Neoplastic and other complications of inflammatory bowel disease.
Patients with inflammatory bowel disease (IBD) have long been known to be at increased risk of development of colorectal cancer; however, there are many nuances to cancer prevention strategies in IBD that remain unresolved. During the past year, two publications reported on the resection of otherwise typical adenoma-like masses by means of polypectomy, after which these patients were followed with continued endoscopic surveillance, rather than pursuing colectomy. Another concern in IBD is whether there is an increase in the number of other cancers, in particular lymphomas. One issue regarding lymphoma risk is whether immunomodulatory drug use predisposes to this cancer. One study of a large group of 6-mercaptopurine users did not suggest an increased risk for patients with IBD using this drug. There are a variety of nonintestinal problems that patients with IBD may confront. Osteopenia has received considerable attention in the past decade. This year, data have been published that quantify for the first time the risk of fractures in patients with IBD based on population, and these data were compared with a matched control group from the same population. Data on the further exploration of the issue of osteopenia in pediatric IBD have also been reported, as have some of the only studies of therapy for osteopenia in IBD. These and data on other extraintestinal manifestations of IBD have all emerged in the past year.
Bernstein
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University of Manitoba Inflammatory Bowel Disease Clinical and Research Centre, GB-443 Health Sciences Centre, 820 Sherbrook Street, Winnipeg, Manitoba R3A-1R9, Canada. cbernst@cc.umanitoba.ca
D019386:Alendronate / Q000627:therapeutic use; D015519:Bone Density; D001851:Bone Diseases, Metabolic / Q000188:drug therapy / Q000453:epidemiology / Q000209:etiology; D003093:Colitis, Ulcerative / Q000150:complications / Q000378:metabolism; D015179:Colorectal Neoplasms / Q000453:epidemiology / Q000209:etiology / Q000235:genetics; D018095:Germ-Line Mutation; D005938:Glucocorticoids / Q000009:adverse effects; D006801:Humans; D015212:Inflammatory Bowel Diseases / Q000150:complications* / Q000378:metabolism / Q000503:physiopathology; D008171:Lung Diseases / Q000453:epidemiology / Q000209:etiology; D018809:Proliferating Cell Nuclear Antigen / Q000378:metabolism; D012307:Risk Factors; D020246:Venous Thrombosis / Q000453:epidemiology / Q000209:etiology
D005938:Glucocorticoids; D018809:Proliferating Cell Nuclear Antigen; C413374:p27 antigen; D019386:Alendronate