Clinical Patterns of Crohn’s Disease in Greece: A Follow-Up Study of 155 Cases

Abstract

The aim of this prospective study was to elucidate the clinical features and natural history of Crohn’s disease in Greece. One hundred and fifty-five Greek patients with definite diagnosis of Crohn’s disease were followed-up for a mean period of 9.7 years and evaluated for clinical patterns and course of illness. The male/female ratio was 1.58:1. The peak incidence of the disease was observed between 20 and 30 years of age. The majority of patients were urban dwellers and of higher socio-economic level compared to the general population of Greece. In almost 50% of the patients symptoms of the disease started below the age of 30, although in almost one in every 5 cases, symptoms appeared after the age of 50. Familial clustering of inflammatory bowel disease was observed in 1.3%. The pattern of anatomic involvement was: ileocolic 33.3%, colon 33.3% and small bowel 33.3%. The kind of predominant symptoms at the time of diagnosis was related to the anatomic location of the disease. At least one extraintestinal manifestation appeared in 42% of patients. Perianal disease was noticed in 21.3% with fistulae and abscesses being the most common manifestation. Fifty-one percent of patients were operated upon at least once during the follow-up period because of acute abdomen, bad response to conservative treatment and fistulae and abscesses. Emergency operation was required in 17.3% of the patients. Evolution to cancer was observed in 3 patients (2%). During the follow-up period of 9.7 ± 6.5 years, 18 patients (11.6%) died. A considerable mortality was noticed in the surgically treated group of patients, while in the nonoperated group the disease was running with milder symptoms. It is concluded that some of the clinicoepidemiological characteristics of patients with Crohn’s disease in Greece are in accordance with those reported from western as well as the neighboring Mediterranean countries. However, other parameters such as the higher incidence of the disease in males, the low incidence of familial clustering, and the low incidence of perianal disease, underline the importance of environmental, genetic and other factors on the evolution and behavior of the disease in different parts of the world.

Clinical features and epidemiology of spondyloarthritides associated with inflammatory bowel disease

“…So, Maeda et al [46] found that out of 203 Japanese CD patients, 21 had arthritis (10.3%) and 3 had spondylitis (1.5%). Triantafillidis et al [47] reported a frequency of 30% of arthritis/arthralgias in a cohort of 155 Greek CD patients. The study by Bernstein et al [48] from Canada was based on the ICD code from hospitalized patients with IBD reporting a 4% prevalence of AS with male CD patients being more frequently affected than male UC patients.…”

Evolução da ocorrência (1980-1999) da doença de Crohn e da retocolite ulcerativa idiopática e análise das suas características clínicas em um hospital universitário do sudeste do Brasil

“…Do mesmo modo, as manifestações clínicas da DC e da RCUI nos casos da presente série, bem como os relativos à localização anatômica das lesões inflamatórias não diferem das descrições publicadas (10,11,26) . Deve ser registrada, porém, a virtual ausência de pacientes com retite ou proctite isoladas.…”

Chios mastic treatment of patients with active Crohn’s disease

“…C r o h n's d i sea se (C D ) i s a ch r o n i c i n f l a m mator y disease of unknown etiology that may affect any level of the gastrointestinal tract [1][2][3] . It is well established that immunological mechanisms are involved in the pathogenesis of the disease.…”