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Case Reports: Unusual association of diseases/symptoms
Cavitary lung nodules as an extraintestinal manifestation of ulcerative colitis
  1. Nicole Paul1,
  2. Mark Lazarev2,
  3. Kristina Montemayor3 and
  4. Alexandra J Horne1
  1. 1Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
  2. 2Division of Gastroenterology and Hepatology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
  3. 3Division of Pulmonary and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
  1. Correspondence to Dr Nicole Paul; npaul11{at}jh.edu

Abstract

A man in his 30s with ulcerative colitis (UC) on immunosuppressive agents and extensive travel history presented with subacute dyspnoea and dry cough. CT of the chest demonstrated numerous cavitary pulmonary nodules. An extensive infectious, malignant and autoimmune evaluation was pursued, ultimately with histopathology most consistent with necrobiotic lung nodules as an extraintestinal manifestation of UC. Steroids and ustekinumab were initiated with improvement in symptoms and resolution of cavitary lesions on follow-up imaging. In a patient with inflammatory bowel disease and cavitary lung lesions, necrobiotic lung nodules should be considered, particularly when evaluation for infectious causes is negative.

  • Inflammatory bowel disease
  • Respiratory medicine
  • Biological agents
  • Ulcerative colitis

http://dx.doi.org/10.1136/bcr-2022-251976

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    Footnotes

    • Contributors NP contributed to conceptualisation and writing of the original draft. ML and KM contributed to review and editing. AJH contributed to conceptualisation, writing of the original draft, review and editing, visualisation and supervision.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.