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1.
Rev. cuba. cir ; 60(3): e1117, 2021.
Article in Spanish | LILACS, CUMED | ID: biblio-1347393

ABSTRACT

Introducción: El plastrón apendicular es una tumoración inflamatoria constituida por el apéndice inflamado, vísceras adyacentes y epiplón mayor. Puede contener o no pus (absceso/flemón). Objetivo: Precisar si está indicada la apendicectomía de urgencia o de intervalo en los pacientes con plastrón y/o absceso apendicular sometidos a tratamiento no quirúrgico inicial. Métodos: Se realizó una revisión en las bases de datos bibliográficas Web of Science, PubMed, Medline y Lilacs, mediante el motor de búsqueda Google académico. Se seleccionaron 28 artículos en inglés y español; 20 (71,2 por ciento) correspondieron al quinquenio 2016-20 y el 96,4 por ciento de autores extranjeros. Desarrollo: El estándar actual es el tratamiento no quirúrgico inicial del plastrón y el drenaje percutáneo del absceso. La apendicectomía de intervalo tiene un beneficio mínimo y puede conducir a un aumento de los costos, estancia hospitalaria, antibioticoterapia intravenosa y de la morbilidad. Se debe realizar un seguimiento cuidadoso en enfermos con riesgo de enfermedad inflamatoria intestinal o cáncer de colon, sin importar qué opción se elija (operación de intervalo u observación). Conclusiones: La apendicectomía de urgencia no es recomendable porque el componente inflamatorio la hace técnicamente difícil, puede necesitar una colectomía y aumentar la morbilidad, aunque actualmente, la apendicectomía laparoscópica de urgencia puede ser más rentable y segura. La decisión posterior de la apendicectomía a intervalos sigue siendo discutible. El intervalo recomendado varía entre 6 y 8 semanas, tres y seis meses después de la normalización clínico humoral(AU)


Introduction: Appendiceal plastron is an inflammatory tumor made up of inflamed appendix, adjacent viscera and greater omentum. It may or may not contain pus (abscess/phlegmon). Objective: To specify whether emergency or interval appendectomy is indicated in patients with appendicular abscess and/or plastron who had undergone initial nonsurgical treatment. Methods: A review was carried out in the bibliographic databases Web of Science, PubMed, Medline and Lilacs, using the search engine Google Scholar. Twenty-eight articles were selected, in English and Spanish; twenty (71.2 percent) corresponded to the quinquennium 2016-20, while 96.4 percent were written by foreign authors. Development: The current standard is the initial nonsurgical treatment of the plastron and percutaneous drainage of the abscess. Interval appendectomy has minimal benefits and can lead to increased costs, hospital stay, intravenous antibiotic therapy and morbidity. Patients at risk for inflammatory bowel disease or colon cancer should be carefully followed up, regardless of which option is chosen (interval operation or observation). Conclusions: Emergency appendectomy is not recommended because the inflammatory component makes it technically difficult; it may require colectomy and increase morbidity, although currently, emergency laparoscopic appendectomy may be more profitable and safer. The subsequent decision for interval appendectomy remains debatable. The recommended interval varies from six to eight weeks, three and six months after clinical-humoral normalization(AU)


Subject(s)
Humans , Appendectomy/methods , Inflammatory Bowel Diseases/epidemiology , Abscess/etiology , Emergencies , Databases, Bibliographic , Colectomy/methods , Search Engine/methods
2.
Arq. gastroenterol ; 58(3): 377-383, July-Sept. 2021. tab, graf
Article in English | LILACS | ID: biblio-1345300

ABSTRACT

ABSTRACT BACKGROUND: Crohn's disease (CD) and ulcerative colitis (UC), two of the main inflammatory bowel diseases (IBD), have been increasingly diagnosed in South America. Although IBD have been intensively studied in the last years, epidemiologic data in Brazil are scarce. OBJECTIVE: To study the clinical and epidemiologic profile of IBD patients treated in the Clinical Hospital of the Federal University of Uberlândia from 1999 to 2014. METHODS: We performed a retrospective study of the medical records of patients diagnosed with IBD, according to the international classification of diseases (ICD) - ICD K50 for CD and ICD K51 for UC - confirmed by endoscopic examination in the case of both diseases. We analyzed the following variables: age; sex; ethnicity; smoking habit; primary diagnosis; site of disease manifestation; main clinical manifestations; IBD-related complications; extraintestinal manifestations; and established drug and/or surgical treatment. RESULTS: We evaluated 183 IBD cases (91 UC and 92 CD cases). The estimated prevalence rate of UC was 15.06/100.000 inhabitants and of CD was 15.23/100.000. The CU and CD female to male incidence ratios were 1.7 and 1.8, respectively. The average age of patients diagnosed with UC was 39.4 years and of those diagnosed with CD was 31.1 years. White-skinned people were the most affected by UC (66.0%) and CD (69.0%). Few patients were submitted to surgical procedures as treatment alternative. CONCLUSION: The estimated prevalence of IBD in this population was low compared to that of populations of North America, but high compared to that of other regions considered to present low incidence, such as some Asian and Latin American countries.


RESUMO CONTEXTO: A doença de Crohn (DC) e a retocolite ulcerativa (RCU), duas das principais doenças inflamatórias intestinais (DIIs), têm sido cada vez mais diagnosticadas na América do Sul. Embora a DII tenha sido intensamente estudada nos últimos anos, os dados epidemiológicos no Brasil são escassos. OBJETIVO: Estudar o perfil clínico e epidemiológico dos pacientes com DII atendidos no Hospital das Clínicas da Universidade Federal de Uberlândia de 1999 a 2014. MÉTODOS: Foi realizado um estudo retrospectivo dos prontuários de pacientes com diagnóstico de DII, de acordo com a classificação internacional de doenças (CID) - CID K50 para DC e CID K51 para RCU - confirmado por exame endoscópico para ambas as doenças. Analisamos as seguintes variáveis: idade; sexo; etnia; hábito tabágico; diagnóstico primário; local de manifestação da doença; principais manifestações clínicas; complicações relacionadas a DII; manifestações extraintestinais; tratamentos medicamentoso e/ou cirúrgico instituídos. RESULTADOS: Foram avaliados 183 casos de DII (91 casos de RCU e 92 casos de DC). A prevalência estimada de RCU foi de 15,06/100.000 habitantes e de DC foi de 15,23/100.000. As taxas de incidência entre pacientes do sexo feminino e masculino foram de 1,7 para RCU e 1,8 para DC. A idade média dos pacientes com diagnóstico de RCU foi de 39,4 anos e daqueles com DC foi de 31,1 anos. A raça branca foi o grupo étnico mais afetado por RCU (66,0%) e DC (69,0%). Poucos pacientes foram submetidos a procedimentos cirúrgicos como alternativas de tratamento. CONCLUSÃO: A prevalência estimada de DII nesta população foi baixa em comparação com populações da América do Norte, mas elevada em comparação com outras regiões consideradas de baixa incidência, como alguns países da Ásia e da América Latina.


