title: Extraintestinal manifestations in inflammatory bowel disease: Prevalence and predictors in Indian patients.
abstract: BACKGROUND
  There is a paucity of reports on extraintestinal manifestations (EIMs) in patients with inflammatory bowel diseases (IBD) from Asia and India.
  
  
  METHODS
  From May 2011 to October 2012, consecutive IBD patients underwent a detailed history and physical examination, also by trained rheumatologist, dermatologist, and ophthalmologist, about whether they experienced any EIM at the time of inclusion or in the past. The disease phenotype/severity and location was classified according to the Montréal classification. All underwent magnetic resonance imaging (MRI) of sacroiliac joints, liver function test (LFT), transabdominal ultrasound, and dual energy X-ray absorptiometry (DEXA) scanning at neck femur (bilateral) and L4-L5 spine.
  
  
  RESULTS
  One hundred twenty patients were analyzed, 62 had Crohn's disease (CD) and 58 had ulcerative colitis (UC). Thirty-eight percent had at least one while 20% suffered from multiple EIMs. Except for uveitis and episcleritis, the frequency of individual EIMs did not differ between CD and UC patients. Twenty-three percent had peripheral arthritis, 18% had ankylosing spondylitis, and 13% had ophthalmological manifestations. Mucocutaneous manifestations, aphthous stomatitis and pyoderma gangrenosum (PG), were seen in 9%. None had erythema nodosum (EN) or primary sclerosing cholangitis (PSC). Fifty percent of patients had either osteopenia or osteoporosis on DEXA. Multivariable analysis revealed female gender, Hindu religion, severe disease, and steroid usage were significantly associated with the presence of EIMs.
  
  
  CONCLUSIONS
  The prevalence of EIM is similar to that reported from Europe and USA, albeit higher than that previously reported in Asian patients. Female sex, religion, severe disease, and steroid use were associated with EIM.
authors.affiliation: Division of Gastroenterology, School of Digestive and Liver Diseases, Institute of Post Graduate Medical Education and Research, 244 A J C Bose Road, Kolkata, 700 020, India.
authors.forename: Debottam
authors.initials: D
authors.lastname: Bandyopadhyay
authors.affiliation: Division of Gastroenterology, School of Digestive and Liver Diseases, Institute of Post Graduate Medical Education and Research, 244 A J C Bose Road, Kolkata, 700 020, India.
authors.forename: Sanjay
authors.initials: S
authors.lastname: Bandyopadhyay
authors.affiliation: Department of Rheumatology, Institute of Post Graduate Medical Education and Research, 244 A J C Bose Road, Kolkata, 700 020, India.
authors.forename: Parasar
authors.initials: P
authors.lastname: Ghosh
authors.affiliation: Department of Dermatology, Institute of Post Graduate Medical Education and Research, 244 A J C Bose Road, Kolkata, 700 020, India.
authors.forename: Abhishek
authors.initials: A
authors.lastname: De
authors.affiliation: All India Institute of Hygiene and Public Health, 27 and 27 B, J C Block, Salt Lake City, Sector 3, Kolkata, 700 098, India.
authors.forename: Anupam
authors.initials: A
authors.lastname: Bhattacharya
authors.affiliation: Division of Gastroenterology, School of Digestive and Liver Diseases, Institute of Post Graduate Medical Education and Research, 244 A J C Bose Road, Kolkata, 700 020, India.
authors.forename: G K
authors.initials: GK
authors.lastname: Dhali
authors.affiliation: Division of Gastroenterology, School of Digestive and Liver Diseases, Institute of Post Graduate Medical Education and Research, 244 A J C Bose Road, Kolkata, 700 020, India. dockmumu@yahoo.co.in.
authors.forename: Kshaunish
authors.initials: K
authors.lastname: Das
mesh_terms: D000328:Adult; D001168:Arthritis / Q000453:epidemiology*; D001851:Bone Diseases, Metabolic / Q000453:epidemiology; D003093:Colitis, Ulcerative / Q000453:epidemiology*; D015897:Comorbidity; D003424:Crohn Disease / Q000453:epidemiology*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007194:India / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D010024:Osteoporosis / Q000453:epidemiology; D015995:Prevalence; D011446:Prospective Studies; D017511:Pyoderma Gangrenosum / Q000453:epidemiology; D015423:Scleritis / Q000453:epidemiology*; D012737:Sex Factors; D013167:Spondylitis, Ankylosing / Q000453:epidemiology*; D013281:Stomatitis, Aphthous / Q000453:epidemiology*; D014605:Uveitis / Q000453:epidemiology*; D055815:Young Adult
keywords: Liver disease; Spondyloarthritis; Surgery; Tuberculosis