Extraintestinal manifestations in Crohn's disease and ulcerative colitis: results from a prospective, population-based European inception cohort
Extraintestinal manifestations in Crohn's disease and ulcerative colitis: results from a prospective, population-based European inception cohort
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DOI：
10.3109/00365521.2014.991752
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发表时间：
2015-03-01
影响因子：
1.9
通讯作者：
Moum, Bjorn
中科院分区：
文献类型：
--
作者：
Isene, Rune;Bernklev, Tomm;Moum, Bjorn
背景资料。在慢性炎症性肠病(克罗恩病[CD]和溃疡性结肠炎[UC])中，常见的症状来自胃肠道外，关节、皮肤、眼睛和肝胆区是最常见的受累部位(称为肠外表现[EIM])。报告的流行率各不相同，这是由于研究设计和调查人群的不同所致。我们研究的目的是确定EIM在欧洲和以色列以人群为基础的初始队列中的流行率。方法：研究方法。IBD患者被纳入从1991年到2004年前瞻性跟踪的队列。共对1145例患者进行了10年的随访。结果。首次EIM的累积患病率为16.9%(193/1145例患者)，平均随访时间为10.1年。CD患者比UC患者更有可能出现免疫调节的症状(关节炎、眼睛、皮肤和肝脏)：20.1%比10.4%(p<；0.001)。最常见的是关节炎，CD组(12.9%)明显高于UC组(8.1%)，p=0.01。在UC中，与直肠炎相比，泛结肠炎增加了EIM的风险。结论。在欧洲的初始队列中，IBD患者的EIMS与可比研究中看到的一致。CD患者发生EIM的可能性是UC患者的两倍，UC中炎症分布越广泛，EIM的风险就越高。
Background. In chronic inflammatory bowel disease (IBD) (Crohn's disease [CD] and ulcerative colitis [UC]), symptoms from outside the gastrointestinal tract are frequently seen, and the joints, skin, eyes, and hepatobiliary area are the most usually affected sites (called extraintestinal manifestations [EIM]). The reported prevalence varies, explained by difference in study design and populations under investigation. The aim of our study was to determine the prevalence of EIM in a population-based inception cohort in Europe and Israel. Methods. IBD patients were incepted into a cohort that was prospectively followed from 1991 to 2004. A total of 1145 patients were followed for 10 years. Results. The cumulative prevalence of first EIM was 16.9% (193/1145 patients) over a median follow-up time of 10.1 years. Patients with CD were more likely than UC patients to have immune-mediated (arthritis, eye, skin, and liver) manifestations: 20.1% versus 10.4% (p < 0.001). Most frequently seen was arthritis which was significantly more common in CD (12.9%) than in UC (8.1%), p = 0.01. Pan-colitis compared to proctitis in UC increased the risk of EIM. Conclusion. In a European inception cohort, EIMs in IBD were consistent with that seen in comparable studies. Patients with CD are twice as likely as UC patients to experience EIM, and more extensive distribution of inflammation in UC increases the risk of EIM.