Subject(s)
Humans , Male , Female , Adult , Inflammatory Bowel Diseases/epidemiology , Colitis, Ulcerative/epidemiology , Crohn Disease/epidemiology , Brazil/epidemiology , Incidence , Retrospective Studies
3.
Säo Paulo med. j ; 138(6): 530-536, Nov.-Dec. 2020. tab, graf
Article in English | LILACS, SES-SP | ID: biblio-1145127

ABSTRACT

ABSTRACT BACKGROUND: Inflammatory bowel diseases affect mostly young patients and have a huge impact on their quality of life and growing treatment costs. Currently, there are few Brazilian studies concerning their epidemiological profile. OBJECTIVE: The aim of this study was to describe the regional clinical and epidemiological profile of these pathological conditions in Caxias do Sul, Brazil. DESIGN AND SETTING: Cross-sectional study in Caxias do Sul (RS), Brazil. METHODS: A search for patients was conducted in the municipality's special medications pharmacy using the International Classification of Diseases, and medical records were manually reviewed for data collection. Sixty-seven patients were included. RESULTS: The patients' mean age was 46.5 years and females predominated (71.6%). Ulcerative colitis was the most prevalent disease (70%) and Montreal E3 was the most prevalent presentation. The mean age at diagnosis was 39 years. Most patients had recently undergone colonoscopy (67%). Only five patients (7.4%) had records of hospital admission due to the disease, while 12 (18%) underwent a surgical procedure during follow-up. Sixty patients (89.5%) were using aminosalicylates, while less than one fifth were using immunosuppressants or immunobiological drugs: 19.4% and 14.9%, respectively. CONCLUSION: The profile of inflammatory bowel disease patients in this region of Brazil is similar in some characteristics to other published Brazilian data, although it differs in others such as higher frequency of pancolitis. A prospective study on these patients is planned in this region, in order to improve the data quality.


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Inflammatory Bowel Diseases/epidemiology , Brazil/epidemiology , Cross-Sectional Studies
4.
Arq. gastroenterol ; 57(3): 272-277, July-Sept. 2020. tab, graf
Article in English | LILACS | ID: biblio-1131673

ABSTRACT

ABSTRACT BACKGROUND: Data regarding the prevalence of anemia in inflammatory bowel disease (IBD) patients are scarce in Brazil. Anemia and iron deficiency anemia have been known to cause significant functional impairment, lower quality of life, and higher morbidity and mortality and may be correlated with an impact on the cost of treatment. OBJECTIVE: The aim of this study was to estimate the prevalence and risk factors for anemia and iron deficiency anemia in patients with IBD in a tertiary IBD unit in Southeast Brazil. METHODS: We conducted an Institutional Review Board-approved retrospective analysis of an adult IBD cohort (IBD Unit, Ribeirão Preto Medical School, University of São Paulo, Brazil) consisting of 579 patients between January 2014 and July 2018. Clinicoepidemiological data, hemoglobin measurements and serum ferritin were extracted from electronic medical records. Anemia prevalence was calculated among ulcerative colitis (UC) and Crohn's disease (CD) phenotypes. Risk factors for anemia were also calculated. RESULTS: A total of 529 (91%) patients had complete blood counts available in their medical records. Only 35.5% of IBD patients were fully screened for anemia. The prevalence of anemia in IBD patients was 24.6% (29.1% in CD and 19.1% in UC, P=0.008). The anemia was moderate to severe in 16.9% (19.8% in CD and 11.4% in UC, P=0.34). The prevalence of iron deficiency was 52.3% (53.6% in CD and 51.2% in UC, P=0.95). Anemia of chronic disease was present in 14.1% of IBD patients. A total of 53.8% of patients with anemia were in clinical remission. CD was associated with an increased prevalence of anemia (P=0.008; OR=1.76; CI 95% =1.16-2.66) compared to UC. The penetrant disease phenotype in CD was associated with a lower risk of anemia (P<0.0001; OR=0.25; CI 95% =0.14-0.43). Active disease compared to the disease in clinical remission was associated with an increased risk of anemia (P=0.0003; OR=2.61; CI 95% =1.56-4.36) in CD. The presence of anemia was less frequent in patients with CD who underwent surgical bowel resection compared to those who did not undergo surgery (P<0.0001; OR=0.24; CI 95% =0.14-0.40). No differences in anemia prevalence were observed regarding CD localization, age at diagnosis, UC extension or biological therapy (P>0.05). CONCLUSION: Despite the low levels of full screening, anemia and iron deficiency anemia were common manifestations of IBD. CD was associated with an increased risk of anemia, especially with active disease. In addition, patients with CD who underwent surgical bowel resection and penetrant disease phenotype in CD were associated with lower risk of anemia.


