Correct!
1. A rapid response to corticosteroid therapy suggests either organizing pneumonia or possibly eosinophilic pneumonia.

Patients with ulcerative colitis are at increased risk of developing organizing pneumonia, even if their ulcerative colitis is well-controlled (1). Ulcerative colitis (UC)-related lung disease is not rare.
In a prior study of 563 patients with UC followed for a mean period of 77 months, 5% of patients demonstrated UC-related lung disease including:

1. Airway disease (2.3%) including bronchitis, bronchiolitis and bronchiectasis
2. Organizing pneumonia (1.8%)
3. Interstitial pneumonitis (1.1%)

In patients with UC who develop evidence of parenchymal lung disease it is often attributed to medication-induced lung toxicity and this always needs to be considered. Stelara (ustekinumab) which the patient had previously received has been associated with lung toxicity (2). Although the patient described had previously been on Stelara for her UC, this had been discontinued and she was not being treated with any medication thought to be associated with organizing pneumonia. UC-associated organizing pneumonia typically responds well to corticosteroid treatment as was the case in our patient although recurrences are reported (1).

References

1. Moda M, Suga M, Kasai S, Okochi Y, Yoshimura N, Fukata M, Tokuda H. Incidence, Characteristics, Clinical Course, and Risk Factors of Ulcerative Colitis-related Lung Diseases. Chest. 2022 Dec;162(6):1310-1323. [CrossRef] [PubMed]
2. Despotes KA, Vigeland CL. Stelara struck: a case of noninfectious pneumonitis secondary to ustekinumab. BMC Pulm Med. 2022 Jul 19;22(1):280. [CrossRef] [PubMed]

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