title: Does inflammatory bowel disease coexist with systemic lupus erythematosus?
abstract: BACKGROUND
  The data regarding the association between inflammatory bowel disease (IBD) and systemic lupus erythematosus (SLE) is mostly composed of case reports and case series indicating an infrequent association.
  
  
  OBJECTIVE
  To investigate the association between IBD and SLE.
  
  
  METHODS
  Patients with SLE were compared with age- and sex-matched controls regarding the prevalence of ulcerative colitis (UC) and Crohn's disease (CD) in a case-control study. Chi-square and t-tests were used for univariate analysis and a logistic regression model was used for multivariate analysis. The study was performed utilizing the medical database of Clalit Health Services.
  
  
  RESULTS
  The study included 5018 patients with SLE and 25,090 age- and sex-matched controls. The prevalence of UC was significantly higher in patients with SLE than in controls in a univariate analysis (0.4% and 0.2%, respectively; p<0.017). However, in a multivariate logistic regression model SLE was not associated with UC (OR 1.67, 95% CI 0.99-2.815, p<0.052). The prevalence of CD was higher in patients with SLE than in controls in a univariate analysis (0.7% and 0.3%, respectively; p<0.001). A multivariate logistic regression model confirmed this finding and corroborated that SLE was associated with comorbid CD (OR 2.23, 95% CI 1.46-3.4, p<0.001).
  
  
  CONCLUSIONS
  Patients with SLE have a greater prevalence of CD than matched controls. The distinction of IBD from SLE gastrointestinal involvement can be challenging as clinical manifestations, laboratory tests, and radiographic findings may appear similar between the two diseases. Therefore, physicians treating patients with rather IBD or SLE should consider this potential association.
authors.affiliation: Department of Gastroenterology, Sheba Medical Center affiliated with the Sackler Faculty of Medicine, Tel-Aviv University, Israel. Electronic address: benamidana@gmail.com.
authors.forename: Dana Ben-Ami
authors.initials: DB
authors.lastname: Shor
authors.affiliation: Department of Medicine 'B', Zabludowicz Center for Autoimmune Diseases, Sheba Medical Center, Tel-Hashomer, Israel; Sackler Faculty of Medicine, Tel-Aviv University, Israel.
authors.forename: Shani
authors.initials: S
authors.lastname: Dahan
authors.affiliation: Chief Physician's Office, Clalit Health Services, Tel Aviv, Israel.
authors.forename: Doron
authors.initials: D
authors.lastname: Comaneshter
authors.affiliation: Chief Physician's Office, Clalit Health Services, Tel Aviv, Israel; Siaal Research Center for Family Medicine and Primary Care, Faculty of Health Sciences, Ben Gurion University of the Negev, Beer Sheva, Israel.
authors.forename: Arnon D
authors.initials: AD
authors.lastname: Cohen
authors.affiliation: Department of Medicine 'B', Zabludowicz Center for Autoimmune Diseases, Sheba Medical Center, Tel-Hashomer, Israel; Sackler Faculty of Medicine, Tel-Aviv University, Israel.
authors.forename: Howard
authors.initials: H
authors.lastname: Amital
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D003093:Colitis, Ulcerative / Q000150:complications / Q000453:epidemiology; D003424:Crohn Disease / Q000150:complications / Q000453:epidemiology; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D015212:Inflammatory Bowel Diseases / Q000150:complications*; D008180:Lupus Erythematosus, Systemic / Q000150:complications*; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D055815:Young Adult
keywords: Crohn's disease (CD); Inflammatory bowel disease (IBD); Systemic lupus erythematosus (SLE); Ulcerative colitis (UC)