Extraintestinale Manifestationen und Begleiterkrankungen entzündlicher Darmerkrankungen

  • Guido Adler

Zusammenfassung

Bei Morbus Crohn und Colitis ulcerosa treten zahlreiche Symptome in verschiedenen Organsystemen auf, die entweder extraintestinale Manifestationen, Komplikationen, Folgekrankheiten oder Nebenwirkungen der Therapie darstellen oder zufällig assoziiert sind. Ätiologie, Pathogenese und Zusammenhang mit der chronisch-entzündlichen Darmerkrankung sind häufig nicht bekannt.

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

Literatur

  1. Greenstein AJ, Janowitz HD, Sachar DB (1976) The extra-intestinal complications of Crohn’s disease and ulcerative Colitis: a study of 700 patients. Medicine 55: 401–412PubMedCrossRefGoogle Scholar
  2. Hyams JS (1994) Extraintestinal manifestations of inflammatory bowel disease in children. J Pediatr Gastroenterol Nutr 19: 7–21PubMedCrossRefGoogle Scholar
  3. Monsen U, Sorstad J, Hellers G et al. (1991) Extracolonic diagnoses in ulcerative Colitis: an epidemiological study. Am J Gastroenterol 85: 711–716Google Scholar
  4. Rankin GB (1991) Extraintestinal and systemic manifestations of inflammatory bowel disease. Med Clin North Am 74: 39–50Google Scholar

Kutane Manifestationen

  1. Apgar JT (1991) Newer aspects of inflammatory bowel disease and its cutaneous manifestations: a selective review. Semin Dermatol 10: 138–147PubMedGoogle Scholar
  2. Ballo FS, Camisa C, Allen CM (1989) Pyostomatitis vegetans. J Am Acad Dermatol 21: 381–387PubMedCrossRefGoogle Scholar
  3. Callen JP (1989) Pyoderma gangrenosum and related disorders. Med Clin North Am 73: 1247–1261PubMedGoogle Scholar
  4. Fenske NA, Gern JE, Pierce D, Vasey FB (1983) Vesiculopustular eruption of ulcerative Colitis. Arch Dermatol 119: 664–669PubMedCrossRefGoogle Scholar
  5. Gregory B, Ho VC (1992) Cutaneous manifestations of gastrointestinal disorders. Part II.J Am Acad Dermatol 26: 371–383CrossRefGoogle Scholar
  6. Gudbjornsson B, Hallgren R (1990) Cutaneous polyarteritis nodosa associated with Crohn’s disease. Report and review of the literature. J Rheumatol 17: 386–390Google Scholar
  7. Kemmett D, Hunter JAA (1990) Sweet’s Syndrome: a clinicopathologic review of twenty-nine cases. J Am Acad Dermatol 23: 508–507CrossRefGoogle Scholar
  8. Kirsch B, Gerhardt H, Gladisch R et al. (1992) Dermatosen bei chronisch entzündlichen Darmerkrankungen. Aktuelle Dermatol 18: 17–22Google Scholar
  9. Labeille B, Gineston J, Denoeux J et al. (1988) Epidermolysis bullosa acquista and Crohn’s disease. A case report with immunological and electron microscopic studies. Arch Intern Med 148: 1457–1459Google Scholar
  10. Plauth M, Jenss H, Meyle J (1991) Oral manifestations of Crohn’s disease. J Clin Gastroenterol 13: 29–37PubMedCrossRefGoogle Scholar
  11. Prokopetz R, Ross JB, Smith P et al. (1990) Multicentric cutaneous Crohn’s disease: a case report and review of literature. Can J Gastroenterol 4: 59–63Google Scholar
  12. Tjandra JJ, Hughes LE (1994) Parastomal pyoderma gangrenosum in inflammatory bowel disease. Dis Colon Rectum 37: 938–942PubMedCrossRefGoogle Scholar
  13. Tsianos EV, Dalekos GN, Tzermias C et al. (1995) Hidradenitis suppurative in Crohn’s disease - A further support to this association. J Clin Gastroenterol 20 (2) 151–153PubMedCrossRefGoogle Scholar

Arthropathien

  1. Gravallese EM, Kantrowitz FG (1988) Arthritic manifestation of inflammatory bowel disease. Am J Gastroenterol 83: 703–709PubMedGoogle Scholar
  2. Mielants H, Veys EM, Goethals K et al. (1990) Destructive lesions of the small joints in seronegative spondyloarthropathies: relation to gut inflammation. Clin Exp Rheumatol 8: 23–27PubMedGoogle Scholar
  3. Scarpa R, D’Arienzo A, DelPuente A et al. (1990) Reverse correlation between extent of colon involvement and number of affected joints in patients with ulcerative Colitis. Am J Gastroenterol 85: 331–332PubMedGoogle Scholar
  4. Weiner SR, Clarke J, Taggart NA et al. (1991) Rheumatic manifestations of inflammatory bowel disease. Semin Arthritis Rheum 20: 353–366CrossRefGoogle Scholar

