1
|
Eliadou E, Moleiro J, Ribaldone DG, Astegiano M, Rothfuss K, Taxonera C, Ghalim F, Carbonnel F, Verstockt B, Festa S, Maia L, Berrozpe A, Zagorowicz E, Savarino E, Ellul P, Vavricka SR, Calvo M, Koutroubakis I, Hoentjen F, Salazar LF, Callela F, Cañete Pizarro F, Soufleris K, Sonnenberg E, Cavicchi M, Wypych J, Hommel C, Ghiani A, Fiorino G. Interstitial and Granulomatous Lung Disease in Inflammatory Bowel Disease Patients. J Crohns Colitis 2020; 14:480-489. [PMID: 31602473 DOI: 10.1093/ecco-jcc/jjz165] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
BACKGROUND Interstitial lung [ILD] disease and granulomatous lung disease [GLD] are rare respiratory disorders that have been associated with inflammatory bowel disease [IBD]. Clinical presentation is polymorphic and aetiology is unclear. METHODS This was an ECCO-CONFER project. Cases of concomitant ILD or GLD and IBD, or drug-induced ILD/GLD, were collected. The criteria for diagnosing ILD and GLD were based on definitions from the American Thoracic Society and the European Respiratory Society and on the discretion of reporting clinician. RESULTS We identified 31 patients with ILD. The majority had ulcerative colitis [UC] [n = 22]. Drug-related ILD was found in 64% of these patients, 25 patients [80.6%] required hospitalisation, and one required non-invasive ventilation. The causative drug was stopped in all drug-related ILD, and 87% of patients received systemic steroids. At follow-up, 16% of patients had no respiratory symptoms, 16% had partial improvement, 55% had ongoing symptoms, and there were no data in 13%. One patient was referred for lung transplantation, and one death from lung fibrosis was reported. We also identified 22 GLD patients: most had Crohn's disease [CD] [n = 17]. Drug-related GLD was found in 36% of patients and 10 patients [45.4%] required hospitalisation. The causative drug was stopped in all drug-related GLD, and 81% of patients received systemic steroids. Remission of both conditions was achieved in almost all patients. CONCLUSIONS ILD and GLD, although rare, can cause significant morbidity. In our series, over half of cases were drug-related and therefore focused pharmacovigilance is needed to identify and manage these cases.
Collapse
Affiliation(s)
- Elena Eliadou
- Gastroenterology Department, Manchester Royal Infirmary, Manchester UK
| | - Joana Moleiro
- Instituto Portugues de Oncologia de Lisboa Francisco Gentil, Lisboa, Portugal
| | | | - Marco Astegiano
- Gastroenterologia-U, Città della Salute e della Scienza di Torino, Turin, Italy
| | - Katja Rothfuss
- Robert-Bosch Hospital, Department of Gastroenterology, Hepatology and Endocrinology, Stuttgart, Germany
| | - Carlos Taxonera
- Department of Gastroenterology, Hospital Clínico San Carlos and Instituto de Investigación del Hospital Clínico San Carlos [IdISSC], Madrid, Spain
| | - Fahd Ghalim
- Gastroenterology Department, Kremlin Bicêtre Hospital, University Paris Sud, Paris, France
| | - Franck Carbonnel
- Gastroenterology Department, Kremlin Bicêtre Hospital, University Paris Sud, Paris, France
| | - Bram Verstockt
- Department of Gastroenterology and Hepatology, University Hospitals Leuven, and Department of CHROMETA, KU Leuven, Leuven, Belgium
| | - Stefano Festa
- Ospedale San Filippo Neri, UOS Malattie Infiammatorie Croniche Intestinali Porto, Portugal
| | - Luís Maia
- Gastroenterology Department, Centro Hospitalar do Porto, Porto, Portugal
| | - Ana Berrozpe
- IBD Unit, Bellvitge's Hospital, Barcelona, SpainWarsaw, Poland
| | - Edyta Zagorowicz
- Maria Sklodowska Curie Memorial Cancer Centre and Institute of Oncology, Department of Gastroenterology,Warsaw, Poland
