Disease course of inflammatory bowel disease unclassified in a European population-based inception cohort: An Epi-IBD study

被引：19

作者：

Burisch, Johan ^{[1
]}

Zammit, Stefania Chetcuti ^{[9
]}

Ellul, Pierre ^{[9
]}

Turcan, Svetlana ^{[10
]}

Duricova, Dana ^{[11
]}

Bortlik, Martin ^{[11
,12
]}

Andersen, Karina Winther ^{[3
]}

Andersen, Vibeke ^{[3
,4
,5
]}

Kaimakliotis, Ioannis P.

Fumery, Mathurin ^{[13
]}

Gower-Rousseau, Corinne ^{[14
,15
]}

Girardin, Giulia ^{[2
,16
]}

Valpiani, Daniela ^{[17
]}

Goldis, Adrian ^{[18
]}

Brinar, Marko ^{[19
]}

Cukovic-Cavka, Silvija ^{[19
]}

Oksanen, Pia ^{[20
,21
]}

Collin, Pekka ^{[20
,21
]}

Barros, Luisa ^{[22
]}

Magro, Fernando ^{[22
,23
]}

Misra, Ravi ^{[24
]}

Arebi, Naila ^{[24
]}

Eriksson, Carl ^{[26
]}

Halfvarson, Jonas ^{[26
]}

Kievit, Hendrika Adriana Linda ^{[7
]}

Pedersen, Natalia ^{[8
]}

Kjeldsen, Jens ^{[6
]}

Myers, Sally ^{[25
]}

Sebastian, Shaji ^{[25
]}

Katsanos, Konstantinos H. ^{[27
]}

Christodoulou, Dimitrios K. ^{[27
]}

Midjord, Jongerd ^{[28
]}

Nielsen, Kari Rubek ^{[27
]}

Kiudelis, Gediminas ^{[29
]}

Kupcinskas, Limas ^{[29
,30
]}

Nikulina, Inna ^{[31
]}

Belousova, Elena ^{[31
]}

Schwartz, Doron ^{[32
,33
]}

Odes, Selwyn ^{[32
,33
]}

Salupere, Riina ^{[34
]}

Carmona, Amalia ^{[35
]}

Pineda, Juan R. ^{[36
]}

Vegh, Zsuzsanna ^{[37
]}

Lakatos, Peter L. ^{[37
,38
]}

Langholz, Ebbe ^{[2
,16
]}

Munkholm, Pia ^{[1
]}

机构：

[1] North Zealand Univ, Dept Gastroenterol, Copenhagen, Denmark

[2] Univ Copenhagen, Herlev & Gentofte Hosp, Dept Gastroenterol, Copenhagen, Denmark

[3] Reg Hosp Viborg, Dept Med, Viborg, Denmark

[4] Hosp Southern Jutland, IRS Ctr Sonderjylland, Focused Res Unit Mol Diagnost & Clin Res MOK, Aabenraa, Denmark

[5] Univ Southern Denmark, Inst Mol Med, Odense, Denmark

[6] Odense Univ Hosp, Dept Gastroenterol, Odense, Denmark

[7] Herning Cent Hosp, Dept Med, Herning, Denmark

[8] Slagelse Hosp, Dept Gastroenterol, Slagelse, Denmark

[9] Mater Dei Hosp, Div Gastroenterol, Msida, Malta

[10] State Univ Med & Pharm Republ Moldova, Dept Gastroenterol, Kishinev, Moldova

[11] ISCARE, IBD Clin & Res Ctr, Prague, Czech Republic

[12] Charles Univ Prague, Fac Med 1, Inst Pharmacol, Prague, Czech Republic

[13] Amiens Univ Hosp, CHU Amiens Sud, Epimad Registry, Gastroenterol Unit, Ave Laennec Salouel, Amiens, France

[14] Lille Univ & Hosp, Registre Epimad, Publ Hlth Epidemiol & Econ Hlth, Lille, France

[15] Lille Univ, LIRIC, Lille, France

[16] Univ Padua, Azienda, Dept Surg Oncol & Gastroenterol Sci, Padua, Italy

[17] Hosp Morgagni Pierantoni, UO Gastroenterol & Endoscopia Digest, Forli, Italy

