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Progressive stridor: extraintestinal airway manifestations in a pediatric patient with inflammatory bowel disease

Kaitlyn Kuntzman1, Sri Kiran Chennupati2, Naser Tolaymat3

  • 1Division of Pediatrics, Lehigh Valley Reilly Children's Hospital, Allentown, USA. Kaitlyn.kuntzman2@gmail.com.

Clinical Journal of Gastroenterology
|August 2, 2022
PubMed

Insights

Pediatric inflammatory bowel disease can rarely affect airways, causing severe breathing problems. This case highlights airway obstruction in a child with ulcerative colitis, successfully treated with steroids.

Area of Science:

  • Pediatric Pulmonology
  • Gastroenterology
  • Rheumatology

Background:

  • Airway manifestations are uncommon complications of pediatric inflammatory bowel disease.
  • Ulcerative colitis (UC) primarily affects the gastrointestinal tract, but extraintestinal manifestations can occur.

Observation:

  • A nine-year-old female presented with two months of progressive stridor and dyspnea.
  • Spirometry revealed severe upper airway obstruction.
  • Imaging (CT scan) showed significant tracheal narrowing with circumferential thickening and nodularity.

Findings:

  • Bronchoscopy identified granulation tissue and an ulcerative lesion in the large airways.
  • The patient was diagnosed with extraintestinal manifestations of UC.
  • Multidisciplinary evaluation involved gastroenterology, oncology, and rheumatology.

Implications:

  • This case underscores the importance of considering airway involvement in pediatric IBD.
  • Systemic corticosteroid therapy effectively resolved symptoms and improved pulmonary function.
  • Early diagnosis and multidisciplinary management are crucial for pediatric patients with airway complications of IBD.

Keywords:
StridorTracheal nodularityTracheal stenosis

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