P303 Factors associated with the development of extraintestinal manifestations in patients with ulcerative colitis
J. Yamamoto-Furusho*1, G. Sanchez-Morales2
1IBD Clinic, Instituto Nacional de Ciencias Medicas y Nutricion, Gastroenterology, Mexico, Mexico, 2Instituto Nacional de Ciencias Medicas y Nutricion, Gastroenterology, Mexico, Mexico
Ulcerative colitis (UC) is a subtype of inflammatory bowel disease (IBD) that can develop extraintestinal manifestations (EIMs) in a sub-group of patients. As many as 36%–56% of patients with inflammatory bowel disease (IBD) have at least 1 EIM along the course of the disease, affecting mainly articular, ocular, hepatobiliary, haematologic, and dermatologic levels. These EIMs might present before, after, or at the time of IBD diagnosis, even more, they could emerge several years after a proctocolectomy. Some of these EIMs have a negative effect in daily activities with a significant decrease in the quality of life. No previous studies have been performed in patients with UC from Latin America. The aim of this study was to identify the factors associated with the development of EIMs in patients with UC.
In the study, 260 Mexican patients with diagnosis of UC confirmed by histology were included. These patients were recruited from the Inflammatory Bowel Diseases Clinic at the National Institute of Medical Sciences and Nutrition in Mexico City during the period between January 2007 and December 2014. Demographic, clinical, endoscopic, and histologic data were gathered from medical records and direct interviews. The variables evaluated included sex, current age, age at diagnosis, family history of IBD, disease duration, extent of disease, medical and surgical treatment, clinical course, histologic activity, high-sensitive C-reactive protein (hs-CRP), p-ANCA, history of appendectomy, current or past history of smoking, and concomitant autoimmune disease. Uni- and multivariate analysis was performed for the identification of factors associated with the development of EIMs. The statistical SPSS programme version 20 was used for the analysis.
In total, 260 patients with UC were included in the study: 125 females (48.1%) and 135 males (51.9%), with a mean age at diagnosis of 31.6 years (range 6 to 65). The development of EIM was present in 145 UC patients (55.8%) with the following distribution: peripheral arthropathies 30%, primary sclerosing cholangitis 9.2%, pyoderma gangrenosum 3.9%, uveitis 3.8%, sacroiliitis 1.9%, ankylosing spondylitis 1.9%, and erythema nodosum 0.4%. The factors associated with the development of EIM were pancolitis (p = 0.003, OR 2.44, 95% CI 1.34–4.56) and previous colectomy (p = 0.02, OR 7.54, 95% CI 1.20–60.44). A clinical course of initial activity and then long-term remission more than 5 years was found to be a protective factor for the development of EIMs (p = 0.002, OR 0.31, 95% CI 0.14–0.67).
The frequency of EIMs was 55.8% in our population, and the factors associated with its development were pancolitis and the presence of colectomy.