[18] Univ Med Victor Babes, Gastroenterol Clin, Timisoara, Romania

[19] Univ Hosp Ctr Zagreb, Div Gastroenterol & Hepatol, Zagreb, Croatia

[20] Tampere Univ Hosp, Dept Gastroenterol & Alimentary Tract Surg, Tampere, Finland

[21] Univ Tampere, Tampere, Finland

[22] Ctr Hosp Sao Joao EPE, Dept Gastroenterol, Porto, Portugal

[23] Univ Porto, Fac Med, Inst Pharmacol, Dept Biomed, Porto, Portugal

[24] Imperial Coll London, St Marks Hosp, IBD Dept, London, England

[25] Hull & East Yorkshire NHS Trust, IBD Unit, Kingston Upon Hull, N Humberside, England

[26] Orebro Univ, Fac Med & Hlth, Dept Gastroenterol, Orebro, Sweden

[27] Univ Hosp Ioannina, Dept Gastroenterol, Ioannina, Greece

[28] Natl Hosp Faroe Islands, Dept Med, Torshavn, Denmark

[29] Med Acad, Inst Digest Res, Kaunas, Lithuania

[30] Lithuanian Univ Hlth Sci, Med Acad, Dept Gastroenterol, Kaunas, Lithuania

[31] Moscow Reg Res Clin Inst, Dept Gastroenterol, Moscow, Russia

[32] Soroka Med Ctr, Dept Gastroenterol & Hepatol, Beer Sheva, Israel

[33] Ben Gurion Univ Negev, Beer Sheva, Israel

[34] Univ Tarty, Tartu Univ Hosp, Div Gastroenterol, Tartu, Estonia

[35] Hosp POVISA, Dept Gastroenterol, Vigo, Spain

[36] Hosp Alvaro Cunqueiro, Inst Invest Sanitaria Galicia Sur, Dept Gastroenterol, EOXI Vigo, Vigo, Spain

[37] Semmelweis Univ, Dept Med 1, Budapest, Hungary

[38] McGill Univ, Ctr Hlth, Div Gastroenterol, Montreal, PQ, Canada

来源：

JOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY | 2019年 / 34卷 / 06期

关键词：

inflammatory bowel disease unclassified; prognosis; treatment; ULCERATIVE-COLITIS; CROHNS-DISEASE; INDETERMINATE COLITIS; SURGERY RATES; DIAGNOSIS; NETHERLANDS; PREVALENCE; COPENHAGEN; EXTENSION; CONSENSUS;

D O I：

10.1111/jgh.14563

中图分类号：

R57 [消化系及腹部疾病];

学科分类号：

摘要：

Background and Aim A definitive diagnosis of Crohn's disease (CD) or ulcerative colitis (UC) is not always possible, and a proportion of patients will be diagnosed as inflammatory bowel disease unclassified (IBDU). The aim of the study was to investigate the prognosis of patients initially diagnosed with IBDU and the disease course during the following 5 years. Methods The Epi-IBD study is a prospective population-based cohort of 1289 IBD patients diagnosed in centers across Europe. Clinical data were captured prospectively throughout the follow-up period. Results Overall, 476 (37%) patients were initially diagnosed with CD, 701 (54%) with UC, and 112 (9%) with IBDU. During follow-up, 28 (25%) IBDU patients were changed diagnoses to either UC (n = 20, 71%) or CD (n = 8, 29%) after a median of 6 months (interquartile range: 4-12), while 84 (7% of the total cohort) remained IBDU. A total of 17 (15%) IBDU patients were hospitalized for their IBD during follow-up, while 8 (7%) patients underwent surgery. Most surgeries (n = 6, 75%) were performed on patients whose diagnosis was later changed to UC; three of these colectomies led to a definitive diagnosis of UC. Most patients (n = 107, 96%) received 5-aminosalicylic acid, while 11 (10%) patients received biologicals, of whom five remained classified as IBDU. Conclusions In a population-based inception cohort, 7% of IBD patients were not given a definitive diagnosis of IBD after 5 years of follow-up. One in four patients with IBDU eventually was classified as CD or UC. Overall, the disease course and medication burden in IBDU patients were mild.

引用

页码：996 / 1003

页数：8

共 50 条

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