Stephan R Vavricka1, Gerhard Rogler, Claudine Gantenbein, Muriel Spoerri, Mareike Prinz Vavricka, Alexander A Navarini, Lars E French, Ekaterina Safroneeva, Nicolas Fournier, Alex Straumann, Florian Froehlich, Michael Fried, Pierre Michetti, Frank Seibold, Peter L Lakatos, Laurent Peyrin-Biroulet, Alain M Schoepfer. 1. 1Division of Gastroenterology and Hepatology, Department of Internal Medicine, University Hospital Zurich, Zurich, Switzerland; 2Department of Medicine, Division of Gastroenterology and Hepatology, Triemlispital Zurich, Zurich, Switzerland; 3Private Practice for Dermatology, Zurich, Switzerland; 4Department of Dermatology, University Hospital Zurich, Switzerland; 5Division of Genetics and Molecular Medicine, King's College, London, United Kingdom; 6Institute of Social and Preventive Medicine (ISPM), University of Bern, Bern, Switzerland; 7Institute of Social and Preventive Medicine (IUMSP), University of Lausanne, Lausanne, Switzerland; 8Department of Medicine, Division of Gastroenterology and Hepatology, University Hospital Basel, Basel, Switzerland; 9Crohn's and Colitis Center, Clinique de La Source, Lausanne, Switzerland; 101st Department of Medicine, Semmelweis University, Budapest, Hungary; 11Department of Medicine, Gastroenterology, Spital Netz Bern Tiefenau, Bern, Switzerland; 12Inserm U954 and Department of Hepato-Gastroenterology, University Hospital of Nancy-Brabois, Université Henri Poincaré 1, Vandoeuvre-lès-Nancy, France; and 13Department of Medicine, Division of Gastroenterology and Hepatology, Centre Hospitalier Universitaire Vaudois (CHUV), Lausanne, Switzerland.
Abstract
BACKGROUND: Data evaluating the chronological order of appearance of extraintestinal manifestations (EIMs) relative to the time of inflammatory bowel disease (IBD) diagnosis is currently lacking. We aimed to assess the type, frequency, and chronological order of appearance of EIMs in patients with IBD. METHODS: Data from the Swiss Inflammatory Bowel Disease Cohort Study were analyzed. RESULTS: The data on 1249 patients were analyzed (49.8% female, median age: 40 [interquartile range, 30-51 yr], 735 [58.8%] with Crohn's disease, 483 [38.7%] with ulcerative colitis, and 31 [2.5%] with indeterminate colitis). A total of 366 patients presented with EIMs (29.3%). Of those, 63.4% presented with 1, 26.5% with 2, 4.9% with 3, 2.5% with 4, and 2.7% with 5 EIMs during their lifetime. Patients presented with the following diseases as first EIMs: peripheral arthritis 70.0%, aphthous stomatitis 21.6%, axial arthropathy/ankylosing spondylitis 16.4%, uveitis 13.7%, erythema nodosum 12.6%, primary sclerosing cholangitis 6.6%, pyoderma gangrenosum 4.9%, and psoriasis 2.7%. In 25.8% of cases, patients presented with their first EIM before IBD was diagnosed (median time 5 mo before IBD diagnosis: range, 0-25 mo), and in 74.2% of cases, the first EIM manifested itself after IBD diagnosis (median: 92 mo; range, 29-183 mo). CONCLUSIONS: In one quarter of patients with IBD, EIMs appeared before the time of IBD diagnosis. Occurrence of EIMs should prompt physicians to look for potential underlying IBD.
BACKGROUND: Data evaluating the chronological order of appearance of extraintestinal manifestations (EIMs) relative to the time of inflammatory bowel disease (IBD) diagnosis is currently lacking. We aimed to assess the type, frequency, and chronological order of appearance of EIMs in patients with IBD. METHODS: Data from the Swiss Inflammatory Bowel Disease Cohort Study were analyzed. RESULTS: The data on 1249 patients were analyzed (49.8% female, median age: 40 [interquartile range, 30-51 yr], 735 [58.8%] with Crohn's disease, 483 [38.7%] with ulcerative colitis, and 31 [2.5%] with indeterminate colitis). A total of 366 patients presented with EIMs (29.3%). Of those, 63.4% presented with 1, 26.5% with 2, 4.9% with 3, 2.5% with 4, and 2.7% with 5 EIMs during their lifetime. Patients presented with the following diseases as first EIMs: peripheral arthritis 70.0%, aphthous stomatitis 21.6%, axial arthropathy/ankylosing spondylitis 16.4%, uveitis 13.7%, erythema nodosum 12.6%, primary sclerosing cholangitis 6.6%, pyoderma gangrenosum 4.9%, and psoriasis 2.7%. In 25.8% of cases, patients presented with their first EIM before IBD was diagnosed (median time 5 mo before IBD diagnosis: range, 0-25 mo), and in 74.2% of cases, the first EIM manifested itself after IBD diagnosis (median: 92 mo; range, 29-183 mo). CONCLUSIONS: In one quarter of patients with IBD, EIMs appeared before the time of IBD diagnosis. Occurrence of EIMs should prompt physicians to look for potential underlying IBD.
Authors: Alicia Algaba; Iván Guerra; Elena Ricart; Eva Iglesias; Miriam Mañosa; Javier P Gisbert; Jordi Guardiola; Miguel Mínguez; Beatriz Castro; Ruth de Francisco; Pilar Nos; Federico Bertoletti; Francisco Mesonero; Jesús Barrio; María Dolores Martín-Arranz; Xavier Calvet; Santiago García-López; Beatriz Sicilia; Gillermo Alcaín; María Esteve; Lucía Márquez; Marta Piqueras; Laura Jiménez; José L Perez-Calle; Luis Bujanda; Mariana García-Sepulcre; Alejandra Fernández; Irene Moraleja; Rufo Humberto Lorente; Orlando García-Bosch; Ana Lambán; Isabel Blázquez; Esther Rodríguez; José M Huguet; Alfredo J Lucendo; Pedro Almela; David Busquets; Patricia Ramírez de la Piscina; Marcela Pérez; Eugeni Domenech; Fernando Bermejo Journal: Dig Dis Sci Date: 2020-07-15 Impact factor: 3.199
Authors: David T Rubin; Walter Reinisch; Thomas Greuter; Paulo G Kotze; Marcia Pinheiro; Rajiv Mundayat; Eric Maller; Marc Fellmann; Nervin Lawendy; Irene Modesto; Stephan R Vavricka; Gary R Lichtenstein Journal: Therap Adv Gastroenterol Date: 2021-05-16 Impact factor: 4.409