The spectrum of respiratory diseases associated with ulcerative colitis. The respiratory diseases associated with ulcerative colitis have recently been recognized, and principally affect the bronchi. Both chronic bronchitis and bronchiectasis may develop after many years, some of the patients having already undergone colectomy. Chronic bronchitis is characterized by cough and chronic mucopurulent sputum, and these symptoms may be exacerbated during acute flare-ups of ulcerative colitis. The bronchial lesions are inflammatory and can be reversed by corticosteroid therapy. Bronchiectasis produces similar symptoms, but has distinctive radiological features. Corticosteroids may sometimes reduce the symptoms, but they have no effect on the bronchial lesions. Salicylazosulfapyridine might be responsible for hypersensitivity lung diseases with eosinophilia, but the drug does not seem to be involved in the genesis of these bronchial manifestations. There have been occasional reports of other respiratory diseases associated with ulcerative colitis, including obliterative bronchiolitis, isolated and asymptomatic airflow obstruction, inflammatory tracheal stenosis, pulmonary vasculitis, pleurisy and pleuropericarditis, chronic pneumonia and interstitial fibrosis which may be diffuse or localized to the apices.

Bronchiectasis↗

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[Bronchiectasis and definitive assisted ventilation (author's transl)].

A 39 year old female with severe respiratory insufficiency by bronchiectasis is treated by assisted ventilation at home. Indication is discussed.

Adult↗

PubMedDate not supplied

[Drug-induced respiratory complications. Study of 27 cases].

Over 8 1/2 years, we observed 27 patients with drug-induced respiratory disease (DIRD). The inducer drugs were mainly those used in cardiology (9 patients, of whom 8 had amiodarone pneumonitis), in oncology (8 patients), in rheumatology (4 patients; 3 from d-penicillamine and 1 from gold), and in neurology (4 cases from ergoline derivatives). The main pattern of DIRD was a diffuse interstitial lung disease having either a rapid, a slowly progressive or a chronic course. Only the two former patterns offered clearing following withdrawal of the drug. Severe bronchiolitis obliterans from d-penicillamine (2 cases) and pulmonary eosinophilia (2 cases) was also observed. The onset of DIRD occurred earlier, i.e. following shorter periods of drug administration (months), in the acute interstitial lung disease variant, while it occurred after years of drug exposure in subacute and chronic forms. In contrast to other reports, bronchoalveolar lavage lymphocytosis was not a prominent feature in amiodarone pneumonitis. The outcome was favourable in 16 patients; deaths was encountered during the florid phase of DIRD in 3; incapacitating sequelae were noted in 6 patients, leading to subsequent death in 2; the underlying disease accounted for 7 additional deaths. Therefore, DIRD are relatively common, develop often in patients with severe underlying conditions, and interstitial pneumonitis is their pattern of predilection. Amiodarone emerges as a common inducer, and accounted for more cases than all chemotherapeutic agents grouped together in our series.

Adult↗

PubMedDate not supplied

[Pericarditis in bird raiser's disease (author's transl)].

The authors report the case of a 53 years-old male who was presenting signs of a chronic interstitial pneumonitis. A pericarditis was found and the ECG abnormalities first disappeared, then reappeared with new exposure to birds, before making the diagnosis of bird raiser's lung on the history and the immunologic findings. The possibility of pericardial involvement during bird raiser's lung or farmer's lung is found in 4 previously reported cases.

Alveolitis, Extrinsic Allergic↗

PubMedDate not supplied