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Vol. 76, No. 2, 2007
Issue release date: February 2008

Extraintestinal Manifestations of Crohn’s Disease

Juillerat P. · Mottet C. · Pittet V. · Froehlich F. · Felley C. · Gonvers J.-J. · Vader J.-P. · Michetti P.
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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.



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References

  1. Gasché C: Extraintestinale Manifestationen der chronisch entzündlichen Darmerkran- kungen. Chir Gastroenterol 1998;14:120–125.

    External Resources

  2. Rankin GB, Watts HD, Melnyk CS, Kelley ML Jr: National Cooperative Crohn’s Disease Study: extraintestinal manifestations and perianal complications. Gastroenterology 1979;77:914–920.
  3. Juillerat P, Mottet C, Froehlich F, Felley C, Vader JP, Burnand B, Gonvers JJ, Michetti P: Extraintestinal manifestations of Crohn’s disease. Digestion 2005;71:31–36.
  4. Parsi MA, Achkar J-P, Brzezinski A, Shen B, Lashner B: Extra-intestinal manifestations of Crohn’s disease respond to infliximab. Am J Gastroenterol 2002;97:S265.

    External Resources

  5. Adler G, Reinshagen M: Extraintestinal manifestations (in German). Z Gastroenterol 2003;41:54–61.
  6. Su CG, Judge TA, Lichtenstein GR: Extraintestinal manifestations of inflammatory bowel disease. Gastroenterol Clin North Am 2002;31:307–327.
  7. Greenstein AJ, Janowitz HD, Sachar DB: The extra-intestinal complications of Crohn’s disease and ulcerative colitis: a study of 700 patients. Medicine 1976;55:401–412.
  8. Farmer RG, Hawk WA, Turnbull RB Jr: Clinical patterns in Crohn’s disease: a statistical study of 615 cases. Gastroenterology 1975;68:627–635.
  9. Veloso FT, Carvalho J, Magro F: Immune-related systemic manifestations of inflammatory bowel disease. A prospective study of 792 patients. J Clin Gastroenterol 1996;23:29–34.
  10. Triantafillidis JK, Emmanouilidis A, Manousos O, Nicolakis D, Kogevinas M: Clinical patterns of Crohn’s disease in Greece: a follow-up study of 155 cases. Digestion 2000;61:121–128.
  11. Katz JP, Lichtenstein GR: Rheumatologic manifestations of gastrointestinal diseases. Gastroenterol Clin North Am 1998;27:533–562.
  12. Bernstein CN, Blanchard JF, Rawsthorne P, Yu N: The prevalence of extraintestinal diseases in inflammatory bowel disease: a population-based study. Am J Gastroenterol 2001;96:1116–1122.
  13. Tromm A, May D, Almus E, Voigt E, Greving I, Schwegler U, Griga T: Cutaneous manifestations in inflammatory bowel disease. Z Gastroenterol 2001;39:137–144.
  14. Chow RK, Ho VC: Treatment of pyoderma gangrenosum. J Am Acad Dermatol 1996;34:1047–1060.
  15. Powell FC, Su WP, Perry HO: Pyoderma gangrenosum: classification and management. J Am Acad Dermatol 1996;34:395–409; quiz 410–412.
  16. Raj V, Lichtenstein DR: Hepatobiliary manifestations of inflammatory bowel disease. Gastroenterol Clin North Am 1999;28:491–513.
  17. Hayllar J, MacPherson AJ, Russell AS, Bjarnason I: Side effects of nonsteroidal anti-inflammatory drugs on the small and large intestine in humans. Gastroenterology 1993;104:1832–1847.
  18. McCartney SA, Mitchell JA, Fairclough PD, Farthing MJG, Warner TD: Selective COX-2 inhibitors and human inflammatory bowel disease. Aliment Pharmacol Ther 1999;13:1115–1117.
  19. Cipolla G, Crema F, Sacco S, Moro E, de Ponti F, Frigo G: Nonsteroidal anti-inflammatory drugs and inflammatory bowel disease: current perspectives. Pharmacol Res 2002;46:1–6.
  20. Evans J, McMahon A, Murray F, McDevitt D, MacDonald T: Non-steroidal anti-inflammatory drugs are associated with emergency admission to hospital for colitis due to inflammatory bowel disease. Gut 1997;40:619–622.
