Prevalence of Extraintestinal Manifestations of Ulcerative Colitis Patients in Turkey: Community-Based Monocentric Observational Study.

Abstract

INTRODUCTION AND OBJECTIVE:

Extraintestinal findings are encountered in about 50% of Ulcerative Colitis (UC) patients. The objective of this study is to find out the prevalence and clinical features of extraintestinal manifestations (EIM) in ulcerative colitis (UC) patients in Turkish society and its relationship with diagnosis of disease, age and gender.

METHODS:

The prevalence of all extraintestinal findings associated with the disease was investigated in patients diagnosed with ulcerative colitis who were followed up in the gastroenterology clinic between January 2014 and March 2019. We retrospectively investigated the prevalence of elevated liver enzyme, primary sclerosing cholangitis, peripheral arthritis, ankylosing spondylitis, iritis/uveitis, pyoderma gangrenosum, erythema nodosum, venous thromboembolic events, lung findings, cardiac diseases and psychiatric disorders as extraintestinal findings in UC patients.

FINDINGS:

Of the 199 patients included in the study, 114 (57.3%) were male and 85 (42.7%) were female (mean age 45 ± 5). The mean disease age of the UC patients studied was 68 months (8-276 months).

Whereas the disease was in remission in 89% of the UC patients, it was active in 11%.

The extra intestinal findings detected include rheumatological diseases in 18 patients (9.2%), cardiac diseases in 9 patients (4.5%), skin diseases in 4 patients (2% [erythema nodosum in 3 patients (1.5%) and pyoderma gangrenosum in 1 patient (0.5%)]), venous thromboembolic events in 7 patients (%4), elevated liver enzyme in 26 patients (13%), primary sclerosing cholangitis in 2 patients (1%), erythema nodosum in 3 patients (1.5%), pyoderma gangrenosum in 1 patient (0.5%), osteopenia in 17 patients (26%), osteoporosis in 4 patients (6%), depression in 3 patients (1.5%), and ocular involvement in 6 patients (3%). At least one extra intestinal involvement was detected in 100 (50.2%) out of 199 patients included in the study.

CONCLUSION: Rheumatological diseases and elevated liver enzyme were found to be the most prevalent extraintestinal findings in ulcerative colitis patients. Relationships of immune-mediated diseases in extraintestinal regions are closely related to activation of IBD. Furthermore, EIMs may help us better understand the pathogenesis of UC.