Bronchial hyperresponsiveness in children and adolescents with Crohn's disease

Pulmonary manifestations have been described in Crohn's disease (CD). Bronc hial responsiveness to methacholine (MCh) was evaluated in 14 children with CD with no evidence of airway disease, 10 asthmatics, and 10 healthy subje cts. In patients with CD total blood eosinophils and serum IgE were 0.20 x 10(9) . L-1 (95% CI -1.68 to 2.08) and 138.4 kU . L-1 (95% CI 18.84 to 257. 96), respectively. Three patients with CD had positive prick tests. Bronchi al hyperresponsiveness (BHR) was demonstrated in 10 patients with CD (71%) and in the asthmatics, but not in control subjects. In patients with CD PD, , appeared significantly greater than in asthmatics (699 mu g [95% CI 238 t o 1,115] versus 104 mu g [95% CI 37.35 to 293]; p < 0.05), and was not rela ted either to baseline FEV1 or IgE or eosinophils (r = 0.32; r = -0.5; r = -0.15, p = NS, respectively). Neither activity nor treatment or duration of CD affected BHR. Five nonatopic CD patients underwent a second MCh challen ge over a 25-mo period: the PD20 appeared significantly greater than basal P-20, (1,941 mu g versus 575 mu g, p < 0.05, respectively), in the absence of significant changes of disease activity. BHR might be the expression of subclinical airway inflammation, a phenomenon which can be responsible for the development of various pulmonary manifestations in CD.