RESUMO CONTEXTO: Dados referentes à prevalência de anemia em pacientes com doença inflamatória intestinal (DII) são escassos no Brasil. Sabe-se que anemia e a anemia ferropriva causam comprometimento funcional significativo, menor qualidade de vida e maior morbimortalidade e podem estar correlacionadas com um impacto no custo do tratamento. OBJETIVO: O objetivo deste estudo foi estimar a prevalência e os fatores de risco de anemia e de anemia ferropriva em pacientes com DII em um centro de referência de DII no Sudeste do Brasil. MÉTODOS: Realizamos uma análise retrospectiva dos pacientes com DII adultos, aprovada pelo Comitê de Ética Institucional do Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto da Universidade de São Paulo, Brasil, constituída por 579 pacientes no período de janeiro de 2014 a julho de 2018. Dados clínico-epidemiológicos, níveis de hemoglobina e de ferritina sérica foram obtidos dos prontuários eletrônicos. A prevalência de anemia foi calculada entre os fenótipos de retocolite ulcerativa (RCU) e doença de Crohn (DC). Fatores de risco para anemia também foram calculados. RESULTADOS: Um total de 529 (91%) pacientes tinha disponível o exame de hemograma completo em seus prontuários médicos. Apenas 35,5% dos pacientes com DII tinha o rastreamento completo para anemia. A prevalência de anemia nos pacientes com DII foi de 24,6% (29,1% na DC e 19,1% na RCU, P=0,008). A anemia foi moderada a grave em 16,9% (19,8% na DC e 11,4% na RCU, P=0,34). A prevalência de deficiência de ferro foi de 52,3% (53,6% na DC e 51,2% na RCU, P=0,95). Anemia de doença crônica estava presente em 14,1% dos pacientes com DII. Um total de 53,8% dos pacientes com anemia estavam em remissão clínica. A DC esteve associada a um aumento da prevalência de anemia (P=0,008; OR=1,76; IC 95% =1,16-2,66) em comparação à RCU. O fenótipo da doença penetrante na DC foi associado a um menor risco de anemia (P<0,0001; OR=0,25; IC 95% =0,14-0,43). A doença ativa comparada à doença em remissão clínica foi associada a um risco aumentado de anemia (P=0,0003; OR=2,61; IC 95% =1,56-4,36) na DC. A presença de anemia foi menos frequente nos pacientes com DC submetidos à ressecção intestinal em comparação aos que não foram submetidos à cirurgia (P<0,0001; OR=0,24; IC 95% =0,14-0,40). Não foram observadas diferenças na prevalência de anemia em relação à localização da DC, idade ao diagnóstico, extensão da RCU ou terapia biológica (P>0,05). CONCLUSÃO: Apesar do baixo rastreamento completo, tanto a anemia como a anemia ferropriva foram manifestações comuns da DII. A DC foi associada a um risco aumentado de anemia, especialmente com doença ativa. Além disto, pacientes com DC submetidos a ressecção intestinal e/ou com fenótipo penetrante tiveram menor risco de anemia.


Subject(s)
Humans , Inflammatory Bowel Diseases/complications , Inflammatory Bowel Diseases/epidemiology , Anemia, Iron-Deficiency/etiology , Anemia, Iron-Deficiency/epidemiology , Quality of Life , Referral and Consultation , Brazil/epidemiology , Prevalence , Retrospective Studies , Risk Factors
5.
J. coloproctol. (Rio J., Impr.) ; 40(2): 99-104, Apr.-Jun. 2020. tab
Article in English | LILACS | ID: biblio-1134979

ABSTRACT

ABSTRACT Objective Evaluation of nutritional status and consumption frequency of inflammatory and anti-inflammatory food by patients with inflammatory bowel diseases. Methods An observational study of the patients assisted by the interdisciplinary inflammatory bowel diseases ambulatory of UNIVALI-SC. The nutritional status of patients was evaluated and each patient was categorized according to his/her body max index and also through a research questionnaire of the individual social-economy situation, life habits, and inflammatory and anti-inflammatory food consumption in a determinate period of time. Results Out of the 65 patients, 57% had Crohn's disease and 43% had ulcerative colitis. According to the disease activity, 71% were in remission and 29% in activity. Of the sample, 57% were classified as overweight. It was not possible to correlate nutritional status and type of inflammatory bowel diseases, nutritional status and income or nutritional status and level of education. The most inflammatory foods were beef (65%) and coffee (60%), while the anti-inflammatory ones were garlic (75%), olive oil (54%), and sweet potatoes (23%). There was no association between the most consumed inflammatory and anti-inflammatory food and body max index. Conclusion According to the results, most of the patients were overweight. The most commonly consumed inflammatory foods were beef and coffee and the anti-inflammatory ones were garlic, olive oil, and sweet potatoes.


RESUMO Objetivo Avaliar o estado nutricional e a frequência de consumo de alimentos inflamatórios e anti-inflamatórios por portadores de doenças inflamatórias intestinais. Metodologia Estudo transversal com indivíduos assistidos pelo ambulatório interdisciplinar de doenças inflamatórias intestinais da UNIVALI-SC. Avaliados por meio do estado nutricional e classificados de acordo com o índice de massa corporal, bem como através de um questionário contendo dados socioeconômicos, hábitos de vida e frequência do consumo de alimentos inflamatórios e anti-inflamatórios. Resultados Dos 65 pacientes, 57% eram portadores de doença de Crohn e 43% de retocolite ulcerativa. De acordo com a atividade da doença, 71% encontravam-se em remissão e 29% em atividade. Da amostra, 57% foram classificados como acima do peso. Não foi possível correlacionar estado nutricional e o tipo de doenças inflamatórias intestinais, estado nutricional e renda ou estado nutricional e escolaridade. Os alimentos inflamatórios mais consumidos foram carne de gado (65%) e café (60%), já os anti-inflamatórios foram alho (75%), azeite de oliva (54%) e batata doce (23%). Não houve associação entre os alimentos inflamatórios e anti-inflamatórios mais consumidos e o índice de massa corporal. Conclusão Segundo os resultados, observou-se que a maioria dos pacientes apresentava excesso de peso. Os alimentos inflamatórios mais consumidos foram carne de gado e café e os anti-inflamatórios foram alho, azeite de oliva e batata doce.


Subject(s)
Humans , Male , Female , Colitis, Ulcerative , Crohn Disease , Eating , Inflammatory Bowel Diseases/epidemiology , Body Mass Index , Nutritional Status , Diet/statistics & numerical data , Overweight
6.
Clinics ; 75: e1909, 2020. tab
Article in English | LILACS | ID: biblio-1101091

ABSTRACT

The world is fighting the COVID-19 outbreak and health workers, including inflammatory bowel diseases specialists, have been challenged to address the specific clinical issues of their patients. We hereby summarize the current literature in the management of inflammatory bowel disease (IBD) patients during the COVID-19 pandemic era that support the rearrangement of our IBD unit and the clinical advice provided to our patients.


Subject(s)
Humans , Male , Female , Child , Adult , Pneumonia, Viral/epidemiology , Inflammatory Bowel Diseases/therapy , Inflammatory Bowel Diseases/epidemiology , Coronavirus Infections/epidemiology , Betacoronavirus , Severity of Illness Index , Brazil , Risk Factors , Risk Assessment , Pandemics , SARS-CoV-2 , COVID-19
7.
Rev. méd. Chile ; 147(2): 212-220, Feb. 2019. tab
Article in Spanish | LILACS | ID: biblio-1004334

ABSTRACT

Environmental factors may influence the development of Inflammatory Bowel Disease and modify its natural history. The objective of this review is to evaluate current evidence about environmental factors associated with the disease. A better knowledge about the pathogenesis of the disease can lead to better treatment strategies and suggestions to prevent the disease.


