Prevalence, risk factors and response to treatment of extra-intestinal manifestations in patients with inflammatory bowel disease

Hernández-Tejero, María; Navacerrada, Alicia Granja; Checa, Pilar Bernal; Becerra, Rubén Pique; García, Alicia Algaba; Marina, I. Guerra; García‐Alonso, Francisco Javier; Syed, Mariano; Bermejo, Fernando

doi:10.17235/reed.2017.4845/2017

Cited by 4 publications

(5 citation statements)

References 18 publications

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“…EIMs had an overall prevalence of 19% in our large series (31,077 patients with IBD). The data published to date in this regard vary widely according to the design, number of patients, and geographical location with values that range between 6 and 40% [4,9,[11][12][13][14][15][16][17][18][19][20][21][22]. Therefore, in spite of the retrospective nature of the data collection (in a registry updated prospectively), the large amount of data ensures that the results are sound.…”

Section: Discussionmentioning

confidence: 99%

Extraintestinal Manifestations in Patients with Inflammatory Bowel Disease: Study Based on the ENEIDA Registry

et al. 2020

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Background Patients with inflammatory bowel disease (IBD) may present extraintestinal manifestations (EIMs) that affect the joints, skin, eyes, and hepatobiliary area, among others. Aims Our aim was to analyse the prevalence and characteristics of EIMs in patients with IBD and to identify the possible risk factors associated with the development of EIMs in the largest series published to date. Methods Observational, cross-sectional study including patients from the Spanish ENEIDA registry promoted by GETECCU. We retrospectively identified all cases of EIMs in the ENEIDA registry until January 2018. ResultsThe study included 31,077 patients, 5779 of whom had at least one EIM (global prevalence 19%; 95% CI 18.2-19.0). Among the different types of EIMs, rheumatic manifestations had a prevalence of 13% (95% CI 12.9-13.7; 63% of EIMs), with a prevalence of 5% (95% CI 4.7-5.2) for mucocutaneous manifestations, 2.1% (95% CI 1.9-2.2) for ocular manifestations, and 0.7% (95% CI 0.6-0.8) for hepatobiliary manifestations. The multivariable analysis showed that the type of IBD (Crohn's disease, p < 0.001), gender (female, p < 0.001), the need for an immunomodulator (p < 0.001) or biologic drugs (p < 0.001), a previous family history of IBD (p < 0.001), and an extensive location of IBD (p < 0.001) were risk factors for the presence of EIMs. Conclusions One-fifth of patients with IBD may have associated EIMs, with rheumatic manifestations as the most frequent (> 60% of EIMs). Female patients with severe Crohn's disease represent the group with the highest risk of developing EIMs. These patients should therefore be specially monitored and referred to the corresponding specialist when suggestive symptoms appear.

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Section: Discussionmentioning

confidence: 99%

Extraintestinal Manifestations in Patients with Inflammatory Bowel Disease: Study Based on the ENEIDA Registry

et al. 2020

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“…The frequency of EIM in IBD has been reported from 16-40% (19)(20)(21)(22) with musculoskeletal (including arthritis, ankylosing spondylitis) and cutaneous presentations (including erythema nodosum, pyoderma gangrenosum) are among the most common observed conditions reported in as high as 50% of the patients in previous reports (19,21,23,24). EIMs in IBD are associated with significant morbidities and lowering the quality of life status (25).…”

Section: Discussionmentioning

confidence: 99%

“…In addition, females and patients with active disease may be at higher risk of joint diseases (29). In line, both female gender and disease activity have been risk factors of EIMs in patients with IBD (19). The disease activity correlated with intestinal neutrophil activity may predict the development of EIMs in patients with active IBD (31).…”

Section: -7 N=36 N (%)mentioning

confidence: 99%

“…Nevertheless, we detected no significant deviated distribution of the EIMs among the 0-6, 7-12, and 13-18 age groups. Accordingly, IBD in children <5 years old has shown distinct pathophysiological and clinical features in comparison with IBD presenting within 11-16 years old (19,35). Oral manifestations (including cobble stoning mucosa, lips, chicks, and gingival involvement) have been reported in 10-80% of patients with CD (36).…”

