Extraintestinal Manifestations of Ulcerative Colitis: The Opinion of a Rheumatologist and Proctologist
Abstract
Extraintestinal manifestations of ulcerative colitis (UC) are detected in up to 25% of patients, more often with pancolitis. Various extraintestinal manifestations may develop, which are important in the diagnosis for both a rheumatologist and a proctologist: Erythema nodosum and gangrenous pyoderma due to circulating immune complexes, bacterial antigens and cryoproteins. Approximately 10% of patients with active colitis show aphthae on the oral mucosa, which disappear as the activity of the underlying disease decreases. 10% of patients suffer from inflammatory diseases of the eye (episiscleritis, uveitis, conjunctivitis, keratitis, retrobulbar neuritis, choroiditis). Often they are combined with other extraintestinal symptoms. The arrow indicates the synechia between the iris and the lens capsule. Inflammatory diseases of the joints: arthritis (25%), sacroileitis (15%) and ankylosing spondylitis (10%) can be combined with colitis or occur before the onset of the main symptomatology. Osteoporosis, osteomalacia, ischemic and aseptic necrosis are among the complications of corticosteroid therapy. Approximately 35% of patients with UC were diagnosed with dysfunction of the respiratory system. The relationship between acute pancreatitis and antibodies to exocrine pancreatic tissue and the true extraintestinal symptoms of ulcerative colitis remains a subject of discussion. In the acute phase of UC, a slight increase in serum transaminases is observed quite often, however, against the background of a decrease in the activity of the underlying disease, the indicators return to normal. While maintaining an increase in the levels of these enzymes, one should bear in mind the possibility of developing primary sclerosing cholangitis. Vasculitis, glomerulonephritis and myositis are rare extraintestinal symptoms. Assessing the severity of UC with extraintestinal complications can be interpreted differently by a rheumatologist and proctologist. From the point of view of a proctologist: usually, the severity of the disease and its activity correspond to the extent of damage to the mucous membrane of the colon, the frequency of relapse and the development of extraintestinal complications. From the point of view of a rheumatologist: the development of extraintestinal articular complications corresponds to a severe degree of ulcerative colitis of the colon and requires complex treatment.
References
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Abstract
References
- D’Incà, R., Podswiadek, M., Ferronato, A., Punzi, L., Salvagnini, M., Sturniolo, G. C. (2009). Articular manifestation in inflammatory bowel disease patients. A prospective study, Dig Liver Dis., 9, March.
- Nguyen, G.C., & Sam, J. (2007). Rising prevalence of venous thromboembolism and its impact an mortality among. Hospitalized inflammatory bowel disease patients, Am. J. Gastroenterol. 102, 174-186.
- Orchard, T.R., Holt, H., Bradbury, L. et al. (2009). The prevalence, clinical features and association of HLA-B27 in sacroiliitis associated with established Chron’s disease. Abiment. Pharmacol. Ther, 29, 193-197.
- Reinshagen, M. (2008). Osteoporosis in inflammatory bowel disease. Journal of Chron’s and Colitis, 2, 202-207.
- Rodriguez, V. E., Costas, P. J., Vazquez, M., Alvarez, G., Perez-Kraft, G., Climent, C., & Nazario, C. M. (2008). Prevalence of spondyloarthropathy in Puerto Rican patients with inflammatory bowel disease. Ethn Dis, 18(2 Suppl 2), S2-225.
- Rothfuss, K. S., Stange, E. F., & Herrlinger, K. R. (2006). Extraintestinal manifestations and complications in inflammatory bowel diseases. World journal of gastroenterology: WJG, 12(30), 4819.
- Sartor R.B., & Sandborn W.J. (2004). Kirsner’s inflammatory bowel disease. — London: Saundrs, pp.754.
- Satsangi J.,& Satherland L.R. (2003). Inflammatory Bowel Disease. — Elsevier. pp.792. Sieper, J., Rudwaleit, M., Baraliakos, X., Brandt, J., Braun, J., Burgos-Vargas, R., ... & Van Der Heijde, D. (2009). The Assessment of SpondyloArthritis international Society (ASAS) handbook: a guide to assess spondyloarthritis. Annals of the rheumatic diseases, 68 (Suppl 2), ii1-ii44.
- Sulyma V., & Sulima O. (2018). Treatment of patients with Crohn`s Disease and Ulcerative Colitis with manifestation arthritis and spondylitis. Abstracts Falk Symposium 213, October 2018, Milan, Italy. –pp. 102.
Details
| Primary Language | English |
|---|---|
| Subjects | Engineering |
| Journal Section | Articles |
| Authors | |
| Publication Date | December 31, 2020 |
| Published in Issue | Year 2020Volume: 11 |