Subject(s)
Humans , Inflammatory Bowel Diseases/etiology , Environmental Exposure/adverse effects , Tobacco/adverse effects , Inflammatory Bowel Diseases/epidemiology , Risk Factors , Probiotics , Diet/adverse effects , Protective Factors , Obesity/complications
8.
Arch. argent. pediatr ; 115(6): 533-540, dic. 2017. ilus, tab
Article in English, Spanish | LILACS, BINACIS | ID: biblio-887392

ABSTRACT

Introducción. La enfermedad inflamatoria intestinal (EII) comprende la colitis ulcerosa (CU) y la enfermedad de Crohn (EC). Su diagnóstico es cada vez más frecuente en pediatría y la incidencia es desconocida en Argentina. El objetivo de este trabajo fue determinar la incidencia anual de EII en menores de 18 años de nuestro país, los aspectos epidemiológicos y las formas clínicas de presentación. Población y métodos. Estudio prospectivo, multicéntrico y observacional que abarcó todo el territorio nacional. Se incluyeron menores de 18 años con diagnóstico de EII de centros públicos y privados entre el 1/6/2012 y el 31/5/2013, a través de protocolo en la web. Resultados. Participaron 17 centros, y se registraron 50 pacientes en 10 centros. La incidencia fue 0, 4/100 000 < 18 años; EC, 20; CU, 25; y EII no clasificable, 5. Distribución según sexo: 26 varones y 24 mujeres. La edad media al momento del diagnóstico fue de 9, 7 años y la demora diagnóstica, de 16, 5 meses. Los síntomas y signos más frecuentes fueron diarrea crónica con sangre y/o moco, dolor abdominal y adelgazamiento. El retraso del crecimiento fue menor de lo esperado. Las manifestaciones extraintestinales se presentaron en el 24% en CU y en el 25% en EC. La localización más frecuente en EC fue ileocolónica, y, en CU, pancolónica. No se observó CU con formas graves. Conclusiones. La incidencia fue menor que la reportada por otros registros. Se considera conveniente la creación de un registro permanente, que no solo permita conocer la incidencia, sino también servir de apoyo a los centros referentes que diagnostican y tratan esta patología.


Introduction. Inflammatory bowel disease (IBD) includes ulcerative colitis (UC) and Crohn's disease (CD). IBD diagnosis has become increasingly common in pediatrics but its incidence is unknown in Argentina. The objective of this study was to determine the annual incidence of IBD in children and adolescents younger than 18 years in Argentina, its epidemiological aspects, and clinical presentations. Population and methods. Prospective, observational, multicenter study conducted in Argentina. Children and adolescents younger than 18 years from public and private facilities, diagnosed with IBD between June 1st, 2012 and May 31st, 2013 were included via a web protocol. Results. Seventeen sites participated in the study; 50 patients were recruited from 10 sites. IBD incidence was 0.4/100 000 among individuals <18 years; CD, 20; UC, 25; and idiopathic IBD, 5. Distribution by sex: 26 boys and 24 girls. Patients' mean age at diagnosis was 9.7 years, and delay in the diagnosis was 16.5 months. The most common symptoms and signs were chronic diarrhea with blood and/or mucus, abdominal pain, and weight loss. Growth retardation was less common than expected. Extraintestinal manifestations were observed in 24% of UC cases and in 25% of CD cases. The most common location of CD was the ileum and colon, and of UC was the entire colon (pancolonic). There were no cases with severe UC. Conclusions. The incidence was lower than that reported in other registries. We recommend the development of an ongoing registry, to establish the incidence of IBD, but also to serve as backup for referring facilities where this disease is diagnosed and treated.


Subject(s)
Humans , Infant , Child, Preschool , Child , Adolescent , Inflammatory Bowel Diseases/epidemiology , Argentina/epidemiology , Colitis, Ulcerative/epidemiology , Crohn Disease/epidemiology , Registries , Incidence , Prospective Studies
9.
J. coloproctol. (Rio J., Impr.) ; 37(4): 273-278, Oct.-Dec. 2017. tab
Article in English | LILACS | ID: biblio-894010

ABSTRACT

ABSTRACT According to several epidemiological studies, there is a significant increase in cases of inflammatory disease in developing countries. Objective: To describe epidemiological data and clinical features of patients with inflammatory bowel disease in patients enrolled in Campo Grande, MS. Method: A retrospective descriptive study with a database analysis of patients who were enrolled and renewed their process in the Exceptional Medications Program of the Health Department from January 2008 to December 2016. Results: 423 patients participated in the study, 260 women and 163 men. Of these, 238 patients had Crohn's disease and 185 had ulcerative rectocolitis. The patients' mean age was 46 years. The most commonly used medication for both diseases was mesalazine and 34.3% of the patients needed to switch their medication during the treatment, most of them with Crohn's disease. In Crohn's patients, the most affected segment was the colon (40.6%) and in patients with ulcerative rectocolitis the entire large intestine was involved (78.8%) was more common. Of the total number of patients, 10.8% of the women and 18.4% of the men needed to use an anti-TNF. Conclusion: Most people on treatment for IBD are female, with a mean age of 46 years and suffering from Crohn's disease. The most affected segments were the entire large intestine in URC cases and the colon in Crohn's disease cases. Mesalazine was the most used drug in both diseases. There was more drug replacement in Crohn's disease patients. In Crohn's disease, younger patients used infliximab more frequently.


RESUMO De acordo com vários estudos epidemiológicos, há aumento significativo de casos de doença inflamatória nos países em desenvolvimento. Objetivo: Descrever os dados epidemiológicos e características clinicas dos pacientes com doença inflamatória intestinal em Campo Grande - MS. Método: Pesquisa descritiva retrospectiva, com análise dos prontuários em banco de dados, em pacientes que cadastraram e renovaram o processo no Programa de Medicamentos Excepcionais da Secretaria de Saúde, de janeiro de 2008 e dezembro de 2016. Resultados: Participaram da pesquisa 423 pacientes, 260 mulheres e 163 homens. Deste total, 238 possuíam doença de Crohn e 185 Retocolite Ulcerativa. A média de idade foi de 46 anos. O medicamento mais utilizado em ambas doenças foi a mesalazina e 34,3% dos pacientes necessitaram realizar troca de medicamentos ao longo do tratamento, sendo a maioria portador da doença de Crohn. Nos pacientes com Crohn o segmento mais acometido foi o cólon (40,6%) e nos pacientes com RCU foi todo o intestino grosso (78,8%). Do total de pacientes, 10,8% das mulheres e 18,4% dos homens necessitaram utilizar anti-TNF. Conclusão: A maioria das pessoas em tratamento para DII são do sexo feminino, com média de idade de 46 anos e portadores de Doença de Crohn. Os segmentos mais acometidos na RCU foi todo o intestino grosso e na Doença de Crohn o colo. A mesalazina foi o medicamento mais utilizado em ambas as doenças. Houve mais troca de medicamentos na Doença de Crohn. Na Doença de Crohn pessoas mais jovens utilizaram mais o infliximabe.