Entzündliche Augenveränderungen

  1. Ernst BB, Lowder CY, Meisler DM et al. (1991) Posterior segment manifestations of inflammatory bowel disease. Ophtalmology 98: 1272–1280Google Scholar
  2. Ruby AJ, Jampol LM (1990) Crohn’s disease and retinal vascular disease. Am J Ophtalmol 110: 349–353Google Scholar
  3. Salmon JF, Wright JP, Murray ADN (1991) Ocular inflammation in Crohn’s disease. Ophtalmology 98: 480–484Google Scholar
  4. Soukiasian SH, Foster CS, Raizman MB (1994) Treatment strategies for scleritis and Uveitis associated with inflammatory bowel disease. Am J Ophtalmol 118: 601–611Google Scholar

Erkrankungen der Leber und der Gallenwege

  1. Beuers U, Spengler U, Kruis W et al. (1992) Ursodeoxycholic acid for treatment of primary sclerosing Cholangitis: a placebo-controlled trial. Hepatology 16: 707–714PubMedCrossRefGoogle Scholar
  2. Broomé U, Glaumann H, Hellers H et al. (1994) Liver disease in ulcerative Colitis: an epidemiological and follow up study in the county of Stockholm. Gut 35: 84–89PubMedCrossRefGoogle Scholar
  3. Esber EJ, Ferguson DR (1994) Primary sclerosing Cholangitis. Gastroenterologist 2: 131–146PubMedGoogle Scholar
  4. Lee Y-M, Kaplan MM (1995) Primary sclerosing Cholangitis. N Engl J Med 332: 924–933PubMedCrossRefGoogle Scholar
  5. Ludwig J (1991) Small-duct primary sclerosing Cholangitis. Semin Liver Dis 11: 11–17PubMedCrossRefGoogle Scholar
  6. Mandal A, Dasgupta A, Jeffers L et al. (1994) Autoantibodies in sclerosing Cholangitis against a shared peptide in biliary and colon epithelium. Gastroenterology 106: 185–192PubMedGoogle Scholar
  7. Mehal WZ. Lo YMD, Wordsworth BP et al. (1994) HLA DR4 is a marker for rapid disease progression in primary sclerosing Cholangitis. Gastroenterology 106: 160–167PubMedGoogle Scholar
  8. Rosen CB, Nagorney DM (1991) Cholangiocarcinoma complicating primary sclerosing Cholangitis. Semin Liver Dis 11: 26PubMedCrossRefGoogle Scholar
  9. Wever V, Gluud C, Schlichting P et al. (1991) Prevalence of hepatobiliary dysfunction in a regional group of patients with chronic inflammatory bowel disease. Scand J Gastroenterol 26: 97–102CrossRefGoogle Scholar

Vaskulitis

  1. Elburg RM van, Henar EL, Bijleveld MA et al. (1992) Vascular compromise prior to intestinal manifestations of Crohn’s disease in a 14-year-old girl. J Pediatr Gastroenterol Nutr 14: 97–100PubMedCrossRefGoogle Scholar
  2. Frid C, Bjarke B, Eriksson M (1986) Myocarditis in children with inflammatory bowel disease. J Pediatr Gastroenterol Nutr 5: 964–965PubMedCrossRefGoogle Scholar
  3. Gasser P, Affolter H, Schuppisser JP (1991) The role of nailbed vasospasm in Crohn’s disease. Int J Colorect Dis 6: 147–151CrossRefGoogle Scholar
  4. Gilliam III JH, Challa VR, Agudelo CA et al. (1981) Vasculitis involving muscle associated with Crohn’s Colitis. Gastroenterology 81: 787–790PubMedGoogle Scholar
  5. Johns DR (1991) Cerebrovascular complications of inflammatory bowel disease. Am J Gastroenterol 86: 367–370PubMedGoogle Scholar
  6. Murch SH, Braegger CP, Sessa WC et al. (1992) High endothelin-1 immunoreactivity in Crohn’s disease and ulcerative Colitis. Lancet 339: 381–385PubMedCrossRefGoogle Scholar
  7. Sheenan-Dare RA, Goodfield MJ, Wilson PD et al. (1989) Axillary artery occlusion as a presenting feature of Crohn’s disease. Postgrad Med J 65: 758–760CrossRefGoogle Scholar
  8. Talbot RW, Heppell J, Dozois RR et al. (1986) Vascular complications of inflammatory bowel disease. Mayo Clin Proc 61: 140–145PubMedGoogle Scholar
  9. Teja K, Crum CP, Friedman C (1980) Giant cell arteritis and Crohn’s disease. Gastoenterology 78: 796–802Google Scholar
  10. Wakefleld AJ, Sankey EA, Dhillon AP et al. (1991) Granulomatous vasculitis in Crohn’s disease. Gastroenterology 100: 1279–1287Google Scholar

