Bandyopadhyay Debottam, Bandyopadhyay Sanjay, Ghosh Parasar, De Abhishek, Bhattacharya Anupam, Dhali G K, Das Kshaunish
Division of Gastroenterology, School of Digestive and Liver Diseases, Institute of Post Graduate Medical Education and Research, 244 A J C Bose Road, Kolkata, 700 020, India.
Department of Rheumatology, Institute of Post Graduate Medical Education and Research, 244 A J C Bose Road, Kolkata, 700 020, India.
Indian J Gastroenterol. 2015 Sep;34(5):387-94. doi: 10.1007/s12664-015-0598-8. Epub 2015 Nov 28.
There is a paucity of reports on extraintestinal manifestations (EIMs) in patients with inflammatory bowel diseases (IBD) from Asia and India.
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 Montréal 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.
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.
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.
来自亚洲和印度的炎症性肠病（IBD）患者肠外表现（EIMs）的报道较少。
2011年5月至2012年10月，连续纳入的IBD患者接受了详细的病史询问和体格检查，由训练有素的风湿病学家、皮肤科医生和眼科医生询问他们在纳入时或过去是否有任何EIMs。疾病表型/严重程度和部位根据蒙特利尔分类法进行分类。所有患者均接受了骶髂关节磁共振成像（MRI）、肝功能检查（LFT）、经腹超声检查以及双侧股骨颈和L4-L5脊柱的双能X线吸收法（DEXA）扫描。
共分析了120例患者，其中62例患有克罗恩病（CD），58例患有溃疡性结肠炎（UC）。38%的患者至少有一种EIMs，20%的患者患有多种EIMs。除葡萄膜炎和巩膜外层炎外，CD和UC患者的个体EIMs发生率无差异。23%的患者有外周关节炎，18%的患者有强直性脊柱炎，13%的患者有眼部表现。9%的患者有黏膜皮肤表现、阿弗他口炎和坏疽性脓皮病（PG）。无一例有结节性红斑（EN）或原发性硬化性胆管炎（PSC）。50%的患者在DEXA检查中有骨质减少或骨质疏松。多变量分析显示，女性、印度教、疾病严重程度和使用类固醇与EIMs的存在显著相关。
EIMs的患病率与欧洲和美国报道的相似，尽管高于先前亚洲患者的报道。女性、宗教、疾病严重程度和类固醇使用与EIMs相关。
