Extraintestinal manifestations in inflammatory bowel disease: Prevalence and predictors in Indian patients
Extraintestinal manifestations in inflammatory bowel disease: Prevalence and predictors in Indian patients
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DOI：
10.1007/s12664-015-0598-8
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发表时间：
2015-09-01
影响因子：
2
通讯作者：
Das, Kshaunish
中科院分区：
文献类型：
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作者：
Bandyopadhyay, Debottam;Bandyopadhyay, Sanjay;Das, Kshaunish
背景 关于亚洲和印度炎症性肠病 (IBD) 患者肠外表现 (EIM) 的报道很少。方法从 2011 年 5 月到 2012 年 10 月，连续的 IBD 患者接受了详细的病史和体格检查，同时由训练有素的风湿病学家、皮肤科医生和眼科医生进行详细的病史和体检，了解他们在入组时或过去是否经历过任何 EIM。疾病表型/严重程度和位置根据蒙特利尔分类进行分类。所有患者均接受了骶髂关节磁共振成像 (MRI)、肝功能检查 (LFT)、经腹超声检查以及股骨颈（双侧）和 L4-L5 脊柱的双能 X 射线吸收测定法 (DEXA) 扫描。 结果 对 120 名患者进行了分析，其中 62 名患有克罗恩病 (CD)，58 名患有溃疡性结肠炎 (UC)。 38% 的人至少患有一种 EIM，而 20% 的人患有多种 EIM。除葡萄膜炎和巩膜外层炎外，CD 和 UC 患者的个体 EIM 频率没有差异。 23% 的人患有外周关节炎，18% 的人患有强直性脊柱炎，13% 的人有眼科表现。 9% 出现皮肤粘膜表现、口疮性口炎和坏疽性脓皮病 (PG)。没有人患有结节性红斑（EN）或原发性硬化性胆管炎（PSC）。 50% 的患者在 DEXA 检测中出现骨质减少或骨质疏松。多变量分析显示，女性、印度教宗教、严重疾病和类固醇使用与 EIM 的存在显着相关。结论 EIM 的患病率与欧洲和美国报告的相似，但高于之前在亚洲患者中报告的患病率。女性、宗教、严重疾病和类固醇使用与 EIM 相关。
Background There is a paucity of reports on extraintestinal manifestations (EIMs) in patients with inflammatory bowel diseases (IBD) from Asia and India.Methods From May 2011 to October 2012, consecutive IBD patients underwent a detailed history and physical examination, also by trained rheumatologist, dermatologist, and ophthalmologist, about whether they experienced any EIM at the time of inclusion or in the past. The disease phenotype/severity and location was classified according to the Montreal classification. All underwent magnetic resonance imaging (MRI) of sacroiliac joints, liver function test (LFT), transabdominal ultrasound, and dual energy X-ray absorptiometry (DEXA) scanning at neck femur (bilateral) and L4-L5 spine.Results One hundred twenty patients were analyzed, 62 had Crohn's disease (CD) and 58 had ulcerative colitis (UC). Thirty-eight percent had at least one while 20% suffered from multiple EIMs. Except for uveitis and episcleritis, the frequency of individual EIMs did not differ between CD and UC patients. Twenty-three percent had peripheral arthritis, 18 % had ankylosing spondylitis, and 13 % had ophthalmological manifestations. Mucocutaneous manifestations, aphthous stomatitis and pyoderma gangrenosum (PG), were seen in 9 %. None had erythema nodosum (EN) or primary sclerosing cholangitis (PSC). Fifty percent of patients had either osteopenia or osteoporosis on DEXA. Multivariable analysis revealed female gender, Hindu religion, severe disease, and steroid usage were significantly associated with the presence of EIMs.Conclusion The prevalence of EIM is similar to that reported from Europe and USA, albeit higher than that previously reported in Asian patients. Female sex, religion, severe disease, and steroid use were associated with EIM.