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日本炎症性肠病患者以肠道外表现为特征的临床特征:远东 1000 例。

Clinical Features Focusing on Extraintestinal Manifestations in Japanese Patients with Inflammatory Bowel Diseases: Far East 1000.

机构信息

Department of Gastroenterology, Graduate School of Medicine, Chiba University, Chiba, Japan,

Department of Gastroenterology, Graduate School of Medicine, Chiba University, Chiba, Japan.

出版信息

Digestion. 2023;104(4):328-334. doi: 10.1159/000529816. Epub 2023 Mar 9.

DOI:10.1159/000529816
PMID:36893744
Abstract

BACKGROUND

Patients with inflammatory bowel diseases (IBD) can develop extraintestinal manifestations (EIMs) during the disease course, which sometimes impact their quality of life.

OBJECTIVES

This study aimed to clarify the prevalence and types of EIMs using a hospital-based IBD cohort in Japan.

METHODS

A patient cohort with IBD was established in 2019, as participated by 15 hospitals in Chiba Prefecture of Japan. Using this cohort, the prevalence and types of EIMs, which are defined based on previous reports and the Japanese guidelines, were investigated.

RESULTS

This cohort enrolled 728 patients, including 542 ulcerative colitis (UC) and 186 Crohn's disease (CD). Of these patients with IBD, 10.0% were identified with one or more EIMs (57 (10.5%) with UC and 16 (8.6%) with CD). Arthropathy and arthritis were the most common EIM in 23 (4.2%) patients with UC, followed by primary sclerosing cholangitis (PSC) (2.6%). Arthropathy and arthritis were also the most common in patients with CD, but no cases of PSC were observed. EIMs were more frequently observed in patients with IBD treated by specialists than in those treated by non-specialists (12.7% vs. 5.5%, p = 0.011). The incidence of EIMs in patients with IBD was not significantly different over time.

CONCLUSIONS

The prevalence and types of EIMs in our hospital-based cohort in Japan did not significantly differ from those reported in previous or Western studies. However, the incidence might be underestimated due to the limited ability of non-IBD specialists to discover and describe EIMs in patients with IBD.

摘要

背景

炎症性肠病(IBD)患者在疾病过程中可能会出现肠外表现(EIMs),有时会影响他们的生活质量。

目的

本研究旨在使用日本基于医院的 IBD 队列阐明 EIM 的患病率和类型。

方法

2019 年建立了 IBD 患者队列,由日本千叶县的 15 家医院参与。利用该队列,根据既往报告和日本指南,调查 EIM 的患病率和类型。

结果

该队列纳入了 728 名患者,包括 542 名溃疡性结肠炎(UC)患者和 186 名克罗恩病(CD)患者。在这些 IBD 患者中,有 10.0%(57 名 UC 患者和 16 名 CD 患者)存在一种或多种 EIM。关节炎和关节病是 UC 患者中最常见的 EIM,共 23 例(4.2%),其次是原发性硬化性胆管炎(PSC)(2.6%)。关节炎和关节病也是 CD 患者中最常见的 EIM,但未观察到 PSC 病例。在专科医生治疗的 IBD 患者中,EIM 的发生率高于非专科医生治疗的患者(12.7%比 5.5%,p = 0.011)。IBD 患者 EIM 的发生率随时间无显著变化。

结论

我们日本基于医院的队列中 EIM 的患病率和类型与既往或西方研究报道的无显著差异。然而,由于非 IBD 专科医生发现和描述 IBD 患者 EIM 的能力有限,发生率可能被低估。

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