  21. Fornaciari G, Salvarani C, Beltrami M, Macchioni P, Stockbrugger RW, Russel MG: Musculoskeletal manifestations in inflammatory bowel disease. Can J Gastroenterol 2001;15:399–403.
  22. Ferraz MB, Tugwell P, Goldsmith CH, Atra E: Metaanalysis of sulfasalazine in ankylosing spondylitis. J Rheumatol 1990;17:1482–1486.
  23. Clegg DO, Reda DJ, Weisman MH, Blackburn WD, Cush JJ, Cannon GW, Mahowald ML, Schumacher HR, Taylor T, Budiman-Mak E, Cohen MR, Vasey FB, Luggen ME, Mejias E, Silverman SL, Makkena R, Alepa FP, Buxbaum J, Haakenson CM, Ward RH, Manaster BJ, Anderson RJ, Ward JR, Henderson WG: Comparison of sulfasalazine and placebo in the treatment of ankylosing spondylitis. A Department of Veterans Affairs Cooperative Study. Arthritis Rheum 1996;39:2004–2012.
  24. Dougados M, van der Linden S, Leirisalo-Repo M, Huitfeldt B, Juhlin R, Veys E, Zeidler H, Kvien TK, Olivieri I, Dijkmans B: Sulfasalazine in the treatment of spondylarthropathy. A randomized, multicenter, double-blind, placebo-controlled study. Arthritis Rheum 1995;38:618–627.
  25. Dougados M, Dijkmans B, Khan M, Maksymowych W, van der Linden S, Brandt J: Conventional treatments for ankylosing spondylitis. Ann Rheum Dis 2002;61:iii40–iii50.
  26. Chen J, Liu C: Sulfasalazine for ankylosing spondylitis. Cochrane Database Syst Rev 2005;2:CD004800.
  27. Thomson GT, Thomson BR, Thomson KS, Ducharme JS: Clinical efficacy of mesalamine in the treatment of the spondyloarthropathies. J Rheumatol 2000;27:714–718.
  28. Dekker-Saeys BJ, Dijkmans BA, Tytgat GN: Treatment of spondyloarthropathy with 5-aminosalicylic acid (mesalazine): an open trial. J Rheumatol 2000;27:723–726.
  29. Salvarani C, Fornaciari G, Beltrami M, Macchioni PL: Musculoskeletal manifestations in inflammatory bowel disease. Eur J Intern Med 2000;11:210–214.
  30. Peters ND, Ejstrup L: Intravenous methylprednisolone pulse therapy in ankylosing spondylitis. Scand J Rheumatol 1992;21: 134–138.
  31. Maugars Y, Mathis C, Berthelot JM, Charlier C, Prost A: Assessment of the efficacy of sacroiliac corticosteroid injections in spondylarthropathies: a double-blind study. Br J Rheumatol 1996;35:767–770.
  32. Generini S, Fiori G, Cerinic MM: Therapy of spondylarthropathy in inflammatory bowel disease. Clin Exp Rheumatol 2002;20:S88–S94.
  33. Brandt J, Buss B, Sieper J, Braun J: Efficacy of treatment of sulfasalazine versus azathioprine in ankylosing spondylitis. J Rheumatol 2000;27:55.
  34. Chen J, Lui C, Lin J: Methotrexate for ankylosing spondylitis. Cochrane Database Syst Rev 2006;4:CD004524.
  35. Altan L, Bingoel U, Karakoç Y, Aydiner S, Yurtkuran M, Yurtkuran M: Clinical investigation of methotrexate in the treatment of ankylosing spondylitis. Scand J Rheumatol 2001;30:255–259.
  36. Gonzalez-Lopez L, Garcia-Gonzalez A, Vazquez-Del-Mercado M, Munoz-Valle JF, Gamez-Nava JI: Efficacy of methotrexate in ankylosing spondylitis: a randomized, double blind, placebo controlled trial. J Rheumatol 2004;31:1568–1574.
  37. Roychowdhury B, Bintley-Bagot S, Bulgen DY, Thompson RN, Tunn EJ, Moots RJ: Is methotrexate effective in ankylosing spondylitis? Rheumatology 2002;41:1330–1332.
  38. Generini S, Giacomelli R, Fedi R, Fulminis A, Pignone A, Frieri G, Del Rosso A, Viscido A, Galletti B, Fazzi M, Tonelli F, Matucci-Cerinic M: Infliximab in spondyloarthropathy associated with Crohn’s disease: an open study on the efficacy of inducing and maintaining remission of musculoskeletal and gut manifestations. Ann Rheum Dis 2004;63:1664–1669.
  39. Brandt J, Listing J, Haibel H, Sorensen H, Schwebig A, Rudwaleit M, Sieper J, Braun J: Long-term efficacy and safety of etanercept after readministration in patients with active ankylosing spondylitis. Rheumatology 2005;44:342–348.
