Paper

Extraintestinal Manifestations of Crohn's Disease
Pascal Juillerat^a, Christian Mottet^a, Valérie Pittet^c, Florian Froehlich^{a, b}, Christian Felley^a, Jean-Jacques Gonvers^a, John-Paul Vader^c, Pierre Michetti<sup>a

a</sup>Division of Gastroenterology and Hepatology, Centre Hospitalier Universitaire Vaudois and University of Lausanne, Lausanne,
^bGastrointestinal Department, University of Basle, Basle, and
^cHealthcare Evaluation Unit, Institute of Social and Preventive Medicine, University of Lausanne, Lausanne, Switzerland

Address of Corresponding Author

Digestion 2007;76:141-148 (DOI: 10.1159/000111029)

  Key Words

• Crohn's disease
• Inflammatory bowel disease
• Extraintestinal manifestations
• Ankylosing spondylitis
• Pyoderma gangrenosum
• Primary sclerosing cholangitis
• Uveitis
• Crohn's disease, extraintestinal manifestations

  Abstract

In each case of extraintestinal manifestations of Crohn's disease, active disease, if present, should be treated to induce remission, which may positively influence the course of most concomitant extraintestinal manifestations. For some extraintestinal manifestations, however, a specific treatment should be introduced. This latter part of disease management will be discussed in this chapter, in particular for pyoderma gangrenosum, uveitis, spondylarthropathy - axial arthropathy - and primary sclerosing cholangitis, which have also been described in quiescent Crohn's disease. Few new drugs for the treatment of extraintestinal manifestations of Crohn's disease have been developed in the past and only the role of infliximab has increased in Crohn's disease-related extraintestinal manifestations. Drugs specifically aimed at this treatment, stemming from a few randomized controlled studies or case series, are sulfasalazine, 5-ASA, corticosteroids, azathioprine or 6-mercaptopurine, methotrexate, infliximab, adalimumab, etanercept and cyclosporine or tacrolimus. Unfortunately, because of the paucity of data in this field, the best evidence presented and discussed in this article for the treatment of these extraintestinal manifestations is extrapolated from patients that for the most part did not suffer from Crohn's disease.

Copyright © 2008 S. Karger AG, Basel

  Author Contacts

Pascal Juillerat, MD
Division of Gastroenterology and Hepatology
Centre Hospitalier Universitaire Vaudois, Rue du Bugnon 46
CH-1011 Lausanne (Switzerland)
Tel. +41 21 314 05 64, Fax +41 21 314 06 84, E-Mail pascal.juillerat@chuv.ch

  Article Information

Published online: February 7, 2008
Number of Print Pages : 8
Number of Figures : 0, Number of Tables : 0, Number of References : 106