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Latent pulmonary function abnormalities in children with Crohn's disease
A Munck1, D Murciano, R Pariente
1Dept of Pediatric Gastroenterology and Nutrition, Hôpital Robert Debré, Paris, France.
Insights
Latent pulmonary involvement occurs in children with active Crohn's disease. Lung transfer factor for carbon monoxide (TLCO) was significantly reduced during active disease compared to remission.
Area of Science:
- Pediatric Gastroenterology
- Pulmonology
- Inflammatory Bowel Disease Research
Background:
- Latent pulmonary involvement is recognized in adult inflammatory bowel disease (IBD) patients.
- Pulmonary manifestations in pediatric IBD, particularly during different disease phases, remain understudied.
- Understanding extradigestive complications in pediatric Crohn's disease is crucial.
Purpose of the Study:
- To investigate pulmonary abnormalities in children with Crohn's disease.
- To compare pulmonary function between acute and quiescent phases of pediatric Crohn's disease.
- To assess the prevalence and nature of lung involvement in pediatric Crohn's disease.
Main Methods:
- Study included 26 children with acute or quiescent Crohn's disease.
- Evaluated clinical pulmonary symptoms, chest radiographs, and pulmonary function tests.
- Specifically measured lung transfer factor for carbon monoxide (TLCO) and compared results between disease phases.
Main Results:
- Chest radiographs were normal in all pediatric subjects.
- No significant differences in pulmonary volumes or expiratory flows were observed between acute and quiescent phases.
- Lung transfer factor for carbon monoxide (TLCO) was significantly decreased during the active phase (53%) versus remission (81%).
Conclusions:
- Latent pulmonary involvement is present in pediatric patients with active Crohn's disease.
- Reduced TLCO during active disease suggests subclinical lung dysfunction.
- Extradigestive pulmonary manifestations should be considered in the aetiopathogenesis of Crohn's disease.
Abstract:
Recently, latent pulmonary involvement has been described in adult patients with inflammatory bowel disease. It is unknown, however, whether this also occurs in children, and whether the pulmonary abnormalities differ between the acute phase and remission. The incidence of pulmonary abnormalities has been investigated in 26 children with acute or quiescent Crohn's disease in terms of the following parameters: clinical pulmonary symptoms, chest roentgenograms and pulmonary function tests, including lung transfer factor for carbon monoxide (TLCO). One child had a severe digital clubbing. Chest radiographs were normal in all subjects. No significant differences were found between acute and quiescent phase for pulmonary volumes and expiratory flows, but TLCO (% predicted) was significantly decreased during the active phase of the disease as compared to remission (53 +/- 15 vs 81 +/- 19% predicted). These data suggest that latent pulmonary involvement is also present in a paediatric population with active Crohn's disease, despite a short disease history and absence of smoking. Although the nature of this abnormality remains unclear, this extradigestive epiphenomenon should be taken into account with respect to the aetiopathogenesis of Crohn's disease.