Extraintestinal Manifestations of Inflammatory Bowel Disease in a Brazilian Tertiary Reference Center
AIBD 2023
Background:
Extraintestinal manifestations (EIMs) are common in inflammatory bowel disease (IBD) and may occur before or after IBD diagnosis. More than one-third of patients with IBD are affected by EIMs. Data on EIMs of IBD in Brazilian patients are limited. The aim of this study was to evaluate the prevalence and clinical characteristics of EIMs in in patients with IBD in a tertiary hospital in Southeastern Brazil.
Methods:
We performed a retrospective study with all patients with Crohn’s disease (CD) and Ulcerative colitis (UC) currently being followed up at the University Hospital, Ribeirão Preto Medical School, until December 2021. The electronic medical records of IBD patients were retrospectively reviewed for demographic, clinical characteristics, presence and chronological order of EIMs.
Results:
In total, 617 IBD patients (349 with CD and 268 with UC) of which 330 (53.5%) were females, with mean age of 46.4 (±15.6) years were included. EIMs were reported in 154 (25.0%) patients, of which 34 (22.1%) had multiple EIMs, and 128 (83.4%) developed an EIM after IBD diagnosis. The most common EIMs were: peripheral arthritis (39.6%), followed by Ankylosing spondylitis (16.2%), and Primary sclerosing cholangitis (PSC) occurred in 13 % of patients. Univariate analysis revealed that female sex (p=0.031, OR 1.51, 95% CI 1.04–2.18), Smoking (p=0.001, OR 2.39, 95% CI 1.42-4.03), Perianal CD (p=0.034, OR 1.76, 95% CI 1.04-2.99), Pancolitis (p=0.0001, OR 3.19, 95% CI 1.77–5.72) were associated with EIMs. We observed that PSC was strongly associated with UC (p = 0.003, OR: 5.64, 95% CI: 1.80–17.78). No significant differences were observed in relation to race, age at diagnosis, location and behavior of CD and previous use of biological agents.
Conclusions:
Our results demonstrate that a quarter of patients with IBD patients have at least one EIM more frequently present in females, smokers and patients with extensive UC and perianal CD. In most cases, the diagnosis of EIM was performed after IBD diagnosis.
