BRONCHOPULMONARY MANIFESTATION IN CROHNS- DISEASE

Symptomatic bronchopulmonary involvement is a rare extraintestinal com plication of Crohn's disease. 18 months after the diagnosis of chronic inflammatory bowel disease a 16-year old female patient developed pro longed afebrile laryngotracheobronchitis and weight loss. Sulfasalazin e treatment had been continued up to this stage and there were no conc omitant intestinal symptoms. Pulmonary function testing revealed mild restrictive impairment,the chest x-ray showed bilaterally increased in terstitial marking. On bronchoscopy there was subglottic laryngitis an d granulomatous non-purulent bronchitis. In bronchial biopsies submuco us non-caseating granulomas with epitheloid cells could be demonstrate d histologically. While clinical symptoms regressed spontaneously over the next weeks, pulmonary function impairment persisted over many mon ths. Discussion: Respiratory involvement in Crohn's disease can occur during remission of abdominal symptoms. The differential diagnosis of respiratory symptoms in patients with Crohn's disease should always in clude extraintestinal manifestations of the primary disease.