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N817 Epidemiological profile of Crohn's disease and ulcerative colitis in a Brazilian single centre

Farinelli E., Pagnin A.F., Silva R.P.L., Sibia C.F., Renosto F.L., Barros J.R., Baima J.P., Hossne R.S., Sassaki L.Y.

Faculdade de Medicina de Botucatu, Botucatu, São Paulo, Brazil

Background

Epidemiological studies of Inflammatory Bowel Disease (IBD) are scarce in Latin America. The purpose of this study was to evaluate the demographic characteristics and clinical aspects of Crohn's Disease (CD) and Ulcerative Colitis (UC) in a single centre in Brazil.

Methods

Retrospective study. Epidemiological and clinical data were extracted from the hospital database containing 136 patients with IBD that live on the Midwestern of Sao Paulo state. The data were collected between January and November 2016 and included all patients with 15 years old or over with CD or UC confirmed. This study was approved by the Research Ethics Committee (CAAE: 50640915.2.0000.5411).

Results

Sixty-two patients with CD and 74 patients with UC were evaluated. Among patients with CD, 54.83% female, 90.32% declared Caucasian ethnicity and mean age was 44.58 years (±15.7). Seven patients were smokers (11.29%). The average disease duration was 13.8y (±8.9). By Montreal Classification, the patients were classified as A1 (≤16 years): 8.06%, A2 (17–40 years): 67.74% and A3 (>40 years): 19.35%; L1 (Terminal ileum): 25.80%, L2 (Colonic): 11.29%, L3 (Ileocolonic): 58.06% and L4 (Isolated upper GI disease): 3.22%; B1 (Nonstricturing, nonpenetrating): 11.29%, B2 (Stricturing): 46.77% and B3 (Penetrating): 35.48%. Any stage of perianal disease was found in 50% of patients. Presence of complications was frequently found in the sample, specially intestinal stenosis (33.87%), fistulae (29.03%) and abscess (12.90%). The most frequent extra-intestinal manifestations were arthralgia (19.35%) and erythema nodosum (9.67%). Primary sclerosing cholangitis (PSC) was described in 3.22% of the patients. About treatment, 74.19% use Azathioprine; 19.35% Mesalazine; 32.25% Infliximab and 24.19% Adalimumab. The use of corticosteroids has been reported in 37.09%. With UC, 74 patients were reported, totalizing 64.86% female, the mean age was 50.1y (±17.7), 9.45% smokers. The average of disease duration was 14.4y (±10.1). Location data included 50.05% of the patients with pancolitis, 16.21% with left colitis, and 20.27% with distal colitis. Arthralgia was presented in 23%, sacroileitis in 4.05% and PSC in 2.70%. One patient developed colorectal cancer. The treatment consisted in oral Mesalazine in 55.40%, Sulfasalazine in 28.37% and Mesalazine suppository in 21.62%. Azathioprine has been used in 35.13% and 3 patients used biological therapy (2 with Infliximab and 1 with Adalimumab).

Conclusion

In this study, there was a small predominance of patients with UC. Females were more prevalent in both diseases. Stenosis, fistulae and abscess were the most common complications on CD patients. For UC, pancolitis was the principal disease location.