Lege Artis Medicinae

[Extraintestinal manifestations in inflammatory bowel diseases]

LAKATOS László

APRIL 20, 2003

Lege Artis Medicinae - 2003;13(03)

[Inflammatory bowel diseases (IBD) are systemic disorders. Bowel symptoms are the predominant manifestations, however during the course of the disease a lot of intestinal and extraintestinal complications may occur. Systemic complications are responsible for substantial co-morbidity and they have negative influence on the quality of life. A part of the extraintestinal symptoms seem to have common pathogenetic background with IBD, while others are the consequences of subsequent metabolic and endocrine abnormalities or may relate to local complications and adverse effects of treatment. Growing evidence is available on the role of genetic and immunologic factors in the pathogenesis of extraintestinal manifestations. Most important systemic complications are: peripheral and axial arthritides, osteoporosis, uveitis, erythema nodosum, pyoderma gangraenosum, primary sclerosing cholangitis, nonalcoholic steatohepatitis, different types of anaemia, thromboembolism, kidney stones and urinary complications. Cooperation with the specialists is very important in the diagnosis and treatment of these comlications. During followup of IBD patients special attention is needed to monitor possible extraintestinal manifestations.]

COMMENTS

0 comments

Further articles in this publication

Lege Artis Medicinae

[Pacemaker therapy - New indications]

VERESS Gábor

[This article details the classical and newer clinical applications of pacing, i. e. the use of permanent pacing for patients with hypertrophic cardiomyopathy, dilated cardiomyopathy, prevention of atrial fibrillation and pacing in long QT syndrome. The cornerstone of definitive pacemaker therapy is the establishement of correct indication and the optimal selection of pacemaker modality which significantly improve the quality of life of patients. The use of combinations of sensors balancing the strengths and weakness of each represents a logical step toward the optimization of rate responsing pacing. Reliable automatic functions have been incorporated in modern pacemakers to improve the efficiency and quality of life of patients.]

Lege Artis Medicinae

[VIII. National Congress on Antibiotics]

SZÉKELY Éva

Lege Artis Medicinae

[Benefit of combined clopidogrel-aspirin platelet aggregation inhibition in acute coronary syndrome and after percutaneous coronary angioplasty]

KELTAI Mátyás

[Platelet aggregation inhibition is equally important both in conservative and interventional cardiological treatment of acute coronary syndrome. Recently, results from three important trial were published. All three proved the efficacy of the combined aspirin + clopidogrel treatment. The basic results of the three clinical trials (CURE, PCI-CURE, CREDO) are summarized in the article. In the CURE trial the combined primary endpoint was reached in 11.4% of the patients in the control group and in 9.3% in the clopidogrel group. The relative risk reduction was 20%. The combined primary endpoint included CV mortality, MI and stroke. The treatment effect was mostly detectable in the prevention of MI and stroke. In the PCI-CURE trial 2658 patients of the CURE trial were analysed. All of them were treated by coronary angioplasty. In this group the primary endpoint (CV death, nonfatal MI, urgent revascularisation) was reached in 6.4% of the aspirin treated and in 4.5% of the aspirin + clopidogrel treated patients. The relative risk reduction was 30%. The CREDO trial investigated patients after coronary angioplasty. The indication of angioplasty was either acute or chronic. All patients received combined aspirin + clopidogrel but only for four weeks in the control group or for one year in the treatment group. The combined primary endpoint was decreased by 26.9%. In all the 3 trials the risk of bleeding was slightly but significantly increased by the combined aspirin + clopidogrel treatment. Clinical application: based on the results of the 3 trials it is concluded that combined aspirin + clopidogrel treatment is indicated in all patients with acute coronary syndrome, independently from the treatment strategy. The treatment should be continued for one year. This is also applicable for all patients treated with coronary angioplasty.]

Lege Artis Medicinae

[The benefit and application of the second generation antipsychotic drugs]

FÜREDI János

Lege Artis Medicinae

[A part and the whole]

KAPÓCS Gábor

All articles in the issue

Related contents

Lege Artis Medicinae

[The role of vitamin D in gastrointestinal diseases]

ZÖLD Éva, BODOLAY Edit, ZEHER Zargit, BARTA Zsolt

[The amount of the fat-soluble vitamin D can be reduced by a number of chronic diseases or even obesity. On the other hand, vitamin D itself can also influence the development or course of these disorders. Some gastrointestinal diseases are known to cause vitamin D deficiency, but some observations and studies have also proved that certain gastrointestinal diseases occur more frequently in case of vitamin D deficiency. Moreover, in case of some intestinal tumours even “vitamin D sensitivity” can occur. Our aim is to introduce the relationship between vitamin D and gastrointestinal diseases, and to highlight the importance of vitamin D replacement in gastrointestinal diseases accompanied by vitamin D deficiency or vitamin D sensitivity.]