Subject(s)
Humans , Male , Female , Adult , Inflammatory Bowel Diseases/physiopathology , Inflammatory Bowel Diseases/epidemiology
11.
Gastroenterol. latinoam ; 28(3): 177-184, 2017.
Article in Spanish | LILACS | ID: biblio-1118805

ABSTRACT

Incidence of obesity is rising worldwide, Chile is no exception with obese patients representing up to one third of general population. This parallels with increasing prevalence of inflammatory bowel disease (IBD). Contrary to conventional belief, comorbidity is high (15-40%), where both diseases present with chronic inflammation and dysbiosis which alters intestinal barrier. Causality between obesity and IBD is difficult to stablish and evidence is scarce to determine association. Obesity would be a risk factor for IBD, particularly in Crohn´s Disease (CD), females and obesity at young age. Other than body mass index (BMI), visceral adipose tissue (VAT) has been recently determined as the best indicator of metabolic and endocrine consequences of obesity. Increasing values of VAT have been related to complicated IBD and worst prognosis. On IBD-related therapy, increasing BMI has been related to suboptimal doses and in biologic therapy, obesity raises the probability of flares, loss of response and therapy optimization. Obese patients require IBD-related surgery before non-obese patients and present more postoperative complications. Similarly, VAT is an independent risk factor for postoperative recurrence in CD. Altogether this evidence suggests that obesity does have an influence on IBD, therefore, multidisciplinary healthcare providers should prevent, educate and intervene actively in obesity in order to improve results in intestinal disease


La obesidad ha ido aumentando progresivamente a nivel mundial. Chile no es la excepción, donde un tercio de la población es obesa. Así mismo, la incidencia y prevalencia de la enfermedad inflamatoria intestinal (EII) también ha ido en aumento. La comorbilidad entre obesidad y EII es alta (15-40%) donde ambas presentan inflamación crónica y dentro de su patogenia tienen en común la disbiosis, que altera la función de barrera intestinal. Establecer una asociación de causalidad es difícil y la evidencia es escasa en relación a su asociación. La obesidad puede ser considerada como factor de riesgo para EII, particularmente en pacientes con Enfermedad de Crohn (EC), mujeres y obesidad temprana. Además, se ha establecido que el tejido adiposo visceral (TAV) es mejor indicador de las consecuencias metabólicas de la obesidad en comparación al índice de masa corporal (IMC) y se ha asociado a EII más complicada y peor evolución natural. Con respecto a la terapia, los pacientes con mayor IMC tienen con mayor frecuencia, dosis subóptima de los fármacos, y en terapia biológica, la obesidad aumenta la probabilidad de crisis, pérdida de respuesta al fármaco u optimización de la terapia. Los pacientes obesos requieren cirugía relacionada a EII antes que los pacientes no obesos, presentan más complicaciones postoperatorias y el TAV es un factor de riesgo independiente para recurrencia postoperatoria en EC. Todos estos resultados sugieren que la obesidad influye en la EII, por lo que una intervención activa y multidisciplinaria pudiese mejorar también los resultados en la enfermedad intestinal.


Subject(s)
Humans , Inflammatory Bowel Diseases/complications , Inflammatory Bowel Diseases/epidemiology , Obesity/complications , Obesity/epidemiology , Inflammatory Bowel Diseases/physiopathology , Inflammatory Bowel Diseases/therapy , Colitis, Ulcerative , Crohn Disease , Comorbidity , Risk Factors , Intra-Abdominal Fat , Obesity/physiopathology , Obesity/therapy
12.
Rev. méd. Chile ; 143(7): 834-840, jul. 2015. graf, tab
Article in Spanish | LILACS | ID: lil-757906

ABSTRACT

Background: The chronic inflammation of the intestinal mucosa, the extra-intestinal manifestations of the disease and the immunosuppressive treatment of inflammatory bowel disease may increase cancer risk. Aim: To report the demographic and clinical features of patients with IBD who developed a malignant tumor. Material and Methods: Retrospective analysis of an IBD patient registry of a private clinic, diagnosed between 1976 and 2014. Results: 437 subjects were included, aged 15-88 years (58% women). Seventy two percent of patients had ulcerative colitis. The median time of follow up was 6 years. Ten patients (2.3%) developed a malignant tumor. In four, the tumor could be related to IBD (two colorectal cancers, one cholangiocarcinoma and one chronic myeloid leukemia (CML)). Two of 45 patients treated with biological therapy developed a tumor (CML and hypernephroma). Three of 170 patients on immunosuppressive treatment developed tumors. Only one had a tumor possibly related with the use of azathioprine (non-melanoma skin cancer). In only two patients, the treatment was changed at the time of their cancer diagnosis, from immunosuppressive medications to mesalamine. Conclusions: Only a small proportion of these patients with IBD developed a malignant tumor. The treatment of IBD has to be determined by the severity of the disease and not by the fear of developing a neoplasia. Following recommendations is fundamental to decrease the possibility of developing this complication.


Subject(s)
Adolescent , Adult , Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Young Adult , Colorectal Neoplasms/etiology , Inflammatory Bowel Diseases/complications , Biological Therapy/adverse effects , Cohort Studies , Chile/epidemiology , Colitis, Ulcerative/complications , Colorectal Neoplasms/classification , Colorectal Neoplasms/epidemiology , Crohn Disease/complications , Immunosuppressive Agents/adverse effects , Inflammatory Bowel Diseases/drug therapy , Inflammatory Bowel Diseases/epidemiology , Risk Factors
13.
J. bras. med ; 102(4)julho - agosto 2014. graf, ilus, tab
Article in Portuguese | LILACS | ID: lil-725929

ABSTRACT

Retocolite ulcerativa inespecífica (RCU) e doença de Crohn (DC) são consideradas as principais doenças inflamatórias intestinais idiopáticas (DIIs). De etiologia ainda desconhecida, evoluem, clinicamente, por surtos recorrentes, intercalando episódios de atividade inflamatória, acompanhados de manifestações digestivas e extradigestivas, com períodos de remissão, ambos imprevisíveis...


Nonspecific ulcerative recolitis (NUC) and Chron's Disease (CD) are considered the mainly idiopathic inflammatory bowel disease (IBD). Etiology unknown, the nonspecific ulcerative recolitis has a clinical proceed, by recurrent outbreaks, episodes of intercalated inflammatory activity, following by digestive and extra digestive symptoms, with period of remission, both of them are unpredictable...


