title: Extraintestinal manifestations of Crohn's disease.
abstract: In each case of extraintestinal manifestations of Crohn's disease, active disease, if present, should be treated to induce remission, which may positively influence the course of most concomitant extraintestinal manifestations. For some extraintestinal manifestations, however, a specific treatment should be introduced. This latter part of disease management will be discussed in this chapter, in particular for pyoderma gangrenosum, uveitis, spondylarthropathy - axial arthropathy - and primary sclerosing cholangitis, which have also been described in quiescent Crohn's disease. Few new drugs for the treatment of extraintestinal manifestations of Crohn's disease have been developed in the past and only the role of infliximab has increased in Crohn's disease-related extraintestinal manifestations. Drugs specifically aimed at this treatment, stemming from a few randomized controlled studies or case series, are sulfasalazine, 5-ASA, corticosteroids, azathioprine or 6-mercaptopurine, methotrexate, infliximab, adalimumab, etanercept and cyclosporine or tacrolimus. Unfortunately, because of the paucity of data in this field, the best evidence presented and discussed in this article for the treatment of these extraintestinal manifestations is extrapolated from patients that for the most part did not suffer from Crohn's disease.
authors.affiliation: Division of Gastroenterology and Hepatology, Centre Hospitalier Universitaire Vaudois and University of Lausanne, Lausanne, Switzerland. pascal.juillerat@chuv.ch
authors.forename: Pascal
authors.initials: P
authors.lastname: Juillerat
authors.forename: Christian
authors.initials: C
authors.lastname: Mottet
authors.forename: Valérie
authors.initials: V
authors.lastname: Pittet
authors.forename: Florian
authors.initials: F
authors.lastname: Froehlich
authors.forename: Christian
authors.initials: C
authors.lastname: Felley
authors.forename: Jean-Jacques
authors.initials: JJ
authors.lastname: Gonvers
authors.forename: John-Paul
authors.initials: JP
authors.lastname: Vader
authors.forename: Pierre
authors.initials: P
authors.lastname: Michetti
mesh_terms: D015209:Cholangitis, Sclerosing / Q000209:etiology* / Q000628:therapy; D003424:Crohn Disease / Q000150:complications*; D018450:Disease Progression; D006801:Humans; D017511:Pyoderma Gangrenosum / Q000209:etiology* / Q000628:therapy; D013167:Spondylitis, Ankylosing / Q000209:etiology* / Q000628:therapy; D014605:Uveitis / Q000209:etiology* / Q000628:therapy