Hungarian Immunology

[Pathomechanism of Crohn’s disease and ulcerative colitis]

GÁL István, CSIKI Zoltán, SZEGEDI László, KISS Gyula

[The two archetypes of inflammatory bowel diseases, Crohn’s disease (CD) and ulcerative colitis (UC) have a considerably high prevalence and chronic morbidity, and thereby a striking public health relevance amongst the maladies involving the gastrointestinal tract. Unveiling their pathogenesis can be the key for the development of successful therapeutic approaches. Our view of these diseases has undergone radical changes in the past few years, and the latest discoveries have shed new light upon their pathomechanism. A multifactorial view is appropriate when explaining their pathogenesis, although certain factors are seemingly of particular importance.]

Lege Artis Medicinae

[INFLAMMATORY BOWEL DISEASE IN CHILDREN]

BODÁNSZKY Hedvig, VERES Gábor

[The term inflammatory bowel disease includes two similar, but distinct intestinal diseases so far of unknown ethiology - ulcerative colitis and Crohn’s disease. They used to be considered diseases of young adults, but in recent decades they have become more common among children, with characteristics different from those in adults. In the past they were considered severe, incurable diseases, but today, owing to modern nutrition, medical and surgical treatment, both diseases have became well manageable, even though complete recovery can not yet be expected.]

Lege Artis Medicinae

[THE GENETICS OF INFLAMMATORY BOWEL DISEASE]

LAKATOS Péter László, LAKATOS László

[The pathogenesis of inflammatory bowel disease is only partly understood; various environmental and host factors (e.g., genetic, epithelial, immune and non-immune) are involved. It is a multifactorial polygenic disease probably with genetic heterogeneity; some genes confer susceptibility to IBD in general, while others specifically increase the risk of ulcerative colitis or Crohn's disease or affect location (localized or extensive) and/or behaviour (e.g., mild, severe, aggressive). This review presents recent advances in the genetics of inflammatory bowel disease including chromosome segments newly recognized to be involved in inflammatory bowel disease as well as the role of NOD2/CARD15, SLC22A4/A5 and DLG5. The increasing genetic information provides, for the time being, a better understanding of the pathogenesis of the disease thus setting a basis for potential targets for therapeutic intervention. In the future, however, genetics may also help in refining the diagnosis or predicting disease course.]

Clinical Neuroscience

[Tension-type headache in ulcerative colitis]

TAJTI Jr. János, LÁTOS Melinda, ÁBRAHÁM Szabolcs, SIMONKA Zsolt, PASZT Attila, LÁZÁR György

[Background and purpose - Tension-type headache is a very common disease with a high socio-economic impact as its lifetime prevalence is 30-78% in the general population. The incidence of inflammatory bowel diseases is continuously rising. Limited data are accessible on quality of life in patients with surgically treated ulcerative colitis. The aim of our study is to examine quality of life, concerning headache, among patients who had undergone surgery due to ulcerative colitis. Methods - Between 1 January 2005 and 1 March 2016, surgery was performed due to ulcerative colitis in 75 patients. During this retrospective analysis the average duration of the follow-up was 46 (1-124) months. The pre-sence of headache was evaluated by the use of Brief Illness Perception and Headache Questionnaires. Results - Among the primary headache disorders (n=27), tension-type headache occurred in 19 (70.4%) cases, and 8 (29.6%) patients had migraine (without aura). Among tension-type headache cases 17 (89.5%) patients experienced episodic form and 2 (10.5%) suffered from chronic form. Patients with headache had obtained a significantly higher score on Brief Illness Perception Questionnaire. Conclusions - According to our study tension-type headache is common among patients with ulcerative colitis. This observation raises the question whether stress plays role in the pathogenesis of both diseases, which influences and worsens considerably quality of life. Neurological examination, psychological and psychiatric guidance are worth considering in patients with ulcerative colitis.]