title: Association of extraintestinal manifestations of inflammatory bowel disease in a province of western Hungary with disease phenotype: results of a 25-year follow-up study.
abstract: OBJECTIVE
  IBD is a systemic disease associated with a large number of extraintestinal manifestations (EIMs). Our aim was to determine the prevalence of EIMs in a large IBD cohort in Veszprem Province in a 25-year follow-up study.
  
  
  METHODS
  Eight hundred and seventy-three IBD patients were enrolled (ulcerative colitis/UC/: 619, m/f: 317/302, mean age at presentation: 38.3 years, average disease duration: 11.2 years; Crohn's disease/CD/: 254, m/f: 125/129, mean age at presentation: 32.5 years, average disease duration: 9.2 years). Intestinal, extraintestinal signs and laboratory tests were monitored regularly. Any alteration suggesting an EIMs was investigated by a specialist.
  
  
  RESULTS
  A total of 21.3% of patients with IBD had EIM (UC: 15.0%, CD: 36.6%). Age at presentation did not affect the likelihood of EIM. Prevalence of EIMs was higher in women and in CD, ocular complications and primary sclerosing cholangitis (PSC) were more frequent in UC. In UC there was an increased tendency of EIM in patients with a more extensive disease. Joint complications were more frequent in CD (22.4% vs UC 10.2%, P<0.01). In UC positive family history increased the risk of joint complications (OR:3.63). In CD the frequency of type-1 peripheral arthritis was increased in patients with penetrating disease (P=0.028). PSC was present in 1.6% in UC and 0.8% in CD. Dermatological complications were present in 3.8% in UC and 10.2% in CD, the rate of ocular complications was around 3% in both diseases. Rare complications were glomerulonephritis, autoimmune hemolytic anaemia and celiac disease.
  
  
  CONCLUSIONS
  Prevalence of EIM in Hungarian IBD patients is in concordance with data from Western countries. The high number of EIM supports a role for complex follow-up in these patients.
authors.affiliation: 1st Department of Medicine, Csolnoky F. Province Hospital, Veszprem, Hungary. laklaci@hotmail.com
authors.forename: Laszlo
authors.initials: L
authors.lastname: Lakatos
authors.forename: Tunde
authors.initials: T
authors.lastname: Pandur
authors.forename: Gyula
authors.initials: G
authors.lastname: David
authors.forename: Zsuzsanna
authors.initials: Z
authors.lastname: Balogh
authors.forename: Pal
authors.initials: P
authors.lastname: Kuronya
authors.forename: Arpad
authors.initials: A
authors.lastname: Tollas
authors.forename: Peter Laszlo
authors.initials: PL
authors.lastname: Lakatos
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D018798:Anemia, Iron-Deficiency / Q000453:epidemiology; D001649:Bile Duct Diseases / Q000453:epidemiology; D002648:Child; D003093:Colitis, Ulcerative / Q000453:epidemiology*; D003424:Crohn Disease / Q000453:epidemiology*; D005128:Eye Diseases / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006814:Hungary / Q000453:epidemiology; D007592:Joint Diseases / Q000453:epidemiology; D008107:Liver Diseases / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D010641:Phenotype; D015995:Prevalence