Prevalence and Characteristics of Extra-intestinal Manifestations in a Large Cohort of Greek Patients with Inflammatory Bowel Disease

J Crohns Colitis. 2016 Apr;10(4):429-36. doi: 10.1093/ecco-jcc/jjv232. Epub 2015 Dec 30.


Background and aims: Extraintestinal manifestations [EIMs] are common in inflammatory bowel disease [IBD]. Data on epidemiology and risk factors of EIMs in IBD patients are limited. The aim of this study was to investigate the prevalence of EIMs in a large cohort of Greek IBD patients and identify risk factors for their development.

Methods: The study population consisted of IBD patients, who were followed in eight tertiary Greek hospitals. Demographic and clinical characteristics of patients were analysed. The diagnosis of EIMs was based on standard criteria and on specialist consultation.

Results: In total, 1860 IBD patients (1001 with Crohn's disease [CD], 859 with ulcerative colitis [UC]) were registered. Among them 615 [33.1%] exhibited at least one EIM; 238 patients [38.6%] developed an EIM before IBD diagnosis. An association between active IBD and presence of an EIM was established in 61.1% of the patients. Arthritic [peripheral arthritis], mucocutaneous [erythema nodosum], and ocular [episcleritis] were the most common manifestations. EIMs were more prevalent in females, patients with CD, smokers [for all p <0.0001], patients with extensive UC [p = 0.007], and patients with a previous appendectomy [p < 0.0001] or a major IBD-related surgery [p = 0.012].

Conclusions: About one-third of Greek IBD patients developed at least one EIM. Of those, more than one-third had their EIM diagnosed before IBD, and in about two-thirds it was related to disease activity. EIMs were more frequently present in females and patients with extensive UC in multivariate analysis.

Keywords: Extraintestinal manifestations; inflammatory bowel disease.

MeSH terms

  • Adult
  • Arthritis / epidemiology
  • Arthritis / etiology
  • Colitis, Ulcerative / epidemiology
  • Colitis, Ulcerative / pathology
  • Crohn Disease / epidemiology
  • Crohn Disease / pathology
  • Erythema Nodosum / epidemiology
  • Erythema Nodosum / etiology
  • Female
  • Greece / epidemiology
  • Humans
  • Inflammatory Bowel Diseases / complications
  • Inflammatory Bowel Diseases / epidemiology*
  • Inflammatory Bowel Diseases / pathology
  • Male
  • Middle Aged
  • Prevalence
  • Risk Factors
  • Scleritis / epidemiology
  • Scleritis / etiology
  • Sex Factors
  • Young Adult