  40. Gorman JD, Sack KE, Davis JC Jr: Treatment of ankylosing spondylitis by inhibition of tumor necrosis factor alpha. N Engl J Med 2002;346:1349–1356.
  41. van der Heijde D, Dijkmans B, Geusens P, Sieper J, DeWoody K, Williamson P, Braun J: Efficacy and safety of infliximab in patients with ankylosing spondylitis: results of a randomized, placebo-controlled trial (ASSERT). Arthritis Rheum 2005;52:582–591.
  42. Zochling J, Maxwell L, Beardmore J, Boonen A: TNF-alpha inhibitors for ankylosing spondylitis. (Protocol) Cochrane Database of Systematic Reviews 2005, Issue 3, Art. No.: CD005468. DOI: 10.1002/14651858. CD005468.
  43. Braun J, Brandt J, Listing J, Zink A, Alten R, Golder W, Gromnica-Ihle E, Kellner H, Krause A, Schneider M, Sorensen H, Zeidler H, Thriene W, Sieper J: Treatment of active ankylosing spondylitis with infliximab: a randomised controlled multicentre trial. Lancet 2002;359:1187–1193.
  44. Van den Bosch F, Kruithof E, Baeten D, Herssens A, de Keyser F, Mielants H, Veys EM: Randomized double-blind comparison of chimeric monoclonal antibody to tumor necrosis factor alpha (infliximab) versus placebo in active spondylarthropathy. Arthritis Rheum 2002;46:755–765.
  45. Braun J, Baraliakos X, Brandt J, Listing J, Zink A, Alten R, Burmester G, Gromnica-Ihle E, Kellner H, Schneider M, Sorensen H, Zeidler H, Sieper J: Persistent clinical response to the anti-TNF-alpha antibody infliximab in patients with ankylosing spondylitis over 3 years. Rheumatology 2005;44:670–676.
  46. van der Heijde D, Kivitz A, Schiff MH, Sieper J, Dijkmans BA, Braun J, Dougados M, Reveille JD, Wong RL, Kupper H, Davis JC Jr: Efficacy and safety of adalimumab in patients with ankylosing spondylitis: results of a multicenter, randomized, double-blind, placebo-controlled trial. Arthritis Rheum 2006;54:2136–2146.
  47. Hanauer SB, Sandborn WJ, Rutgeerts P, Fedorak RN, Lukas M, MacIntosh D, Panaccione R, Wolf D, Pollack P: Human anti-tumor necrosis factor monoclonal antibody (adalimumab) in Crohn’s disease: the CLASSIC-I Trial. Gastroenterology 2006;130:323–333.
  48. Sieper J, Rudwaleit M, Braun J: Adalimumab for the treatment of ankylosing spondylitis. Expert Opin Pharmacother 2007;8:831–838.
  49. Sandborn WJ, Hanauer SB, Katz S, Safdi M, Wolf DG, Baerg RD, Tremaine WJ, Johnson T, Diehl NN, Zinsmeister AR: Etanercept for active Crohn’s disease: a randomized, double-blind, placebo-controlled trial. Gastroenterology 2001;121:1088–1094.
  50. Maksymowych WP, Jhangri GS, Fitzgerald AA, LeClercq S, Chiu P, Yan A, Skeith KJ, Aaron SL, Homik J, Davis P, Sholter D, Russell AS: A six-month randomized, controlled, double-blind, dose-response comparison of intravenous pamidronate (60 mg versus 10 mg) in the treatment of nonsteroidal antiinflammatory drug-refractory ankylosing spondylitis. Arthritis Rheum 2002;46:766–773.
  51. Cairns AP, Wright SA, Taggart AJ, Coward SM, Wright GD: An open study of pulse pamidronate treatment in severe ankylosing spondylitis, and its effect on biochemical markers of bone turnover. Ann Rheum Dis 2005;64:338–339.
  52. Grover R, Shankar S, Aneja R, Marwaha V, Gupta R, Kumar A: Treatment of ankylosing spondylitis with pamidronate: an open label study. Ann Rheum Dis 2006;65:688–689.
  53. Haibel H, Brandt J, Rudwaleit M, Soerensen H, Sieper J, Braun J: Treatment of active ankylosing spondylitis with pamidronate. Rheumatology (Oxford) 2003;42:1018–1020.
  54. Bernstein CN: Treatment of the extraintestinal manifestations of inflammatory bowel disease. Curr Gastroenterol Rep 2002;4:513–516.
  55. Rozen SM, Nahabedian MY, Manson PN: Management strategies for pyoderma gangrenosum: case studies and review of literature. Ann Plast Surg 2001;47:310–315.
  56. Sanders CJ, Hulsmans RF: Successful treatment of pyoderma gangrenosum with topical 5-aminosalicylic acid. Cutis 1993;51:262–264.
