炎症性肠病相关肺损伤的诊治策略

摘要/Abstract

摘要： 炎症性肠病(inflammatory bowel disease,IBD)是一种慢性、复发性的胃肠道炎症性疾病,常伴有肠外表现,可严重影响患者的生活质量,甚至危及生命。肺损伤是IBD罕见且易被忽视的肠外表现,其形式主要包括气道疾病、肺间质疾病、肺栓塞、胸膜疾病及药物所致肺损伤。本文总结了IBD相关肺损伤的类型、临床特点和治疗等方面的研究进展,旨在为临床诊疗提供参考。未来通过多学科协作诊疗模式将有助于提高IBD相关肺损伤的诊治水平。

关键词: 炎症性肠病, 肠外表现, 肺损伤, 多学科团队协作

Abstract: Inflammatory bowel disease (IBD) is a chronic and recurrent gastrointestinal inflammatory disorder, often accompanied by extraintestinal manifestations (EIM), which can seriously affect the quality of life of IBD patients and sometimes even threaten their lives. Lung injury is a rare and easily overlooked extraintestinal manifestation of IBD. IBD combined with lung injury includes airway diseases, interstitial lung diseases, pulmonary embolism, pleural diseases, and drug-related lung injury. This article summarizes the progress in the types, clinical characteristics, and treatment of IBD combined with lung injury, aiming to provide a strategy for the diagnosis and treatment of IBD combined with lung injury. In the future, multidisciplinary collaborative diagnosis and treatment will become the main diagnosis and treatment mode of IBD complicated with lung injury.

Key words: Inflammatory bowel disease, Extraintestinal manifestations, Lung Injury, Multidisciplinary team collaboration

中图分类号:

R574

葛文松. 炎症性肠病相关肺损伤的诊治策略[J]. 内科理论与实践.

GE Wensong. Diagnosis and Management strategy of Lung Injury in Inflammatory Bowel Disease[J]. Journal of Internal Medicine Concepts & Practice.