| | - Edoardo Savarino
- Department of Surgery, Oncology and Gastroenterology,University of Padua, Padua, Italy
| | - Pierre Ellul
- Division of Gastroenterology, Mater Dei Hospital, Valleta, Malta
| | - Stephan R Vavricka
- Department of Gastroenterology and Hepatology, Center for Gastroenterology and Hepatology, Zurich, Switzerland
| | - Marta Calvo
- Gastroenterology Department, Hospital Universitario Puerta de Hierro Majadahonda, Madrid, Spain
| | | | - Frank Hoentjen
- Department of Gastroenterology, Radboud University Medical Center, Nijmegen, The Netherlands
| | | | - Francesca Callela
- UOC Gastroenterologia, Ospedale San Giuseppe, Empoli, Firenze, Italy
| | | | - Konstantinos Soufleris
- Department of Gastroenterology, Theagenion Cancer Hospital of Thessaloniki, Thessaloniki, Greece
| | | | - Maryan Cavicchi
- Department of Gatroenterology, Clinique de Bercy, Creteil, France
| | - Joanna Wypych
- Surgery & Gastroenterology Department, Copernicus Hospital, Gdansk, Poland
| | - Christophe Hommel
- Department of Gastroenterology and Hepatology, CHU UCL Namur, Yvoir, Belgium,Catholic University of Louvain, Brussels, Belgium
| | - Alessandro Ghiani
- Schillerhoehe Lung Clinic [Robert-Bosch-Hospital], Department of Pneumology and Respiratory Medicine, Gerlingen, Germany
| | - Gionata Fiorino
- Humanitas Clinical and Research Center, Gastroenterology Department, Rozzano, Milan, Italy.,Humanitas University, Department of Biomedical Sciences, Rozzano, Milan, Italy
| | | |
Collapse
|
2
|
Ghrenassia E, Mekinian A, Chapelon-Albric C, Levy P, Cosnes J, Sève P, Lefèvre G, Dhôte R, Launay D, Prendki V, Morell-Dubois S, Sadoun D, Mehdaoui A, Soussan M, Bourrier A, Ricard L, Benamouzig R, Valeyre D, Fain O. Digestive-tract sarcoidosis: French nationwide case-control study of 25 cases. Medicine (Baltimore) 2016; 95:e4279. [PMID: 27442665 PMCID: PMC5265782 DOI: 10.1097/md.0000000000004279] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2016] [Revised: 06/19/2016] [Accepted: 06/22/2016] [Indexed: 12/21/2022] Open
Abstract
Digestive tract sarcoidosis (DTS) is rare and case-series are lacking. In this retrospective case-control study, we aimed to compare the characteristics, outcome, and treatment of patients with DTS, nondigestive tract sarcoidosis (NDTS), and Crohn disease.We included cases of confirmed sarcoidosis, symptomatic digestive tract involvement, and noncaseating granuloma in any digestive tract. Each case was compared with 2 controls with sarcoidoisis without digestive tract involvement and 4 with Crohn disease.We compared 25 cases of DTS to 50 controls with NDTS and 100 controls with Crohn disease. The major digestive clinical features were abdominal pain (56%), weight loss (52%), nausea/vomiting (48%), diarrhea (32%), and digestive bleeding (28%). On endoscopy of DTS, macroscopic lesions were observed in the esophagus (9%), stomach (78%), duodenum (9%), colon, (25%) and rectum (19%). As compared with NDTS, DTS was associated with weight loss (odds ratio [OR] 5.8; 95% confidence interval [CI] 1.44-23.3) and the absence of thoracic adenopathy (OR 5.0; 95% CI 1.03-25). As compared with Crohn disease, DTS was associated with Afro-Caribbean origin (OR 27; 95% CI 3.6-204) and the absence of ileum or colon macroscopic lesions (OR 62.5; 95% CI 10.3-500). On the last follow-up, patients with DTS showed no need for surgery (versus 31% for patients with Crohn disease; P = 0.0013), and clinical digestive remission was frequent (76% vs. 35% for patients with Crohn disease; P = 0.0002).The differential diagnosis with Crohn disease could be an issue with DTS. Nevertheless, the 2 diseases often have different clinical presentation and outcome.
