Crohn's disease in rheumatology clinic--an Indian experience.
BACKGROUND
Prevalence of Crohn's disease (CD) among patients with rheumatic illnesses in India is grossly under estimated, especially when it has overtaken that of Ulcerative Colitis in the West.


OBJECTIVE
To study the frequency of histologically unequivocal CD amongst clinically suspected patients with enteropathic arthropathy and to ascertain if the arthritics with CD have any independent clinical predictor.


METHODS
Retrospective datasheet analysis from a Rheumatology clinic of a large tertiary care centre.


METHODS
Patients of suspected enteropathic arthropathy were studied by ileocolonoscopy and segmental colonic biopsy for histological evidence of Crohn's disease and followed up.


METHODS
Logistic regression analysis was done to find out any clinical predictor of histologically proven CD.


RESULTS
Fourteen of the twenty-nine patients studied had histologically confirmed CD. Those with CD were younger than those without (34.7 yr vs 41.6 yrs, p=0.057). The CD group also had significantly higher number of people with loss of weight (12 vs 1), fever (11 vs 0), perianal fistula (4 vs 0), abdominal pain (8 vs 2), history of dysentery (4 vs 0) and uveitis (6 vs 1) (p=0.00002, 0.00001, 0.026, 0.013, 0.026 & 0.01 respectively). However logistic regression analysis of the most relevant ones among these, namely, loss of weight, fever, and perianal fistula showed loss of weight as only independent predictor of CD in this subset of patients (p=0.03 with odds ratio of 28).


CONCLUSIONS
Presence of significant loss of weight in an Indian patient with clinically suspected enteropathic arthropathy is an independent predictor of CD.
Danda
Debashish
D
Department of Medicine II and Clinical Immunology & Rheumatology Unit, Christian Medical College and Hospital, Vellore, India. debashish.danda@cmcvellore.ac.in
Kurian
G
G
Chacko
A
A
Chandy
G
G
Patra
S
S
Mathew
A
A
Thomas
K
K
D000328:Adult; D001168:Arthritis / Q000150:complications*; D003424:Crohn Disease / Q000150:complications*; D005260:Female; D006801:Humans; D007194:India; D008297:Male; D008875:Middle Aged; D010044:Outpatient Clinics, Hospital; D012189:Retrospective Studies; D015431:Weight Loss