GRANULOMATOUS BRONCHIOLITIS ASSOCIATED WITH CROHNS-DISEASE

Symptomatic bronchopulmonary disorders have been only occasionally rep orted in Crohn's disease, although several studies have documented the possibility of latent involvement of the respiratory tract. We report the case of a patient with long-standing Crohn's disease who presente d with acute transient chest pain and a recent history of mild dyspnea and nonproductive cough. Chest radiographs were normal, while high-re solution computed tomography demonstrated a mosaic pattern of attenuat ion that was consistent with a bronchiolar disorder. Pulmonary functio n tests showed mild airway obstruction and normal diffusion indices. T horacoscopic lung biopsy demonstrated focal infiltration of the bronch iolar walls by mononuclear cells and non-necrotizing granulomas. To ou r knowledge, this is the first account of isolated granulomatous bronc hiolitis in Crohn's disease. These findings suggest that a granulomato us inflammatory process of the bronchioles could be involved in the de velopment of airway obstruction in patients with Crohn's disease.