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Pulmonary functions in children with inflammatory bowel disease
Guy Gut1, Amir Ben-Tov, Avishai Lahad
1Departments of aPediatric Pulmonology, Critical Care and Sleep Medicine bPediatric Gastroenterology, 'Dana-Dwek' Children's Hospital, Tel Aviv Sourasky Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
Insights
Fractional exhaled nitric oxide (FeNO) levels are elevated in children with Crohn's disease (CD) and ulcerative colitis (UC), indicating airway inflammation. These elevated FeNO levels in pediatric inflammatory bowel disease patients do not correlate with disease activity.
Area of Science:
- Pediatric Gastroenterology
- Pulmonology
- Immunology
Background:
- Inflammatory bowel diseases (IBD), including Crohn's disease (CD) and ulcerative colitis (UC), are chronic inflammatory conditions affecting the gastrointestinal tract.
- Airway inflammation, indicated by fractional exhaled nitric oxide (FeNO) levels, has been observed in adults with IBD, but data in pediatric populations are limited.
Purpose of the Study:
- To investigate fractional exhaled nitric oxide (FeNO) levels in children diagnosed with CD and UC.
- To assess the correlation between FeNO levels and the activity of intestinal disease in these pediatric patients.
- To compare FeNO levels and spirometry results between children with IBD and healthy controls.
Main Methods:
- Recruitment of children aged 8-18 years with CD and UC, along with age-matched healthy controls.
- Assessment of disease activity using validated scoring systems.
- Performance of spirometry and fractional exhaled nitric oxide (FeNO) tests on all participants.
Main Results:
- Children with CD exhibited higher mean FeNO levels compared to healthy controls.
- A significantly higher percentage of children with CD (46%) and UC (33%) had elevated FeNO levels (>23 parts per billion) compared to controls (0%).
- No significant correlation was found between FeNO levels and intestinal disease activity, nor were there differences in spirometric variables.
Conclusions:
- Fractional exhaled nitric oxide (FeNO) is elevated in pediatric patients with inflammatory bowel diseases (IBD), suggesting airway inflammation.
- Elevated FeNO levels in children with CD and UC are independent of their intestinal disease activity.
- The findings suggest potential latent pulmonary involvement in pediatric IBD, even in the absence of respiratory symptoms.
Objective:
To investigate fractional exhaled nitric-oxide (FeNO) levels in children with Crohn's disease (CD) and ulcerative colitis (UC) and their correlation to disease activity.
Materials And Methods:
Children with CD and UC (aged 8-18 years) and age-matched healthy controls without respiratory symptoms were recruited. Disease activity was assessed using validated scores. All children performed spirometry and FeNO tests and the association between intestinal disease parameters and pulmonary functions was studied.
Results:
Thirty-five children with CD, nine with UC, and 24 healthy controls were enrolled. The mean FeNO level was higher in children with CD compared with the controls. Increased FeNO levels (>23 parts per billion) were more common among CD and UC compared with healthy children (46, 33, and 0%, respectively, P<0.05). Nevertheless, FeNO levels did not correlate with disease activity. There were no significant differences between CD, UC patients, and healthy controls in any of the spirometric variables.
Conclusion:
FeNO level, a marker of airway inflammation, is elevated in children with inflammatory bowel diseases irrespective of their intestinal disease activity. Increased FeNO levels are not associated with respiratory symptoms, suggesting a latent pulmonary involvement in the systemic disease.
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