Clinical characteristics and factors related to extraintestinal manifestations in patients with Crohn′s disease
10.3760/cma.j.cn101480-20200125-00007
- VernacularTitle:克罗恩病患者合并肠外表现的临床特征及相关因素分析
- Author:
Haichao WANG
1
;
Chen YE
;
Yaling WU
;
Pengyu YANG
;
Zhuoma DEJI
;
Lei ZHANG
;
Zhanju LIU
;
Xiaolei WANG
Author Information
1. 同济大学附属第十人民医院消化内科，上海 200072；同济大学医学院，上海 200072
- Publication Type:Journal Article
- Keywords:
Crohn′s disease;
Extraintestinal manifestations;
Risk factors;
Characteristics
- From:
Chinese Journal of Inflammatory Bowel Diseases
2020;04(3):206-211
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the clinical characteristics and possible influencing factors of the extraintestinal manifestations (EIM) in patients with Crohn′s disease (CD) .Methods:Clinical data of 623 patients diagnosed as CD at Department of Gastroenterology, Shanghai Tenth People′s Hospital, from January 2008 to January 2018 were retrospectively analyzed. These patients were divided into two groups according to whether EIM was complicated. Univariate analysis was used to evaluate the clinical features, and multivariate analysis was used to reveal the risk factors of EIM. Fisher′s exact test was used to analyze the associations among various EIMs.Results:Among 623 CD patients, 422 (67.7%) were male and 201 (32.3%) were female; the median age at diagnosis was 31.0 years old (23.0 to 43.0 years old) ; the medium follow-up time was 53.5 months (29.0 to 84.0 months) . One hundred and twelve patients (18.0%) complicated with EIM, including 86 cases with one EIM, 22 case (19.6%) with two EIM, 3 case (2.7%) with three EIM, and 1 case (0.9%) with four EIMs simultaneously. Oral involvement was found in 84 cases (75.0%) , joints and bones in 36 cases (32.1%) , skin in 17 cases (15.2%) , and eye in 7 cases (6.3%) . Compared to patients without EIM, those with EIM had higher ratios of female (41.1% vs. 30.3%) , ileocolic (L3) type (52.7% vs. 37.6%) , non-stenosis and non-penetration (B1) type (69.6% vs. 54.2%) , diarrhea or fever as the first symptom (43.8% vs. 32.5%, 14.3% vs 6.5%) and steroids administration (53.6% vs. 39.3%) , while they had lower ratios of distal ileum (L1) type (19.6% vs. 36.8%) , stenosis (B2) type (26.8% vs. 37.0%) , penetration (B3) type (3.6% vs. 8.8%) , infliximab treatment (46.4% vs. 60.7%) , and abdominal surgery (14.3% vs. 24.1%) (all P<0.05) . Multivariate analysis showed that female ( OR = 1.665, 95% CI: 1.067-2.600, P = 0.025) , colonic type ( OR = 1.996, 95% CI: 1.072-3.718, P = 0.029) , ileocolic type ( OR = 2.568, 95% CI: 1.490-4.427, P = 0.001) , B1 type (B1 vs. B3: OR = 2.977, 95% CI: 1.015-8.726, P = 0.047; B1 vs. B2: OR = 1.882, 95% CI: 1.168-3.302, P = 0.009) and fever ( OR = 2.276, 95% CI: 1.170-4.430, P = 0.015) were the independent risk factors of EIM in CD patients. The oral lesion was significantly associated with spondylarthritis and skin diseases, and the spondylarthritis was closely associated with skin and eyes lesions (all P<0.05) . Conclusions:Female, colon involvement, B1 type and fever are the high risk factors of EIM for CD patients. Various EIM possess certain associations with each other.