参考文献

[1] Gordon H, Burisch J, Ellul P, et al.ECCO guidelines on extraintestinal manifestations in Inflammatory bowel disease[J]. J Crohn's Colitis,2024,18(1):1-37.
[2] Pemmasani G, Loftus EV, Tremaine WJ.Prevalence of pulmonary diseases in association with inflammatory bowel disease[J]. Dig Dis Sci,2022,67(11):5187-5194.
[3] Saez A, Herrero-Fernandez B, Gomez-Bris R, et al.Pathophysiology of inflammatory bowel disease: innate immunesystem[J]. Int J Mol Sci,2023,24(2):1526.
[4] Jarmakiewicz-Czaja S, Zielińska M, Sokal A, et al.Genetic and epigenetic etiology of inflammatory bowel disease: an update[J]. Genes (Basel),2022,13(12):2388.
[5] Kröner PT, Lee A, Farraye FA, et al.Respiratory tract manifestations of inflammatory bowel disease[J]. Inflamm Bowel Dis,2021,27(4):563-574.
[6] Camba-Gómez M, Arosa L, Gualillo O, et al.Chemokines and chemokine receptors in inflammatory bowel disease: Recent findings and future perspectives[J]. Drug Discov Today,2022,27(4):1167-1175.
[7] Du BX, Fu Y, Han YX, et al.The lung-gut crosstalk in respiratory and inflammatory bowel disease[J]. Front Cell Infect Microbiol,2023,13:1218565.
[8] Rogler G,Singh A,Kavanaugh A,et al.Extraintestinal manifestations of inflammatory bowel disease:current concepts, treatment, and implications for disease management[J]. Gastroenterology,2021,161(4):1118-1132.
[9] Jacobsen HA, Karachalia Sandri A, Weinreich UM, et al.Increased risk of obstructive lung disease in inflammatory bowel disease: a population-based cohort study[J]. United European Gastroenterol J,2024,12(4):477-486.
[10] Alhalabi M, Ali Deeb S, Ali F, et al.Ulcerative colitis-associated bronchiectasis: a rare extraintestinal manifestation of inflammatory bowel disease: a case report[J]. Medicine(Baltimore),2022,101(34):e30202.
[11] Ellrichmann M, Bethge J, Boesenkoetter J, et al.Subclinical pulmonary involvement in active IBD responds to biologic therapy[J]. J Crohn's Colitis,2021,15(8):1339-1345.
[12] Massart A, Hunt DP.Pulmonary manifestations of infammatory bowel disease[J]. Am J Med,2020,133(1):39-43.
[13] Cheng K, Faye AS.Venous thromboembolism in inflammatory bowel disease[J]. World J Gastroenterol,2020,26(12):1231-1241.
[14] Higgins PDR, Skup M, Mulani PM, et al.Increased risk of venous thromboembolic events with corticosteroid vs biologic therapy for inflammatory bowel disease[J]. Clin Gastroenterol Hepatol,2015,13(2):316-321.
[15] Detrez I, Thomas D, Van Steen K, et al.Successful infliximab treatment is associated with reversal of clotting abnormalities in Inflammatory bowel disease patients[J]. J Clin Gastroenterol,2020,54(9):819-825.
[16] Tanoglu A,Tekin Ö, Düzenli T, et al.A diagnostic conundrum in a newly diagnosed ulcerative colitis patient who presented with pleuropericardial effusion[J]. Ann Colorectal Res,2019,7(2): 1-4.
[17] Dierkes-Globisch A, Mohr HH.Pulmonary function abnormalities in respiratory asymptomatic patients with inflammatory bowel disease[J]. Eur J Intern Med,2002, 13(6):385.
[18] Georgakopoulou VE, Tarantinos K, Papalexis P, et al.Role of pulmonary function testing in inflammatory bowel diseases(Review)[J]. Med Int(Lond),2022,2(4):25.
[19] Takuro S, Manabu T, Isho I, et al.Mesalazine-induced lung injury in a child; the value of bronchoscopy[J]. Pediatr Int,2021,63(11):1402-1404.
[20] Pereira FM, Marques C, Boncoraglio T, et al.Mesalazine-induced hypersensitivity pneumonitis[J]. Eur J Case Rep Intern Med,2021,8(1):002194.
[21] Sablin OA, Chernousova VV, Komlev AD.Lung disease/pneumonitis in a patient with ulcerative colitis due to mesalazine[J]. Ter Arkh,2021,93(2):199-203.
[22] Nagy F, Molnar T, Makula E, et al.A case of interstitial pneumonitis in a patient with ulcerative colitis treated with azathioprine[J]. World J Gastroenterol,2007,13(2):316-319.
[23] Ananthakrishnan AN, Attila T, Otterson MF, et al.Severe pulmonary toxicity after azathioprine/6-mercaptopurine initiation for the treatment of inflammatory bowel disease[J]. J Clin Gastroenterol,2007,41(7):682-688.
[24] Atzeni F, Boiardi L, Sallì S, et al.Lung involvement and drug-induced lung disease in patients with rheumatoid arthritis[J]. Expert Rev Clin Immunol,2013,9(7):649-657.
[25] Fragoulis GE,Conway R, Nikiphorou E.Methotrexate and interstitial lung disease: controversies and questions. A carrative review of the literature[J]. Rheumatology(Oxford),2019,58(11):1900-1906.
[26] (已撤稿,需替换) Rajizadeh MA, Hosseini MH, Bahrami M, et al. Comparison of preventive and therapeutic effects of continuous exercise on acute lung injury induced with methotrexate[J]. Exp Physiol,2023,108(9):1215-1227.
[27] Aqsa A, Sharma D, Chalhoub M.Adalimumab induced interstitial lung disease[J]. Respir Med Case Rep,2020,29:101012.
[28] Perez-Alvarez R, Perez-de-Lis M, Diaz-Lagares C, et al. Interstitial lung disease induced or exacerbated by TNF-targeted therapies: analysis of 122 cases[J]. Semin Arthritis Rheum,2011,41(2):256-264.
[29] Pugliese D, Privitera G, Schepis T, et al.Drug-related pneumonitis in patients receiving vedolizumab therapy for inflammatory bowel disease[J]. Clin Gastroenterol Hepatol,2022,20(6): e1483-e1487.
[30] Brinker A, Cheng C, Chan V.Association of noninfectious pneumonia with ustekinumab use[J]. JAMA Dermatol,2019,155(2): 221-224.
[31] Kalra SS, Chizinga M, Trillo-Alvarez C, et al.Ustekinumab associated chronic eosinophilic pneumonia[J]. J. Asthma,2021,58(12):1670-1674.
[32] Ytterberg SR, Bhatt DL, Mikuls TR, et al.Cardiovascular and cancer risk with tofacitinib in rheumatoid arthritis[J]. N Engl J Med,2022,386(4):316-326.