Table 1.

A summary of infliximab-induced interstitial lung disease in patients with ulcerative colitis

Ref #	Case presentation	Infliximab use	Signs and symptoms	Investigations	Diagnosis and outcome
120	29-year-old woman with a history of recently diagnosed UC started on infliximab presenting with progressive dyspnoea.	3 months prior to admission.	Dyspnoea, non-productive cough, night sweats and hypoxaemia.	CXR—bibasilar infiltrates. CT chest—bilateral patchy infiltrates Bronchoscopy BAL and transbronchial biopsy—non-specific inflammation. Video-assisted thoracoscopic biopsy— acute lung injury pattern and interstitial pneumonia.	Non-specific interstitial pneumonitis. Discontinuation of infliximab and corticosteroid initiation resulted in clinical improvement and complete radiological resolution at 3 months.
225	32-year-old woman with a 14-year history of pulmonary biopsy proven Langerhan’s cell histiocytosis (in chronic remission) and an 8-year history of UC started on infliximab present with dyspnoea.	6 weeks induction course prior to admission.	Fatigue, asthenia, dyspnoea, peripheral oedema, pruritus and fever.	CXR—bilateral, symmetric reticulonodular infiltrates. PFT—obstructive lung disease. CBC—eosinophilia.	Langerhan’s cell histiocytosis reactivation secondary to infliximab therapy. Discontinuation of infliximab and initiation of corticosteroids resulted in complete remission.
326	66-year-old man with a 4-year history of UC recently flared and started on infliximab therapy.	14 weeks prior to admission.	Progressive dyspnoea on exertion. No other symptoms reported.	Echocardiogram—right ventricular hypertrophy, with normal left ventricle CT chest—diffuse bilateral ground-glass opacities.	Infliximab-induced alveolitis. Discontinuation of infliximab resulted in slow improvement with complete resolution of ground-glass opacities at 6 months follow-up.
427	63-year-old woman with UC maintained on azathioprine and infliximab therapy presenting with progressive dyspnoea for 3 weeks and hypoxaemia.	6 months prior to admission	Bilateral wheezing and rhonchi and increased right basal dullness on percussion.	CXR—mild, bilateral diffuse air-space disease with no pleural effusions CT chest—bilateral peripheral ground-glass opacities. Bronchoscopy showed chronic inflammation with no sign of infection on BAL Open lung biopsy—lymphocytic interstitial pneumonitis and histiocytic pneumonia with eosinophils.	Infliximab-induced interstitial lymphocytic pneumonitis and hypersensitivity histiocytic pneumonia. Discontinuation of infliximab and initiation of corticosteroids lead to complete resolution after slow tapering of steroid dose over a few months.

BAL, bronchoalveolar lavage; CXR, chest plain radiograph; PFT, pulmonary function test; CBC, complete blood count.