Pulmonary Manifestations of Inflammatory Bowel Disease
Bibliographic record
Abstract
1Department of Medicine, McMaster University, Hamilton, Ontario; 2Department of Medicine, University of Calgary, Calgary, Alberta Correspondence: Dr David Ryan Stather, Division of Respiratory Medicine, Health Sciences Center, 3330 Hospital Drive Northwest, Calgary, Alberta T2N 4N1. Telephone 403-210-3866, fax 403-944-1577, e-mail davestather@yahoo.ca Three patients with Crohn disease were evaluated for cough and dyspnea. A 63-year-old woman was found to have bronchiolitis obliterans and bronchiectasis that responded to oral prednisone (Figure 1A). A 38-year-old man was found to have airflow obstruction and pulmonary nodules. Open lung biopsy revealed necrobiotic nodules and bronchiolitis obliterans (Figure 1B). A 49-year-old man experienced severe airflow obstruction and was confirmed via bronchoscopy and imaging to have three different manifestations of inflammatory bowel disease (IBD); tracheobronchitis, bronchiectasis and bronchiolitis obliterans (Figures 1C and 1D). Improvements in airflow obstruction and symptoms occurred with oral prednisone. Although pulmonary manifestations have historically been believed to be a rare complication of IBD, recent publications suggest that this may be more frequent than previously recognized (1,2). Respiratory manifestations of IBD are varied and include bronchiectasis (most common), tracheobronchitis (including rare laryngeal and glottic involvement), chronic bronchitis, bronchiolitis obliterans, pulmonary nodules (necrobiotic or granulomatous), pleuritis and a variety of parenchymal and interstitial diseases (1). IBD patients are at increased risk for venous thromboembolic disease and a growing body of literature suggests a link between IBD and sarcoidosis, asthma and alpha-1 antitrypsin deficiency (1). Pulmonary manifestations rarely precede the diagnosis of IBD, do not correlate with colonic disease and may present years after colonic disease is controlled (3). A high index of suspicion for respiratory disorders is warranted in patients with IBD because it may be easily identified with appropriate history, pulmonary function testing and imaging, and may be treatable if identified early.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".