Störungen der Hämostase und thromboembolische Komplikationen

  1. Chamouard P, Grunebaum L, Wiesel ML et al. (1994) Prevalence and significance of anticardiolipin antibodies in Crohn’s disease. Dig Dis Sei 39: 1501–1504CrossRefGoogle Scholar
  2. Collins CE, Rampton DS (1995) Platelet dysfunetion: a new dimension in inflammatory bowel disease. Gut 36: 5–8PubMedCrossRefGoogle Scholar
  3. Collins CE, Cahill MR, Newland AC et al. (1994) Platelets circulate in an activated State in inflammatory bowel disease. Gastroenterology 106: 840–845PubMedGoogle Scholar
  4. Conlan MG, Haire WD, Burnett DA (1989) Prothrombotic abnormalities in inflammatory bowel disease. Dig Dis Sei 43: 1089–1093CrossRefGoogle Scholar
  5. Crowe A, Taffinder N, Layer GT et al. (1992) Portal vein thrombosis in a complicated case of Crohn’s disease. Postgrad Med J 68: 291–293PubMedCrossRefGoogle Scholar
  6. Edwards RL, Levine JB, Green R et al. (1987) Activation of blood coagulation in Crohn’s disease. Increased plasma fibrinopeptide A levels and enhanced generation of monocyte tissue factor activity. Gastroenterology 92: 329–337PubMedGoogle Scholar
  7. Johns DR (1991) Cerebrovascular complications of inflammatory bowel disease. Am J Gastroenterol 86: 367–370PubMedGoogle Scholar
  8. Novotny DA, Rubin RJ, Slezak FA et al. (1992) Arterial thromboembolic complications of inflammatory bowel disease. Dis Colon Rectum 35: 193–196PubMedCrossRefGoogle Scholar

Hämatologische Erkrankungen

  1. Fava S, Caruana Galizia A, Vassallo M (1993) Autoimmune haemolytic anaemia associated with ulcerative Colitis. Eur J Gastroenterol Hepatol 5: 885–888Google Scholar
  2. Merrin P, Lancaster Smith MJ (1989) Leukaemoid reaction and ulcerative Colitis. Gut 30: 1154–1155PubMedCrossRefGoogle Scholar
  3. Mir Madjlessi SH, Farmer RG, Weick K (1986) Inflammatory bowel disease and leukemia. Dig Dis Sei 31: 1025–1031CrossRefGoogle Scholar
  4. Orii S, Sugai T, Nakano O et al. (1991) Acute promyelocytic leukemia in Crohn’s disease. J Clin Gastroenterol 13: 325–327PubMedCrossRefGoogle Scholar

Amyloidose

  1. Gitkind MJ, Wright SC (1990) Amyloidosis complicating inflammatory bowel disease. Dig Dis Sei 35: 906–908CrossRefGoogle Scholar
  2. Gries E, Singer M, Goebell H (1989) Amyloidose bei Morbus Crohn. Med Klin 84: 65–71Google Scholar
  3. Shorvon PJ (1977) Amyloidosis and inflammatory bowel disease. Dig Dis 22: 209–213CrossRefGoogle Scholar

Bronchopulmonale Manifestationen

  1. Calder CJ, Lacy D, Raafat F et al. (1993) Crohn’s disease with pulmonary involvement in a 3- year-old boy. Gut 34: 1636–1638PubMedCrossRefGoogle Scholar
  2. Giocchetti P, Schiavina M, Campieri M et al. (1990) Bronchopulmonary involvement in ulcerative Colitis. J Clin Gastroenterol 12: 647–650CrossRefGoogle Scholar
  3. Kayser K, Probst F, Gabius HJ et al. (1990) Are there characteristic alterations of lung tissue associated with Crohn’s disease? Pathol Res Pract 186: 485–490PubMedGoogle Scholar
  4. Puntis JWL, Tarlow MJ, Raafat F et al. (1992) Crohn’s disease of the lung. Arch Dis Child 65: 1270–1271CrossRefGoogle Scholar
  5. Sommer H, Schmidt M, Gruber KD (1986) Lungenfunktionsstörungen bei Colitis ulcerosa und Morbus Crohn. Dtsch Med Wochenschr 111: 812–815PubMedCrossRefGoogle Scholar

