Skin gangrene as an extraintestinal manifestation of inflammatory bowel disease

Abstract Background Anemia is a common extraintestinal manifestation of Inflammatory Bowel Disease (IBD) affecting negatively the patients’ quality of life. The aim of this study was to determine the frequency and real-life management of anemia in IBD patients in Greece. Methods This study was conducted in 17 Greek IBD referral centers. Demographic, clinical, laboratory, IBD and anemia treatment data were collected and analyzed retrospectively. Results A total of 1394 IBD patients [560 ulcerative colitis (UC), 834 Crohn’s disease (CD)] were enrolled. Anemia at any time was reported in 687 (49.3%) patients of whom 413 (29.6%) had episodic and 274 (19.7%) had recurrent/persistent anemia. Anemia was diagnosed before IBD in 45 (6.5%), along with IBD in 269 (39.2%) and after IBD in 373 (54.3%) patients. In the multivariate analysis the presence of extraintestinal manifestations (p = 0.0008), IBD duration (p = 0.026), IBD related surgeries and hospitalizations (p = 0.026 and p = 0.004 accordingly) were risk factors of recurrent/persistent anemia. Serum ferritin was measured in 839 (60.2%) IBD patients. Among anemic patients, 535 (77.9%) received treatment. Iron supplementation was administered in 485 (90.6%) patients, oral in 142 (29.3%) and intravenous in 393 (81%). Conclusions The frequency of anemia in IBD patients, followed at Greek referral centers, is approximately 50%. Development of recurrent/persistent anemia may be observed in 20% of cases and is independently associated with the presence of extraintestinal manifestations, IBD duration, IBD related surgeries and hospitalizations. Anemia treatment is administered in up to $$4/5$$ 4 / 5 of anemia IBD patients with the majority of them receiving iron intravenously.

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URINARY BLADDER NECROSIS - AN EXTRAINTESTINAL MANIFESTATION OF INFLAMMATORY BOWEL DISEASE IN A PEDIATRIC PATIENT

Gastroenterology ◽

10.1053/j.gastro.2021.01.083 ◽

2021 ◽

Vol 160 (3) ◽

pp. S23

Author(s):

Nicholas Norris ◽

Bruce Schlomer ◽

Bhaskar Gurram

Keyword(s):

Inflammatory Bowel Disease ◽

Urinary Bladder ◽

Pediatric Patient ◽

Bowel Disease ◽

Extraintestinal Manifestation ◽

Bladder Necrosis ◽

Inflammatory Bowel

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Cerebral Arterial Thrombosis in Ulcerative Colitis

Case Reports in Gastrointestinal Medicine ◽

10.1155/2013/679147 ◽

2013 ◽

Vol 2013 ◽

pp. 1-4 ◽

Cited By ~ 1

Author(s):

Giovanni Casella ◽

Claudio Camillo Cortelezzi ◽

DeLodovici Marialuisa ◽

Princiotta Cariddi Lucia ◽

Verrengia Elena Pinuccia ◽

...

Keyword(s):

Ulcerative Colitis ◽

Inflammatory Bowel Disease ◽

Bowel Disease ◽

Arterial Thrombosis ◽

Sclerosing Cholangitis ◽

International Literature ◽

Extraintestinal Manifestation ◽

Intraarterial Thrombolysis ◽

Inflammatory Bowel ◽

Cerebral Arterial Thrombosis

Thrombosis, mainly venous, is a rare and well-recognized extraintestinal manifestation of inflammatory bowel disease (IBD). We describe a 25-year-old Caucasian man affected by ulcerative colitis and sclerosing cholangitis with an episode of right middle cerebral arterial thrombosis resolved by intraarterial thrombolysis. We perform a brief review of the International Literature.

