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
