Extraintestinal manifestations may increase the risk of synchronous and metachronous development of other extraintestinal manifestations in Crohn’s disease

Abstract In this study, we evaluated the relationship between the development of different types of EIM in CD. Patients with CD who were under regular follow-up from March 1986to October 2011 were included in our study. Accompanying EIMs and time of development were recorded. The frequency of EIMs and their association with each other were investigated. 336 patients with CD (55.4% male) with a mean follow-up duration of 7.54 years were included in the study. At the onset of CD diagnosis 21.1% of patients had at least one EIM. The prevalence of EIMs was 47.3% at 25-year follow-up.The prevalence of multiple EIMs was 12.2% and 22.9% at the onset of CD and at 25-year follow-up, resepectively. Oral, joint and skin involvement (32.4%, 24.7%, 9.2%, respectively) were the most common EIMs. The development of peripheral arthritis was a significantly associated with axial spondiloarthropathy, skin involvement, ocular involvement, oral ulcers, and vascular thromboembolism (p<0.05).There was significant relationship between oral ulcers and peripheral arthritis, axial arthritis, skin involvement, ocular involvement, liver involvement and thromboembolism (p<0.05).Development of EIMs in patients with CD may trigger development of other EIMs during the course of disease.