Extraintestinal Manifestations of Crohn’s Disease

Juillerat, Pascal; Mottet, Christian; Pittet, Valérie; Froehlich, Florian; Felley, Christian; Gonvers, Jean‐Jacques; Vader, John‐Paul; Michetti, Pierre

doi:10.1159/000111029

Cited by 39 publications

(24 citation statements)

References 158 publications

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“…Symptomatic treatment in combination with physiotherapy is often sufficient. Treatment recommendations for IBD-related arthropathy are based almost entirely on extrapolation from the treatment of other forms of arthritis/spondyloarthropathy [14]. A paucity of controlled trials exists in IBD; only small, open-label trials and case reports have been published [15].…”

Section: Arthritis and Arthropathymentioning

confidence: 99%

Treatment of Extraintestinal Manifestations in Inflammatory Bowel Disease

Lakatos

Lakatos²,

Kiss

et al. 2012

Digestion

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Inflammatory bowel disease (IBD) is a systemic disease associated with a large number of extraintestinal manifestations (EIM). EIM are present in 15–20% of patients with ulcerative colitis and in 20–40% of patients with Crohn’s disease. The management of EIM is best provided by a multidisciplinary team, which includes specialists in the affected organ systems with training in the treatment of IBD. Therapeutic strategy is often empirical. This is explained by the paucity of randomized-controlled studies for the specific treatment of EIM in IBD and by the fact that treatment models are based on extrapolation from patients with similar conditions but without IBD. For most EIM, the mainstay of therapy is the treatment of the underlying active IBD. However, some EIM such as axial arthritis, pyoderma gangrenosum, uveitis and primary sclerosing cholangitis run a clinical course independent of IBD activity and need specific therapy (e.g. TNF antagonists in ankylosing spondylitis and skin manifestations). This review summarizes the conventional and novel (e.g. anti-TNF) treatment modalities, and the therapeutic implications for the management of extraintestinal symptoms in IBD, in order to assist clinicians in optimizing treatment strategies for IBD patients with EIM.

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Section: Arthritis and Arthropathymentioning

confidence: 99%

Treatment of Extraintestinal Manifestations in Inflammatory Bowel Disease

Lakatos

Lakatos²,

Kiss

et al. 2012

Digestion

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“…EIMs are estimated to be present in 21-36% of IBD patients, with the number and frequency of organ systems affected varying between CD and UC [6,7,8]. In some cases, EIMs such as peripheral arthritis parallel IBD progression and severity, whereas ankylosing spondylitis seems independent of disease activity [9,10,11]. …”

Section: Introductionmentioning

confidence: 99%

Extraintestinal Manifestations of Inflammatory Bowel Disease and the Influence of Smoking

Roberts

Shesh²,

Pan³

et al. 2014

Digestion

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Aims: To define the number/frequency of organ systems affected by extraintestinal manifestations (EIMs), to identify factors affecting the clinical course of inflammatory bowel disease (IBD) and EIM development, and to determine the impact of smoking, disease duration and location on the diagnosis of EIMs in Crohn's disease (CD) and ulcerative colitis (UC). Methods: IBD patients were derived from a single university colorectal surgery practice. Smoking data were obtained through a modified Behavioral Risk Factor Surveillance System survey. The frequencies of arthritis/arthralgia, primary sclerosing cholangitis (PSC), ocular and cutaneous EIMs were determined. Results: Of the 757 patients evaluated (CD 488, UC 269), 50% had ≥1 EIM. Arthritis/arthralgia, cutaneous and ocular EIMs were significantly higher in frequency in CD compared to UC patients. Prolonged disease duration was associated with increased prevalence of arthritis/arthralgia in IBD (p ≤ 0.001) as well as PSC (p = 0.049), ocular (p = 0.030) and cutaneous (p = 0.009) EIMs in CD. Disease location affected the occurrence of EIMs in CD. Smoking appeared to increase the prevalence of ocular EIMs in UC (p = 0.026). Conclusion: Arthritis/arthralgia, cutaneous and ocular EIMs occurred in a significantly higher proportion of CD patients. CD patients with longer disease duration had a significantly higher prevalence of PSC, ocular and cutaneous EIMs. Smoking was found to increase ocular EIMs in UC.

