Johan Burisch1, Stefania Chetcuti Zammit2, Pierre Ellul2, Svetlana Turcan3, Dana Duricova4, Martin Bortlik4,5, Karina Winther Andersen6, Vibeke Andersen6,7,8, Ioannis P Kaimakliotis9, Mathurin Fumery10, Corinne Gower-Rousseau11,12, Giulia Girardin13, Daniela Valpiani14, Adrian Goldis15, Marko Brinar16, Silvija Čuković-Čavka16, Pia Oksanen17,18, Pekka Collin17,18, Luisa Barros19, Fernando Magro19,20, Ravi Misra21, Naila Arebi21, Carl Eriksson22, Jonas Halfvarson22, Hendrika Adriana Linda Kievit23, Natalia Pedersen24, Jens Kjeldsen25, Sally Myers26, Shaji Sebastian26, Konstantinos H Katsanos27, Dimitrios K Christodoulou27, Jóngerð Midjord28, Kári Rubek Nielsen28, Gediminas Kiudelis29, Limas Kupcinskas29,30, Inna Nikulina31, Elena Belousova31, Doron Schwartz32, Selwyn Odes32, Riina Salupere33, Amalia Carmona34, Juan R Pineda35, Zsuzsanna Vegh36, Peter L Lakatos36,37, Ebbe Langholz38, Pia Munkholm1. 1. Department of Gastroenterology, North Zealand Hospital, University of Copenhagen, Copenhagen, Denmark. 2. Division of Gastroenterology, Mater Dei Hospital, Msida, Malta. 3. Department of Gastroenterology, State University of Medicine and Pharmacy of the Republic of Moldova, Chisinau, Republic of Moldova. 4. IBD Clinical and Research Centre, ISCARE, Prague, Czech Republic. 5. Institute of Pharmacology, 1st Faculty of Medicine, Charles University, Prague, Czech Republic. 6. Medical Department, Regional Hospital of Viborg, Viborg, Denmark. 7. Focused Research Unit for Molecular Diagnostic and Clinical Research (MOK), IRS-Center Sonderjylland, Hospital of Southern Jutland, Aabenraa, Denmark. 8. Institute of Molecular Medicine, University of Southern Denmark, Odense, Denmark. 9. Nicosia Private Practice, Nicosia, Cyprus. 10. Gastroenterology Unit, Epimad Registry, CHU Amiens Sud, Avenue Laennec-Salouel, Amiens University Hospital, Amiens, France. 11. Public Health, Epidemiology and Economic Health, Registre Epimad, Lille University and Hospital, Lille, France. 12. Lille Inflammation Research International Center LIRIC, Lille University, Lille, France. 13. Department of Surgical, Oncological and Gastroenterological Sciences, Azienda, University of Padua, Padua, Italy. 14. U.O. Gastroenterologia ed Endoscopia digestiva, Hospital Morgagni Pierantoni, Forlì, Italy. 15. Clinic of Gastroenterology, University of Medicine 'Victor Babes', Timisoara, Romania. 16. Division of Gastroenterology and Hepatology, University Hospital Center Zagreb, Zagreb, Croatia. 17. Department of Gastroenterology and Alimentary Tract Surgery, Tampere University Hospital, Tampere, Finland. 18. University of Tampere, Tampere, Finland. 19. Department of Gastroenterology, Centro Hospitalar de São João EPE, Porto, Portugal. 20. Department of Biomedicine, Institute of Pharmacology, Faculty of Medicine of Porto University, Porto, Portugal. 21. IBD Department, St Marks Hospital, Imperial College London, London, UK. 22. Department of Gastroenterology, Faculty of Medicine and Health, Örebro University, Örebro, Sweden. 23. Department of Medicine, Herning Central Hospital, Herning, Denmark. 24. Gastroenterology Department, Slagelse Hospital, Slagelse, Denmark. 25. Gastroenterology Department, Odense University Hospital, Odense, Denmark. 26. IBD Unit, Hull and East Yorkshire NHS Trust, Hull, UK. 27. Department of Gastroenterology, University Hospital of Ioannina, Ioannina, Greece. 28. Medical Department, The National Hospital of the Faroe Islands, Torshavn, Faroe Islands. 29. Institute for Digestive Research, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania. 30. Department of Gastroenterology, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania. 31. Department of Gastroenterology, Moscow Regional Research Clinical Institute, Moscow, Russian Federation. 32. Department of Gastroenterology and Hepatology, Soroka Medical Center and Ben Gurion, University of the Negev, Beer Sheva, Israel. 33. Division of Gastroenterology, Tartu University Hospital, University of Tarty, Tartu, Estonia. 34. Department of Gastroenterology, Hospital POVISA, Vigo, Spain. 35. Department of Gastroenterology, Hospital Alvaro Cunqueiro, Instituto Investigación Sanitaria Galicia Sur, EOXI de Vigo, Vigo, Spain. 36. 1st Department of Medicine, Semmelweis University, Budapest, Hungary. 37. Division of Gastroenterology, McGill University Health Center, Montreal, Canada. 38. Department of Gastroenterology, Herlev and Gentofte Hospital, University of Copenhagen, Copenhagen, Denmark.
