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P775 Finger clubbing and Crohn's disease: higher frequency in patients with upper GI lesions in a prospective study

S. Romeo1, B. Neri*1, E. Lolli1, E. Calabrese1, E. De Cristofaro1, C. Gesuale1, L. Biancone1

1University of Rome 'Tor Vergata', Gastroenterology, Rome, Italy

Background

Finger clubbing (FC) has been associated with Crohn’s disease (CD). Clinical relevance of this finding is undefined. Primary aim was, in a prospective single-centre study, to assess if FC is associated with CD severity and behaviour.

Methods

From January to December 2016, patients with a diagnosis of CD and detailed clinical records were enrolled. Data expressed as median (range), Chi-squared or T-test as appropriate.

Results

FC was assessed in 267 CD patients. Population characteristics were: M 163 (60%), age 47.3 (17–83); age at diagnosis 33.2 (10–82); CD duration 13.3 (1–56). The disease involved ileum (I) in 160 (59.9%); Colon (C) in 12 (4.5%); ileum-colon (I-C) in 69 (25.8%), upper GI in 26 (9.8%) patients. Disease behaviour was non stricturing-non penetrating in 69 (25.8%), stricturing in 137 (51.3%); penetrating in 61 (22.9%) patients. Perianal disease (PA) was observed in 40 (14.9%) patients. Previous surgery in 143 (53.5%); thiopurines use in 113 (42.3%); anti-TNFα use in 99 (37.1%) patients. Smoking habits in CD were recorded (Yes, No, Ex: n = 82 [30.7%], n = 87 [32.5%], n = 98 [36.8%]. Chronic pulmonary diseases were observed in 19 (7.1%). FC was observed in 45/267 (16.8%) patients. In these patients with FC (n = 45) the lesions involved ileum in 25 (55.6%), colon in 1 (2.2%), I-C in 10 (22.2%), upper GI in 9 (20%). The frequency of upper GI lesions was significantly higher in CD patients with vs. without FC (9/45 [20%] vs. 17/222 [7.7%]; p = 0.01, OR 3.01, CI (95%): 1.2477 to 7.2841). FC was detected in 9/26 (34.6%) patients with upper CD. Other CD lesions were equally distributed in patients with vs. without FC (I: 25/45 [55.6%] vs. 135/222 [60.8%]; p = 0.511; C: 1/45 (2.2%) vs. 11/222 (4.9%); p = 0.419; I-C: 10/45 (22.2) vs. 59/222 (26.6%); p = 0.542. There was no difference between the two groups in terms of conventional immunosuppressive (ISS) nor Anti TNFa therapy (ISS: 21/45 [56.6%] vs. 92/222 [41.4%]; p = 0.58; Anti-TNFa: 20/45 [44.4%] vs. 79/222 [35.6%]; p = 0.26). The frequency of smokers, ex-, no-smokers did not differ between CD patients w/o FC (17/45 [37.8%] vs. 65/222 [29.3%]; p = 0.26; 17/45 [37.8%] vs. 81/222 [36.4%]; p = 0.87; 11/45 [24.4%] vs. 76/222 [34.2%]; p = 0.2. Pneumopaties were recorded in 3/45 (6.6%) with clubbing.

Study population characteristics.

Finger clubbing prevalence in study population.

Conclusion

The prevalence of FC was significantly higher in patients with upper GI lesions. FC in CD patients appeared not related to smoking habits nor to pulmonary diseases.