The development of extraintestinal manifestation and related risk factors in Crohn's patients

Abstract

Background Crohn's disease (CD) primarily involves gastrointestinal tract; however, it can present with extraintestinal manifestations (EIMs), which leads to significant morbidity. Frequency of EIMs and associated risk factors vary due to genetic and environmental differences in studies. Aim To examine the frequency and risk factors associated with EIMs in CD. Method Patients with CD under follow-up from March 1986 to October 2011 were included in this study. Demographics, type of EIMs, autoimmune diseases, and clinical features of CD were recorded. Frequency of EIMs and associated risk factors were analyzed. Results Three hundred thirty-six patients with CD were included in the study (mean follow-up duration 7.54 years). 55.4% (n: 186) were male and the mean age at diagnosis of CD was 30.6 years (range, 10.3-68.2 years). At least one EIM was detected in 47.3% and multiple EIMs in 22.9% of the cohort. Oral, joint, and skin involvements (32.4%, 24.7%, 9.2%, respectively) were the most common EIMs. Female gender (OR: 2.19, 95% CI: 1.34-3.58,p = 0.001), corticosteroid usage (OR: 2.32, 95% CI: 1.28-4.22,p = 0.007), and positive family history (OR: 5.61, 95% CI: 1.95-3.58,p = 0.001) were independent risk factors for EIM development. Colonic involvement (OR: 3.93, 95% CI: 1.59-9.68,p = 0.003), no surgical operation (OR: 2.31, 95% CI: 1.14-4.68,p = 0.020), and corticosteroid usage (OR: 2.85, 95% CI: 1.07-7.61,p = 0.037) were independent risk factors for multiple EIM development. Conclusion Although the immunological and clinical associations between EIMs and CD cannot be fully elucidated, identifying specific relationships of immune-mediated diseases will help to better understand CD pathogenesis.