title: Pulmonary involvement: a rare extraintestinal manifestation of ulcerative colitis.
abstract: Ulcerative colitis (UC) is associated with a number of extraintestinal manifestations (EIMs) that may affect most organ systems. Among the EIMs, those involving the lung are rare. We report a case of pulmonary involvement and pyoderma gangrenosum in a patient with refractory UC. A chest computed tomography showed multiple nodular infiltrates in bilateral lungs. The patient had no respiratory symptoms. No infectious agents were detected. A transbronchial biopsy specimen showed nonspecific features. Prednisolone was initiated with significant improvement in the patient's abdominal symptoms and pyoderma gangrenosum. Subsequent imaging after steroid therapy showed improvement of the pulmonary infiltrates. The patient's abdominal symptoms relapsed when prednisolone was tapered. The patient subsequently received a proctocolectomy. Chest radiographs have shown resolution of pulmonary infiltrates. Because pulmonary involvement follows an independent course and a proctocolectomy may not be protective against a recurrence of pulmonary involvement, a careful follow-up should be continued.
authors.affiliation: Department of Gastroenterology and Hematology, Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama, 2630 Sugitani, Toyama, 930-0194, Japan, junnishi@med.u-toyama.ac.jp.
authors.forename: Jun
authors.initials: J
authors.lastname: Nishikawa
authors.forename: Ayumu
authors.initials: A
authors.lastname: Hosokawa
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Mihara
authors.forename: Ryuji
authors.initials: R
authors.lastname: Hayashi
authors.forename: Shigeharu
authors.initials: S
authors.lastname: Miwa
authors.forename: Tatsuhiko
authors.initials: T
authors.lastname: Kane
authors.forename: Sohachi
authors.initials: S
authors.lastname: Nanjo
authors.forename: Takayuki
authors.initials: T
authors.lastname: Ando
authors.forename: Haruka
authors.initials: H
authors.lastname: Fujinami
authors.forename: Shinya
authors.initials: S
authors.lastname: Kajiura
authors.forename: Masami
authors.initials: M
authors.lastname: Minemura
authors.forename: Toshiro
authors.initials: T
authors.lastname: Sugiyama
mesh_terms: D003093:Colitis, Ulcerative / Q000150:complications*; D006801:Humans; D008171:Lung Diseases / Q000209:etiology*; D008297:Male; D055815:Young Adult