title: Pulmonary and hematological alterations in idiopathic ulcerative colitis.
abstract: 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.
authors.affiliation: Department of Gastroenterology, Post-Graduate Institute of Medical Education and Research, Chandigarh 160 012.
authors.forename: Pradeepta Kumar
authors.initials: PK
authors.lastname: Sethy
authors.forename: Usha
authors.initials: U
authors.lastname: Dutta
authors.forename: Ashutosh N
authors.initials: AN
authors.lastname: Aggrawal
authors.forename: Reena
authors.initials: R
authors.lastname: Das
authors.forename: Madhu
authors.initials: M
authors.lastname: Gulati
authors.forename: Saroj Kant
authors.initials: SK
authors.lastname: Sinha
authors.forename: Kartar
authors.initials: K
authors.lastname: Singh
mesh_terms: 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