A patient with idiopathic inflammatory bowel disease (IBD - Crohn's disease or ulcerative colitis) may develop a chronic tracheobronchitis.

The tracheobronchitis:

(1) tends to affect young women

(2) may correlate with an exacerbation of the IBD


Clinical features:

(1) dry or productive cough

(2) dyspnea on exertion

(3) wheezing

(4) stridor


Laboratory findings:

(1) mild leukocytosis

(2) elevation in erythrocyte sedimentation rate (ESR) or C-reactive protein (CRP)

(3) inflammation in sputum and/or bronchial washings


Respiratory function testing:

(1) upper airway obstructive pattern in the flow-volume loop

(2) hyperresponsive bronchi


Imaging studies should not show an infiltrate in the lung fields unless there is another process such as pneumonia or pneumonitis.


Bronchoscopy may show:

(1) inflammation of the airway mucosa

(2) stenosis in the upper airway


Complications may include:

(1) progression to respiratory failure

(2) stenosis of the upper airway


Differential diagnosis:

(1) chronic bronchitis associated with COPD

(2) infectious bronchitis

(3) pulmonary toxicities of medications

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