Year 2017 / Volume 109 / Number 9
Original
Prevalence, risk factors and response to treatment of extra-intestinal manifestations in patients with inflammatory bowel disease

627-633

DOI: 10.17235/reed.2017.4845/2017

María Hernández-Tejero, Alicia Granja Navacerrada, Pilar Bernal Checa, Rubén Piqué Becerra, Alicia Algaba García, Iván Guerra Marina, Francisco Javier García-Alonso, Mariano Syed, Fernando Bermejo,

Abstract
Introduction: Patients with inflammatory bowel disease can experience extra-intestinal manifestations that may cause significant morbidity. Aims: To describe the prevalence, characteristics, treatment and evolution of extra-intestinal manifestations in inflammatory bowel disease patients treated in our hospital and to identify associated risk factors. Methods: This was a retrospective, observational, case-control study. All inflammatory bowel disease patients with extra-intestinal manifestations were considered as cases and inflammatory bowel disease patients without extra-intestinal manifestations were considered as controls. Results: Six hundred and nineteen patients with inflammatory bowel disease (327 Crohn’s disease, 265 ulcerative colitis, 27 indeterminate colitis) were included in the study; 16.5% experienced at least one extra-intestinal manifestation (CI 95% 13.5-19.5; n = 102). The most frequent extra-intestinal manifestations observed were musculoskeletal (n = 50; 40%) and cutaneous manifestations (n = 50; 40%). With regard to treatment, arthropathies were treated with non-steroidal anti-inflammatory drugs (31%) and corticosteroids (19%, oral or intra-articular), and the majority of the cutaneous manifestations were managed with corticosteroids. Overall, the efficacy of extra-intestinal manifestation treatment was 90% and only 13% of patients had a recurrence of extra-intestinal manifestations. The multivariate analysis showed that female gender (p = 0.012; OR = 1.61; 95% CI 1.11-2.34) and the severity of inflammatory bowel disease (p = 0.009; OR = 1.65; 95% CI 1.13-2.4 if immunosuppressant therapy alone, or p = 0.029; OR = 2.28; 95% CI 1.09-4.78 if in combination with adalimumab) were associated with an increased risk of developing extra-intestinal manifestations. Conclusions: The most frequent extra-intestinal manifestations in our environment were musculoskeletal and cutaneous manifestations. Female gender and a more severe disease were associated with a higher risk of developing extra-intestinal manifestations. Individualized treatment of extra-intestinal manifestations is effective and the risk is low in our series.
Share Button
New comment
Comments
No comments for this article
References
Harbord M, Annese V, Vavricka SR, et al. The First European Evidence-based Consensus on Extra-intestinal Manifestations in Inflammatory Bowel Disease. J Crohns Colitis. 2016 Mar;10(3):239-54.
Gionchetti P, Calabrese C, Rizzello F. Inflammatory Bowel Diseases and Spondyloarthropathies. J Rheumatol Suppl. 2015 Nov;93:21-3.
Vavricka SR, Rogler G, Gantenbein C, et al. Chronological Order of Appearance of Extraintestinal Manifestations Relative to the Time of IBD Diagnosis in the Swiss Inflammatory Bowel Disease Cohort. Inflamm Bowel Dis. 2015 Aug;21(8):1794-800.
Corica D, Romano C. Renal Involvement in Inflammatory Bowel Diseases. J Crohns Colitis. 2016 Feb;10(2):226-35.
Hagen JW, Swoger JM, Grandinetti LM. Cutaneous Manifestations of Crohn Disease. Dermatol Clin. 2015 Jul;33(3):417-31.
Molodecky NA, Soon IS, Rabi DM, et al. Increasing incidence and prevalence of the inflammatory bowel diseases with time, based on systematic review. Gastroenterology. 2012 Jan;142(1):46-54.
Brown SR, Coviello LC. Extraintestinal Manifestations Associated with Inflammatory Bowel Disease. Surg Clin North Am. 2015 Dec;95(6):1245-59, vii.
Lennard-Jones JE. Classification of inflammatory bowel disease. Scand J Gastroenterol Suppl. 1989;170:2-6; discussion 16-9.
Mendoza JL, Lana R, Taxonera C, et al. [Extraintestinal manifestations in inflammatory bowel disease: differences between Crohn's disease and ulcerative colitis]. Med Clin (Barc). 2005 Sep 10;125(8):297-300. Spanish. PubMed PMID: 16159555.
Repiso A, Alcántara M, Muñoz-Rosas C, et al. Extraintestinal manifestations of Crohn's disease: prevalence and related factors. Rev Esp Enferm Dig. 2006 Jul;98(7):510-7.
Rojas-Feria M, Castro M, Suárez E, et al. Hepatobiliary manifestations in inflammatory bowel disease: the gut, the drugs and the liver. World J Gastroenterol. 2013 Nov 14;19(42):7327-40.
Veloso FT, Carvalho J, Magro F. Immune-related systemic manifestations of inflammatory bowel disease. A prospective study of 792 patients. J Clin Gastroenterol. 1996 Jul;23(1):29-34.
Greenstein AJ, Janowitz HD, Sachar DB. The extra-intestinal complications of Crohn's disease and ulcerative colitis: a study of 700 patients. Medicine (Baltimore). 1976 Sep;55(5):401-12.
Vavricka SR, Brun L, Ballabeni P, et al. Frequency and risk factors for extraintestinal manifestations in the Swiss inflammatory bowel disease cohort. Am J Gastroenterol. 2011 Jan;106(1):110-9.
Kaufman I, Caspi D, Yeshurun D, et al. The effect of infliximab on extraintestinal manifestations of Crohn's disease. Rheumatol Int. 2005 Aug;25(6):406-10.
Generini S, Giacomelli R, Fedi R, et al. Infliximab in spondyloarthropathy associated with Crohn's disease: an open study on the efficacy of inducing and maintaining remission of musculoskeletal and gut manifestations. Ann Rheum Dis. 2004 Dec;63(12):1664-9.
Hagen JW, Swoger JM, Grandinetti LM. Cutaneous Manifestations of Crohn Disease. Dermatol Clin. 2015 Jul;33(3):417-31.
Vavricka SR, Schoepfer A, Scharl M, et al. Extraintestinal Manifestations of Inflammatory Bowel Disease. Inflamm Bowel Dis. 2015 Aug;21(8):1982-92.
Peyrin-Biroulet L, Van Assche G, Gómez-Ulloa D, et al. Systematic Review of Tumor Necrosis Factor Antagonists in Extraintestinal Manifestations in Inflammatory Bowel Disease. Clin Gastroenterol Hepatol. 2017 Jan;15(1):25-36.
Guerra I, Algaba A, Pérez-Calle JL, et al. Induction of psoriasis with anti-TNF agents in patients with inflammatory bowel disease: a report of 21 cases. J Crohns Colitis. 2012 Jun;6(5):518-23.
Related articles