Abstract
BACKGROUND AND AIM: A definitive diagnosis of Crohn's disease (CD) or ulcerative colitis (UC) is not always possible, and a proportion of patients will be diagnosed as inflammatory bowel disease unclassified (IBDU). The aim of the study was to investigate the prognosis of patients initially diagnosed with IBDU and the disease course during the following 5 years. METHODS: The Epi-IBD study is a prospective population-based cohort of 1289 IBD patients diagnosed in centers across Europe. Clinical data were captured prospectively throughout the follow-up period. RESULTS: Overall, 476 (37%) patients were initially diagnosed with CD, 701 (54%) with UC, and 112 (9%) with IBDU. During follow-up, 28 (25%) IBDU patients were changed diagnoses to either UC (n = 20, 71%) or CD (n = 8, 29%) after a median of 6 months (interquartile range: 4-12), while 84 (7% of the total cohort) remained IBDU. A total of 17 (15%) IBDU patients were hospitalized for their IBD during follow-up, while 8 (7%) patients underwent surgery. Most surgeries (n = 6, 75%) were performed on patients whose diagnosis was later changed to UC; three of these colectomies led to a definitive diagnosis of UC. Most patients (n = 107, 96%) received 5-aminosalicylic acid, while 11 (10%) patients received biologicals, of whom five remained classified as IBDU. CONCLUSIONS: In a population-based inception cohort, 7% of IBD patients were not given a definitive diagnosis of IBD after 5 years of follow-up. One in four patients with IBDU eventually was classified as CD or UC. Overall, the disease course and medication burden in IBDU patients were mild.
BACKGROUND AND AIM: A definitive diagnosis of Crohn's disease (CD) or ulcerative colitis (UC) is not always possible, and a proportion of patients will be diagnosed as inflammatory bowel disease unclassified (IBDU). The aim of the study was to investigate the prognosis of patients initially diagnosed with IBDU and the disease course during the following 5 years. METHODS: The Epi-IBD study is a prospective population-based cohort of 1289 IBDpatients diagnosed in centers across Europe. Clinical data were captured prospectively throughout the follow-up period. RESULTS: Overall, 476 (37%) patients were initially diagnosed with CD, 701 (54%) with UC, and 112 (9%) with IBDU. During follow-up, 28 (25%) IBDUpatients were changed diagnoses to either UC (n = 20, 71%) or CD (n = 8, 29%) after a median of 6 months (interquartile range: 4-12), while 84 (7% of the total cohort) remained IBDU. A total of 17 (15%) IBDUpatients were hospitalized for their IBD during follow-up, while 8 (7%) patients underwent surgery. Most surgeries (n = 6, 75%) were performed on patients whose diagnosis was later changed to UC; three of these colectomies led to a definitive diagnosis of UC. Most patients (n = 107, 96%) received 5-aminosalicylic acid, while 11 (10%) patients received biologicals, of whom five remained classified as IBDU. CONCLUSIONS: In a population-based inception cohort, 7% of IBDpatients were not given a definitive diagnosis of IBD after 5 years of follow-up. One in four patients with IBDU eventually was classified as CD or UC. Overall, the disease course and medication burden in IBDUpatients were mild.
Authors: Piotr Eder; Aleksandra Zielińska; Jacek Karczewski; Agnieszka Dobrowolska; Ryszard Słomski; Eliana B Souto Journal: J Nanobiotechnology Date: 2021-10-29 Impact factor: 10.435
Authors: Mohamed Elbadry; Mohamed O Nour; Mohamed Hussien; Elsayed Awad Ghoneem; Mohammed A Medhat; Hany Shehab; Sherif Galal; Mohamed Eltabbakh; Fathiya El-Raey; Mohamed Negm; Shimaa Afify; Walaa Abdelhamed; Ahmed Sherief; Ahmed Abdelaziz; Mohamed Abo Elkasem; Aya Mahrous; Ghada Kamal; Maha Maher; Omar Abdel-Hameed; Abubakr Elbasuny; Islam El-Zayyadi; Ahmed Bassiony; Abdelmajeed Moussa; Essam Bedewy; Asem Elfert; Mohamed El Kassas Journal: Front Med (Lausanne) Date: 2022-04-19