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Renal involvement in paediatric inflammatory bowel disease

Pediatric Nephrology ◽

10.1007/s00467-019-04413-5 ◽

2019 ◽

Author(s):

Mohamed Mutalib

Keyword(s):

Inflammatory Bowel Disease ◽

Bowel Disease ◽

Renal Involvement ◽

Host Immune System ◽

Inflammatory Disorder ◽

Extraintestinal Manifestation ◽

Metabolic Complications ◽

Chronic Inflammatory Disorder ◽

Renal Manifestation ◽

Inflammatory Bowel

AbstractInflammatory bowel disease (IBD), which includes Crohn’s disease, ulcerative colitis and inflammatory bowel disease unclassified, is a chronic inflammatory disorder that predominantly affects the gastrointestinal (GI) tract and has a rising incidence in both children and adults. Symptoms are caused by inappropriate inflammatory response triggered by interaction between the environment, gut microbiome and host immune system in a genetically susceptible individual. Extranintestinal manifestations of IBD are common and can affect any body system outside the gut; they can precede or run parallel to GI inflammation. Renal involvement in IBD is uncommon and can be part of extraintestinal manifestation or metabolic complications of IBD. Many medications used to treat IBD can cause renal damage. Renal manifestation in children with IBD can range from asymptomatic biochemical abnormalities to variable stages of renal impairment with significant morbidity and even mortality burden.

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High Prevalence of Ultrasound Verified Enthesitis in Patients With Inflammatory Bowel Disease With or Without Spondylarthritis

Frontiers in Medicine ◽

10.3389/fmed.2021.637459 ◽

2021 ◽

Vol 8 ◽

Author(s):

Rusmir Husic ◽

Angelika Lackner ◽

Patrizia Katharina Kump ◽

Christoph Högenauer ◽

Winfried Graninger ◽

...

Keyword(s):

Inflammatory Bowel Disease ◽

Irritable Bowel Syndrome ◽

Bowel Disease ◽

Healthy Subjects ◽

Ultrasound Examination ◽

Clinical Signs ◽

Extraintestinal Manifestation ◽

High Prevalence ◽

Inflammatory Bowel ◽

Irritable Bowel

Background: Inflammatory bowel disease (IBD) is closely associated with spondylarthritis (SpA) and enthesitis, as an important feature of SpA, is a common extraintestinal manifestation of IBD. Enthesitis may be clinically silent in a high proportion of patients with IBD without clinical signs or a diagnosis of SpA.Objectives: The aim of this study was to compare the prevalence of ultrasound (US) verified enthesitis in IBD patients with and without SpA, with patients with irritable bowel syndrome (IBS) and healthy subjects (HC) serving as controls.Methods: IBD patients with or without SpA, patients with IBS and HC were prospectively recruited and clinically assessed. Ultrasound examination was performed at 14 entheses. The ultrasound abnormalities were scored according to the Madrid Ankylosing Spondylitis Enthesitis Index (MASEI).Results: We included 33 IBD patients without SpA, 14 IBD patients with SpA, 26 IBS patients and 18 HC. Higher MASEI scores were found in patients with IBD without SpA [median 21.0 range (8.0–53.0)] and IBD associated SpA [33.0 (8–50)] than in IBS patients [10.5 (0–42.0)-p < 0.001 for both comparison] and HC [12.0 (2.0–38.0)-p < 0.01]. PD, enthesophytes and erosions were more common in patients with IBD with or without SpA as compared to IBS patients and HC. IBD patients with SpA compared to IBD without SpA demonstrated significant higher prevalence of erosion and structural irregularity and consequently significant higher MASEI (p < 0.05 for all comparison).Conclusions: Ultrasound verified enthesitis is more common in patients with IBD with or without SpA as compared to patients with IBS or HC.

