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Observational Study
. 2021 Jun;66(6):2014-2023.
doi: 10.1007/s10620-020-06424-x. Epub 2020 Jul 15.

Extraintestinal Manifestations in Patients with Inflammatory Bowel Disease: Study Based on the ENEIDA Registry

Alicia Algaba  1   2 , Iván Guerra  3   4 , Elena Ricart  5   6   7 , Eva Iglesias  8   9 , Miriam Mañosa  7   10 , Javier P Gisbert  7   11   12   13 , Jordi Guardiola  14   15 , Miguel Mínguez  16   17 , Beatriz Castro  18   19 , Ruth de Francisco  20   21 , Pilar Nos  7   22 , Federico Bertoletti  23 , Francisco Mesonero  24 , Jesús Barrio  25 , María Dolores Martín-Arranz  26   27 , Xavier Calvet  7   28   29 , Santiago García-López  30 , Beatriz Sicilia  31 , Gillermo Alcaín  32 , María Esteve  7   33 , Lucía Márquez  34   35 , Marta Piqueras  36 , Laura Jiménez  3   4 , José L Perez-Calle  37 , Luis Bujanda  7   38   39 , Mariana García-Sepulcre  40 , Alejandra Fernández  41 , Irene Moraleja  42 , Rufo Humberto Lorente  43 , Orlando García-Bosch  44 , Ana Lambán  45 , Isabel Blázquez  46 , Esther Rodríguez  47 , José M Huguet  48 , Alfredo J Lucendo  7   49 , Pedro Almela  50 , David Busquets  51 , Patricia Ramírez de la Piscina  52 , Marcela Pérez  53 , Eugeni Domenech  7   10 , Fernando Bermejo  3   4 ; Spanish GETECCU Group (ENEIDA Project)
Affiliations
Observational Study

Extraintestinal Manifestations in Patients with Inflammatory Bowel Disease: Study Based on the ENEIDA Registry

Alicia Algaba et al. Dig Dis Sci. 2021 Jun.

Abstract

Background: Patients with inflammatory bowel disease (IBD) may present extraintestinal manifestations (EIMs) that affect the joints, skin, eyes, and hepatobiliary area, among others.

Aims: Our aim was to analyse the prevalence and characteristics of EIMs in patients with IBD and to identify the possible risk factors associated with the development of EIMs in the largest series published to date.

Methods: Observational, cross-sectional study including patients from the Spanish ENEIDA registry promoted by GETECCU. We retrospectively identified all cases of EIMs in the ENEIDA registry until January 2018.

Results: The study included 31,077 patients, 5779 of whom had at least one EIM (global prevalence 19%; 95% CI 18.2-19.0). Among the different types of EIMs, rheumatic manifestations had a prevalence of 13% (95% CI 12.9-13.7; 63% of EIMs), with a prevalence of 5% (95% CI 4.7-5.2) for mucocutaneous manifestations, 2.1% (95% CI 1.9-2.2) for ocular manifestations, and 0.7% (95% CI 0.6-0.8) for hepatobiliary manifestations. The multivariable analysis showed that the type of IBD (Crohn's disease, p < 0.001), gender (female, p < 0.001), the need for an immunomodulator (p < 0.001) or biologic drugs (p < 0.001), a previous family history of IBD (p < 0.001), and an extensive location of IBD (p < 0.001) were risk factors for the presence of EIMs.

Conclusions: One-fifth of patients with IBD may have associated EIMs, with rheumatic manifestations as the most frequent (> 60% of EIMs). Female patients with severe Crohn's disease represent the group with the highest risk of developing EIMs. These patients should therefore be specially monitored and referred to the corresponding specialist when suggestive symptoms appear.

Keywords: Eye manifestations; Inflammatory bowel disease; Rheumatic diseases; Sclerosing cholangitis; Skin manifestations.

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