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. 2016 Feb;45(4):475-82.
doi: 10.1016/j.semarthrit.2015.07.006. Epub 2015 Jul 26.

Vasculitis in patients with inflammatory bowel diseases: A study of 32 patients and systematic review of the literature

Alice Sy  1 , Nader Khalidi  2 , Natasha Dehghan  3 , Lillian Barra  4 , Simon Carette  1 , David Cuthbertson  5 , Gary S Hoffman  6 , Curry L Koening  7 , Carol A Langford  6 , Carol McAlear  8 , Larry Moreland  9 , Paul A Monach  10 , Philip Seo  11 , Ulrich Specks  12 , Antoine Sreih  8 , Steven R Ytterberg  13 , Gert Van Assche  14 , Peter A Merkel  8 , Christian Pagnoux  15 ; Vasculitis Clinical Research Consortium (VCRC); Canadian Vasculitis Network (CanVasc)
Affiliations

Vasculitis in patients with inflammatory bowel diseases: A study of 32 patients and systematic review of the literature

Alice Sy et al. Semin Arthritis Rheum. 2016 Feb.

Abstract

Background: Published small case series suggest that inflammatory bowel disease [IBD; Crohn's disease (CD) or ulcerative colitis (UC)] and vasculitis co-occur more frequently than would be expected by chance.

Objectives: To describe this association by an analysis of a large cohort of carefully studied patients and through a systematic literature review.

Methods: Patients with both IBD and vasculitis enrolled in the Vasculitis Clinical Research Consortium (VCRC) Longitudinal Studies, followed in Canadian Vasculitis research network (CanVasc) centers and/or in the University of Toronto's IBD clinic were included in this case series. A systematic literature review of patients with IBD and vasculitis involved a PubMed search through February 2014. The main characteristics of patients with Takayasu arteritis (TAK) and IBD were compared to those in patients with TAK without IBD followed in the VCRC.

Results: The study identified 32 patients with IBD and vasculitis: 13 with large-vessel vasculitis [LVV; 12 with TAK, 1 with giant cell arteritis (GCA); 8 with CD, 5 with UC]; 8 with ANCA-associated vasculitis [AAV; 6 granulomatosis with polyangiitis (GPA), 2 with eosinophilic granulomatosis with polyangiitis (EGPA)]; 5 with isolated cutaneous vasculitis; and 6 with other vasculitides. Patients with LVV and AAV were mostly female (18/21). The diagnosis of IBD preceded that of vasculitis in 12/13 patients with LVV and 8/8 patients with AAV. The review of the literature identified 306 patients with IBD and vasculitis: 144 with LVV (133 TAK; 87 with IBD preceding LVV), 19 with AAV [14 GPA, 1 EGPA, 4 microscopic polyangiitis (MPA)], 66 with isolated cutaneous vasculitis, and 77 with other vasculitides. Patients with IBD and TAK were younger and had more frequent headaches, constitutional symptoms, or gastrointestinal symptoms compared to those patients in the VCRC who had TAK without IBD.

Conclusions: These findings highlight the risk of vasculitis, especially TAK, in patients with IBD (both CD and UC).

Keywords: Crohn’s disease; Inflammatory bowel disease; Takayasu arteritis; Ulcerative colitis; Vasculitis.

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Figures

Fig
Fig
Algorithm of the literature search (ANCA, anti-neutrophil cytoplasmic antibody; n, number of cases; x, number of articles).
See this image and copyright information in PMC

Comment in

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