Crohn\'s disease (CD), known as the disease of gastrointestinal system, is a granulamatous systemic disorder with extraintestinal manifestations including the respiratory system. The resemblance in the embriological origins and the immunities of both organ systems\' mucosae, also the circulating immune complexes and the autoantibodies are accepted as contributing factors. The shift of inflammation may become prominent when the colon is removed after colectomy and independent of the bowel disease activity; pulmonary involvement may be exarbecated. In the pediatric population, CD associated pulmonary involvement is very rare, mainly in the form of subclinical alterations and the data are limited mostly to case reports. Therefore, it is possibly overlooked since the diagnosis relies on suspicion. We represent a 5-year-old CD patient with previous bronchiolitis episodes that might have resulted from CD-associated pulmonary involvement; whom later developed severe pneumonia resulting in acute respiratory distress syndrome and bronchiectasia following a colectomy operation.
Lu DG, Ji XQ, Liu X, Li HJ, Zhang CQ. Pulmonary manifestations of Crohn's disease. World J Gastroenterol 2014;20:133-41.
Peradzynska J, Krenke K, Lange J, Banaszkiewicz A, Lazowska-Przeorek I, Radzikowski A, et al. Low prevalence of pulmonary involvement in children with inflammatory bowel disease. Respir Med 2012;106:1048-54.
Mansi A, Cucchiara S, Greco L, Sarnelli P, Pisanti C, Franco MT, et al. Bronchial hyperresponsiveness in children and adolescents with Crohn's disease. Am J Respir Crit Care Med 2000;161 (3 Pt 1):1051-4.
Mahadeva R, Walsh G, Flower CD, Shneerson JM. Clinical and radiological characteristics of lung disease in inflammatory bowel disease. Eur Respir J 2000;15:41-8.
Papanikolaou I, Kagouridis K, Papiris SA. Patterns of airway involvement in inflammatory bowel diseases. World J Gastrointest Pathophysiol 2014;5:560-9.
Mahgoub LE, Puntis JW, Chetcuti PA, Sugarman ID. Severe Crohn disease of the lung following colectomy. J Pediatr Gastroenterol Nutr 2007;45:477-9.
Munck A, Murciano D, Pariente R, Cezard JP, Navarro J. Latent pulmonary function abnormalities in children with Crohn's disease. Eur Respir J 1995;8:377-80.
Black H, Mendoza M, Murin S. Thoracic manifestations of inflammatory bowel disease. Chest 2007;131:524-32.
Kelly MG, Frizelle FA, Thornley PT, Beckert L, Epton M, Lynch AC. Inflammatory bowel disease and the lung: Is there a link between surgery and bronchiectasis? Int J Colorectal Dis 2006;21:754-7.
Vermeire S, Van Assche G, Rutgeerts P. C-reactive protein as a marker for inflammatory bowel disease. Inflamm Bowel Dis 2004;10:661-5.
Riegert-Johnson DL, Godfrey JA, Myers JL, Hubmayr RD, Sandborn WJ, Loftus EV Jr. Delayed hypersensitivity reaction and acute respiratory distress syndrome following infliximab infusion. Inflamm Bowel Dis 2002;8:186-91.
Caccaro R, Savarino E, D'Incà R, Sturniolo GC. Noninfectious interstitial lung disease during infliximab therapy: Case report and literature review. World J Gastroenterol 2013;19:5377-80.