Tracheal Stenosis Related to Ulcerative Colitis

Abstract

Background: Ulcerative colitis (UC) is a chronic inflammatory disease of the intestines. UC-related respiratory disease is fairly rare. Early diagnosis is important and can prevent significant potential effects, but can be challenging, due to mild symptoms and inconclusive radiology findings. This report describes some elements that can assist with early diagnosis. Case Report: A 41-year-old female with diagnosed UC and Takayasu arteritis presented with a dry cough ongoing for 3 weeks. The patient had experienced no recent symptoms related to UC and had discontinued use of medication. A pulmonary function test (PFT) indicated an obstruction during inhalation and exhalation in the flow-volume loop. Irregular diffuse tracheal wall thickening was observed on chest computed tomography images. Bronchoscopy revealed that the trachea/ bronchus had a rough, hyperemic appearance. Lymphoplasmacytic inflammation observed in the bronchus biopsy sample was compatible with UC-related respiratory disease. No symptoms or obstruction were seen in the PFT after 2 months of treatment with azathioprine and methylprednisolone. Conclusion: Early bronchoscopy in patients with unclear radiological findings is important for an early diagnosis and the prevention of potentially irreversible complications in UC-related respiratory disease.