Clin Endosc.  2016 Mar;49(2):202-206. 10.5946/ce.2015.059.

Tracheal Involvement in Crohn Disease: the First Case in Korea

• Park S
• Park J
• Kim HK
• Kim JY
• Hur SC
• Lee JH
• Jung JW
• Lee J

• KMID: 2165047
• DOI: http://doi.org/10.5946/ce.2015.059

Abstract

Respiratory involvement in Crohn disease (CD) is rare condition with only about a dozen reported cases. We report the first case of CD with tracheal involvement in Korea. An 18-year-old woman with CD was hospitalized because of coughing, dyspnea, and fever sustained for 3 weeks. Because she had stridor in her neck, we performed computed tomography of the neck, which showed circumferential wall thickening of the larynx and hypopharynx. Bronchoscopy revealed mucosal irregularity, ulceration, and exudates debris in the proximal trachea, and bronchial biopsy revealed chronic inflammation with granulation tissue. Based on these findings, we suspected CD with tracheal involvement and began administering intravenous methylprednisolone at 1 mg/kg per day, after which her symptoms and bronchoscopic findings improved.

Keyword

Crohn disease; Inflammatory bowel diseases; Tracheobronchial involvement

MeSH Terms

Adolescent
Biopsy
Bronchoscopy
Cough
Crohn Disease*
Dyspnea
Exudates and Transudates
Female
Fever
Granulation Tissue
Humans
Hypopharynx
Inflammation
Inflammatory Bowel Diseases
Korea*
Larynx
Methylprednisolone
Neck
Respiratory Sounds
Trachea
Ulcer
Methylprednisolone

Figure

• 

  Fig. 1. (A, B) Computed tomography of neck showed abrupt narrowing of proximal trachea (arrows).

• 

  Fig. 2. Flexible bronchoscopy showed mucosal irregularity, edema, and yellowish patch-like mucosal lesion on the proximal part of trachea.

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  Fig. 3. Bronchoscopic biopsy. (A) Dense inflammatory cell infiltration in the mucosa and submucosa of trachea (H&E stain, ×10). (B) Granulation tissue representing healing of damaged tissue (H&E stain, ×100).

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  Fig. 4. Flexible bronchoscopy findings after treatment show marked improvement.

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