Ulcerative colitis and steroid-responsive, diffuse interstitial lung disease. A trial of N = 1

Area of Science:

• Pulmonology
• Gastroenterology
• Rheumatology

Background:

• Ulcerative colitis (UC) is a chronic inflammatory bowel disease.
• Extracolonic manifestations can affect various organ systems in UC patients.
• Pulmonary involvement in UC is rare but recognized.

Observation:

• A patient with UC and extracolonic manifestations developed diffuse interstitial pulmonary disease.
• Symptoms included cough and exertional dyspnea, with radiographic evidence of infiltrates.
• Pulmonary function tests showed reduced forced vital capacity.

Findings:

• Transbronchial biopsy revealed interstitial infiltrates and mild fibrosis, excluding vasculitis or granulomas.
• High-dose glucocorticoid therapy led to rapid symptomatic improvement.
• Pulmonary function and radiographic findings improved over 2.5 years with continued glucocorticoid treatment.

Implications:

• Glucocorticoids are effective in managing drug-induced interstitial lung disease in UC patients.
• This case highlights the importance of considering pulmonary complications in UC.
• Prompt diagnosis and treatment can lead to favorable outcomes in UC-related lung disease.