Clinical Research
Copyright ©The Author(s) 2003. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Oct 15, 2003; 9(10): 2300-2307
Published online Oct 15, 2003. doi: 10.3748/wjg.v9.i10.2300
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
Laszlo Lakatos, Tunde Pandur, Gyula David, Zsuzsanna Balogh, Pal Kuronya, Arpad Tollas, Peter Laszlo Lakatos
Laszlo Lakatos, Tunde Pandur, Gyula David, 1st Department of Medicine, Csolnoky F. Province Hospital, Veszprem
Zsuzsanna Balogh, Department of Medicine, Grof Eszterhazy Hospital, Papa
Pal Kuronya, Department of Infectious Diseases, Magyar Imre Hospital, Ajka
Arpad Tollas, Department of Medicine, Municipal Hospital, Varpalota
Peter Laszlo Lakatos, 1st Department of Medicine, Semmelweis University, Budapest, Hungary
Author contributions: All authors contributed equally to the work.
Correspondence to: Laszlo Lakatos, MD, 1st Department of Medicine, Csolnoky F. Province Hospital, Korhaz u.1, Veszprem, H-8200 Hungary. laklaci@hotmail.com
Telephone: +36-20-911-9339 Fax: +36-1-313-0250
Received: June 21, 2003
Revised: July 25, 2003
Accepted: August 2, 2003
Published online: October 15, 2003
Abstract

AIM: IBD is a systemic disease associated with a large number of extraintestinal manifestations (EIMs). Our aim was to determine the prevalence of EIMs in a large IBD cohort in Veszprem Province in a 25-year follow-up study.

METHODS: Eight hundred and seventy-three IBD patients were enrolled (ulcerative colitis/UC/: 619, m/f: 317/302, mean age at presentation: 38.3 years, average disease duration: 11.2 years; Crohn’s disease/CD/: 254, m/f: 125/129, mean age at presentation: 32.5 years, average disease duration: 9.2 years). Intestinal, extraintestinal signs and laboratory tests were monitored regularly. Any alteration suggesting an EIMs was investigated by a specialist.

RESULTS: A total of 21.3% of patients with IBD had EIM (UC: 15.0%, CD: 36.6%). Age at presentation did not affect the likelihood of EIM. Prevalence of EIMs was higher in women and in CD, ocular complications and primary sclerosing cholangitis (PSC) were more frequent in UC. In UC there was an increased tendency of EIM in patients with a more extensive disease. Joint complications were more frequent in CD (22.4% vs UC 10.2%, P < 0.01). In UC positive family history increased the risk of joint complications (OR: 3.63). In CD the frequency of type-1 peripheral arthritis was increased in patients with penetrating disease (P = 0.028). PSC was present in 1.6% in UC and 0.8% in CD. Dermatological complications were present in 3.8% in UC and 10.2% in CD, the rate of ocular complications was around 3% in both diseases. Rare complications were glomerulonephritis, autoimmune hemolytic anaemia and celiac disease.

CONCLUSION: Prevalence of EIM in Hungarian IBD patients is in concordance with data from Western countries. The high number of EIM supports a role for complex follow-up in these patients.

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