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“…Hafif oligoartriti olan hastalar genellikle istirahat, fizyoterapi ve eklem içi steroid enjeksiyonlarına cevap verir (25). Hastaların çoğu nonsteroid antiinflamatuar ilaçlara cevap verir çünkü bu ilaçlar semptomları ve eklem inflamasyonunu kontrol altına alır.…”

Section: Discussionunclassified

Inflammatory Bowel Disease Presenting with Only Joint Involvement

Erdem¹,

Sametoglu²,

Yılmaz³

et al. 2013

Istanbul Med J

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İnflamatuar bağırsak hastalığı idyopatik ve kronik bir intestinal inflamasyondur. Bu hastalığın major semptomları diyare, rektal kanama, tenezmus, mukuslu dışkılama ve kramp şeklinde karın ağrısıdır. Hastalı-ğın boyutu ile semptomların ciddiyeti korelasyon gösterir. Periferal artrit inflamatuar bağırsak hastalığının ekstraintestinal manifestasyonlarından biridir. Hastaların %15-20'sinde ortaya çıkar. Eklem tutulumu genellikle asimetrik, poliartiküler, gezicidir ve büyük eklemleri etkiler. Bu olgu sunumunda inflamatuar bağırsak hastalığı ile ilişkili simetrik, poliartiküler ve küçük eklem tutulumlu bir vakayı anlattık. Hasta 18 yaşında bir erkekti ve beş ay boyunca gastrointestinal semptomları olmadığından dolayı teşhis konulamamıştı. Hastanın kolonoskopik biyopsi sonucunun inflamatuar bağırsak hastalığı ile uyumlu olduğu görüldü.Anahtar Kelimeler: Periferik artrit, inflamatuar bağırsak hastalığı, simetrik poliartrit Inflammatory bowel disease is an idiopathic and chronic intestinal inflammation. The major symptoms of the disease are diarrhea, rectal bleeding, tenesmus, passage of mucus, and crampy abdominal pain. The severity of the symptoms correlates with the extent of the disease. Peripheral arthritis is one of the extraintestinal manifestations of inflammatory bowel disease and is detected in about 15-20% of patients. It is usually asymmetric, polyarticular, and affects migratory large joints. In this report we describe a case of inflammatory bowel disease associated with symmetric, polyarticular, small-joint involvement. The patient was an 18-year-old male who had not been diagnosed for five months because of the absence of gastrointestinal symptoms. Colonoscopic biopsy results were compatible with inflammatory bowel disease.Key Words: Peripheral arthritis, inflammatory bowel disease, symmetric polyarthritis Girişİnflamatuar bağırsak hastalığı kronik zeminde nükslerle seyreden gastrointestinal sistemin inflamatuar bir bozukluğudur. Ayrıca bu hastalık eklem, göz ve deri tutulumuna (eritema nodosum…), vaskülit ve hemolitik anemiye neden olabilir (1-4). Bir hasta serisinde ülseratif koliti veya Crohn hastalığı olan hastaların yüzde 36'sında bu manifestasyonların bir veya daha fazlasının olduğu görülmüştür (1).Artrit inflamatuar bağırsak hastalığının en sık görülen ekstraintestinal manifestasyonudur. Bu tutulumun hastanın morbiditesi ve hayat kalitesi üzerine kayda değer etkileri olabilmektedir. İnf-lamatuar bağırsak hastalığı ile ilişkili artropatinin seronegatif spondilartropatilerin bir subtipi olduğu düşünülmektedir. Aksial, periferal veya her iki cins eklemi de etkileyebilir. Periferal artrit genellikle erozif nitelik taşımaz ve oligoartiküler tutulum özellikle intestinal hastalık aktivitesi ile korelasyon gösterir (5).İnflamatuar bağırsak hastalığı olan hastalar çok büyük bir oranda gastrointestinal şikayetlerle doktora başvururlar. Ancak bizim ele almış olduğumuz vakada hastanın simetrik, poliartiküler, küçük ve büyük neredeyse tüm eklemleri tutan artriti bulunuyorken, 5 ay boyunca gastrointestinal hiçbi...

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Extraintestinal Manifestations of Crohn’s Disease

Cited by 39 publications

References 158 publications

Treatment of Extraintestinal Manifestations in Inflammatory Bowel Disease

Treatment of Extraintestinal Manifestations in Inflammatory Bowel Disease

Extraintestinal Manifestations of Inflammatory Bowel Disease and the Influence of Smoking

Inflammatory Bowel Disease Presenting with Only Joint Involvement

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