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CC BY-NC-ND 4.0 · Journal of Coloproctology 2021; 41(01): 008-013
DOI: 10.1055/s-0041-1724056
Original Article

Ocular Affection as an Extraintestinal Manifestation in Cases of Inflammatory Bowel Disease at the Kafrelsheikh Governorate

Afecção ocular como manifestação extraintestinal em casos de doença inflamatória intestinal
Mohammed Hussien Ahmed 
1   Department of Hepatology, Gastroenterology and Infectious Diseases, Faculty of Medicine, Kafrelsheikh University, Kafr Al Sheikh First, Kafr El Sheikh Governorate, Egypt
,
Mohammed Elashery
2   Department of Ophthalmology, Faculty of Medicine, Kafrelsheikh University, Kafr Al Sheikh First, Kafr El Sheikh Governorate, Egypt
,
Hebatallah Abdel Maksoud 
3   Department of Community Medicine, Faculty of Medicine, Kafrelsheikh University, Kafr Al Sheikh First, Kafr El Sheikh Governorate, Egypt
,
Aya Mohammed Mahros 
1   Department of Hepatology, Gastroenterology and Infectious Diseases, Faculty of Medicine, Kafrelsheikh University, Kafr Al Sheikh First, Kafr El Sheikh Governorate, Egypt
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Abstract

Introduction The manifestations of inflammatory bowel disease (IBD) are not restricted to the gastrointestinal tract. Musculoskeletal conditions are considered the most common extraintestinal manifestations, followed by mucocutaneous and ocular diseases. Many general practitioners are unaware of the variety and severity of the ocular affection in IBD patients.

Objective To assess the prevalence of extraintestinal manifestations in IBD patients at Kafrelsheikh governorate, and to evaluate the different ocular manifestations and their relationship to the severity of the disease.

Methods A cross-sectional study evaluating 120 patients treated at the Kafrelsheikh University Hospital. The diagnosis of IBD was made between December 2018 and December 2019 through clinical, endoscopic and histopathological examinations. All patients were assessed for any extraintestinal manifestation or evidence of ocular affection through slit-lamp examinations, tonometry, visual acuity, and indirect ophthalmoscopy.

Results The mean age of the sample was 35.5 ±  13.3 years. In total, 52 (43.3%) patients were male and 68 (56.7%) were female. Ocular manifestations represent ∼ 22.5% of extraintestinal manifestations. The most common ocular findings were conjunctivitis (25.8%) and anterior uveitis (10.8%), followed by scleritis (9.2%) and cataract (8.3%). Other extraintestinal manifestations were observed in 41 (34.1%) 29 (29.9%) of ulcerative colitis cases, and 12 (52%) of Crohn disease cases. There was no statistically significant difference in the presence of ocular involvement in relation to the two types of IBD included in the Montreal classification.

Conclusion Ocular manifestations in cases of IBD are common and usually nonspecific in presentation. The severity of the IBD does not reflect the severity of the ocular affection.

Resumo

Introdução As manifestações da doença inflamatória intestinal (DII) não se restringem ao trato gastrointestinal. Distúrbios musculoesqueléticos são considerados as manifestações extraintestinais mais comuns, seguidos de doenças oculares e mucocutâneas. Muitos clínicos gerais desconhecem a variedade e a severidade das afecções oculares em casos de DII.

Objetivo Determinar a prevalência das manifestações extraintestinais em pacientes com DII na província de Kafrelsheikh, no Egito, e avaliar as diferentes manifestações oculares e sua relação com a gravidade da doença.

Métodos Um estudo transversal que avaliou 120 pacientes tratados no Kafrelsheikh University Hospital. O diagnóstico de DII foi feito entre dezembro de 2018 e dezembro de 2019 por meio de exames clínicos, endoscópicos e histopatológicos. Por meio de exames de lâmpada de fenda, tonometria, acuidade visual, e oftalmoscopia indireta, todos os pacientes foram avaliados para se determinar a ocorrência de quaisquer manifestações extraintestinais ou afecções oculares.

Resultados A média de idade da amostra foi de 35,5 ± 13,3 anos. No total, 52 (43,3%) pacientes com DII eram do sexo masculino, e 68 (56,7%), do sexo feminino. As manifestações oculares representaram ∼ 22,5% das manifestações extraintestinais. Os achados oculares mais comuns foram conjuntivite (25,8%) e uveíte anterior (10,8%), seguidas de esclerite (9,2%) e catarata (8,3%). Outras manifestações extraintestinais foram observadas em 41 (34,1%) pacientes, entre elas, 29,9% de casos de colite ulcerativa, e 52% de casos de doença de Crohn. Não houve diferença estatisticamente significativa na presença de envolvimento ocular com relação aos dois tipos de DII descritos na classificação de Montreal.

Conclusão As manifestações oculares em pacientes de DII são comuns e, geralmente, não específicas em termos de apresentação. A gravidade da DII não reflete a gravidade da afecção ocular.

Keywords

inflammatory bowel disease - ocular manifestations

Palavras-chave

doença inflamatória intestinal - manifestações oculares


Publication History

Received: 07 April 2020

Accepted: 08 August 2020

Article published online:
19 March 2021

© 2021. Sociedade Brasileira de Coloproctologia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commecial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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