Alicia Algaba1,2, Iván Guerra3,4, Elena Ricart5,6,7, Eva Iglesias8,9, Miriam Mañosa7,10, Javier P Gisbert7,11,12,13, Jordi Guardiola14,15, Miguel Mínguez16,17, Beatriz Castro18,19, Ruth de Francisco20,21, Pilar Nos7,22, Federico Bertoletti23, Francisco Mesonero24, Jesús Barrio25, María Dolores Martín-Arranz26,27, Xavier Calvet7,28,29, Santiago García-López30, Beatriz Sicilia31, Gillermo Alcaín32, María Esteve7,33, Lucía Márquez34,35, Marta Piqueras36, Laura Jiménez3,4, José L Perez-Calle37, Luis Bujanda7,38,39, Mariana García-Sepulcre40, Alejandra Fernández41, Irene Moraleja42, Rufo Humberto Lorente43, Orlando García-Bosch44, Ana Lambán45, Isabel Blázquez46, Esther Rodríguez47, José M Huguet48, Alfredo J Lucendo7,49, Pedro Almela50, David Busquets51, Patricia Ramírez de la Piscina52, Marcela Pérez53, Eugeni Domenech7,10, Fernando Bermejo3,4. 1. Department of Gastroenterology of Hospital Universitario de Fuenlabrada, Madrid, Spain. alicia_algaba@hotmail.com. 2. Instituto de Investigación Sanitaria Hospital La Paz (IdiPaz), Madrid, Spain. alicia_algaba@hotmail.com. 3. Department of Gastroenterology of Hospital Universitario de Fuenlabrada, Madrid, Spain. 4. Instituto de Investigación Sanitaria Hospital La Paz (IdiPaz), Madrid, Spain. 5. Department of Gastroenterology of Hospital Clinic, Barcelona, Spain. 6. Institut d'Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS), Barcelona, Spain. 7. Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Madrid, Spain. 8. Department of Gastroenterology of Hospital Universitario Reina Sofía, Córdoba, Spain. 9. Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), Córdoba, Spain. 10. Department of Gastroenterology of Hospital Universitari Germans Trias i Pujol, Barcelona, Spain. 11. Department of Gastroenterology of Hospital Universitario de La Princesa, Madrid, Spain. 12. Instituto de Investigación Sanitaria Princesa (IIS-IP), Madrid, Spain. 13. Universidad Autónoma de Madrid, Madrid, Spain. 14. Department of Gastroenterology of Hospital Universitari de Bellvitge, Barcelona, Spain. 15. Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), Barcelona, Spain. 16. Department of Gastroenterology of Hospital Clínico de Valencia, Valencia, Spain. 17. Universitat of Valencia, Valencia, Spain. 18. Department of Gastroenterology of Hospital Universitario Marqués de Valdecilla, Santander, Spain. 19. Instituto de Investigación Marqués de Valdecilla, Santander, Spain. 20. Department of Gastroenterology of Hospital Universitario Central de Asturias, Asturias, Spain. 21. Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Spain. 22. Gastroenterology Department, Hospital Universitari i Politècnic La Fe, Valencia, Spain. 23. Department of Gastroenterology of Hospital de la Santa Creu i Sant Pau, Barcelona, Spain. 24. Department of Gastroenterology of Hospital Universitario Ramón y Cajal, Madrid, Spain. 25. Department of Gastroenterology of Hospital Universitario Rio Hortega, Valladolid, Spain. 26. Department of Gastroenterology of La Paz Hospital, Madrid, Spain. 27. Innate Immunity Group, IdiPAZ Institute for Health Research, La Paz Hospital, Madrid, Spain. 28. Department of Gastroenterology of Corporació Sanitària Universitària Parc Taulí, Sabadell, Spain. 29. Universitat Autònoma de Barcelona, Barcelona, Spain. 30. Department of Gastroenterology of Hospital Universitario Miguel Servet, Zaragoza, Spain. 31. Department of Gastroenterology of Hospital Universitario de Burgos, Burgos, Spain. 32. Department of Gastroenterology of Hospital Clínico de Málaga, Málaga, Spain. 33. Department of Gastroenterology of Hospital Universitari Mútua Terrassa, Barcelona, Spain. 34. Gastroenterology Department, Hospital del Mar, Barcelona, Spain. 35. IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain. 36. Department of Gastroenterology of Consorci Sanitari Terrassa, Barcelona, Spain. 37. Department of Gastroenterology of Hospital Universitario Fundación Alcorcón, Madrid, Spain. 38. Department of Gastroenterology of Hospital Donostia/Instituto Biodonostia, San Sebastián, Guipúzcoa, Spain. 39. Universidad del País Vasco UPV/EHU, San Sebastián, Guipúzcoa, Spain. 40. Department of Gastroenterology of Hospital General Universitario Elche, Alicante, Spain. 41. Department of Gastroenterology of Hospital Universitario de Salamanca, Salamanca, Spain. 42. Department of Gastroenterology of Hospital de Galdakao, Vizcaya, Spain. 43. Gastroenterology Department, Hospital General Universitario de Ciudad Real, Ciudad Real, Spain. 44. Department of Gastroenterology of Hospital de Sant Joan Despí Moisès Broggi, Barcelona, Spain. 45. Department of Gastroenterology of Hospital General San Jorge, Huesca, Spain. 46. Department of Gastroenterology of Hospital de Torrejón, Madrid, Spain. 47. Department of Gastroenterology of Hospital Universitario Nuestra Señora Candelaria, Santa Cruz de Tenerife, Spain. 48. Department of Gastroenterology of Hospital General Universitario de Valencia, Valencia, Spain. 49. Department of Gastroenterology of Hospital General de Tomelloso, Ciudad Real, Spain. 50. Department of Gastroenterology of Hospital General Universitari de Castelló, Castellón, Spain. 51. Department of Gastroenterology of Hospital Dr. Josep Trueta, Girona, Spain. 52. Department of Gastroenterology of Hospital Universitario Áraba, Vitoria-Gasteiz, Álava, Spain. 53. Department of Gastroenterology of Hospital Sant Jaume de Calella, Barcelona, Spain.
