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Erschienen in: Indian Journal of Gastroenterology 5/2021

27.09.2021 | Original Article

Prevalence of extraintestinal manifestations in ulcerative colitis and associated risk factors

verfasst von: Krishn Kant Rawal, Varun P. Shukla, Shabbir Chikani, Milan Thakkar, Mukesh Ruparelia, Rajesh K. Chudasama

Erschienen in: Indian Journal of Gastroenterology | Ausgabe 5/2021

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Abstract

Background

The data on prevalence of extraintestinal manifestations (EIM) in ulcerative colitis (UC) are  scanty and highly variable.

Methods

Consecutive patients with UC were prospectively evaluated from November 2016 to August 2017. A detailed history was obtained and physical examination was done. Presence of EIM was confirmed by a consultant rheumatologist, ophthalmologist and dermatologist. Tests performed were hemogram, liver function test, abdominal ultrasound, slit lamp examination, X-ray and magnetic resonance imaging when deemed necessary.

Results

A total of 227 patients with UC were enrolled in this study. The prevalence of EIM was 7.92%. Mucocutaneous (4.84%) manifestations were the commonest, followed by musculoskeletal (1.32%) and ocular (0.88%). Hepatobiliary (0.44%) and vascular (0.44) manifestations were present in equal frequency. History of appendicectomy was associated with  EIM.