  57. Futami H, Kodaira M, Furuta T, Hanai H, Kaneko E: Pyoderma gangrenosum complicating ulcerative colitis: successful treatment with methylprednisolone pulse therapy and cyclosporine. J Gastroenterol 1998;33:408–411.
  58. Eisen AZ, Fitzpatrick TB: Dermatology; in Textbook of Dermatology, ed 5. Oxford, Blackwell Scientific, 2000, pp 1140–1148.
  59. Johnson R, Lazarus G: Pulse therapy: therapeutic efficacy in the treatment of pyoderma gangrenosum. Arch Dermatol 1982;11:76–84.
  60. Prystowsky JH, Kahn SN, Lazarus GS: Present status of pyoderma gangrenosum – review of 21 cases. Arch Dermatol 1989;125:57–64.
  61. Jolles S, Niclasse S, Benson E: Combination oral and topical tacrolimus in therapy-resistant pyoderma gangrenosum. Br J Dermatol 1999;140:564–565.
  62. Abu-Elmagd K, Jegasothy BV, Ackerman CD, Thomson AW, Rilo H, Nikolaidis N, Van Thiel D, Fung JJ, Todo S, Starzl TE: Efficacy of FK 506 in the treatment of recalcitrant pyoderma gangrenosum. Transplant Proc 1991;23:3328–3329.
  63. Schuppe HC, Homey B, Assmann T, Martens R, Ruzicka T: Topical tacrolimus for pyoderma gangrenosum. Lancet 1998;351:832.
  64. Matis WL, Ellis CN, Griffiths CE, Lazarus GS: Treatment of pyoderma gangrenosum with cyclosporine. Arch Dermatol 1992;128:1060–1064.
  65. Friedman S, Marion JF, Scherl E, Rubin PH, Present DH: Intravenous cyclosporine in refractory pyoderma gangrenosum complicating inflammatory bowel disease. Inflamm Bowel Dis 2001;7:1–7.
  66. Rapini RP: Cytotoxic drugs in the treatment of skin disease. Int J Dermatol 1991;30:313–322.
  67. Arnott ID, McDonald D, Williams A, Ghosh S: Clinical use of infliximab in Crohn’s disease: the Edinburgh experience. Aliment Pharmacol Ther 2001;15:1639–1646.
  68. Hong JJ, Merel NH, Hanauer SB: Treatment of pyoderma gangrenosum (PG) complicating Crohn’s disease (CD) with infliximab. Gastroenterology 2001;120:3153.
  69. Ljung T, Staun M, Grove O, Fausa O, Vatn MH, Hellstrom PM: Pyoderma gangrenosum associated with Crohn disease: effect of TNF-alpha blockade with infliximab. Scand J Gastroenterol 2002;37:1108–1110.
  70. Regueiro M, Plevy S, Valentine J, Fleisher M, Lichtenstein G: Successful treatment of IBD-associated pyoderma gangrenosum with infliximab. Gastroenterology 2002;122:W1357.
  71. Triantafillidis JK, Cheracakis P, Sklavaina M, Apostolopoulou K: Favorable response to infliximab treatment in a patient with active Crohn disease and pyoderma gangrenosum. Scand J Gastroenterol 2002;37:863–865.
  72. Foster EN, Nguyen KK, Bolce RJ, Prindiville TP: Cutaneous manifestations of inflammatory bowel disease improve with infliximab therapy. Gastroenterology 2002;122:W1366.
  73. Juillerat P, Christen-Zach S, Troillet FX, Gallot-Lavallee S, Pannizzon RG, Michetti P: Infliximab for the treatment of disseminated pyoderma gangrenosum associated with ulcerative colitis. Case report and literature review. Dermatology 2007;215:245–251.
  74. Tan MH, Gordon M, Lebwohl O, George J, Lebwohl MG: Improvement of pyoderma gangrenosum and psoriasis associated with Crohn disease with anti-tumor necrosis factor alpha monoclonal antibody. Arch Dermatol 2001;137:930–933.
  75. Regueiro M, Valentine J, Plevy S, Fleisher MR, Lichtenstein GR: Infliximab for treatment of pyoderma gangrenosum associated with inflammatory bowel disease. Am J Gastroenterol 2003;98:1821–1826.
  76. Brooklyn TN, Dunnill MG, Shetty A, Bowden JJ, Williams JD, Griffiths CE, Forbes A, Greenwood R, Probert CS: Infliximab for the treatment of pyoderma gangrenosum: a randomised, double blind, placebo controlled trial. Gut 2006;55:505–509.
  77. Pastor N, Betlloch I, Pascual JC, Blanes M, Banuls J, Silvestre JF: Pyoderma gangrenosum treated with anti-TNF alphatherapy (etanercept). Clin Exp Dermatol 2005;31:152–153.

