title: Granulomatous bronchiolitis associated with Crohn's disease.
abstract: Symptomatic bronchopulmonary disorders have been only occasionally reported in Crohn's disease, although several studies have documented the possibility of latent involvement of the respiratory tract. We report the case of a patient with long-standing Crohn's disease who presented with acute transient chest pain and a recent history of mild dyspnea and nonproductive cough. Chest radiographs were normal, while high-resolution computed tomography demonstrated a mosaic pattern of attenuation that was consistent with a bronchiolar disorder. Pulmonary function tests showed mild airway obstruction and normal diffusion indices. Thoracoscopic lung biopsy demonstrated focal infiltration of the bronchiolar walls by mononuclear cells and non-necrotizing granulomas. To our knowledge, this is the first account of isolated granulomatous bronchiolitis in Crohn's disease. These findings suggest that a granulomatous inflammatory process of the bronchioles could be involved in the development of airway obstruction in patients with Crohn's disease.
authors.affiliation: Service de Pneumologie, Service d'Anatomo-pathologie, Service de Radiologie, Service de Gastro-entérologie, Cliniques Universitaires UCL de Mont-Godinne, Yvoir, Belgium.
authors.forename: O
authors.initials: O
authors.lastname: Vandenplas
authors.forename: S
authors.initials: S
authors.lastname: Casel
authors.forename: M
authors.initials: M
authors.lastname: Delos
authors.forename: J P
authors.initials: JP
authors.lastname: Trigaux
authors.forename: M
authors.initials: M
authors.lastname: Melange
authors.forename: E
authors.initials: E
authors.lastname: Marchand
mesh_terms: D000328:Adult; D000402:Airway Obstruction / Q000209:etiology; D001706:Biopsy; D001988:Bronchiolitis / Q000150:complications* / Q000175:diagnosis; D002637:Chest Pain / Q000209:etiology; D003371:Cough / Q000209:etiology; D003424:Crohn Disease / Q000150:complications*; D004417:Dyspnea / Q000209:etiology; D005260:Female; D015769:Granuloma, Respiratory Tract / Q000150:complications* / Q000175:diagnosis; D006801:Humans; D007963:Leukocytes, Mononuclear / Q000473:pathology; D013906:Thoracoscopy; D014057:Tomography, X-Ray Computed