthy controls.
- Evaluations comprised spirometry, methacholine bronchial challenge, fractional exhaled nitric oxide (FeNO), and high-resolution computed tomography (HRCT).
Main Results:
- No significant differences were observed in spirometry, lung volumes, or diffusing capacity between IBD patients and controls.
- Fractional exhaled nitric oxide (FeNO) levels were significantly different across CD, UC, and control groups (p=0.000).
- Bronchial hyperresponsiveness was detected in 14.6% of IBD patients; HRCT revealed mild bronchiectasis in one patient.
Conclusions:
- Pulmonary involvement is infrequent in pediatric IBD patients.
- Screening for lung issues in pediatric IBD may allow early detection of related pulmonary diseases.
- Elevated FeNO might serve as a marker for airway involvement in pediatric UC patients, warranting further investigation.
Background:
Since extraintestinal sites of inflammation have been demonstrated in patients with Crohn's disease (CD) and ulcerative colitis (UC), both entities are regarded as systemic disorders. There are only scarce data on the prevalence of inflammatory bowel disease (IBD)-associated lung involvement in children.
Objectives:
The aim of our study was to investigate pulmonary involvement in pediatric patients with IBD.
Material And Methods:
Fifty children with IBD (25 UC and 25 CD, mean age 14.2 ± 3.2 yrs) and 39 age-matched, healthy, control subjects were included in the study. Pulmonary function testing, methacholine bronchial challenge, fractional exhaled nitric oxide (FeNO) and high resolution computed tomography (HRCT) were used to detect functional and/or structural pulmonary involvement.
Results:
There were no differences in spirometric parameters, lung volumes or lung diffusion capacity for carbon monoxide between IBD patients and control subjects. Highly significant differences were found in FeNO between CD, UC and control patients (mean 9.3 ± 3.3, 27.7 ± 14.8 and 16.6 ± 9.28, respectively; p = 0.000). Bronchial hyperresponsiveness was diagnosed in six IBD cases (14.6%). HRCT (performed in 32 patients from the study group) revealed mild bilateral bronchiectasis in one patient.
Conclusions:
The prevalence of pulmonary involvement in children with IBD is low. Screening for pulmonary involvement in children and young adults with IBD may enable early detection of IBD-related pulmonary diseases which, seems to be notably more common in adult patients. Elevated FeNO could probably be regarded as a marker of airway involvement in non-smoking UC pediatric patients. This requires further studies.
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