title: Prevalence and Characteristics of Extra-intestinal Manifestations in a Large Cohort of Greek Patients with Inflammatory Bowel Disease.
abstract: OBJECTIVE
  Extraintestinal manifestations [EIMs] are common in inflammatory bowel disease [IBD]. Data on epidemiology and risk factors of EIMs in IBD patients are limited. The aim of this study was to investigate the prevalence of EIMs in a large cohort of Greek IBD patients and identify risk factors for their development.
  
  
  METHODS
  The study population consisted of IBD patients, who were followed in eight tertiary Greek hospitals. Demographic and clinical characteristics of patients were analysed. The diagnosis of EIMs was based on standard criteria and on specialist consultation.
  
  
  RESULTS
  In total, 1860 IBD patients (1001 with Crohn's disease [CD], 859 with ulcerative colitis [UC]) were registered. Among them 615 [33.1%] exhibited at least one EIM; 238 patients [38.6%] developed an EIM before IBD diagnosis. An association between active IBD and presence of an EIM was established in 61.1% of the patients. Arthritic [peripheral arthritis], mucocutaneous [erythema nodosum], and ocular [episcleritis] were the most common manifestations. EIMs were more prevalent in females, patients with CD, smokers [for all p <0.0001], patients with extensive UC [p = 0.007], and patients with a previous appendectomy [p < 0.0001] or a major IBD-related surgery [p = 0.012].
  
  
  CONCLUSIONS
  About one-third of Greek IBD patients developed at least one EIM. Of those, more than one-third had their EIM diagnosed before IBD, and in about two-thirds it was related to disease activity. EIMs were more frequently present in females and patients with extensive UC in multivariate analysis.
authors.affiliation: Department of Gastroenterology, Venizeleio General Hospital, Heraklion, Crete.
authors.forename: Konstantinos
authors.initials: K
authors.lastname: Karmiris
authors.affiliation: Department of Gastroenterology, University Hospital, Heraklion, Crete.
authors.forename: Anastasios
authors.initials: A
authors.lastname: Avgerinos
authors.affiliation: Department of Gastroenterology, Venizeleio General Hospital, Heraklion, Crete.
authors.forename: Aikaterini
authors.initials: A
authors.lastname: Tavernaraki
authors.affiliation: Department of Gastroenterology, Tzaneion General Hospital, Piraeus, Greece.
authors.forename: Christos
authors.initials: C
authors.lastname: Zeglinas
authors.affiliation: Department of Gastroenterology, Evangelismos Hospital, Athens, Greece.
authors.forename: Pantelis
authors.initials: P
authors.lastname: Karatzas
authors.affiliation: Department of Gastroenterology, Evangelismos Hospital, Athens, Greece.
authors.forename: Theodoros
authors.initials: T
authors.lastname: Koukouratos
authors.affiliation: Department of Gastroenterology, University Hospital, Larissa, Greece.
authors.forename: Konstantinos A
authors.initials: KA
authors.lastname: Oikonomou
authors.affiliation: Department of Gastroenterology, Laikon Hospital, Athens, Greece.
authors.forename: Athanasios
authors.initials: A
authors.lastname: Kostas
authors.affiliation: Department of Gastroenterology, Alexandra General Hospital, Athens, Greece.
authors.forename: Evanthia
authors.initials: E
authors.lastname: Zampeli
authors.affiliation: Department of Gastroenterology, Attikon University Hospital, Athens, Greece.
authors.forename: Vasileios
authors.initials: V
authors.lastname: Papadopoulos
authors.affiliation: Department of Gastroenterology, Venizeleio General Hospital, Heraklion, Crete.
authors.forename: Angeliki
authors.initials: A
authors.lastname: Theodoropoulou
authors.affiliation: Department of Gastroenterology, Evangelismos Hospital, Athens, Greece.
authors.forename: Nikos
authors.initials: N
authors.lastname: Viazis
authors.affiliation: Department of Gastroenterology, Attikon University Hospital, Athens, Greece.
authors.forename: Dimitrios
authors.initials: D
authors.lastname: Polymeros
authors.affiliation: Department of Gastroenterology, Alexandra General Hospital, Athens, Greece.
authors.forename: Spyridon
authors.initials: S
authors.lastname: Michopoulos
authors.affiliation: Department of Gastroenterology, Laikon Hospital, Athens, Greece.
authors.forename: Giorgos
authors.initials: G
authors.lastname: Bamias
authors.affiliation: Department of Gastroenterology, University Hospital, Larissa, Greece.
authors.forename: Andreas
authors.initials: A
authors.lastname: Kapsoritakis
authors.affiliation: Department of Gastroenterology, Evangelismos Hospital, Athens, Greece.
authors.forename: Dimitrios G
authors.initials: DG
authors.lastname: Karamanolis
authors.affiliation: Department of Gastroenterology, Evangelismos Hospital, Athens, Greece.
authors.forename: Gerassimos J
authors.initials: GJ
authors.lastname: Mantzaris
authors.affiliation: Department of Gastroenterology, Tzaneion General Hospital, Piraeus, Greece.
authors.forename: Charalampos
authors.initials: C
authors.lastname: Tzathas
authors.affiliation: Department of Gastroenterology, University Hospital, Heraklion, Crete ikoutroub@med.uoc.gr.
authors.forename: Ioannis E
authors.initials: IE
authors.lastname: Koutroubakis
mesh_terms: D000328:Adult; D001168:Arthritis / Q000453:epidemiology / Q000209:etiology; D003093:Colitis, Ulcerative / Q000453:epidemiology / Q000473:pathology; D003424:Crohn Disease / Q000453:epidemiology / Q000473:pathology; D004893:Erythema Nodosum / Q000453:epidemiology / Q000209:etiology; D005260:Female; D006115:Greece / Q000453:epidemiology; D006801:Humans; D015212:Inflammatory Bowel Diseases / Q000150:complications / Q000453:epidemiology* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012307:Risk Factors; D015423:Scleritis / Q000453:epidemiology / Q000209:etiology; D012737:Sex Factors; D055815:Young Adult
keywords: Extraintestinal manifestations; inflammatory bowel disease