Journal of Epidemiology and Global Health

In Press, Corrected Proof, Available Online: 12 April 2020

Extraintestinal Manifestations of Inflammatory Bowel Disease in Middle Eastern Patients

Authors
Heba Adam1, Maryam Alqassas1, Omar I. Saadah2, 3, Mahmoud Mosli1, 3, *
1Department of Medicine, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
2Department of Pediatrics, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
3Inflammatory Bowel Disease Research Group, King Abdulaziz University, Jeddah, Saudi Arabia
*Corresponding author. Email: mmosli@kau.edu.sa
Corresponding Author
Mahmoud Mosli
Received 24 August 2019, Accepted 1 March 2020, Available Online 12 April 2020.
DOI
https://doi.org/10.2991/jegh.k.200330.001How to use a DOI?
Keywords
Inflammatory bowel disease, extraintestinal, manifestations, incidence, predictors
Abstract

Background and Aims: The Inflammatory Bowel Diseases (IBDs), Crohn’s Disease (CD) and Ulcerative Colitis (UC), are gastrointestinal autoimmune disorders with many Extraintestinal Manifestations (EIMs). Previously reported incidences of EIMs in IBD patients have ranged from 10% to 50%. The large variation in occurrence of EIMs has been linked to genetic predisposition. Correlations between individual EIMs are unclear. Therefore, we aim to estimate the incidence of EIMs in a Middle Eastern cohort of patients with IBD and examine possible relationships with EIMs.

Patients and Methods: We conducted a retrospective study involving all patients included in the King Abdulaziz University IBD information system registry between 2013 and 2018. Data on demographics, disease characteristics, and EIMs were extracted and analyzed using descriptive statistics: the standard Student’s t-test and chi-squared test. Logistic regression analysis was used to examine associations using STATA software version 11.2 (StataCorp, TX, USA).

Results: We reviewed the electronic medical files of 284 patients with confirmed IBD, of which 158 (55.6%) were females, the mean age was 27.8 (±15) years; 146 (51.4%) patients had CD and 138 (48.6%) UC. The overall incidence risk of EIMs was 138 (52.3%) over a mean duration of follow up of 7.3 (±3.9) years. The most common EIM was arthritis (33%), followed by aphthous ulcers (16%). Pyoderma gangrenosum occurred in 8% of patients and appeared to be specific for CD patients (p = 0.002), whereas Primary Sclerosing Cholangitis (PSC) was more specific for UC (p = 0.001). Certain EIMs appeared to occur together such as arthritis with PSC (p = 0.001). Regression analysis identified disease type (in favor of UC; odds ratio = 0.50, p = 0.03) and age at the time of diagnosis (odds ratio = 1.04, p = 0.001) as the only significant predictors of EIMs.

Conclusion: Our results demonstrate that more than half of IBD patients have at least one EIM. Contrary to what has often been reported, we found that EIMs occur more commonly in UC than CD. A multidisciplinary assessment is recommended as part of IBD management to improve overall health outcomes.

Copyright
© 2020 Atlantis Press International B.V.
Open Access
This is an open access article distributed under the CC BY-NC 4.0 license (http://creativecommons.org/licenses/by-nc/4.0/).

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Journal
Journal of Epidemiology and Global Health
Publication Date
2020/04
ISSN (Online)
2210-6014
ISSN (Print)
2210-6006
DOI
https://doi.org/10.2991/jegh.k.200330.001How to use a DOI?
Copyright
© 2020 Atlantis Press International B.V.
Open Access
This is an open access article distributed under the CC BY-NC 4.0 license (http://creativecommons.org/licenses/by-nc/4.0/).

Cite this article

TY  - JOUR
AU  - Heba Adam
AU  - Maryam Alqassas
AU  - Omar I. Saadah
AU  - Mahmoud Mosli
PY  - 2020
DA  - 2020/04
TI  - Extraintestinal Manifestations of Inflammatory Bowel Disease in Middle Eastern Patients
JO  - Journal of Epidemiology and Global Health
SN  - 2210-6014
UR  - https://doi.org/10.2991/jegh.k.200330.001
DO  - https://doi.org/10.2991/jegh.k.200330.001
ID  - Adam2020
ER  -