Conclusion

The prevalence of EIM in UC was low in our study. History of appendicectomy was a risk factor for EIM.
Literatur
1.
Zurück zum Zitat Zippi M, Corrado C, Pica R, et al. Extraintestinal manifestations in a large series of Italian inflammatory bowel disease patients. World J Gastroenterol. 2014;20:17463–7. Zippi M, Corrado C, Pica R, et al. Extraintestinal manifestations in a large series of Italian inflammatory bowel disease patients. World J Gastroenterol. 2014;20:17463–7.
2.
Zurück zum Zitat Singh B, Kedia S, Konijeti G, et al. Extraintestinal manifestations of inflammatory bowel disease and intestinal tuberculosis: frequency and relation with disease phenotype. Indian J Gastroenterol. 2015;34:43–50. Singh B, Kedia S, Konijeti G, et al. Extraintestinal manifestations of inflammatory bowel disease and intestinal tuberculosis: frequency and relation with disease phenotype. Indian J Gastroenterol. 2015;34:43–50.
3.
Zurück zum Zitat Das KM. Relationship of extraintestinal involvements in inflammatory bowel disease: new insights into autoimmune pathogenesis. Dig Dis Sci. 1999;44:1–13.CrossRef Das KM. Relationship of extraintestinal involvements in inflammatory bowel disease: new insights into autoimmune pathogenesis. Dig Dis Sci. 1999;44:1–13.CrossRef
4.
Zurück zum Zitat Lakatos L, Pandur T, David G, et al. Association of extraintestinal manifestations of inflammatory bowel disease in a province of western Hungary with disease phenotype: results of a 25-year follow-up study. World J Gastroenterol. 2003;9:2300–7. Lakatos L, Pandur T, David G, et al. Association of extraintestinal manifestations of inflammatory bowel disease in a province of western Hungary with disease phenotype: results of a 25-year follow-up study. World J Gastroenterol. 2003;9:2300–7.
5.
Zurück zum Zitat Bernstein CN, Blanchard JF, Rawsthorne P, Yu N. The prevalence of extraintestinal diseases in inflammatory bowel disease: a population-based study. Am J Gastroenterol. 2001;96:1116–22.CrossRef Bernstein CN, Blanchard JF, Rawsthorne P, Yu N. The prevalence of extraintestinal diseases in inflammatory bowel disease: a population-based study. Am J Gastroenterol. 2001;96:1116–22.CrossRef
6.
Zurück zum Zitat Habeeb MA, Rajalingam R, Dhar A, Kumar A, Sharma MP, Mehra NK. HLA association and occurrence of autoantibodies in Asian-Indian patients with ulcerative colitis. Am J Gastroenterol. 1997;92:772-6. Habeeb MA, Rajalingam R, Dhar A, Kumar A, Sharma MP, Mehra NK. HLA association and occurrence of autoantibodies in Asian-Indian patients with ulcerative colitis. Am J Gastroenterol. 1997;92:772-6.
7.
Zurück zum Zitat Ricart E, Panaccione R, Loftus EV, et al. Autoimmune disorders and extraintestinal manifestations in first-degree familial and sporadic inflammatory bowel disease: a case-control study. Inflamm Bowel Dis. 2004;10:207–14.CrossRef Ricart E, Panaccione R, Loftus EV, et al. Autoimmune disorders and extraintestinal manifestations in first-degree familial and sporadic inflammatory bowel disease: a case-control study. Inflamm Bowel Dis. 2004;10:207–14.CrossRef
8.
Zurück zum Zitat 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;106:110–9. 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;106:110–9.
9.
Zurück zum Zitat 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;10:239–54. 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;10:239–54.
10.
Zurück zum Zitat Orchard TR, Chua CN, Ahmad T, Cheng H, Welsh KI, Jewell DP. Uveitis and erythema nodosum in inflammatory bowel disease: clinical features and the role of HLA genes. Gastroenterology. 2002;123:714-8. Orchard TR, Chua CN, Ahmad T, Cheng H, Welsh KI, Jewell DP. Uveitis and erythema nodosum in inflammatory bowel disease: clinical features and the role of HLA genes. Gastroenterology. 2002;123:714-8.
11.
Zurück zum Zitat Hedin CRH, Vavricka SR, Stagg AJ, et al. The pathogenesis of extraintestinal manifestations: implications for IBD research, diagnosis and therapy. J Crohns Colitis. 2019;13:541–54. Hedin CRH, Vavricka SR, Stagg AJ, et al. The pathogenesis of extraintestinal manifestations: implications for IBD research, diagnosis and therapy. J Crohns Colitis. 2019;13:541–54.
12.
Zurück zum Zitat Verbraak FD, Schreinemachers MC, Tiller A, van Deventer SJ, de Smet MD. Prevalence of subclinical anterior uveitis in adult patients with inflammatory bowel disease. Br J Ophthalmol. 2001;85:219-21. Verbraak FD, Schreinemachers MC, Tiller A, van Deventer SJ, de Smet MD. Prevalence of subclinical anterior uveitis in adult patients with inflammatory bowel disease. Br J Ophthalmol. 2001;85:219-21.
13.
Zurück zum Zitat Bandyopadhyay D, Bandyopadhyay S, Ghosh P, et al. Extraintestinal manifestations in inflammatory bowel disease: prevalence and predictors in Indian patients. Indian J Gastroenterol. 2015;34:387–94. Bandyopadhyay D, Bandyopadhyay S, Ghosh P, et al. Extraintestinal manifestations in inflammatory bowel disease: prevalence and predictors in Indian patients. Indian J Gastroenterol. 2015;34:387–94.