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Two Cases of Pericarditis Associated with Inflammatory Bowel Disease

Acta Medica (Hradec Kralove Czech Republic) ◽

10.14712/18059694.2018.28 ◽

2005 ◽

Vol 48 (1) ◽

pp. 43-44 ◽

Cited By ~ 2

Author(s):

Bilge Tunc ◽

Levent Filik ◽

Aysel Ulker ◽

Erkan Parlak

Keyword(s):

Ulcerative Colitis ◽

Inflammatory Bowel Disease ◽

Cardiac Disease ◽

Bowel Disease ◽

The Other ◽

Intestinal Disease ◽

Extraintestinal Manifestations ◽

Extraintestinal Manifestation ◽

Inflammatory Bowel ◽

Cardiac Manifestations

Extraintestinal manifestations are common complications of inflammatory bowel disease (IBD) whereas the association of cardiac disease with IBD is rarely reported. Cardiac manifestations may be diagnosed before, concomitantly or after the diagnosis of the specific type of inflammatory bowel disease. Pericarditis and myocarditis are potentially serious complications. This extraintestinal manifestation developed in one patient concomitantly with onset of intestinal disease. One patient had ulcerative colitis (UC), while other had Crohn’s disease (CD). Indomethacin was effective in one and the other patient required prednisone in addition. Chest symptoms in patients with inflammatory bowel disease should be evaluated to exclude myopericardial disease.

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Management of Iron Deficiency Anaemia in Inflammatory Bowel Disease

Acta Haematologica ◽

10.1159/000496728 ◽

2019 ◽

Vol 142 (1) ◽

pp. 30-36 ◽

Cited By ~ 3

Author(s):

Kristine Michelle Jimenez ◽

Christoph Gasche

Keyword(s):

Inflammatory Bowel Disease ◽

Iron Deficiency ◽

Bowel Disease ◽

Iron Deficiency Anaemia ◽

Intravenous Iron ◽

Extraintestinal Manifestation ◽

Deficiency Anaemia ◽

Multiple Parameters ◽

Inflammatory Bowel ◽

Selection Of

Inflammatory bowel disease (IBD) is a group of chronic relapsing inflammatory disorders affecting the large and small intestine, with a rising worldwide incidence and prevalence. Anaemia is the most common extraintestinal manifestation of IBD, correlating with disease activity, and tending to relapse even after successful therapy. Iron deficiency is the most common cause; however, it often manifests in combination with anaemia of inflammation. As such, multiple parameters are used for the diagnosis of iron deficiency anaemia in IBD. Timely recognition and selection of appropriate therapy leads to an improvement in the quality of life and prevention of potential sequelae. Oral iron can be effective under specific circumstances; however, as luminal iron changes microbiota and bacterial metabolism, oral administration should be avoided. Intravenous iron is preferred as it bypasses the sites of inflammation. Nevertheless, the optimization of IBD treatment should occur simultaneously, as this improves both patient condition and response to iron therapy. Herein, we discuss the screening, diagnosis, selection of therapy, and follow-up for iron deficiency anaemia in IBD.

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Chronic cough in a patient with stable ulcerative colitis: a rare but important extraintestinal manifestation of inflammatory bowel disease

BMJ Case Reports ◽

10.1136/bcr-2018-227066 ◽

2019 ◽

Vol 12 (1) ◽

pp. bcr-2018-227066 ◽

Cited By ~ 2

Author(s):

Thomas Chad ◽

Jeremy Brown

Keyword(s):

Ulcerative Colitis ◽

Inflammatory Bowel Disease ◽

Bowel Disease ◽

Lower Lobe ◽

Gas Transfer ◽

Extraintestinal Manifestation ◽

Sputum Production ◽

Inflammatory Bowel ◽

The Right

A 74-year-old woman presented to her general practitioner with cough and occasional sputum production. Having failed to respond to courses of antibiotics in the community, she was referred to the thoracic medicine clinic. High-resolution CT chest revealed cylindrical bronchiectasis predominantly in the right lower lobe. Lung function revealed preserved FEV1 and FVC but reduced gas transfer values. Bronchiectasis secondary to ulcerative colitis was diagnosed. Inhaled corticosteroid therapy was initiated, with good clinical response noted at 6 monthly follow-up. Remission was sustained with tapering of the steroid dose. Recognition of respiratory complications in cases of inflammatory bowel disease is likely still poor among clinicians. Although rare, a working knowledge of principles of investigation and management will aid timely diagnosis and treatment, potentially preventing progression of respiratory disease.

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