Temporal Relationship of Extraintestinal Manifestations in Inflammatory Bowel Disease

Abstract

Objectives: Thus far, few attempted to characterize the temporal onset of extraintestinal manifestations (EIM) in inflammatory bowel diseases (IBD). We sought to determine the time of onset of these findings in a patient cohort with IBD. Methods: We reviewed the electronic health records of 508 IBD patients (303 CD, 205 UC) and summarized general patient characteristics and the temporal relationship and order of presentation of extraintestinal manifestations. Results: CD patients were younger at diagnosis. CD patients with ileocolonic involvement (L3) were younger, and UC patients with pancolitis (E3) were slightly younger at diagnosis. A total of 127 out of 303 (41.91%) CD and 81 out of 205 (39.51%) UC patients had EIMs (p = 0.5898). Some patients presented with EIMs before the diagnosis of IBD (9.45% of Crohn’s disease and 17.28% of ulcerative colitis patients with EIMs, respectively). Of these, seven cases (four in CD and three in UC) were visible by inspection of the patients (either dermatologic or ocular findings). The diagnosis of IBD and extraintestinal symptoms often occurred within a year (22.83% of CD and 16.04% of UC patients). Typically, the diagnosis of the first extraintestinal symptoms happened after the onset of bowel disease (+4.3 (±6.3) years, range: 10 years before to 30 years after in Crohn’s disease and +3.8 (±10) years, range: 24 years before to 30 years after) in ulcerative colitis. UC patients with pancolitis (E3) usually had EIMs earlier in the disease course and displayed EIMs more frequently before IBD diagnosis. Furthermore, patients with pancolitis developed EIMs more frequently than other sub-groups. Conclusion: Extraintestinal manifestations in inflammatory bowel diseases can present at any time, relative to the bowel symptoms. In cases, the presence of a characteristic EIM might be a harbinger of the development of IBD.

Myositis as an Extraintestinal Manifestation of Ulcerative Colitis: A Case Report and Literature Review

“…The most common myositis documented is polymyositis compared to dermatomyositis. The mainstay of diagnosis and treatment is a muscle biopsy and steroids, respectively [ 9 ]. Unfortunately in our case, a muscle biopsy was not completed, which could have further supported the diagnosis.…”

The impact of family function on mental health status in patient with inflammatory bowel disease: The mediating role of self-esteem

“…In Mandel's investigation of hospitalization rates among IBD patients, the risk of IBD-related hospitalization fell only in CD patients receiving the same treatment (anti-TNF medication) ( 34 ). In contrast, UC patients demonstrate more significant extraintestinal symptoms than CD patients before the beginning of IBD ( 35 ). Due to their earlier exposure to extraintestinal signs, UC patients may experience physical and psychological suffering.…”

Contrasting Autoimmune Comorbidities in Microscopic Colitis and Inflammatory Bowel Diseases

“…Our paper is an extension of two of our earlier datasets of patients with microscopic colitis (MC—103 patients) and inflammatory bowel disease (IBD—508 patients) [ 11 , 12 ]. In total, we included 611 patients in the current paper, within four groups.…”