Abstract
BACKGROUND: Patients with inflammatory bowel disease (IBD) may present extraintestinal manifestations (EIMs) that affect the joints, skin, eyes, and hepatobiliary area, among others. AIMS: Our aim was to analyse the prevalence and characteristics of EIMs in patients with IBD and to identify the possible risk factors associated with the development of EIMs in the largest series published to date. METHODS: Observational, cross-sectional study including patients from the Spanish ENEIDA registry promoted by GETECCU. We retrospectively identified all cases of EIMs in the ENEIDA registry until January 2018. RESULTS: The study included 31,077 patients, 5779 of whom had at least one EIM (global prevalence 19%; 95% CI 18.2-19.0). Among the different types of EIMs, rheumatic manifestations had a prevalence of 13% (95% CI 12.9-13.7; 63% of EIMs), with a prevalence of 5% (95% CI 4.7-5.2) for mucocutaneous manifestations, 2.1% (95% CI 1.9-2.2) for ocular manifestations, and 0.7% (95% CI 0.6-0.8) for hepatobiliary manifestations. The multivariable analysis showed that the type of IBD (Crohn's disease, p < 0.001), gender (female, p < 0.001), the need for an immunomodulator (p < 0.001) or biologic drugs (p < 0.001), a previous family history of IBD (p < 0.001), and an extensive location of IBD (p < 0.001) were risk factors for the presence of EIMs. CONCLUSIONS: One-fifth of patients with IBD may have associated EIMs, with rheumatic manifestations as the most frequent (> 60% of EIMs). Female patients with severe Crohn's disease represent the group with the highest risk of developing EIMs. These patients should therefore be specially monitored and referred to the corresponding specialist when suggestive symptoms appear.
BACKGROUND:Patients with inflammatory bowel disease (IBD) may present extraintestinal manifestations (EIMs) that affect the joints, skin, eyes, and hepatobiliary area, among others. AIMS: Our aim was to analyse the prevalence and characteristics of EIMs in patients with IBD and to identify the possible risk factors associated with the development of EIMs in the largest series published to date. METHODS: Observational, cross-sectional study including patients from the Spanish ENEIDA registry promoted by GETECCU. We retrospectively identified all cases of EIMs in the ENEIDA registry until January 2018. RESULTS: The study included 31,077 patients, 5779 of whom had at least one EIM (global prevalence 19%; 95% CI 18.2-19.0). Among the different types of EIMs, rheumatic manifestations had a prevalence of 13% (95% CI 12.9-13.7; 63% of EIMs), with a prevalence of 5% (95% CI 4.7-5.2) for mucocutaneous manifestations, 2.1% (95% CI 1.9-2.2) for ocular manifestations, and 0.7% (95% CI 0.6-0.8) for hepatobiliary manifestations. The multivariable analysis showed that the type of IBD (Crohn's disease, p < 0.001), gender (female, p < 0.001), the need for an immunomodulator (p < 0.001) or biologic drugs (p < 0.001), a previous family history of IBD (p < 0.001), and an extensive location of IBD (p < 0.001) were risk factors for the presence of EIMs. CONCLUSIONS: One-fifth of patients with IBD may have associated EIMs, with rheumatic manifestations as the most frequent (> 60% of EIMs). Female patients with severe Crohn's disease represent the group with the highest risk of developing EIMs. These patients should therefore be specially monitored and referred to the corresponding specialist when suggestive symptoms appear.
Authors: Stephan R Vavricka; Lionel Brun; Pierluigi Ballabeni; Valérie Pittet; Bettina Mareike Prinz Vavricka; Jonas Zeitz; Gerhard Rogler; Alain M Schoepfer Journal: Am J Gastroenterol Date: 2010-08-31 Impact factor: 10.864
Authors: Stephan R Vavricka; 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 Journal: Inflamm Bowel Dis Date: 2015-08 Impact factor: 5.325
Authors: Stephan R Vavricka; Alain Schoepfer; Michael Scharl; Peter L Lakatos; Alexander Navarini; Gerhard Rogler Journal: Inflamm Bowel Dis Date: 2015-08 Impact factor: 5.325
Authors: René Roth; Stephan Vavricka; Michael Scharl; Philipp Schreiner; Ekaterina Safroneeva; Thomas Greuter; Jonas Zeitz; Benjamin Misselwitz; Alain Schoepfer; Mamadou Pathé Barry; Gerhard Rogler; Luc Biedermann Journal: United European Gastroenterol J Date: 2021-08-25 Impact factor: 6.866
Authors: Koen M J Janssen; Hilde Hop; Arjan Vissink; Gerard Dijkstra; Menke J de Smit; Elisabeth Brouwer; Johanna Westra Journal: Int J Environ Res Public Health Date: 2020-11-01 Impact factor: 3.390