No abstract

Background: patients with inflammatory bowel disease may suffer one or more extraintestinal manifestations during the course of their condition, these being more frequent in Crohn's disease. The aim of our study was to evaluate the prevalence of extraintestinal manifestations in patients with Crohn's disease in our healthcare area, and to assess the relationship between its presence and diverse clinical-evolutionary variables.Material and methods: extraintestinal manifestations in 157 patients diagnosed with Crohn's disease in our center were retrospectively studied. The clinical-evolutionary characteristics of this population were compared with respect to the presence or absence of different extraintestinal manifestations.Results: seventy-two patients (46%) presented at least with one extraintestinal manifestation. Thirty-one percent were colitisrelated manifestations (22% rheumatologic, 13% muco-cutaneous, 4% ophthalmologic), 11% cholelithiasis, 8% nephrolithiasis, 3% thromboembolic illness, and other manifestations were less frequent. Fourteen percent presented with more than one extraintestinal manifestation. Rheumatologic and muco-cutaneous manifestations were significantly more frequent in patients with disease confined to the colon. Cholelithiasis was significantly associated to those over 40 and also to males. Nephrolithiasis was also significantly associated to those over 40, and thromboembolic illness was linked to females.Conclusions: forty-six percent of patients with Crohn's disease presented at least with one extraintestinal manifestation. Thirty-one percent presented with colitis-related manifestations, rheumatologic and muco-cutaneous manifestations being the most frequent, whereas hepatic manifestations were infrequent. Rheumatologic and muco-cutaneous manifestations were more frequent in patients with disease confined to the colon.

CE is a useful tool for the diagnosis of subtle small bowel Crohn's disease. The diagnostic yield of CE in patients with suspicion of Crohn's disease but negative results from the traditional diagnostic work-up is significantly higher in patients with anemia and increased platelet count than in patients without this combination of clinical features.

Crohn's disease (CD) presents a complex multifactorial etiology with genetic and environmental factors contributing to the disorder. Epidemiological studies have shown that three major CARD15 polymorphisms, R702W, G908R, and 1007fs, are associated with CD. We studied the frequencies of these three polymorphisms in patients from Toledo, Spain, and compared them with the frequencies found in studies of other populations. A total of 183 patients with CD and 172 healthy controls from Toledo, Spain, were included in this study. All of these individuals were genotyped for the three CARD15 polymorphisms R702W, G908R, and 1007fs. Frequencies were analyzed to identify any genotype-phenotype associations. The control population exhibited frequencies of CARD15 polymorphisms similar to the results of previous studies, 3.4%, 1.1%, and 2.0% for the R702W, G908R, and 1007fs polymorphisms, respectively, whereas CD patients had allele frequencies of 7.6%, 3.0%, and 4.6%, respectively. Significant associations were found between the presence of R702W and patients carrying two susceptibility variants with early age of onset and stricturing pattern.

CD44v6 expression in IBD is significantly associated with activity detected by means of endoscopy and pathological features. Our data suggest that CD44v6 expression may have some usefulness in conjunction with other factors as a means of evaluating the disease activity. Moreover, CD44v6 expression was higher in ulcerative colitis than Crohn's disease (P = 0.02), although this does not confirm the utility of monoclonal antibody 2F10 in differential diagnosis between ulcerative colitis and Crohn's disease, as there was a notable percentage of positive samples of Crohn's disease.