Letter

Hepatosplenic T-cell lymphoma and inflammatory bowel disease

DOI: 10.17235/reed.2023.9472/2023

Digestive Diseases Image

Black esophagus

DOI: 10.17235/reed.2022.9217/2022

Review

Clinical settings with tofacitinib in ulcerative colitis

DOI: 10.17235/reed.2022.8660/2022

Letter

Anal neoplasia and perianal Crohn’s disease: myth or reality?

DOI: 10.17235/reed.2021.8317/2021

Letter

Apoptotic colopathy as a manifestation of Good’s syndrome

DOI: 10.17235/reed.2021.8297/2021

Original

Radon exposure and inflammatory bowel disease in a radon prone area

DOI: 10.17235/reed.2021.8239/2021

Review

Inflammatory bowel disease and solid organ transplantation

DOI: 10.17235/reed.2020.7361/2020

Editorial

Is celiac disease really associated with inflammatory bowel disease?

DOI: 10.17235/reed.2019.6779/2019

Original

Megacolon in inflammatory bowel disease: response to infliximab

DOI: 10.17235/reed.2020.6394/2019

Editorial

Diet in the etiology of inflammatory bowel disease

DOI: 10.17235/reed.2018.6119/2018

Case Report

Serrated Lesions in patients with Inflammatory Bowel Disease.

DOI: 10.17235/reed.2019.5910/2018

Editorial

Lung transplantation and esophageal dysfunction

DOI: 10.17235/reed.2018.5693/2018

Editorial

Online social networks and inflammatory bowel disease

DOI: 10.17235/reed.2018.5496/2018

Letter to the Editor

Idiopathic portal hypertension with regard to thiopurine treatment

DOI: 10.17235/reed.2018.5256/2017

Original

Colonic diverticulosis and the metabolic syndrome: an association?

DOI: 10.17235/reed.2017.5009/2017

Editorial

Specialist care in the management of inflammatory bowel disease

DOI: 10.17235/reed.2016.4628/2016

Citation tools
Hernández-Tejero M, Granja Navacerrada A, Bernal Checa P, Piqué Becerra R, Algaba García A, Guerra Marina I, et all. Prevalence, risk factors and response to treatment of extra-intestinal manifestations in patients with inflammatory bowel disease. 4845/2017


Download to a citation manager

Download the citation for this article by clicking on one of the following citation managers:

Metrics
This article has received 1259 visits.
This article has been downloaded 432 times.

Statistics from Dimensions


Statistics from Plum Analytics

Publication history

Received: 16/01/2017

Accepted: 20/05/2017

Online First: 27/07/2017

Published: 31/08/2017

Article revision time: 123 days

Article Online First time: 192 days

Article editing time: 227 days


Share
This article hasn't been rated yet.
Reader rating:
Valora este artículo:




Asociación Española de Ecografía Digestiva Sociedad Española de Endoscopia Digestiva Sociedad Española de Patología Digestiva
The Spanish Journal of Gastroenterology is the official organ of the Sociedad Española de Patología Digestiva, the Sociedad Española de Endoscopia Digestiva and the Asociación Española de Ecografía Digestiva
Cookie policy Privacy Policy Legal Notice © Copyright 2023 y Creative Commons. The Spanish Journal of Gastroenterology