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Am. J. Respir. Crit. Care Med., Volume 161, Number 3, March 2000, 1051-1054

Bronchial Hyperresponsiveness in Children and Adolescents with Crohn's Disease

ANTONIO MANSI, SALVATORE CUCCHIARA, LUIGI GRECO, PAOLA SARNELLI, CHIARA PISANTI, MARIA TERESA FRANCO, and FRANCESCA SANTAMARIA

Department of Pediatrics, Federico II University, Naples, Italy

Pulmonary manifestations have been described in Crohn's disease (CD). Bronchial responsiveness to methacholine (MCh) was evaluated in 14 children with CD with no evidence of airway disease, 10 asthmatics, and 10 healthy subjects. In patients with CD total blood eosinophils and serum IgE were 0.20 × 109 · L-1 (95% CI -1.68 to 2.08) and 138.4 kU · L-1 (95% CI 18.84 to 257.96), respectively. Three patients with CD had positive prick tests. Bronchial hyperresponsiveness (BHR) was demonstrated in 10 patients with CD (71%) and in the asthmatics, but not in control subjects. In patients with CD PD20 appeared significantly greater than in asthmatics (699 µg [95% CI 238 to 1,115] versus 104 µg [95% CI 37.35 to 293]; p < 0.05), and was not related either to baseline FEV1 or IgE or eosinophils (r = 0.32; r = -0.5; r = -0.15, p = NS, respectively). Neither activity nor treatment or duration of CD affected BHR. Five nonatopic CD patients underwent a second MCh challenge over a 25-mo period: the PD20 appeared significantly greater than basal PD20 (1,941 µg versus 575 µg, p < 0.05, respectively), in the absence of significant changes of disease activity. BHR might be the expression of subclinical airway inflammation, a phenomenon which can be responsible for the development of various pulmonary manifestations in CD. Mansi A, Cucchiara S, Greco L, Sarnelli P, Pisanti C, Franco MT, Santamaria F. Bronchial hyperresponsiveness in children and adolescents with Crohn's disease.




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