Moda et al reviewed lung diseases associated with ulcerative colitis. Understanding the particular type of involvement is important for patient management. The authors are from multiple institutions in Tokyo.
Patient selection: ulcerative colitis
Ulcerarive colitis-related lung disease (UCLD) was defined as all of the following:
(1) the presence of significant respiratory symptoms
(2) CT features of pulmonary involvement
(3) in a patient with ulcerative colitis
(4) without other known cause.
Types of UCLD:
(1) airway disease: chronic productive cough for >= 3 months AND CT evidence of bronchiectasis, bronchial wall thickening, centrilobular nodules and/or branching linear opacities
(2) organizing pneumonia: respiratory or systemic findings AND patchy consolidation or other CT changes consistent with organizing pneumonia
(3) interstitial pneumonia other than organizing pneumonia: respiratory symptoms AND CT changes (diffuse ground-glass opacities, reticulation, traction bronchiectasis, volume loss and/or honeycombing)
(4) pleuritis
Airway disease responds favorably to inhaled or systemic corticosteroids but may be recurrent.
Organizing pneumonia may be drug-induced, as suggested by improvement after drug discontinuation with or without corticosteroid therapy.
The prognosis of a patient with interstitial pneumonia depends on the degree and progression of fibrosis.
