Pulmonary and hematological alterations in idiopathic ulcerative colitis.
BACKGROUND
Patients with idiopathic ulcerative colitis (IUC) may suffer from one or more extraintestinal manifestations. We decided to prospectively study the prevalence of extraintestinal manifestations among patients with IUC, with special reference to pulmonary and hematological alterations.


METHODS
Fifty-one consecutive patients with IUC attending the gastroenterology services of our tertiary-care referral center were evaluated prospectively. A detailed clinical evaluation of the musculoskeletal system, eye and skin, X-ray examination of the sacroiliac joints and chest, liver function tests, coagulation profile, hemogram, pulmonary function tests (PFT) and diffusion capacity for carbon monoxide (DLCO) were done in all patients. ERCP, liver biopsy and high-resolution computerized tomography (HRCT) of the chest were performed whenever indicated.


RESULTS
Nearly half (24/51; 47%) the patients had one or more extraintestinal manifestations; these included pulmonary function abnormalities (14 patients; 27%), sacroiliitis (8; 16%), arthritis (5; 10%), ocular complications (4; 8%), and pyoderma gangrenosum and Budd-Chiari syndrome (one patient each). Of the 14 (27%) patients who had abnormal pulmonary function, isolated PFT abnormalities were seen in 8 (restrictive pattern in 7, obstructive pattern in 1), decreased DLCO in four, and both of the above in two. All patients with decreased DLCO (n=6) were asymptomatic and had normal chest X-ray and HRCT chest. Thirteen (25%) patients had thrombocytosis, 19 (37%) had increased fibrinogen level, and one patient had decreased antithrombin level. Disease activity had significant association with decreased DLCO (p=0.008), increased platelet count (p<0.0001), increased fibrinogen level (p=0.016), low antithrombin levels (p=0.046) and arthritis (p=0.002).


CONCLUSIONS
Extraintestinal manifestations of IUC were seen in 47% of patients. Asymptomatic pulmonary interstitial involvement was seen in 12%, more often among patients with active disease.
Sethy
Pradeepta Kumar
PK
Department of Gastroenterology, Post-Graduate Institute of Medical Education and Research, Chandigarh 160 012.
Dutta
Usha
U
Aggrawal
Ashutosh N
AN
Das
Reena
R
Gulati
Madhu
M
Sinha
Saroj Kant
SK
Singh
Kartar
K
D000328:Adult; D001168:Arthritis / Q000453:epidemiology / Q000209:etiology; D003093:Colitis, Ulcerative / Q000150:complications*; D005260:Female; D006402:Hematologic Diseases / Q000453:epidemiology / Q000209:etiology*; D006801:Humans; D008171:Lung Diseases / Q000453:epidemiology / Q000209:etiology*; D008297:Male; D015995:Prevalence; D011446:Prospective Studies; D012129:Respiratory Function Tests; D012446:Sacroiliac Joint