Vol. 10, No 3, 2003 pp. 139 - 144
UC 616.345
CLINICAL EXTRAINTESTINAL MANIFESTATIONS
OF ULCERATIVE COLITIS
Biljana Radovanović-Dinić1, Aleksandar
Nagorni1, Vuka Katić2,
Goran Bjelaković1
1 Clinic of Gastroenterology and Hepatology,
2 Institute of Pathology
Faculty of Medicine, Niš, Serbia
Summary. Ulcerative colitis is a chronic, inflammatory bowel disease
which can clinically be manifested either only with bowel symptomatology
or with extraintestinal symptomes. A prospective study analysed 107 patients
with ulcerative colitis (57 male and 50 female, mean age 41.25, range 21-70).
The presence of the most common extraintestinal manifestations (EM) (myoskeletal,
skin, ocular and hepatobiliary) has been analyzed. Out of the whole number
of the examined, these manifestations were verified in 23 (21.49%) patients
(10 male and 13 female, mean age 43.25, range 27-70). Patients with EM
suffered longer from UC on the average, that is 6.06 years, while the others
suffered for 4.44 years. Peripheral arthritis was the most common EM, verified
in 13 (56.52%) patients. In 9 (39.14%) patients two or more EM were verified.
In 77.27% patients, EM were clinically detectable after the intestinal
symptomatology. No statistically significant difference was established
in the duration of disease between patients with one EM and those with
several EM. Patients with EM had more extensive and more active UC on average,
in relation to others. No statistically significant difference was established,
in extension and activity of disease, between patients with and without
EM. The fact that EM can affect the clinical course of UC, therapy response
and the quality of patient's life, oblige the doctors to be very cautious
during the evaluation of patients with UC in order to recognize EM on time.
In case of the above-mentioned illnesses without clinically manifested
or undeveloped UC, large bowel screening should be performed to diagnose
possible UC in the subclinical stage.
Key words: Ulcerative colitis, extraintestinal manifestations,
index activity
KLINIČKE EKSTRAINTESTINALNE MANIFESTACIJE
ULCEROZNOG KOLITISA
Kratak sadržaj: Ulcerozni kolitis je hronična, zapaljenska bolest
debelog creva koja se može manifestovati kako intestinalnom tako i ekstraintestinalnom
simptomatologijom. Prospektivnom studijom je analizirano 107 obolelih od
ulceroznog kolitisa (57 muškaraca i 50 žena, prosečne starosti 41,25, koja
se kretala od 21 do70). Analizirano je prisustvo najčešćih ekstraintestinalnih
manifestacija (EM). Od ukupnog broja ispitanika ove manifestacije su verifikovane
u 23 (21,49%) (10 muškaraca i 13 žena, prosečne starosti 43,25, koja se
kretala od 27-70). Ispitanici sa EM su u proseku duže bolovali od UC, 6,06
godina, za razliku od preostalih koji su bolovali 4.44 godina. Periferni
artritis je bila najčešća EM, verifikovana u 13 (56,52%) ispitanika. U
9 (39,14%) ispitanika su verifikovane po dve i više EM. U 77,27% ispitanika
EM su se klinički ispoljile nakon intestinalne simptomatologije. Nije uočena
statistički značajna razlika u dužini trajanja bolesti izmedju pacijenata
sa jednom i pacijenata sa više EM. Ispitanici sa EM su u proseku imali
ekstenzivniji i aktivniji UC u odnosu na ostale ispitanike. Nije uočena
statistički značajna razlika u ekstenzivnosti i aktivnosti bolesti izmedju
ispitanika sa i bez EM.
Činjenica da EM mogu da utiču na klinički tok UC, terapijski odgovor
i kvalitet pacijentovog života, obavezuje kliničara da tokom evaluacije
obolelih od UC bude na oprezu kako bi pravovremeno prepoznao EM. U slučaju
postojanja navedenih bolesti bez klinički manifestnog ili još ne razvijenog
UC treba uraditi skrining debelog creva u cilju eventualne dijagnoze UC
u subkliničkoj fazi.
Ključne reči: Ulcerozni kolitis, ekstraintestinalne manifestacije,
indeks aktivnosti