Subject(s)
Humans , Male , Female , Inflammatory Bowel Diseases/diagnosis , Inflammatory Bowel Diseases/epidemiology , Inflammatory Bowel Diseases/therapy , Anemia/etiology , Appendectomy/adverse effects , Colitis, Ulcerative/diagnosis , Adrenal Cortex Hormones/therapeutic use , Diagnosis, Differential , Diagnostic Imaging , Diagnostic Techniques, Digestive System , Disease Outbreaks , Crohn Disease/diagnosis , Smoking/adverse effects , Immunosuppressive Agents/therapeutic use , Salicylates/therapeutic use , Clinical Laboratory Techniques
14.
Rev. méd. Chile ; 142(8): 1006-1013, ago. 2014. graf, tab
Article in Spanish | LILACS | ID: lil-728349

ABSTRACT

Background: The incidence and prevalence of Inflammatory Bowel Disease (IBD) has increased. Aim: To determine demographic and clinical characteristics of patients with IBD in a Chilean private hospital. Patients and Methods: Review of a prospective registry of patients with IBD, started on 2012. It includes clinical, imaging, endoscopical and pathological information of patients. Results: Data of 316 patients with IBD, aged 16 to 86 years (56% females), were analyzed. Ulcerative Colitis (UC), Crohn´s and non-classifiable IBD were diagnosed in 230, 77 and 9 patients, respectively. The disease was diagnosed in 82% of patients in the period between 2002 and 2012. There was a peak in the diagnosis of both UC and CD between 20 and 39 years of age, without gender differences. The disease switched from UC to CD in six patients. In four, there was a change in disease behavior. Thirty eight patients were treated with biological therapy. The median lapse between the diagnosis and the use of biological therapy was 1 year in patients diagnosed after 2007, compared with 5.5 years among those patients diagnosed before 2007 (p = 0.001). There was a trend towards a higher requirement of surgery until 2006. Subsequently there was a stabilization of the requirement, concomitant with the incorporation of biological therapy. Conclusions: An adequate registry of IBD patients is necessary to improve demographic and clinical characteristics. A national registry is needed to assess the epidemiological changes of IBD in Chile.


Subject(s)
Adolescent , Adult , Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Young Adult , Inflammatory Bowel Diseases , Age Distribution , Cohort Studies , Chile/epidemiology , Inflammatory Bowel Diseases/diagnosis , Inflammatory Bowel Diseases/epidemiology , Inflammatory Bowel Diseases/therapy , Severity of Illness Index
15.
Säo Paulo med. j ; 132(3): 140-146, 14/abr. 2014. tab
Article in English | LILACS | ID: lil-710419

ABSTRACT

CONTEXT AND OBJECTIVES: Anemia is the most frequent extraintestinal complication of inflammatory bowel disease. This study aimed to: 1) determine the prevalence of anemia among patients with inflammatory bowel disease; 2) investigate whether routine laboratory markers are useful for diagnosing anemia; and 3) evaluate whether any association exists between anemia and clinical/laboratory variables. DESIGN AND SETTING: Cross-sectional at a federal university. METHODS: 44 outpatients with Crohn's disease and 55 with ulcerative colitis were evaluated. Clinical variables (disease activity index, location of disease and pharmacological treatment) and laboratory variables (blood count, iron laboratory, vitamin B12 and folic acid) were investigated. RESULTS: Anemia and/or iron laboratory disorders were present in 75% of the patients with Crohn's disease and in 78.2% with ulcerative colitis. Anemia was observed in 20.5% of the patients with Crohn's disease and in 23.6% with ulcerative colitis. Iron-deficiency anemia was highly prevalent in patients with Crohn's disease (69.6%) and ulcerative colitis (76.7%). Anemia of chronic disease in combination with iron deficiency anemia was present in 3% of the patients with Crohn's disease and in 7% of the patients with ulcerative colitis. There was no association between anemia and disease location. In ulcerative colitis, anemia was associated with the disease activity index. CONCLUSIONS: Most patients present iron laboratory disorders, with or without anemia, mainly due to iron deficiency. The differential diagnosis between the two most prevalent types of anemia was made based on clinical data and routine laboratory tests. In ulcerative colitis, anemia was associated with the disease activity index. .


CONTEXTO E OBJETIVOS: Anemia é a mais frequente complicação extraintestinal na doença inflamatória intestinal. Este estudo objetivou: 1) determinar a prevalência de anemia em portadores de doença inflamatória intestinal; 2) investigar se os marcadores laboratoriais de uso rotineiro são úteis para o diagnóstico da anemia; 3) avaliar se existe associação entre anemia e variáveis clínico-laboratoriais. TIPO DE ESTUDO E LOCAL: Estudo transversal em uma universidade federal. MÉTODOS: Foram avaliados 44 pacientes ambulatoriais com doença de Crohn e 55 com retocolite ulcerativa. Foram investigados aspectos clínicos (índice de atividade da doença, localização da doença e tratamento farmacológico) e laboratoriais (hemograma, ferrocinética, vitamina B12 e ácido fólico). RESULTADOS: Anemia e/ou anormalidades na ferrocinética estavam presentes em 75% dos pacientes com doença de Crohn e em 78,2% dos pacientes com retocolite. Anemia foi observada em 20,5% do grupo com doença de Crohn e em 23,6% do grupo com retocolite. Anemia por deficiência de ferro predominou entre os pacientes com doença de Crohn (69,6%) e com retocolite (76,7%). Anemia de doença crônica associada à anemia ferropriva estava presente em 3% dos pacientes com doença de Crohn e em 7% daqueles com retocolite. Na retocolite, a anemia estava associada com o índice de atividade da doença. CONCLUSÕES: A maioria dos pacientes apresentava alterações na ferrocinética com ou sem anemia, principalmente decorrente da ferropenia. O diagnóstico diferencial entre os dois tipos mais prevalentes de anemia foi baseado nos dados clínicos e nos testes laboratoriais de rotina. Anemia estava associada com o índice de atividade na retocolite. .


