Garamszegi Mária
Tolna Megyei Önkormányzat Balassa János Kórháza Szekszárd.
Orv Hetil. 2011 Apr 24;152(17):663-71. doi: 10.1556/OH.2011.29075.
Extraintestinal manifestations of ulcerative colitis and Crohn's disease are symptoms of varied organ injuries due to systemic inflammatory process. Bowel disease seems to be primary but upon genetic disposition disturbed immune regulation may result in inflammation of other organs that may appear simultaneously, precede bowel disease or follow it in the quiescent phase. As far as possible extraintestinal manifestations have to be distinguished from the complications of the intestinal inflammation and also from side effects of drugs for its treatment. Involvement of bones and joints, skin, eyes, liver and biliary tract is more common but disease of blood coagulation system, lung, kidneys and nervous system may also appear. Treatment of extraintestinal manifestations is influenced by their association with the activity of the bowel disease. Beyond some specific interventions, to achieve improvement of manifestations independent from activity long lasting anti-inflammatory therapy or immunomodulation is almost always needed. Clinical evidence of different levels from reports support the favorable effect of biologic therapy in different extraintestinal manifestations of inflammatory bowel diseases as well. Care and follow-up of patients is a multidisciplinary task.
溃疡性结肠炎和克罗恩病的肠外表现是由于全身炎症过程导致的各种器官损伤症状。肠道疾病似乎是原发性的，但在遗传易感性的基础上，免疫调节紊乱可能导致其他器官的炎症，这些炎症可能与肠道疾病同时出现、在肠道疾病之前出现或在肠道疾病静止期之后出现。尽可能将肠外表现与肠道炎症的并发症以及治疗药物的副作用区分开来。骨骼和关节、皮肤、眼睛、肝脏和胆道受累更为常见，但血液凝固系统、肺、肾脏和神经系统疾病也可能出现。肠外表现的治疗受其与肠道疾病活动度相关性的影响。除了一些特定干预措施外，为了实现与活动度无关的表现改善，几乎总是需要长期的抗炎治疗或免疫调节。来自不同层面报告的临床证据也支持生物治疗对炎症性肠病不同肠外表现的有益作用。对患者的护理和随访是一项多学科任务。
