Pathogenesis and clinical approach to extraintestinal manifestations of inflammatory bowel disease

D. Agrawal, S. Rukkannagari, S. R. Kethu

Research output: Contribution to journalArticle

18 Citations (Scopus)

Abstract

Crohn's disease (CD) and ulcerative colitis (UC), both should be considered as systemic diseases as they are associated with clinical manifestations involving the organs outside the alimentary tract. In a genetically susceptible host with inflammatory bowel disease (IBD), complex interaction of bacterial or other local factors in the colon with antigen presenting cells may trigger an immune reaction to a shared antigen in the involved organs. These extraintestinal manifestations (EIM) are observed in up to 20-40% of the patients with IBD. Patients with CD are more susceptible to EIMs than patients with UC. Joints, eyes, skin and biliary tract are the most commonly involved organ systems. Some manifestations such as uveitis, episcleritis may precede the onset bowel disease and some may occur in conjunction with or subsequent to the diagnosis of active bowel disease. Although many EIMs tend to follow the clinical course of IBD and respond to the treatment of underlying bowel disease, some EIMs such as primary sclerosing cholangitis and ankylosing spondylitis tend to follow a course independent of the bowel disease activity. Biological agents, particularly anti-TNFα based therapies now assume an important role in the treatment of EIMs. Early recognition and treatment of EIMs are crucial in preventing major morbidity.

Original languageEnglish (US)
Pages (from-to)233-248
Number of pages16
JournalMinerva Gastroenterologica e Dietologica
Volume53
Issue number3
StatePublished - Sep 2007

Fingerprint

Inflammatory Bowel Diseases
Ulcerative Colitis
Crohn Disease
Scleritis
Sclerosing Cholangitis
Ankylosing Spondylitis
Uveitis
Biological Factors
Biliary Tract
Antigen-Presenting Cells
Therapeutics
Colon
Joints
Morbidity
Antigens
Skin

Keywords

  • Inflammatory bowel diseases, immunology
  • Inflammatory bowel diseases, physiopatology
  • Rheumatology

ASJC Scopus subject areas

  • Gastroenterology

Cite this

Pathogenesis and clinical approach to extraintestinal manifestations of inflammatory bowel disease. / Agrawal, D.; Rukkannagari, S.; Kethu, S. R.

In: Minerva Gastroenterologica e Dietologica, Vol. 53, No. 3, 09.2007, p. 233-248.

Research output: Contribution to journalArticle

@article{4ff395c5257746c7aa19c424032cc495,
title = "Pathogenesis and clinical approach to extraintestinal manifestations of inflammatory bowel disease",
abstract = "Crohn's disease (CD) and ulcerative colitis (UC), both should be considered as systemic diseases as they are associated with clinical manifestations involving the organs outside the alimentary tract. In a genetically susceptible host with inflammatory bowel disease (IBD), complex interaction of bacterial or other local factors in the colon with antigen presenting cells may trigger an immune reaction to a shared antigen in the involved organs. These extraintestinal manifestations (EIM) are observed in up to 20-40{\%} of the patients with IBD. Patients with CD are more susceptible to EIMs than patients with UC. Joints, eyes, skin and biliary tract are the most commonly involved organ systems. Some manifestations such as uveitis, episcleritis may precede the onset bowel disease and some may occur in conjunction with or subsequent to the diagnosis of active bowel disease. Although many EIMs tend to follow the clinical course of IBD and respond to the treatment of underlying bowel disease, some EIMs such as primary sclerosing cholangitis and ankylosing spondylitis tend to follow a course independent of the bowel disease activity. Biological agents, particularly anti-TNFα based therapies now assume an important role in the treatment of EIMs. Early recognition and treatment of EIMs are crucial in preventing major morbidity.",
keywords = "Inflammatory bowel diseases, immunology, Inflammatory bowel diseases, physiopatology, Rheumatology",
author = "D. Agrawal and S. Rukkannagari and Kethu, {S. R.}",
year = "2007",
month = "9",
language = "English (US)",
volume = "53",
pages = "233--248",
journal = "Minerva Gastroenterologica",
issn = "0026-4776",
publisher = "Edizioni Minerva Medica S.p.A.",
number = "3",

}

TY - JOUR

T1 - Pathogenesis and clinical approach to extraintestinal manifestations of inflammatory bowel disease

AU - Agrawal, D.

AU - Rukkannagari, S.

AU - Kethu, S. R.

PY - 2007/9

Y1 - 2007/9

N2 - Crohn's disease (CD) and ulcerative colitis (UC), both should be considered as systemic diseases as they are associated with clinical manifestations involving the organs outside the alimentary tract. In a genetically susceptible host with inflammatory bowel disease (IBD), complex interaction of bacterial or other local factors in the colon with antigen presenting cells may trigger an immune reaction to a shared antigen in the involved organs. These extraintestinal manifestations (EIM) are observed in up to 20-40% of the patients with IBD. Patients with CD are more susceptible to EIMs than patients with UC. Joints, eyes, skin and biliary tract are the most commonly involved organ systems. Some manifestations such as uveitis, episcleritis may precede the onset bowel disease and some may occur in conjunction with or subsequent to the diagnosis of active bowel disease. Although many EIMs tend to follow the clinical course of IBD and respond to the treatment of underlying bowel disease, some EIMs such as primary sclerosing cholangitis and ankylosing spondylitis tend to follow a course independent of the bowel disease activity. Biological agents, particularly anti-TNFα based therapies now assume an important role in the treatment of EIMs. Early recognition and treatment of EIMs are crucial in preventing major morbidity.

AB - Crohn's disease (CD) and ulcerative colitis (UC), both should be considered as systemic diseases as they are associated with clinical manifestations involving the organs outside the alimentary tract. In a genetically susceptible host with inflammatory bowel disease (IBD), complex interaction of bacterial or other local factors in the colon with antigen presenting cells may trigger an immune reaction to a shared antigen in the involved organs. These extraintestinal manifestations (EIM) are observed in up to 20-40% of the patients with IBD. Patients with CD are more susceptible to EIMs than patients with UC. Joints, eyes, skin and biliary tract are the most commonly involved organ systems. Some manifestations such as uveitis, episcleritis may precede the onset bowel disease and some may occur in conjunction with or subsequent to the diagnosis of active bowel disease. Although many EIMs tend to follow the clinical course of IBD and respond to the treatment of underlying bowel disease, some EIMs such as primary sclerosing cholangitis and ankylosing spondylitis tend to follow a course independent of the bowel disease activity. Biological agents, particularly anti-TNFα based therapies now assume an important role in the treatment of EIMs. Early recognition and treatment of EIMs are crucial in preventing major morbidity.

KW - Inflammatory bowel diseases, immunology

KW - Inflammatory bowel diseases, physiopatology

KW - Rheumatology

UR - http://www.scopus.com/inward/record.url?scp=36749006135&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=36749006135&partnerID=8YFLogxK

M3 - Article

C2 - 17912186

AN - SCOPUS:36749006135

VL - 53

SP - 233

EP - 248

JO - Minerva Gastroenterologica

JF - Minerva Gastroenterologica

SN - 0026-4776

IS - 3

ER -