Subject(s)
Adolescent , Adult , Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Young Adult , Anemia, Iron-Deficiency/etiology , Colitis, Ulcerative/complications , Crohn Disease/complications , Iron/blood , Anemia, Iron-Deficiency/blood , Anemia, Iron-Deficiency/diagnosis , Anemia, Iron-Deficiency/epidemiology , Anemia/diagnosis , Anemia/epidemiology , Anemia/etiology , Blood Cell Count , Biomarkers/blood , Brazil/epidemiology , Cross-Sectional Studies , Colitis, Ulcerative/diagnosis , Colitis, Ulcerative/epidemiology , Crohn Disease/diagnosis , Crohn Disease/epidemiology , Diagnosis, Differential , Inflammatory Bowel Diseases/complications , Inflammatory Bowel Diseases/diagnosis , Inflammatory Bowel Diseases/epidemiology , Iron/deficiency , Prevalence
16.
Braz. j. infect. dis ; 18(1): 60-64, Jan-Feb/2014. tab
Article in English | LILACS | ID: lil-703052

ABSTRACT

Objective: Inflammatory bowel disease (IBD) is a chronic disorder involving the gastrointestinal tract. Immunosuppressive drugs are usually prescribed to treat IBD patients, and this treatment can lead to tuberculosis reactivation. This paper aimed to analyze tuberculin skin test (TST) results in IBD patients at a reference center in Brazil. Methods: We evaluated TST results in IBD patients using a cross-sectional study. We also analyzed the medical records of patients treated at a reference IBD outpatient unit where TST is routinely performed. Results: We reviewed 119 medical records of 57 (47.9%) Crohn's disease (CD), 57 (47.9%) ulcerative colitis (UC) and 5 (4.2%) indeterminate colitis (IC) patients. The mean (SD) age was 43.5 (13.7) years old. TST was positive in 24 (20.2%) of the patients. TST was positive in 16/57 (28.1%) UC and 6/57 (10.5%) CD patients (prevalence ratio [PR] 2.7). Forty-one patients (34.5%) were taking immunosuppressive drugs (azathioprine or prednisone) at the time of the TST, and six of these patients (14.6%) had positive test results. Two patients using infliximab had negative TST results. Thirty-five of the 41 patients (85.4%) on immunosuppressive treatment were anergic compared with 73.1% (57/78) of the untreated patients (PR 1.2). Conclusions: Patients with IBD have TST results similar to the general Brazilian population. Within the IBD population, CD patients have a lower frequency of TST positivity than UC patients. .


Subject(s)
Adult , Female , Humans , Male , Middle Aged , Endemic Diseases , Inflammatory Bowel Diseases , Tuberculin Test , Tuberculosis/diagnosis , Brazil/epidemiology , Cross-Sectional Studies , Colitis, Ulcerative/epidemiology , Colitis, Ulcerative/immunology , Crohn Disease/epidemiology , Crohn Disease/immunology , Inflammatory Bowel Diseases/epidemiology , Inflammatory Bowel Diseases/immunology
17.
Recife; s.n; 2014. 84 p. ilus.
Thesis in Portuguese | LILACS | ID: lil-720604

ABSTRACT

Fatores genéticos e imunológicos foram associados à patogenese da doença inflamatória intestinal (DII), ela inclui Retocolite Ulcerativa Idiopática (RCUI) e doença de Crohn (CD). A hiperresponsividade de celulas B e a autoreatividade de células T contribuem para a polarização da resposta imune Th1 em CD e Th2 em RCUI. Sítios polimórficos na região 3'não traduzida do gene HLA-G (completa) e região promotora dos genes IL-10 ( - 1082A/G e - 819C/T) e TNF (completa) foram associados a susceptibilidade a diversas doenças. Estudamos 217 portadores de DII e 249 doadores saudáveis, pareados por sexo e idade. A ascendência africana foi maior em RCUI e caucasiana em DC (p =0,005). Comparados aos controles, o genótipo HLA - G 14bpINS - INS (associado com baixa expressão de HLA - G) (p =0,006) e IL - 10 - 1082G - G (associado com alta expressão de IL - 10) (p =0,030) foram menos frequentes em pacientes com DC, possivelmente contribuindo para a polarização Th1, mas não foram encontradas diferenças nas frequências de TNF. Em RCUI, as frequências do alelo HLA-G +3003C (p =0,015) e genótipo +3003C-T (p =0,003) estavam aumentadas. Apesar da alta frequência do alelo T em africanos, após estratifica rmos por ascendência, o genótipo +3003C - T ainda estava mais frequente em pacientes com ascendência africana (p =0,012)...


Genetic and immunological factors have been associated with inflammatory bowel disease (IBD) pathogenesis, encompassing ulcerative colitis (UC) and Crohn's disease (CD).B cell hyperresponsiveness and T cell auto-reactivity have contributedto a Th1 polarization immune response in CD and a Th2 polarization in UC. Sincepolymorphic sites at the 3’untranslated region (3’UTR)...


Subject(s)
Colitis, Ulcerative/genetics , Colitis, Ulcerative/immunology , Crohn Disease/genetics , Crohn Disease/immunology , Inflammatory Bowel Diseases/epidemiology , Inflammatory Bowel Diseases/genetics , Inflammatory Bowel Diseases/immunology , HLA Antigens/genetics , HLA Antigens/immunology , Tumor Necrosis Factor-alpha/genetics , Tumor Necrosis Factor-alpha/immunology , /genetics , /immunology
18.
Rev. cuba. invest. bioméd ; 31(4): 490-500, oct.-dic. 2012.
Article in Spanish | LILACS | ID: lil-660160

ABSTRACT

Es frecuente que en pacientes con enfermedad inflamatoria intestinal se observen cambios analíticos o clínicos que indican la existencia de una enfermedad hepatobiliar. La frecuencia de estos hallazgos oscila entre 11-49 porciento en colitis ulcerosa y entre 15-30 porciento en enfermedad de Crohn. En algunos casos, estas alteraciones se observan desde el primer momento en que se estudia a los pacientes, otras surgen en el curso de la enfermedad. Se realizó un estudio descriptivo observacional retrospectivo donde se incluyó 180 pacientes con enfermedad inflamatoria intestinal, que se atienden en el Instituto de Gastroenterología, de ellos con manifestaciones hepatobiliares, 17 pacientes (9,4 porciento), 12 colitis ulcerosa y 5 Crohn. Las variables estudiadas fueron: sexo, edad, años de evolución según tipo de enfermedad inflamatoria, tipo de manifestación hepatobiliar, síntomas clínicos, estudio de enzimas hepáticas y hallazgos ultrasonográficos. Se concluyó que existe predominio de pacientes con colitis ulcerosa. Predominó el sexo femenino en la colitis ulcerosa; el Crohn no tuvo variaciones significativas. La edad estuvo comprendida entre 30 y 49 años. La manifestación hepatobiliar más frecuente en el Crohn fue la hepatopatía de etiología no filiada y en la colitis ulcerosa la colangitis esclerosante primaria. El síntoma clínico que predominó en ambos grupos fue la astenia, y en la colitis ulcerosa también predominó el prurito e íctero. Con respecto a las enzimas bioquímicas predominó la hipertransaminasemia, y por ultrasonido el aspecto granular y aumento de la ecogenicidad hepática


