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World J Gastroenterol. Jun 14, 2011; 17(22): 2702-2707
Published online Jun 14, 2011. doi: 10.3748/wjg.v17.i22.2702
Extraintestinal manifestations of inflammatory bowel disease: Do they influence treatment and outcome?
Fernando Tavarela Veloso
Fernando Tavarela Veloso, Department of Gastroenterology, Hospital S. João, Faculdade de Medicina, Al. Prof. Hernâni Monteiro, 4200-319 Porto, Portugal
Author contributions: Veloso FT wrote this paper.
Correspondence to: Fernando Tavarela Veloso, Professor, R. D. António Meireles, nº 16 - 10º Dt., 4250-054 Porto, Portugal.
Telephone: +351-22-8316311 Fax: +351-22-8316311
Received: April 27, 2010
Revised: August 11, 2010
Accepted: August 18, 2010
Published online: June 14, 2011

Crohn’s disease and ulcerative colitis are chronic inflammatory bowel diseases that often involve organs other than those of the gastrointestinal tract. Immune-related extraintestinal manifestations (EIMs) are usually related to disease activity, but sometimes may take an independent course. Globally, about one third of patients develop these systemic manifestations. Phenotypic classification shows that certain subsets of patients are more susceptible to developing EIMs, which frequently occur simultaneously in the same patient overlapping joints, skin, mouth, and eyes. The clinical spectrum of these manifestations varies from mild transitory to very severe lesions, sometimes more incapacitating than the intestinal disease itself. The great majority of these EIMs accompany the activity of intestinal disease and patients run a higher risk of a severe clinical course. For most of the inflammatory EIMs, the primary therapeutic target remains the bowel. Early aggressive therapy can minimize severe complications and maintenance treatment has the potential to prevent some devastating consequences.

Keywords: Inflammatory bowel disease, Immune-related extraintestinal manifestations, Treatment