Granulomatous bronchiolitis associated with Crohn's disease

Am J Respir Crit Care Med. 1998 Nov;158(5 Pt 1):1676-9. doi: 10.1164/ajrccm.158.5.9801070.


Symptomatic bronchopulmonary disorders have been only occasionally reported 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 presented with acute transient chest pain and a recent history of mild dyspnea and nonproductive cough. Chest radiographs were normal, while high-resolution computed tomography demonstrated a mosaic pattern of attenuation that was consistent with a bronchiolar disorder. Pulmonary function tests showed mild airway obstruction and normal diffusion indices. Thoracoscopic lung biopsy demonstrated focal infiltration of the bronchiolar walls by mononuclear cells and non-necrotizing granulomas. To our knowledge, this is the first account of isolated granulomatous bronchiolitis in Crohn's disease. These findings suggest that a granulomatous inflammatory process of the bronchioles could be involved in the development of airway obstruction in patients with Crohn's disease.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Airway Obstruction / etiology
  • Biopsy
  • Bronchiolitis / complications*
  • Bronchiolitis / diagnosis
  • Chest Pain / etiology
  • Cough / etiology
  • Crohn Disease / complications*
  • Dyspnea / etiology
  • Female
  • Granuloma, Respiratory Tract / complications*
  • Granuloma, Respiratory Tract / diagnosis
  • Humans
  • Leukocytes, Mononuclear / pathology
  • Thoracoscopy
  • Tomography, X-Ray Computed