It is common for patients with inflammatory bowel disease to present analytical or clinical changes pointing to the presence of hepatobiliary disease. The frequency of such findings ranges between 11-49 percent in ulcerous colitis and between 15-30 percent in Crohn's disease. In some cases, the alterations are found when the patient is first examined, while in others they emerge during the course of the disease. An observational retrospective descriptive study was conducted of 180 patients with inflammatory bowel disease cared for at the Institute of Gastroenterology. Hepatobiliary manifestations were found in 17 patients (9.4 percent): 12 with ulcerous colitis and 5 with Crohn's disease. The variables studied were sex, age, years of evolution by type of inflammatory disease, type of hepatobiliary manifestation, clinical symptoms, study of hepatic enzymes and ultrasonographic findings. There was a predominance of patients with ulcerous colitis. Female sex prevailed in ulcerous colitis. No significant differences were found in Crohn's disease. Age ranged between 30-49. The most common hepatobiliary manifestations were liver disease of unknown etiology in Crohn's disease and primary sclerosing cholangitis in ulcerous colitis. The prevailing clinical symptom in both groups was asthenia. Pruritus and jaundice were also predominant in ulcerous colitis. With respect to biochemical enzymes, there was a predominance of hypertransaminasemia. Ultrasonographically, a granular aspect and increased hepatic echogenicity were the prevailing features


Subject(s)
Inflammatory Bowel Diseases/epidemiology , Liver Diseases/pathology , Gallbladder/pathology , Epidemiology, Descriptive , Observational Studies as Topic , Retrospective Studies
19.
Article in English | IMSEAR | ID: sea-156306

ABSTRACT

Background. A misconception that milk and lactose intolerance increases disease activity in inflammatory bowel disease leads to the exclusion of dietary dairy products, and patients are at an increased risk of low bone mineral density. Methods. Patients with inflammatory bowel disease (n=45, 19 men and 26 women) and healthy controls were included in this prospective open-label study. As part of exploratory dietary intervention, patients were advised to exclude milk and milk products from diet for the first 7 days and reintroduce at least 250 ml of milk for the next 21 days. Milk and lactose intolerance was assessed in patients and healthy subjects using clinical symptoms and lactose hydrogen breath test, respectively; bone mineral density was assessed in patients using a Hologic QDR 4500A DXA machine. Results. Milk and lactose intolerance was statistically comparable in patients with inflammatory bowel disease (31% and 44%, respectively) and healthy subjects (22% and 27%, respectively). Most of the patients (40%) had excluded dairy products from their diet, and 53% had dietary intake of calcium <200 mg/day. More than 60% of the patients had either osteopenia or osteoporosis. Conclusion. Milk and lactose intolerance in patients with inflammatory bowel disease was not different from that in healthy subjects. The proportion of patients with osteoporosis and osteopenia was high in this population. Hence, patients with inflammatory bowel disease in remission phase may be encouraged to add dairy products in their diet, unless otherwise indicated.


Subject(s)
Bone Density , Bone Diseases, Metabolic/epidemiology , Humans , India , Inflammatory Bowel Diseases/epidemiology , Lactose Intolerance/epidemiology , Osteoporosis/epidemiology , Pilot Projects , Prospective Studies
20.
Rev. bras. colo-proctol ; 31(2): 115-119, abr.-jun. 2011.
Article in Portuguese | LILACS | ID: lil-599907

ABSTRACT

A doença inflamatória intestinal idiopática (DII) representa um grupo de condições inflamatórias crônicas, resultantes de ativação persistente e inadequada do sistema imune mucoso. Além dos sintomas intestinais característicos, as DII podem se manifestar através de uma série de manifestações extraintestinais (MEI). Objetivos: Avaliar a incidência das MEI das doenças inflamatórias intestinais no Hospital Universitário da Universidade Federal de Sergipe; diagnosticar as MEI das DII; instituir o tratamento adequado dos pacientes portadores dessas manifestações. Métodos: Foi aplicado um protocolo para diagnóstico das MEI; quando necessário os pacientes foram encaminhados para as respectivas especialidades. Resultados: Foram catalogados 49 pacientes portadores de DII; destes, 41 (83,6 por cento) apresentaram MEI. As MEI reumatológicas foram as mais frequentes, acometendo 35 pacientes. O restante das MEI foram assim distribuídas: um caso de MEI dermatológica; um caso de MEI urológica; um caso MEI pneumológica; quatro casos de MEI oftalmológicas; oito casos de MEI hepáticas. Conclusões: As MEI têm alta incidência (I=83,6 por cento) entre os pacientes portadores de DII; as MEI tiveram incidência semelhante entre os pacientes portadores de retocolite ulceratica idiopática e de Crohn; o início das MEI foi mais comum após o diagnóstico da DII; a classe de MEI mais prevalente foi a reumatológica (P=71,4 por cento).


Idiopathic inflammatory bowel disease (IBD) represents a group of chronic inflammatory conditions, resulting from persistent and inappropriate activation of mucosal immune system. Besides the typical intestinal symptoms, the IBD can manifest itself through a series of extraintestinal manifestations (EIM). Objectives: To evaluate the incidence of EIM in the Hospital Universitario of Universidade Federal de Sergipe; to diagnose EIM of IBD; to institute the appropriate treatment of patients with these manifestations. Methods: We applied a protocol for diagnosis of EIM; when necessary, patients were referred to their specialities. Results: We categorized 49 patients with IBD, whose 41 (83.6 percent) had EIM. The rheumatologics EIM were the most frequent, affecting 35 patients. The others EIM were distributed as follows: one case of dermatological EIM; one case of urologic EIM, one case of pulmonology EIM, four cases of ophthalmic EIM; eight cases of hepatic EIM. Conclusions: The EIM have a high incidence (I=83.6 percent) among patients with IBD; the EIM had similar incidence among patients with ulcerative colitis and Crohn's disease. The beginning of EIM was more common after the diagnosis of IBD; the rheumatologic EIM was most prevalent (P=71.4 percent).


Subject(s)
Humans , Inflammatory Bowel Diseases/diagnosis , Inflammatory Bowel Diseases/epidemiology , Colonic Diseases/pathology , Proctocolitis , Cohort Studies , Data Collection
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