P306 Frequency and structure of extra-intestinal manifestations in IBD
M. Skalinskaya, E. Skazyvaeva, I. Bakulin, I. Rasmagina, D. Komarova, K. Ivanova
North-Western State Medical University n.a. I.I.Mechnikov, the Chair of the Propedeutics of Internal Diseases, Gastroenterology and Dietology n.a. S.M. Riss, Saint Petersburg, Russian Federation
Background
IBD are immunomediated diseases that usually manifest at an early age, require lifelong pathogenetic therapy and significantly reduce the quality of life of a patient.
Methods
Since February 2017, the ‘North-West register of IBD patients’ has installed data of 1130 patients with an introduced diagnosis of UC or CD: 41.3% of them are patients with a diagnosis of CD and 58.7%—with a diagnosis of UC.
Results
Among patients with IBD the majority had mild (33.4%) and moderate activity (34%), a quarter was in remission and 7.65%—expressed activity. A population researches study using the University of Manitoba’s IBD epidemiology database (UMIBDED) reported that 6.2% of IBD patients had at least one extraintestinal manifestation, and 0.3% had several. The extraintestinal manifestations were observed in 43.4% of patients; meanwhile, 25% of them revealed mostly than one extraintestinal manifestation. System manifestations were more often registered in CD than in UC. The most frequent extraintestinal manifestations were signs of involvement of skeletal and muscular system. On the first place, it is peripheral arthropathy (73.6%), sacroiliitis (8.8%), ankylosing spondyloarthritis (8.8%), entezitis (10.3%) rheumatoid arthritis (1.5%), dactylitis (1.5%) were less frequent. Generally, articulate manifestations were noted by 17.5% of all included patients. In CD and UC, extra-intestinal manifestations were more often common in patients with a moderate attack (in 75.6 % and 51.6% of cases). In CD, extra-intestinal manifestations were more often frequent in patients with moderate attack −50.8%, in patients in remission there numbered to 32.8%, in severe attack-14.8%, in mild-1.6%. In UC, extra-intestinal manifestations were observed in severe attack in 2.6%, in moderate attack 35.9%, in mild attack 41%, in patients in remission 20.5%.
Conclusion
Among patients with IBD, extraintestinal manifestations, among which joint lesions prevail, are detected in 43.4% of the examined persons. The trend is noted to reduce the number of patients with severe attacks of the disease and extraintestinal manifestations, that can be related with improving the quality of diagnosis, reduction of terms of diagnosing and developing new methods of treatment for IBD. Peripheral arthropathy predominate among the extra-intestinal manifestations. We found no correlation between the severity of IBD and the presence of extra-intestinal manifestations. The spectrum of extra-intestinal manifestations includes more than 20 manifestations (diseases), which requires skills and experience in their diagnosis, as well as joint management of such patients by specialists of various profiles.