Störungen des Knochenstoffwechsels

  1. Clements D, Compston J (1994) Osteoporosis: a serious complication of inflammatory bowel disease. Eur J Gastroenterol Hepatol 6: 757–760CrossRefGoogle Scholar
  2. Freeman HJ, Kwan WCP (1993) Brief report: Non-corticosteroid-associated osteonecrosis of the femoral heads in two patients with inflammatory bowel disease. N Engl J Med 329: 1314–1316PubMedCrossRefGoogle Scholar
  3. Ghosh S, Cowen S, Hannan WJ et al. (1994) Low bone mineral density in Crohn’s disease, but not in ulcerative Colitis, at diagnosis. Gastroenterology 107: 1031–1039PubMedGoogle Scholar
  4. Ryde SJS, Clements D, Evans WD et al. (1991) Total body calcium in patients with inflammatory bowel disease: a longitudinal study. Clin Sei 80: 319–324Google Scholar
  5. Tromm A, Rickeis K, Hüppe D et al. (1994) Osteopenie bei chronisch entzündlichen Darmerkrankungen. Leber Magen Darm 24: 23–30PubMedGoogle Scholar

Pankreatitis

  1. Børkje B, Vetvik K, Ødegaard S et al. (1985) Chronic pancreatitis in patients with sclerosing Cholangitis and ulcerative Colitis. Scand J Gastroenterol 20: 539–542PubMedCrossRefGoogle Scholar
  2. Garau P, Orenstein SR, Neigut A et al. (1994) Pancreatitis associated with Olsalazine and Sulfalazine in children with ulcerative Colitis. J Pediatr Gastroenterol Nutr 18: 481–485PubMedCrossRefGoogle Scholar
  3. Matsumoto T, Matsui T, Iida M et al. (1989) Acute pancreatitis as a complication of Crohn’s disease. Am J Gastroenterol 84: 804–807PubMedGoogle Scholar
  4. Scully RE (ed) (1994) Case records of the Massachusetts General Hospital. Weekly clinicopathologic exercises. Case 3 - 1994. N Engl J Med 330: 96–202Google Scholar
  5. Seibold F, Weber P, Jenss H et al. (1991) Antibodies to a trypsin sensitive pancreatic antigen in chronic inflammatory bowel disease: specific markers for a subgroup of patients with Crohn’s disease. Gut 32: 1192–1197PubMedCrossRefGoogle Scholar
  6. Tromm A, Holtmann B, Hüppe D et al. (1991) Hyperamylasämie, Hyperlipasämie und akute Pankreatitiden bei chronisch entzündlichen Darmerkrankungen. Leber Magen Darm 1/91: 15–22Google Scholar

Renale Komplikationen

  1. Glassman M, Kaplan M, Spivak W (1986) Immune-complex glomerulonephritis in Crohn’s disease. J Pediatr Gastroenterology 30: 966–969CrossRefGoogle Scholar
  2. Schofield PM, Williams PS (1984) Proliferative glomerulonephritis associated with Crohn’s disease. Br Med J 289: 1039CrossRefGoogle Scholar
  3. Wilcox GM, Aretz HT, Roy MA et al. (1990) Glomerulonephritis associated with inflammatory bowel disease. Gastroenterology 98: 786–791PubMedGoogle Scholar

Neurologische Manifestationen

  1. Humbert P, Monnier G, Billerey C et al. (1989) Polyneuropathy: an unusual extraintestinal manifestation of Crohn’s disease. Acta Neurol Scand 80: 301–306PubMedCrossRefGoogle Scholar
  2. Kitchin LI, Knobler RL, Friedman LS (1991) Crohn’s disease in a patient with multiple sclerosis. J Clin Gastroenterol 13: 331–334PubMedCrossRefGoogle Scholar
  3. Lindgren S, Lilja B, Rosen I et al. (1991) Disturbed autonomic nerve funetion in patients with Crohn’s disease. Scand J Gastroenterol 26: 361–366PubMedCrossRefGoogle Scholar
  4. Nemni R, Fazio R, Corbo M et al. (1987) Peripheral neuropathy associated with Crohn’s disease. Neurology 37: 1414–1417PubMedGoogle Scholar
  5. Purrmann J, Borchard F, Bertrams J (1992) Association of Crohn’s disease and multiple sclerosis - Is there a common background? J Clin Gastroenterol 14: 43–46PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 1996

Authors and Affiliations

  • Guido Adler
    • 1
  1. 1.Medizinische Klinik und PoliklinikUniversität UlmUlmGermany

Personalised recommendations