Extraintestinal Manifestations of Inflammatory Bowel Disease: Focus on the Musculoskeletal, Dermatologic, and Ocular Manifestations

Paul E. Evans, MD; Darrell S. Pardi, MD

Disclosures

March 19, 2007

Introduction

Crohn's disease and ulcerative colitis, the 2 main subtypes of inflammatory bowel disease (IBD), are autoimmune disorders of unknown etiology that primarily involve the bowel. Additionally, multiple other organ systems can be affected in IBD, including the bones and joints, skin, eyes, hepatobiliary system, lungs, and kidneys (Table). Collectively, these are called extraintestinal manifestations of IBD, and they can occur prior to, in conjunction with, or subsequent to active bowel disease. The overall prevalence of any extraintestinal manifestation in IBD patients ranges from 21%-40%.[1,2,3] In most large studies of IBD, the prevalence of extraintestinal manifestations is higher in Crohn's disease compared with ulcerative colitis.[2,3,4] There may also be racial differences in prevalence, with blacks having a higher risk for eye and joint manifestations, and Hispanics having a higher risk for skin manifestations, compared with whites.[5]

This article focuses on the clinical implications of extraintestinal manifestations involving the musculoskeletal system, eyes, and skin, including issues in diagnosis and treatment.

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