Introduction: Extraintestinal manifestations, including pulmonary manifestations like organizing pneumonia (OP), may be the presenting complaints in inflammatory bowel disease (IBD). In this case study, we discuss a case of OP in Crohn's disease to understand the pulmonary manifestation of IBD and its management.
Case description: A 33-year-old female came with complaints of cough with minimal expectoration, headache, vomiting for 4 days, and dyspnea on exertion for 1 day. The patient has been a known case of Crohn's disease for the past 5 years. The patient had no history of smoking. High-resolution computed tomography (HRCT) thorax done on admission showed ground glass opacities and peribronchovascular interstitial thickening in the left lung, predominantly the left lower lobe. Transbronchial lung biopsy (TBLB) was done, and histopathology was suggestive of OP. The patient improved clinically and radiologically with steroids.
Conclusion: Pulmonary manifestations of IBD are reported in numerous case studies. A patient with Crohn's disease presenting with respiratory symptoms should be carefully evaluated for infective etiology since patients are on immunosuppressants. Drug-induced lung disease is the most frequent pulmonary complication of IBD. OP is a rare manifestation of Crohn's disease, which requires careful evaluation, including bronchoscopy and biopsy, for diagnosis and management.
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