Corica Domenico, Romano Claudio
Department of Pediatrics, University of Messina, Messina, Italy.
Department of Pediatrics, University of Messina, Messina, Italy
J Crohns Colitis. 2016 Feb;10(2):226-35. doi: 10.1093/ecco-jcc/jjv138. Epub 2015 Jul 29.
The prevalence of extraintestinal manifestations in inflammatory bowel diseases varies from 6% to 46%. The aetiology of extraintestinal manifestations remains unclear. There are theories based on an immunological response influenced by genetic factors. Extraintestinal manifestations can involve almost every organ system. They may originate from the same pathophysiological mechanism of intestinal disease, or as secondary complications of inflammatory bowel diseases, or autoimmune diseases susceptibility. The most frequently involved organs are the joints, skin, eyes, liver and biliary tract. Renal involvement has been considered as an extraintestinal manifestation and has been described in both Crohn's disease and ulcerative colitis. The most frequent renal involvements in patients with inflammatory bowel disease are nephrolithiasis, tubulointerstitial nephritis, glomerulonephritis and amyloidosis. The aim of this review is to evaluate and report the most important data in the literature on renal involvement in patients with inflammatory bowel disease. Bibliographical searches were performed of the MEDLINE electronic database from January 1998 to January 2015 with the following key words (all fields): (inflammatory bowel disease OR Crohn's disease OR ulcerative colitis) AND (kidney OR renal OR nephrotoxicity OR renal function OR kidney disease OR renal disease OR glomerulonephritis OR interstitial nephritis OR amyloidosis OR kidney failure OR renal failure) AND (5-aminosalicylic acid OR aminosalicylate OR mesalazine OR TNF-α inhibitors OR cyclosporine OR azathioprine OR drugs OR pediatric).
炎症性肠病肠外表现的患病率在6%至46%之间。肠外表现的病因仍不清楚。有基于受遗传因素影响的免疫反应的理论。肠外表现几乎可累及每个器官系统。它们可能源于肠道疾病相同的病理生理机制,或是炎症性肠病的继发性并发症,或是自身免疫性疾病易感性。最常受累的器官是关节、皮肤、眼睛、肝脏和胆道。肾脏受累已被视为一种肠外表现,在克罗恩病和溃疡性结肠炎中均有描述。炎症性肠病患者最常见的肾脏受累情况是肾结石、肾小管间质性肾炎、肾小球肾炎和淀粉样变性。本综述的目的是评估并报告文献中关于炎症性肠病患者肾脏受累的最重要数据。对1998年1月至2015年1月的MEDLINE电子数据库进行了文献检索,使用了以下关键词(所有字段):(炎症性肠病或克罗恩病或溃疡性结肠炎)以及(肾脏或肾或肾毒性或肾功能或肾脏疾病或肾病或肾小球肾炎或间质性肾炎或淀粉样变性或肾衰竭或肾功能衰竭)以及(5-氨基水杨酸或氨基水杨酸盐或美沙拉嗪或肿瘤坏死因子-α抑制剂或环孢素或硫唑嘌呤或药物或儿科)。