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Association of extraintestinal manifestations of inflammatory bowel disease in a province of western Hungary with disease phenotype: Results of a 25-year follow-up study
作者姓名:Lakatos L  Pandur T  David G  Balogh Z  Kuronya P  Tollas A  Lakatos PL
作者单位:Laszlo Lakatos,Tunde Pandur,Gyula David(1st Department of Medicine, Csolnoky F. Province Hospital, Veszprem);Zsuzsanna Balogh(Department of Medicine, Grof Eszterhazy Hospital, Papa);Pal Kuronya(Department of Infectious Diseases, Magyar Imre Hospital, Ajka);Arpad Tollas(Department of Medicine, Municipal Hospital, Varpalota);Peter Laszlo Lakatos(1st Department of Medicine, Semmelweis University, Budapest, Hungary) 
摘    要:AIM: IBD is a systemic disease associated with a large number of extraintestinal manifestations (EIMs). Our aim was to determine the prevalence of EIMs in a large IBD cohort in Veszprem Province in a 25-year follow-up study. METHODS: Eight hundred and seventy-three IBD patients were enrolled (ulcerative colitis/UC/: 619, m/f: 317/302,mean age at presentation: 38.3 years, average disease duration: 11.2 years; Crohn‘s disease/CD/: 254, m/f: 125/129,mean age at presentation: 32.5 years, average disease duration: 9.2 years). Intestinal, extraintestinal signs and laboratory tests were monitored regularly. Any alteration suggesting an EIMs was investigated by a specialist. RESULTS: A total of 21.3 % of patients with IBD had EIM(UC: 15.0 %, CD: 36.6 %). Age at presentation did not affect the likelihood of EIM. Prevalence of EIMs was higher in women and in CD, ocular complications and primary sclerosing cholangitis (PSC) were more frequent in UC. In UC there was an increased tendency of EIM in patients with a more extensive disease. Joint complications were more frequent in CD(22.4 % vsUC 10.2 %, P<0.01). In UC positive family history increased the risk of joint complications (OR:3.63). In CD the frequency of type-1 peripheral arthritis was increased in patients with penetrating disease (P=-0.028). PSC was present in 1.6 % in UC and 0.8 % in CD. Dermatological complications were present in 3.8 % in UC and 10.2 % in CD, the rate of ocular complications was around 3 % in both diseases. Rare complications were glomerulonephritis, autoimmune hemolytic anaemia and celiac disease. CONCLUSION: Prevalence of EIM in Hungarian IBD patients is in concordance with data from Western countries. The high number of EIM supports a role for complex followup in these patients.

关 键 词:肠外症状  炎性肠病  匈牙利西部  流行病学
收稿时间:2003 Jun 21

Association of extraintestinal manifestations of inflammatory bowel disease in a province of western Hungary with disease phenotype: results of a 25-year follow-up study
Lakatos L,Pandur T,David G,Balogh Z,Kuronya P,Tollas A,Lakatos PL.Association of extraintestinal manifestations of inflammatory bowel disease in a province of western Hungary with disease phenotype: results of a 25-year follow-up study[J].World Journal of Gastroenterology,2003,9(10):2300-2307.
Authors:Lakatos Laszlo  Pandur Tunde  David Gyula  Balogh Zsuzsanna  Kuronya Pal  Tollas Arpad  Lakatos Peter Laszlo
Institution:1. 1st Department of Medicine, Csolnoky F. Province Hospital, Veszprem
2. Department of Medicine, Grof Eszterhazy Hospital, Papa
3. Department of Infectious Diseases, Magyar Imre Hospital, Ajka
4. Department of Medicine, Municipal Hospital, Varpalota
5. 1st Department of Medicine, Semmelweis University, Budapest, Hungary
Abstract:AIM: IBD is a systemic disease associated with a large number of extraintestinal manifestations (EIMs). Our aim was to determine the prevalence of EIMs in a large IBD cohort in Veszprem Province in a 25-year follow-up study. METHODS: Eight hundred and seventy-three IBD patients were enrolled (ulcerative colitis/UC/: 619, m/f: 317/302, mean age at presentation: 38.3 years, average disease duration: 11.2 years; Crohn's disease/CD/: 254, m/f: 125/129, mean age at presentation: 32.5 years, average disease duration: 9.2 years). Intestinal, extraintestinal signs and laboratory tests were monitored regularly. Any alteration suggesting an EIMs was investigated by a specialist. RESULTS: A total of 21.3% of patients with IBD had EIM (UC: 15.0%, CD: 36.6%). Age at presentation did not affect the likelihood of EIM. Prevalence of EIMs was higher in women and in CD, ocular complications and primary sclerosing cholangitis (PSC) were more frequent in UC. In UC there was an increased tendency of EIM in patients with a more extensive disease. Joint complications were more frequent in CD (22.4% vs UC 10.2%, P<0.01). In UC positive family history increased the risk of joint complications (OR:3.63). In CD the frequency of type-1 peripheral arthritis was increased in patients with penetrating disease (P=0.028). PSC was present in 1.6% in UC and 0.8% in CD. Dermatological complications were present in 3.8% in UC and 10.2% in CD, the rate of ocular complications was around 3% in both diseases. Rare complications were glomerulonephritis, autoimmune hemolytic anaemia and celiac disease. CONCLUSION: Prevalence of EIM in Hungarian IBD patients is in concordance with data from Western countries. The high number of EIM supports a role for complex follow-up in these patients.
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