Abstract
A 23-year-old Japanese woman with Crohn’s disease treated with mesalazine one year previously presented with a four-day history of fever, dry cough, and chest pain during swallowing. Chest computed tomography revealed wall thickening on the trachea, whereas magnetic resonance imaging (MRI) confirmed a high-signal intensity and wall thickening on the trachea. Laboratory data showed leukocytosis and increased inflammatory response. We initially considered a diagnosis of bacterial infection and relapsing polychondritis, but antibiotics and steroid administration were ineffective. We considered that respiratory disorders associated with inflammatory bowel disease was unlikely, because colonoscopy showed no active findings of Crohn’s disease. However, when we interrupted mesalazine on day 12, all of the symptoms disappeared, and white cell count and inflammatory response gradually improved. Although there have been reports of mesalazine causing respiratory complications, this is the first case of lesions confined to the trachea.
