engleski

Extraintestinal manifestations in inflammatory bowel disease ; the prevalence in tertiary referral center

Background: Inflammatory bowel disease (IBD) patients (pts) frequently suffer one or more extraintestinal manifestations (EIMs) during their course of disease. EIMs are important because they can produce greater morbidity than the underlying intestinal disease. The aim of the study was to evaluate the prevalence of EIMs in IBD patients hospitalized in tertiary referral center and to assess the relationship between disease phenotype and EIM. Methods: The clinical backgrounds of 324 IBD patients, 212 with Crohn’s disease (CD) and 112 with ulcerative colitis (UC), were analyzed respectively. Patients were phenotyped according to Montreal classification. Musculosceletal (arthritis, arthralgia, sacroileitis), skin (erythema nodosum, pyoderma gangrenosum), hepatic (primary sclerosing cholangitis (PSC), chronic hepatitis) and ocular manifestations (episcleritis, uveitis) were assessed. The relationship between disease phenotype and EIM was analyzed statistically. Results: In our cohort regarding to behaviour there were 94 CD pts (44.5%) with inflammatory type (B1), 71 pts (33.5%) with stricturing (B2) and 47 pts (22.1%) with penetrating behaviour (B3). Perianal disease (p) had 74 pts (35.07%). Regarding localization 71 CD pts (33.65%) had ileal disease (L1), colonic localization (L2) had 34 CD pts (16.11%), ileocolonic localization (L3) had 104 pts (49.29%) and isolated upper gastrointestinal tract (L4) involvement had 3 pts (1.41%). There were 11 UC patients (9.9%) with proctitis, 23 pts (20.7%) with left-sided colitis and 78 pts (69.4%) with extensive colitis. Overall prevalence of EIMs in IBD pts was 22.2%. EIMs were confirmed in 48 pts (22.6%) with CD and 24 pts (21.4%) in UC (p = 0.889, Fisher). There was no significant difference in the prevalence of musculosceletal, ocular and skin manifestations between CD and UC pts. PSC was significantly more discovered in UC than in CD group (p = 0.008, Fisher). Extension of UC disease did not influence the prevalence of EIMs. Ileal localization (L1) in CD patients influenced the presence of skin manifestations (p = 0.038). There was also noticed an association between inflammatory behaviour (B1) and skin manifestations (p = 0.05). Conclusions: The reported frequency of EIMs in our IBD cohort is in accordance with previously published results. The significant association between UC and PSC was also confirmed. Two recognized associations between inflammatory CD phenotype and ileal disease with skin manifestations needs to be clarifyed in a larger cohort of patients.

extraintestinal manifestations; inflammatory bowel disease

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