extraintestinal manifestations
Last reviewed 05/2022
Common in Crohn’s disease with around 35% patients being affected (1).
It is more common with colonic Crohn's disease, but they may be present in any subtype (2).
Extraintestinal manifestations seen in Crohn’s disease include:
- mild iron-deficiency anaemia secondary to blood loss
- arthritis; ankylosing spondylitis is associated with Crohn's disease due to the common HLA-B27 antigen
- arthralgia
- clubbing
- skin tags
- hepatobiliary disease, ranging from pericholangitis to cirrhosis
- erythema nodosum
- megaloblastic anaemia
- pyoderma gangrenosum
- uveitis and episcleritis (1)
- rarely, amyloidosis as a result of long-standing Crohn's disease
- rarely granulomatous cheilitis may be a presenting feature of Crohn's Disease
- venous thromboembolism (1)
Extraintestinal manifestations may
- be related temporally to CD activity e.g. - Peripheral arthritis, erythema nodosum, oral aphthous ulcers and episcleritis
- occur independently e.g. - pyoderma gangrenosum, uveitis, axial arthropathy and primary sclerosing cholangitis (1)
Perianal fistulas are present in 10% of patients at the time of diagnosis, and may be the presenting complaint (2).
Reference:
- (1) Van Assche G et al. The second European evidence-based consensus on the diagnosis and management of Crohn's disease: Special situation. Journal of Crohn's and Colitis 2010; 4:63-101
- (2) Van Assche G et al. The second European evidence-based consensus on the diagnosis and management of Crohn's disease: Definitions and diagnosis. Journal of Crohn's and Colitis 2010; 4:7–27