Ozkahraman Adnan, Kayar Yusuf, Dertli Ramazan, Konur Sevki, Kılıc Guner, Baran Bulent, Ormeci Asli Cifcibasi, Akyuz Filiz, Demir Kadir, Besisik Fatih, Kaymakoglu Sabahattin
Department of Internal Medicine, Van Teaching and Research Hospital, Health Sciences University, Van, Turkey.
Division of Gastroenterology, Department of Internal Medicine, Van Teaching and Research Hospital, Health Sciences University, Van, Turkey.
Sci Rep. 2025 Jul 1;15(1):20629. doi: 10.1038/s41598-025-07180-6.
Although Crohn's disease (CD) affects the intestines, it is known to be a systemic disease rather than being limited to the intestines. Extra intestinal manifestations (EIMs) accompanying CD are reported at rates varying from 6 to 53%. While EIM negatively affects the quality of life of some patients, some EIMs, such as primary sclerosing cholangitis and thromboembolism, can be life-threatening. Although more than one EIM can occur simultaneously, the development of one EIM increases the probability of developing another EIM. There are few studies on how EIMs affect each other. The aim of this study was to examine the frequency of EIMs accompanying CD and their interactions with each other. This study included patients with CD who were under regular follow-up from March 1986 to October 2011. Accompanying EIMs and the time of development were recorded. The frequency of EIMs and their associations with each other were investigated. In total, 336 patients with CD (55.4% male) with a mean follow-up duration of 7.54 years (range, 6 months-25.4 years) were evaluated. At the time of CD diagnosis, 21.1% of the patients had at least one EIM, and at the end of the 25-year follow-up period, the prevalence of EIMs was 47.3%. The prevalence of multiple EIMs was 12.2% and 22.9% at the onset of CD and at the 25-year follow-up, respectively. Oral, joint 9.2%, respectively) were the most common EIMs. The development and skin involvement (32.4%, 24.7%, and of peripheral arthritis was significantly associated with axial spondiloarthropathy, skin involvement, ocular involvement, oral ulcers, and vascular thromboembolism (p < 0.05). There was a significant relationship between oral ulcers and peripheral arthritis, axial arthritis, skin involvement, ocular involvement, liver involvement and thromboembolism (p < 0.05). No significant relationship was detected between neurological involvement and any other EIMs. The development of EIMs in patients with CD may trigger the development of other EIMs during the course of the disease.
虽然克罗恩病（CD）累及肠道，但它是一种全身性疾病，而非局限于肠道。据报道，CD伴发的肠外表现（EIMs）发生率在6%至53%之间。虽然EIMs对部分患者的生活质量有负面影响，但一些EIMs，如原发性硬化性胆管炎和血栓栓塞，可能危及生命。虽然多种EIMs可能同时出现，但一种EIM的发生会增加出现另一种EIM的可能性。关于EIMs如何相互影响的研究较少。本研究的目的是调查CD伴发EIMs的频率及其相互作用。本研究纳入了1986年3月至2011年10月期间接受定期随访的CD患者。记录伴发的EIMs及其发生时间。调查EIMs的频率及其相互关联。共评估了336例CD患者（男性占55.4%），平均随访时间为7.54年（范围为6个月至25.4年）。在CD诊断时，21.1%的患者至少有一种EIMs，在25年随访期结束时，EIMs的患病率为47.3%。在CD发病时和25年随访时，多种EIMs的患病率分别为12.2%和22.9%。口腔、关节和皮肤受累（分别为32.4%、24.7%和9.2%）是最常见的EIMs。外周关节炎的发生与中轴型脊柱关节炎、皮肤受累、眼部受累、口腔溃疡和血管血栓栓塞显著相关（p<0.05）。口腔溃疡与外周关节炎、中轴关节炎、皮肤受累、眼部受累、肝脏受累和血栓栓塞之间存在显著关系（p<0.05）。未发现神经受累与任何其他EIMs之间存在显著关系。CD患者中EIMs的发生可能在疾病过程中引发其他EIMs的发生。
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