Organizing pneumonia in Crohn's disease: a case report and literature review.

Authors

Soumaya Debiche, Hela Cherif, Sarra Ben Rjeb, Ferdaous Yangui, Salma Mokaddem, Mondher Briki, Mariem Triki, Mohamed Ridha Charfi

Published in

Respiratory medicine case reports. Volume 64. Pages 102503. Epub Sep 28, 2026.

Abstract

Organizing pneumonia (OP) is a rare pulmonary manifestation in patients with inflammatory bowel disease (IBD). Distinguishing between a primary extra-intestinal manifestation of Crohn's disease (CD) and mesalazine-induced lung injury remains a major clinical challenge, as both conditions are steroid-responsive. We report the case of a 31-year-old woman with CD who developed progressive dyspnea and migratory pulmonary infiltrates one month after initiating mesalazine. Laboratory findings revealed marked peripheral eosinophilia (1276/mm³) and a mixed eosinophilic bronchoalveolar lavage profile (30.8%). Histopathology confirmed OP with Masson bodies. Due to the diagnostic overlap, mesalazine was replaced by azathioprine, and systemic corticosteroid therapy (0.75 mg/kg) was initiated. Complete radiological resolution was achieved at 8 months. This case illustrates the diagnostic complexity of eosinophilic-rich OP in CD and emphasizes that while pathology confirms the pattern, the etiology often remains a dual hypothesis between systemic disease and drug toxicity.

PMID:
42859623
Bibliographic data and abstract were imported from PubMed on 11 Oct 2026.

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