Extra-intestinal manifestations in Crohn disease and ulcerative rectocolitis: prevalence and correlation with diagnosis, extension, activity, disease evolution time / Manifestações extra-intestinais em doença de Crohn e retocolite ulcerativa: prevalência e correlação com o diagnóstico, extensão, atividade, tempo de evolução da doença

Erodilho Sande Mota

INTRODUCTION: Intestinal inflammatory diseases have been calling the attention of the scientific community due to the multiplicity of manifestations in the digestive tract, extra-intestinal manifestations and due to its growing incidence. Theres great prevalence of extra-intestinal manifestations in Crohns disease and ulcerative rectocolitis bearers, varying in literature from 24 to 65%. These alterations may arise before the intestinal symptoms, either at the same time or after, and they may or may not be related to the activity of the intestinal disease. Knowing these extra-intestinal manifestations, as well as their clinical condition, evolution and treatment is important, due to the enhancement in morbidity and mortality aroused by them. AIM: The objective of this paper was to determine the prevalence of extra-intestinal manifestations in ulcerative rectocolitis and Crohns disease, relating it with the diagnosis of the kind of intestinal inflammatory disease, extension, evolution time and the arising of the symptoms, sex and disease activity. METHODS: The patients who took part in the study are registered in the Ambulatory for Inflammatory Diseases of the Anus, Rectum and Colon Surgery Service in the Gastroenterology Service of the Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, from September 1984 until September 2004. The data for the research were retrospectively gotten from one thousand protocols that were filled out in a prospective character during the patients first consultation, and updated during subsequent consultations. Articular, dermatological, ophthalmologic, urologic, hepatic, pulmonary and vascular manifestations were studied. RESULTS: Among the 1,000 patients studied 468 were found to have Crohns disease (46.8%) and 532 had ulcerative rectocolitis (53.2%). 627 patients were found with at least one form of extra-intestinal manifestation (315-59.2% had ulcerative retocolitis and 312-66.7% had Crohns disease). The average duration time of the intestinal inflammatory disease of the patients who had extra-intestinal manifestations was of 10.23 years, compared to 7.89 years of those who had no disease, being statistically significant. It was also evident that the extra-intestinal manifestations came about more frequently subsequently to intestinal symptoms of the disease. CONCLUSIONS: In ulcerative rectocolitis, the greater extension of the disease in the colon was proportional to the incidence of extra-intestinal manifestations, whereas in Crohns disease, when there was some colonic assault, the incidence of these manifestations was greater. Only the urologic manifestations have greater predisposition for Crohns disease and in these ones, in the masculine sex. Articular and dermatological manifestations were more prevalent in the feminine sex both for ulcerative rectocolitis and for Crohns disease. In Crohns disease there was also greater prevalence of hepatic manifestations in the feminine sex. Articular, dermatological and vascular manifestations had greater correlation with the intestinal disease activity in both groups.

AUTOR(ES)

DATA DE PUBLICAÇÃO

RESUMO

ASSUNTO(S)

ACESSO AO ARTIGO

Documentos Relacionados