Extraintestinal complications of inflammatory bowel disease

Orchard, Tim

doi:10.1007/s11894-003-0042-6

Cited by 58 publications

(33 citation statements)

References 37 publications

(35 reference statements)

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“…Recently, the region of the major histocompatibility complex (MHC) class I chain-related genes was reported to be important in the pathogenesis of PSC [24]. The significance of human leukocyte antigen (HLA) genes has also been demonstrated in providing a genetic predisposition to other EIMs of IBD [25], but no association with NOD2 mutations was observed [13,26].…”

Section: Discussionmentioning

confidence: 99%

Haptoglobin Polymorphisms Are Associated with Crohn’s Disease, Disease Behavior, and Extraintestinal Manifestations in Hungarian Patients

et al. 2007

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Functional differences and association with inflammatory disorders were found relating to three major haptoglobin (Hp) phenotypes. Our aim was to investigate Hp polymorphisms in Hungarian patients with Crohn's disease (CD). Four hundred sixty-eight CD patients and 384 healthy controls were examined. Hp phenotypes were determined by sodium dodecyl sulfate-polyacrylamide gel electrophoresis and immunoblotting of the sera. The frequency of the Hp(1) allele was significantly higher in CD (0.395; OR, 1.24; 95% CI, 1.02-1.52; P=0.03) compared to controls (0.345). In CD, Hp phenotype was associated with disease behavior (OR [Hp(2-1) vs other], 2.06; 95% CI, 1.29-3.28 for inflammatory behavior). Furthermore, an increased frequency of primary sclerosing cholangitis was observed in the Hp 2-2 compared to the Hp 1-1 phenotype (6.5% vs. 0.0%; P=0.039). We conclude that the Hp polymorphism is associated with CD, inflammatory disease behavior, and primary sclerosing cholangitis in Hungarian patients. Further studies are required to evaluate the significance of Hp polymorphisms in other populations from geographically diverse regions.

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Section: Discussionmentioning

confidence: 99%

Haptoglobin Polymorphisms Are Associated with Crohn’s Disease, Disease Behavior, and Extraintestinal Manifestations in Hungarian Patients

et al. 2007

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“…133 Supportive therapy, including bed rest and avoidance of contact irritation of affected areas, has a relevant role. However, in situations where lesions occur during the quiescent phase, low doses of oral steroids can lead to rapid remission of the cutaneous lesions in most cases.…”

Section: Sweet's Syndromementioning

confidence: 99%

Cutaneous Manifestations in Patients With Inflammatory Bowel Diseases

Marzano

Borghi

Stadnicki

et al. 2014

Inflammatory Bowel Diseases

114

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The skin is one of the most common extraintestinal organ system affected in patients with inflammatory bowel disease (IBD), including both Crohn's disease and ulcerative colitis. The skin manifestations associated with IBD are polymorphic and can be classified into 4 categories according to their pathophysiology: (1) specific, (2) reactive, (3) associated, and (4) induced by IBD treatment. Cutaneous manifestations are regarded as specific if they share with IBD the same granulomatous histopathological pattern: perianal or metastatic Crohn's disease (commonly presenting with abscesses, fistulas or hidradenitis suppurativa-like features) is the prototype of this setting. Reactive cutaneous manifestations are different from IBD in the histopathology but have close physiopathological links: pyoderma gangrenosum, a neutrophil-mediated autoinflammatory skin disease typically manifesting as painful ulcers, is the paradigm of this group. Among the cutaneous diseases associated with IBD, the most commonly seen are erythema nodosum, a form of panniculitis most commonly involving bilateral pretibial areas, and psoriasis, a T helper 1/T helper 17-mediated erythematous squamous inflammatory disease. Finally, the number of cutaneous adverse reactions because of IBD therapies is progressively increasing. The most frequent drug-induced cutaneous manifestations are psoriasis-like, eczema-like, and lichenoid eruptions, as well as cutaneous lupus erythematosus for biologics, and nonmelanoma skin cancer, mainly basal cell and squamous cell carcinomas for thiopurines.

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“…As many as 36% of the IBD patients have at least one EIM: some correlate to the activity of bowel inflammation (joint, skin, and ocular manifestations), some to small bowel dysfunction (cholelithiasis or nephrolithiasis), while others are nonspecific disorders (osteoporosis or hepatobiliary disease) [1]. The most frequent EIMs in IBD are arthropathies (4–23%), followed by cutaneous manifestations (2–34%), ocular manifestations (4–12%), hepatobiliary diseases (5–15%), and metabolic bone diseases [2]. Muscular involvement in IBD is rarely reported in the literature [3].…”

Section: Introductionmentioning

confidence: 99%

Isolated Bilateral Gastrocnemius Myositis in Crohn Disease Successfully Treated with Adalimumab

Prampero

Marino

Toso

et al. 2016

Case Rep Gastroenterol

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Extraintestinal manifestations are common in inflammatory bowel disease; however, muscular involvement in Crohn disease is rarely reported. We present a case of a 26-year-old male with ileocolonic Crohn disease who developed sudden tenderness in both calves. Doppler ultrasound was negative for deep vein thrombosis. Magnetic resonance imaging of the gastrocnemius muscle showed high intensity signal in the muscle fibers, and muscle biopsy demonstrated nonspecific lymphocytic myositis. Other relevant laboratory results included normal antineutrophil cytoplasmic antibodies and creatine kinase as well as elevated C-reactive protein, erythrocyte sedimentation rate, and anti-Saccharomyces cerevisiae IgG titer. The patient was in clinical remission, being treated with azathioprine 2.5 mg/kg. Prednisone 60 mg/day was initiated with rapid resolution of calf tenderness; however, tenderness soon returned when the dose was tapered to 10 mg/day. Subsequently, prednisone and azathioprine were discontinued, and adalimumab was started at standard induction and maintenance doses. The patient’s symptoms resolved shortly after the first induction dose. A repeat magnetic resonance imaging of the calves – 3 months after starting adalimumab – showed complete resolution of muscle inflammation. To our knowledge, this is the first case of gastrocnemius myositis – a rare extraintestinal manifestation of Crohn disease – successfully treated with anti-tumor necrosis factor agents.

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Extraintestinal complications of inflammatory bowel disease

Cited by 58 publications

References 37 publications

Haptoglobin Polymorphisms Are Associated with Crohn’s Disease, Disease Behavior, and Extraintestinal Manifestations in Hungarian Patients

Haptoglobin Polymorphisms Are Associated with Crohn’s Disease, Disease Behavior, and Extraintestinal Manifestations in Hungarian Patients

Cutaneous Manifestations in Patients With Inflammatory Bowel Diseases

Isolated Bilateral Gastrocnemius Myositis in Crohn Disease Successfully Treated with Adalimumab

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