Section: -7 N=36 N (%)mentioning

confidence: 99%

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Extra Intestinal Manifestations in Children with Inflammatory Bowel Disease, A Single Center Report from Iran

Dehghani

Shahramian

Bazi

et al. 2021

ABCMed

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Introduction: Inflammatory bowel disease (IBD) is a disorder of unknown etiology categorized into three groups including Crohn disease (CD), ulcerative colitis [UC], and intermediate colitis (IC). In addition to gastrointestinal (GI) symptoms, childhood IBD frequently present with extra GI manifestations. In present study, we aimed to determine extra GI symptoms in children with IBD in Iran. Methods: Children <18 years old with established IBD diagnosis referred to the Gastroenterology Clinic affiliated with Shiraz University of Medical Sciences during 2007-2017 were included. Results: Eighty-five children were assessed. CD and UC comprised 26 (30.6%) and 47 (55.3%) of the patients. The mean age was 14.09±2.5 years old with 50% of them were boys. The most frequent presenting complaint was rectal bleeding (37.2%). In patients with CD and UC, 30% and 29% of the patients represented at least one extra GI symptom. The most common extra GI manifestations were growth retardation (11.5%) and arthralgia (7.8%) in children with CD and UC respectively. Conclusions: Extra GI symptoms are relatively common in children with IBD. Caution should be taken to avoid confusion with other disorders and to timely manage these manifestations.

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“…8 The envisaging of IBD as a systemic disease has now been fostered by a group examining the extraintestinal manifestations (EIM) of IBD. 9 We based on the contents of this review, and those of a previous one, 10 to reappraise such challenging matters.…”

Section: Introductionmentioning

confidence: 99%

The gut and the inflammatory bowel diseases inside-out: extra-intestinal manifestations

Ribaldone

Pellicano

Actis

2020

Minerva Gastroenterol Dietol

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An increasing deal of attention is being conveyed on the extra-intestinal manifestations of inflammatory bowel diseases (IBD). We compiled the present review in an attempt to upgrade the accuracy of the classification of such polymorphic entities. We focused on three patterns. First, the conventional extra-intestinal manifestations localized to bone and joints, to the eye, to the biliary tree and to the skin. Second, the so-called IBD-like syndromes accompanied by bone marrow-derived anomalies of innate or acquired immunity. Third, specific disorders of the skin and of the lungs. The extra-intestinal manifestations are thought to derive from an altered gut permeability, the release of cross-reacting antigens, and subsequent peripheral inflammation; T helper 17 cells boosted by a polymorphic interleukin 23 circuitry would be the main effectors of this chain. Inflammatory bowel disease-like pictures would derive from inborn errors of the immune response causing undue inflammation home to the gut. Monogenic IBD belong to this subset, and are of specific pediatric interest. Psoriasis, chronic obstructive pulmonary disease, and IBD are all inflammatory disorders of the barrier organs: skin, lungs, and gut. The demonstration that specific antigen hyper-or hyporesponsiveness raised at any of the three districts can modulate the response of the other two sites, has led to the innovative concept of a system-wide mucosal immunological organ. An improved knowledge of these entities has not only a speculative importance, but can also bear a clinical impact, insofar as the extra-intestinal manifestations prove often more disabling than the underlying IBD itself.

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Prevalence, risk factors and response to treatment of extra-intestinal manifestations in patients with inflammatory bowel disease

Cited by 4 publications

References 18 publications

Extraintestinal Manifestations in Patients with Inflammatory Bowel Disease: Study Based on the ENEIDA Registry

Extraintestinal Manifestations in Patients with Inflammatory Bowel Disease: Study Based on the ENEIDA Registry

Extra Intestinal Manifestations in Children with Inflammatory Bowel Disease, A Single Center Report from Iran

The gut and the inflammatory bowel diseases inside-out: extra-intestinal manifestations

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