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P068. Factors associated with the development of rheumatologic manifestations in patients with ulcerative colitis

J.K. Yamamoto-Furusho, K. Olvera-Obregon

IBD Clinic, Instituto Nacional de Ciencias Médicas y Nutrición, Mexico, Mexico

Aim: To investigate the factors associated with the development of rheumatologic manifestations in patients with Ulcerative Colitis (UC).

Materials and Methods: Retrospective case–control study that included 200 patients with diagnosis of UC recruited during the period from January 2010 to September 2010. All patients were divided in 2 groups: (1) UC patients with rheumatologic manifestations including peripheral arthritis and axial involvement (N = 100) and (2) UC patients without rheumatologic manifestations (N = 100). Demographic, laboratory exam tests and clinical characteristics were evaluated such as gender, age at diagnosis, C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), blood count, antinuclear antibodies (ANA), anti-neutrophil cytoplasmic antibodies (ANCAs), disease extent, clinical course, disease activity by Mayo Score Index and medical treatment. We excluded patients with history of concomitant autoimmune disease including rheumatologic diseases, other type of extra-intestinal manifestations and incomplete medical records. All variables were analyzed by parametric statistics. Odds ratios (OR) and 95% confidence intervals (CI) assessing the risk of rheumatologic manifestations were estimated by univariate and multivariate analyses using multiple logistic regression analysis. A P-value ≤0.05 was considered statistically significant. All statistical analyses were conducted using the statistics program SPSS/PC version 13.0 (SPSS Inc., Illinois, USA, 2004).

Results: We studied a total of 200 UC patients (99 female, 101 male), with a mean age of 41.7±22.2 years. Age at diagnosis was 32.7±11.5 years, and disease duration was 7.6±5.1 years. The rheumatologic manifestations were peripheral arthritis in 72% (type 1 arthritis in 80% and type 2 arthritis in 20%) and axial involvement in 28% (spondylitis 14% and sacroiliitis 14%). At the time of clinical evaluation, 92 (94.8%) patients were in treatment with aminosalicylates, 33 (34%) with azathioprine, and 31 (31.9%) with prednisone. Regarding the extension, 58 (59.8%) patients had pancolitis, extensive colitis in 3 (3.1%), left-sided colitis in 5 (5.2%) and distal colitis in 31 (31.9%). Univariate and multiple regression analysis model showed that anemia (p < 0.0001; OR = 6.76 95% CI: 2.79–16.3); leukocytosis (P = 0.005, OR = 3.59, 95% CI: 1.4–9.19) and elevated C-Reactive Protein (P = 0.0004, OR = 5.04, 95% CI: 1.9–13.5) were associated with the presence of peripheral arthritis and axial involvement including sacroiliitis and spondylitis compared to those UC patients without. No association was found with other characteristics such as gender, age at diagnosis, ESR, ANCA, ANA, disease extension and activity, type of medical treatment were not significantly associated with positive ANAs test

Conclusion: The factors associated with the development of rheumatologic manifestations in UC patients were anemia, leukocytosis and elevated CRP.