Background and Aims: Due to a p aucity of s uch data we
aimed to a ssess the type and f requency o f extraintestinal
manifestations ( EIM) in I BD p atients and to e valuate their
chronologic behavior.
Methods: A nalysis of d ata from t he Swiss Inflammatory Bowel
Disease Cohort (SIBDCS) which c ollects data since 2 005 on a
large sample o f IBD patients f rom hospitals and private
practices across Switzerland.
Results: A t total o f 1,143 patients were a nalyzed ( 572 (50%)
female, mean age 42.1 ± 14.4 years), 629 with Crohn's disease
(CD), 501 with ulcerative colitis (UC), and 13 with indeterminate
colitis ( IC). Of t hese, 3 74 (32.7%) presented o ne to five E IM
(65% w ith CD, 3 3% w ith UC, 2% w ith IC). O f those patients
suffering from EIM, 4 1.7% p resented two, 1 2.4% t hree, 5 .3%
four, and 3.2% f ive E IM d uring lifetime. T he initial EIM
presented with the following frequencies: p eripheral a rthritis
(PA) 6 3.4%, ankylosing spondylitis (AS) 8 .1%, primary
sclerosing cholangitis (PSC) 6%, uveitis 5.7%, oral a phthosis
5.7%, erythema nodosum (EN) 5 %, other 3 .6%, pyoderma
gangrenosum 1.8%, psoriasis 0.7%. In only 7.1% of cases, the
EIM m anifested before IBD diagnosis was made (median time
28 months b efore IBD diagnosis, I QR 7 -60 months), in 9 2.9%
EIM m anifested a fter e stablished IBD d iagnosis (median 72
months, IQR 9-147 months).
Conclusions: EIM are a frequent problem in IBD patients. The
vast m ajority of E IM m anifest a fter I BD d iagnosis has b een
established. P eripheral a rthritis, a nkylosing spondylitis, a nd
PSC represent the most frequent first manifestations of an EIM.