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Review
. 2011 Jun 14;17(22):2702-7.
doi: 10.3748/wjg.v17.i22.2702.

Extraintestinal manifestations of inflammatory bowel disease: do they influence treatment and outcome?

Fernando Tavarela Veloso  1
Affiliations
Review

Extraintestinal manifestations of inflammatory bowel disease: do they influence treatment and outcome?

Fernando Tavarela Veloso. World J Gastroenterol. .

Abstract

Crohn's disease and ulcerative colitis are chronic inflammatory bowel diseases that often involve organs other than those of the gastrointestinal tract. Immune-related extraintestinal manifestations (EIMs) are usually related to disease activity, but sometimes may take an independent course. Globally, about one third of patients develop these systemic manifestations. Phenotypic classification shows that certain subsets of patients are more susceptible to developing EIMs, which frequently occur simultaneously in the same patient overlapping joints, skin, mouth, and eyes. The clinical spectrum of these manifestations varies from mild transitory to very severe lesions, sometimes more incapacitating than the intestinal disease itself. The great majority of these EIMs accompany the activity of intestinal disease and patients run a higher risk of a severe clinical course. For most of the inflammatory EIMs, the primary therapeutic target remains the bowel. Early aggressive therapy can minimize severe complications and maintenance treatment has the potential to prevent some devastating consequences.

Keywords: Immune-related extraintestinal manifestations; Inflammatory bowel disease; Treatment.

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Figures

Figure 1
Figure 1
Associations of the four major inflammatory extraintestinal manifestations in 169 of 480 Crohn’s disease patients.
Figure 2
Figure 2
Cumulative probability of having a repetition of the same inflammatory extraintestinal manifestations.
Figure 3
Figure 3
Distribution of inflammatory extraintestinal manifestations according to the Vienna classification in 169 Crohn’s disease patients.
Figure 4
Figure 4
Severe lesions of erythema nodosum treated with infliximab.
Figure 5
Figure 5
Pyoderma gangrenosum before, during and after treatment with infliximab.
Figure 6
Figure 6
Aphthous ulcers in the buccal mucosa and on the tongue.
Figure 7
Figure 7
Ankylosing spondylitis and uveitis in the same patient.
Figure 8
Figure 8
ERCP showing sclerosing cholangitis and endoscopic view of carcinoma of the colon observed in the same patient.
See this image and copyright information in PMC

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MeSH terms