Agne Timinskaite1, Goda Denapienė1,2
1Faculty of Medicine, Vilnius University, Vilnius, Lithuania.
2 Center of Hepatology, Gastroenterology and Dietetics, Vilnius University Hospital “Santaros Klinikos”, Vilnius, Lithuania
Inflammatory bowel disease is a group of conditions, which includes ulcerative colitis and Crohn’s disease, is associated with frequent and varied extraintestinal manifestations. Which not only increase patients’ mortality but also impair their quality of life and require specific treatment. These diseases can affect many organs, most often the musculoskeletal system, skin, eyes and hepatopancreatobiliary system. In rare cases inflammatory bowel disease can damage lungs, liver, pancreas and any other organs. Approximately 36% of patients with inflammatory bowel disease present with at least one extraintestinal manifestation. Patients with perianal Crohn’s disease have been reported to have a higher incidence of extraintestinal manifestations than other types of inflammatory bowel disease. Some manifestations, such as erythema nodosum, aphthous ulceration of the mouth, episcleritis, are more commonly associated with the active bowel disease, whereas other extraintestinal manifestations such as uveitis, ankylosing spondylitis occur independently from the activity of inflammatory bowel disease. The association with disease activity is unclear due to some extraintestinal manifestations such as pyoderma gangrenosum, primary sclerosing cholangitis. Early diagnosis and treatment of extraintestinal manifestations leads to better outcomes and a better quality of life. Therefore, in such cases, the multidisciplinary team approach is significantly important to ensure effective and optimal management and therapy of critical conditions. This work describes four clinical cases of patients with inflammatory bowel disease and severe extraintestinal manifestations. Cases are reviewed on the basis of recent literature data, diagnostic criteria, and treatment options.
Keywords: Crohn`s disease, extraintestinal manifestations, inflammatory bowel disease, ulcerative colitis.