Collapse
Affiliation(s)
- Etienne Ghrenassia
- AP-HP, Hôpital Saint-Antoine, Sorbonne Universités, UPMC Université Paris 06, service de médecine interne and Inflammation-Immunopathology-Biotherapy Department (DHU i2B)
| | - Arsene Mekinian
- AP-HP, Hôpital Saint-Antoine, Sorbonne Universités, UPMC Université Paris 06, service de médecine interne and Inflammation-Immunopathology-Biotherapy Department (DHU i2B)
| | - Catherine Chapelon-Albric
- APHP, Hôpital Pitié-Salpétrière, Sorbonne Universités, UPMC Université Paris 06, service de médecine interne
| | - Pierre Levy
- APHP, Hôpital Tenon, Sorbonne Universités, UPMC Université Paris 06, Public health department
| | - Jacques Cosnes
- APHP, Hôpital Saint-Antoine, Sorbonne Universités, UPMC Université Paris 06, service de gastro-entérologie, Paris
| | - Pascal Sève
- Hôpital de la Croix-Rousse, Hospices Civils de Lyon, department of internal medicine, F-Lyon. University Claude Bernard Lyon 1, F-69100, Villeurbanne
| | | | - Robin Dhôte
- APHP, Hôpital Avicenne, service de médecine interne, université Paris 13, Bobigny, France
| | - David Launay
- Hôpital Claude Huriez, service de médecine interne, Lille, France
| | - Virginie Prendki
- Department of internal medicine, Division of internal medicine and rehabilitation, rehabilitation and geriatrics, Geneva University Hospitals and University of Geneva, Geneva, Switzerland
| | | | - Danielle Sadoun
- APHP, Hôpital Avicenne, Université Paris 13, service de pneumologie, Bobigny
| | | | - Michael Soussan
- APHP, Hôpital Avicenne, Université Paris 13, service de médecine nucléaire
| | - Anne Bourrier
- APHP, Hôpital Saint-Antoine, Sorbonne Universités, UPMC Université Paris 06, service de gastro-entérologie, Paris
| | - Laure Ricard
- AP-HP, Hôpital Saint-Antoine, Sorbonne Universités, UPMC Université Paris 06, service de médecine interne and Inflammation-Immunopathology-Biotherapy Department (DHU i2B)
| | - Robert Benamouzig
- APHP, Hôpital Avicenne, Université Paris 13, service de gastro-entérologie, Bobigny, France
| | - Dominique Valeyre
- APHP, Hôpital Avicenne, Université Paris 13, service de pneumologie, Bobigny
| | - Olivier Fain
- AP-HP, Hôpital Saint-Antoine, Sorbonne Universités, UPMC Université Paris 06, service de médecine interne and Inflammation-Immunopathology-Biotherapy Department (DHU i2B)
| |
Collapse
|
4
|
Bermejo PE, Burgos A. [Neurological complications of inflammatory bowel disease]. Med Clin (Barc) 2008; 130:666-75. [PMID: 18501131 DOI: 10.1157/13120693] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Although ulcerative colitis and Crohn's disease have traditionally been considered to be inflammatory diseases limited to the gastrointestinal tract, it has been shown that both pathologies are frequently accompanied by various extraintestinal disorders. There is an increasing evidence that they may also manifest in the nervous system, including the peripheral and the central parts. Although some of these neurological complications have been known for a long time, such as cerebrovascular disease, vasculitis and autoinmune processes including neuropathies and cerebral demyelination, others have been recently described. With the exception of some of this complications such as the thromboembolism, evidence for a casual relationship relies merely on single case reports or case series. In this article, we try to review the existing evidence on neurological manifestations of both variants of inflammatory bowel disease.
Collapse
Affiliation(s)
- Pedro Emilio Bermejo
- Servicio de Neurología, Hospital Universitario Puerta de Hierro, Madrid, España.
| | | |
Collapse
|