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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

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World Journal of Gastroenterology 2003年第10期9卷 2300-2307页

作者： Laszlo Lakatos Tunde Pandur gyula david Zsuzsanna Balogh Pal Kuronya Arpad Tollas Peter Laszlo Lakatos 1~(st) Department of Medicine Csolnoky F.Province HospitalVeszprem Department of Medicine Grof Eszterhazy HospitalPapa Department of Infectious Diseases Magyar Imre HospitalAjka Department of Medicine Mumcipal HospitalVarpalota 1~(st) Department of Medicine Semmelweis UniversityBudapestHungary

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 *** 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 *** of EIMs was higher in women and in CD,ocular complications and primary sclerosing cholangitis (PSC) were more frequent in *** UC there was an increased tendency of EIM in patients with a more extensive *** 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 *** complications were present in 3.8% in UC and 10.2% in CD,the rate of ocular complications was around 3% in both *** complications were glomerulonephritis,autoimmune hemolytic anaemia and celiac disease. CONCLUSION:Prevalence of EIM in Hungarian IBD patients is in concordance with data from Western *** high number of EIM supports a role for complex follow-up in these patients.

关键词： Adolescent Adult Age Distribution Aged Aged, 80 and over Anemia, Iron-Deficiency Bile Duct Diseases Child Colitis, Ulcerative Crohn Disease Eye Diseases Female Follow-Up Studies Humans Hungary Joint Diseases Liver Diseases Male Middle Aged Phenotype Prevalence

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Perianal disease,small bowel disease,smoking,prior steroid or early azathioprine/biological therapy are predictors of disease behavior change in patients with Crohn's disease

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World Journal of Gastroenterology 2009年第28期15卷 3504-3510页

作者： Peter Laszlo Lakatos Zsofia Czegledi Tamas Szamosi Janos Banai gyula david Ferenc Zsigmond Tunde Pandur Zsuzsanna Erdelyi Orsolya Gemela Janos Papp Laszlo Lakatos 1st Department of Medicine Semmelweis University H-1083 Budapest Hungary Department of Gastroenterology State Health Center H-1062 Budapest Hungary 1st Department of Medicine Csolnoky F. County Hospital HH8201-Veszprem Hungary

AIM:To assess the combined effect of disease phenotype, smoking and medical therapy [steroid, azathioprine(AZA), AZA/biological therapy] on the probability of disease behavior change in a Caucasian cohort of patients with Crohn's disease(CD).METHODS:Three hundred and forty well-characterized, unrelated, consecutive CD patients were analyzed(M/F:155/185, duration:9.4 ± 7.5 years) with a complete clinical *** records including disease phenotype according to the Montreal classification, extraintestinal manifestations, use of medications and surgical events were analyzed *** were interviewed on their smoking habits at the time of diagnosis and during the regular follow-up ***:A change in disease behavior was observed in 30.8% of patients with an initially non-stricturing, non-penetrating disease behavior after a mean diseaseduration of 9.0 ± 7.2 *** a logistic regression analysis corrected for disease duration, perianal disease, smoking, steroid use, early AZA or AZA/ biological therapy use were independent predictors of disease behavior *** a subsequent Kaplan-Meier survival analysis and a proportional Cox regression analysis, disease location(P = 0.001), presence of perianal disease(P < 0.001), prior steroid use(P = 0.006), early AZA(P = 0.005) or AZA/biological therapy(P = 0.002), or smoking(P = 0.032) were independent predictors of disease behavior ***:Our data suggest that perianal disease, small bowel disease, smoking, prior steroid use, early AZA or AZA/biological therapy are all predictors of disease behavior change in CD patients.

关键词： Crohn's disease Smoking Azathioprine Infliximab Monoclonal antibodies Colectomy Risk Reoperation

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