14.
Zurück zum Zitat Mendoza JL, Lana R, Taxonera C, Alba C, Izquierdo S, Díaz-Rubio M. Extraintestinal manifestations in inflammatory bowel disease: differences between Crohn's disease and ulcerative colitis. Med Clin (Barc). 2005;125:297-300. Mendoza JL, Lana R, Taxonera C, Alba C, Izquierdo S, Díaz-Rubio M. Extraintestinal manifestations in inflammatory bowel disease: differences between Crohn's disease and ulcerative colitis. Med Clin (Barc). 2005;125:297-300.
15.
Zurück zum Zitat Karmiris K, Avgerinos A, Tavernaraki A, et al. Prevalence and characteristics of extra-intestinal manifestations in a large cohort of Greek patients with inflammatory bowel disease. J Crohns Colitis. 2016;10:429–36. Karmiris K, Avgerinos A, Tavernaraki A, et al. Prevalence and characteristics of extra-intestinal manifestations in a large cohort of Greek patients with inflammatory bowel disease. J Crohns Colitis. 2016;10:429–36.
16.
Zurück zum Zitat Algaba A, Guerra I, Ricart E et al. Extraintestinal manifestations in patients with inflammatory bowel disease: study based on the ENEIDA registry. Dig Dis Sci. 2021;66:2014-23. Algaba A, Guerra I, Ricart E et al. Extraintestinal manifestations in patients with inflammatory bowel disease: study based on the ENEIDA registry. Dig Dis Sci. 2021;66:2014-23.
17.
Zurück zum Zitat Kochhar R, Mehta SK, Nagi B, et al. Extraintestinal manifestations in idiopathic ulcerative colitis. Indian J Gastroenterol. 1991;10:88–9. Kochhar R, Mehta SK, Nagi B, et al. Extraintestinal manifestations in idiopathic ulcerative colitis. Indian J Gastroenterol. 1991;10:88–9.
18.
Zurück zum Zitat Pokharna RK, Kabra PK, Sharma R, Kochar DK. Extraintestinal manifestations of idiopathic ulcerative colitis in northwestern India. Indian J Gastroenterol. 2004;23:89–90.PubMed Pokharna RK, Kabra PK, Sharma R, Kochar DK. Extraintestinal manifestations of idiopathic ulcerative colitis in northwestern India. Indian J Gastroenterol. 2004;23:89–90.PubMed
19.
Zurück zum Zitat Makharia GK, Ramakrishna BS, Abraham P, et al. Survey of inflammatory bowel diseases in India. Indian J Gastroenterol. 2012;31:299–306.CrossRef Makharia GK, Ramakrishna BS, Abraham P, et al. Survey of inflammatory bowel diseases in India. Indian J Gastroenterol. 2012;31:299–306.CrossRef
20.
Zurück zum Zitat Amarapurkar AD, Amarapurkar DN, Rathi P, et al. Risk factors for inflammatory bowel disease: A prospective multi-center study. Indian J Gastroenterol. 2018;37:189–95. Amarapurkar AD, Amarapurkar DN, Rathi P, et al. Risk factors for inflammatory bowel disease: A prospective multi-center study. Indian J Gastroenterol. 2018;37:189–95.
21.
Zurück zum Zitat Sharma JB, Sharma B, Sharma R, Mahajan SK, Raina R, Sharma P. The profile of inflammatory bowel disease in natives of western Himalayas. Trop Gastroenterol. 2017;38:115–21. Sharma JB, Sharma B, Sharma R, Mahajan SK, Raina R, Sharma P. The profile of inflammatory bowel disease in natives of western Himalayas. Trop Gastroenterol. 2017;38:115–21.
22.
Zurück zum Zitat Lennard-Jones JE. Classification of inflammatory bowel disease. Scand J Gastroenterol Suppl.1989;170:2-6. Lennard-Jones JE. Classification of inflammatory bowel disease. Scand J Gastroenterol Suppl.1989;170:2-6.
23.
Zurück zum Zitat Silverberg MS, Satsangi J, Ahmad T, et al. Toward an integrated clinical, molecular and serological classification of inflammatory bowel disease: report of a working party of the 2005 Montreal World Congress of Gastroenterology. Can J Gastroenterol. 2005;19:5A–36A. Silverberg MS, Satsangi J, Ahmad T, et al. Toward an integrated clinical, molecular and serological classification of inflammatory bowel disease: report of a working party of the 2005 Montreal World Congress of Gastroenterology. Can J Gastroenterol. 2005;19:5A–36A.
24.
Zurück zum Zitat Schroeder KW, Tremaine WJ, Ilstrup DM. Coated oral 5-aminosalicylic acid therapy for mildly to moderately active ulcerative colitis. A randomized study. N Engl J Med. 1987;317:1625–9.CrossRef Schroeder KW, Tremaine WJ, Ilstrup DM. Coated oral 5-aminosalicylic acid therapy for mildly to moderately active ulcerative colitis. A randomized study. N Engl J Med. 1987;317:1625–9.CrossRef
25.
Zurück zum Zitat Alnaqbi KA, Touma Z, Passalent L, et al. Development, sensibility, and reliability of the Toronto Axial Spondyloarthritis Questionnaire in inflammatory bowel disease. J Rheumatol. 2013;40:1726–35. Alnaqbi KA, Touma Z, Passalent L, et al. Development, sensibility, and reliability of the Toronto Axial Spondyloarthritis Questionnaire in inflammatory bowel disease. J Rheumatol. 2013;40:1726–35.
26.
Zurück zum Zitat Edwards FC, Truelove SC. The course and prognosis of ulcerative colitis. Gut. 1964;5:1–15. Edwards FC, Truelove SC. The course and prognosis of ulcerative colitis. Gut. 1964;5:1–15.
27.
