Higher Incidence of Abnormal Pap Smears in Women With Inflammatory Bowel Disease

Abstract

Women with IBD have a higher risk of an abnormal Pap smear compared with healthy controls. Patients with immunomodulator use have a higher risk of an abnormal Pap smear associated with HPV infection. Women with IBD should be included in the American College of Obstetrics and Gynecology screening guidelines for immunocompromised individuals.

The long-term risk of continuous immunosuppression using thioguanides in inflammatory bowel disease

“…Recently, it has been recommended that newly diagnosed females with IBD should receive HPV vaccination [Rahier et al 2009]. It has been illustrated that female patients on all forms of immunomodulator therapy for IBD are significantly more likely to have abnormal cervical smears related to HPV infection [Kane et al 2008]. The risk appears to increase with greater levels of immunosuppression with the risk of cervical abnormalities in women treated with thiopurines being increased by 3040% among women who use these agents in addition to corticosteroids [Singh et al 2009].…”

Intestinal Microbes in Inflammatory Bowel Diseases

“…In a large prospective observational study of 11,798 anti-TNF-treated rheumatoid arthritis patients, the risk of serious infections was slightly but signifi cantly increased over nonbiologic agent disease-modifying drugs (adjusted hazard index 1.2; 95 % CI 1.1 -1.5), with most risk incurring in the fi rst 6 months of treatment ( 54 ). Abnormal pap smears have also been observed in patients taking immunosuppressive therapy ( 55 ). Additionally, the anti-α 4 integrin antibody natalizumab has been associated with multifocal leukoencephalopathy because of reactivation of JC viral infection ( 56 ).…”

Desarrollo de neoplasia en pacientes con enfermedad inflamatoria intestinal

“…Mientras algunos estudios han sugerido un aumento en el riesgo de neoplasia de cérvix 28 , otros han señalado que este no es diferente al compararlo con el grupo sin EII 29 . Recientemente, un estudio que incluyó 27.408 mujeres con EII señaló que el riesgo de lesión intraepitelial de bajo y alto grado era mayor en pacientes con EII y el de neoplasia de cérvix estaba aumentado específicamente en pacientes con EC 19 .…”

“…Recientemente, un estudio que incluyó 27.408 mujeres con EII señaló que el riesgo de lesión intraepitelial de bajo y alto grado era mayor en pacientes con EII y el de neoplasia de cérvix estaba aumentado específicamente en pacientes con EC 19 . Además, se ha descrito un riesgo mayor asociado al uso de inmunosupresores Kane et al demostraron que aquellas mujeres con EII en tratamiento inmunosupresor por tiempo mayor a 6 meses tenían mayor riesgo de presentar un frotis cervical alterado, con un odds ratio de 1,5 28 . En nuestro estudio, la paciente que desarrolló una neoplasia cervicouterina, sin embargo, se encontraba en tratamiento con mesalazina.…”