Vasculitis in patients with inflammatory bowel diseases: A study of 32 patients and systematic review of the literature

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• 作者：Alice Sy ; MD^a ; Nader Khalidi ; MD^b ; Natasha Dehghan ; MD^c ; Lillian Barra ; MD ; MPH^d ; Simon Carette ; MD^a ; David Cuthbertson ; MS^e ; Gary S. Hoffman ; MD^f ; Curry L. Koening ; MD^g ; Carol A. Langford ; MD^f ; Carol McAlear ; MA^h ; Larry Moreland ; MDⁱ ; Paul A. Monach ; MD ; PhD^j ; ^k ; Philip Seo ; MD^l ; Ulrich Specks ; MD^m ; Antoine Sreih ; MD^h ; Steven R. Ytterberg ; MDⁿ ; Gert Van Assche ; MD ; PhD^o ; Peter A. Merkel ; MD ; MPH^h ; Christian Pagnoux ; MD ; MSc ; MPH^a ; ^{cpagnoux@msn.com" class="auth_mail" title="E-mail the corresponding author} ; ^{cpagnoux@mtsinai.on.ca" class="auth_mail" title="E-mail the corresponding author} ; Vasculitis Clinical Research Consortium (VCRC) ; the Canadian Vasculitis Network (CanVasc)
• 关键词：Vasculitis ; Takayasu arteritis ; Inflammatory bowel disease ; Crohn&rsquo ; s disease ; Ulcerative colitis
• 刊名：Seminars in Arthritis and Rheumatism
• 出版年：2016
• 出版时间：February 2016
• 年：2016
• 卷：45
• 期：4
• 页码：475-482
• 全文大小：296 K

文摘

Published small case series suggest that inflammatory bowel disease [IBD; Crohn’s disease (CD) or ulcerative colitis (UC)] and vasculitis co-occur more frequently than would be expected by chance.

Objectives

To describe this association by an analysis of a large cohort of carefully studied patients and through a systematic literature review.

Methods

Patients with both IBD and vasculitis enrolled in the Vasculitis Clinical Research Consortium (VCRC) Longitudinal Studies, followed in Canadian Vasculitis research network (CanVasc) centers and/or in the University of Toronto’s IBD clinic were included in this case series. A systematic literature review of patients with IBD and vasculitis involved a PubMed search through February 2014. The main characteristics of patients with Takayasu arteritis (TAK) and IBD were compared to those in patients with TAK without IBD followed in the VCRC.

Results

The study identified 32 patients with IBD and vasculitis: 13 with large-vessel vasculitis [LVV; 12 with TAK, 1 with giant cell arteritis (GCA); 8 with CD, 5 with UC]; 8 with ANCA-associated vasculitis [AAV; 6 granulomatosis with polyangiitis (GPA), 2 with eosinophilic granulomatosis with polyangiitis (EGPA)]; 5 with isolated cutaneous vasculitis; and 6 with other vasculitides. Patients with LVV and AAV were mostly female (18/21). The diagnosis of IBD preceded that of vasculitis in 12/13 patients with LVV and 8/8 patients with AAV. The review of the literature identified 306 patients with IBD and vasculitis: 144 with LVV (133 TAK; 87 with IBD preceding LVV), 19 with AAV [14 GPA, 1 EGPA, 4 microscopic polyangiitis (MPA)], 66 with isolated cutaneous vasculitis, and 77 with other vasculitides. Patients with IBD and TAK were younger and had more frequent headaches, constitutional symptoms, or gastrointestinal symptoms compared to those patients in the VCRC who had TAK without IBD.

Conclusions

These findings highlight the risk of vasculitis, especially TAK, in patients with IBD (both CD and UC).