Zurück zum Zitat Orchard TR, Wordsworth BP, Jewell DP. Peripheral arthropathies in inflammatory bowel disease: their articular distribution and natural history. Gut. 1998;42:387–91.CrossRef Orchard TR, Wordsworth BP, Jewell DP. Peripheral arthropathies in inflammatory bowel disease: their articular distribution and natural history. Gut. 1998;42:387–91.CrossRef
28.
Zurück zum Zitat Philip M, Augustine P, Thomas V, et al. Multi-center prospective survey of inflammatory bowel diseases in Kerala: More than 2000 cases. Indian J Gastroenterol. 2017;36:459–67.CrossRef Philip M, Augustine P, Thomas V, et al. Multi-center prospective survey of inflammatory bowel diseases in Kerala: More than 2000 cases. Indian J Gastroenterol. 2017;36:459–67.CrossRef
29.
Zurück zum Zitat Card TR, Langan SM, Chu TP. Extra-gastrointestinal manifestations of inflammatory bowel disease may be less common than previously reported. Dig Dis Sci. 2016;61:2619–26.CrossRef Card TR, Langan SM, Chu TP. Extra-gastrointestinal manifestations of inflammatory bowel disease may be less common than previously reported. Dig Dis Sci. 2016;61:2619–26.CrossRef
30.
Zurück zum Zitat Park SK, Wong Z, Park SH, et al. Extraintestinal manifestation of inflammatory bowel disease in Asian patients: a multinational study. Dig Liver Dis. 2021;53:196–201.CrossRef Park SK, Wong Z, Park SH, et al. Extraintestinal manifestation of inflammatory bowel disease in Asian patients: a multinational study. Dig Liver Dis. 2021;53:196–201.CrossRef
31.
Zurück zum Zitat Evans J, Sapsford M, Raine T, et al. AB0719 Prevalence of undiagnosed axial spondyloarthritis in patient with inflammatory bowel disease: a systemic literature review and primary research study. Ann Rheum Dis. 2019;78:1822–3. Evans J, Sapsford M, Raine T, et al. AB0719 Prevalence of undiagnosed axial spondyloarthritis in patient with inflammatory bowel disease: a systemic literature review and primary research study. Ann Rheum Dis. 2019;78:1822–3.
32.
Zurück zum Zitat Chopra A. Disease burden of rheumatic diseases in India: COPCORD perspective. Indian J Rheumatol. 2015;10:70–7.CrossRef Chopra A. Disease burden of rheumatic diseases in India: COPCORD perspective. Indian J Rheumatol. 2015;10:70–7.CrossRef
33.
Zurück zum Zitat Rudwaleit M, van der Heijde D, Landewe R, et al. The development of Assessment of SpondyloArthritis International Society classification criteria for axial spondyloarthritis (part II): validation and final selection. Ann Rheum Dis. 2009;68:777–83. Rudwaleit M, van der Heijde D, Landewe R, et al. The development of Assessment of SpondyloArthritis International Society classification criteria for axial spondyloarthritis (part II): validation and final selection. Ann Rheum Dis. 2009;68:777–83.
34.
Zurück zum Zitat De Marco G, McGonagle D, Lettieri G, et al. MRI assessment of axial involvement in inflammatory bowel disease related SpA: age at the disease diagnosis, not extent and severity of axial disease relates to HLA-B27. Ann Rheum Dis. 2016;75:331. De Marco G, McGonagle D, Lettieri G, et al. MRI assessment of axial involvement in inflammatory bowel disease related SpA: age at the disease diagnosis, not extent and severity of axial disease relates to  HLA-B27. Ann Rheum Dis. 2016;75:331.
35.
Zurück zum Zitat Maksymowych WP. The role of imaging in the diagnosis and management of axial spondyloarthritis. Nat Rev Rheumatol. 2019;15:657–72.CrossRef Maksymowych WP. The role of imaging in the diagnosis and management of axial spondyloarthritis. Nat Rev Rheumatol. 2019;15:657–72.CrossRef
36.
Zurück zum Zitat de Winter J, de Hooge M, van de Sande M, et al. Magnetic resonance imaging of the sacroiliac joints indicating sacroiliitis according to the assessment of spondyloarthritis international society definition in healthy individuals, runners, and women with postpartum back pain. Arthritis Rheum. 2018;70:1042–8. de Winter J, de Hooge M, van de Sande M, et al. Magnetic resonance imaging of the sacroiliac joints indicating sacroiliitis according to the assessment of spondyloarthritis international society definition in healthy individuals, runners, and women with postpartum back pain. Arthritis Rheum. 2018;70:1042–8.
37.
Zurück zum Zitat Tibdewal P, Bhatt P, Jain A, Gupta D, Bhatia S, Shukla A. Clinical profile and outcome of primary sclerosing cholangitis: A single-centre experience from western India. Indian J Gastroenterol. 2019;38:295-302. Tibdewal P, Bhatt P, Jain A, Gupta D, Bhatia S, Shukla A. Clinical profile and outcome of primary sclerosing cholangitis: A single-centre experience from western India. Indian J Gastroenterol. 2019;38:295-302.
Metadaten
Titel
Prevalence of extraintestinal manifestations in ulcerative colitis and associated risk factors
verfasst von
Krishn Kant Rawal
Varun P. Shukla
Shabbir Chikani
Milan Thakkar
Mukesh Ruparelia
Rajesh K. Chudasama
Publikationsdatum
27.09.2021
Verlag
Springer India
Erschienen in
Indian Journal of Gastroenterology / Ausgabe 5/2021
Print ISSN: 0254-8860
Elektronische ISSN: 0975-0711
DOI
https://doi.org/10.1007/s12664-021-01181-9

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