To the Editor. —
The article by Balestra et al1 that reports a case of diffuse interstitial lung disease that developed 14 months after total colectomy for ulcerative colitis is of interest, but I think that the authors have exercised poetic license in making the assumption that the lung disease was related to the ulcerative colitis. A probable and much more reasonable assumption is that the patient who had had ulcerative colitis subsequently developed unrelated lung disease one year after surgery. Both ulcerative colitis and interstitial lung disease are quite common. Rarely, the diseases will occur in the same patient but this does not necessarily imply any relationship. To establish a definite relationship, one would have to show that there was an increased incidence of interstitial lung disease in patients with ulcerative colitis or that there was an increased incidence of ulcerative colitis in patients with interstitial lung disease.
Janower ML. Ulcerative Colitis and Diffuse Interstitial Lung Disease: Rare Association or Complete Coincidence?. JAMA. 1989;261(3):381–382. doi:10.1001/jama.1989.03420030055023
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