    External Resources

  78. Roy DB, Conte ET, Cohen DJ: The treatment of pyoderma gangrenosum using etanercept. J Am Acad Dermatol 2006;54:S128–S134.
  79. Hubbard VG, Friedmann AC, Goldsmith P: Systemic pyoderma gangrenosum responding to infliximab and adalimumab. Br J Dermatol 2005;152:1059–1061.
  80. Lindor KD: Ursodiol for primary sclerosing cholangitis. The Mayo Primary Sclerosing Cholangitis-Ursodeoxycholic Acid Study Group. N Engl J Med 1997;336:691–695.
  81. Harnois DM, Angulo P, Jorgensen RA, LaRusso NF, Lindor KD: High-dose ursodeoxycholic acid as a therapy for patients with primary sclerosing cholangitis. Am J Gastroenterol 2001;96:1558–1562.
  82. Mitchell SA, Bansi DS, Hunt N, Von Bergmann K, Fleming KA, Chapman RW: A preliminary trial of high-dose ursodeoxycholic acid in primary sclerosing cholangitis. Gastroenterology 2001;121:900–907.
  83. Olsson R, Boberg KM, de Muckadell OS, Lindgren S, Hultcrantz R, Folvik G, Bell H, Gangsoy-Kristiansen M, Matre J, Rydning A, Wikman O, Danielsson A, Sandberg-Gertzen H, Ung KA, Eriksson A, Lööf L, Prytz H, Marschall HU, Broome U: High-dose ursodeoxycholic acid in primary sclerosing cholangitis: a 5-year multicenter, randomized, controlled study. Gastroenterology 2005;129:1464–1472.
  84. Leuschner M, Maier K-P, Schlichting J, Strahl S, Herrmann G, Dahm H, Ackermann H, Happ J, Leuschner U: Oral budesonide and ursodeoxycholic acid for treatment of primary biliary cirrhosis: results of a prospective double-blind trial. Gastroenterology 1999;117:918–925.
  85. van Hoogstraten HJF, Vleggaar FP, Boland GJ, van Steenbergen W, Griffioen P, Hop WCJ, van Hattum J, van Berge Henegouwen GP, Schalm SW, van Buuren HR: Budesonide or prednisone in combination with ursodeoxycholic acid in primary sclerosing cholangitis: a randomized double-blind pilot study. Am J Gastroenterol 2000;95:2015–2022.
  86. Chen W, Gluud C: Glucocorticosteroids for primary sclerosing cholangitis. Cochrane Database Syst Rev 2004;3:CD004036.
  87. Knox TA, Kaplan MM: A double-blind controlled trial of oral-pulse methotrexate therapy in the treatment of primary sclerosing cholangitis. Gastroenterology 1994;106:494–499.
  88. Lindor KD, Jorgensen RA, Anderson ML, Gores GJ, Hofmann AF, LaRusso NF: Ursodeoxycholic acid and methotrexate for primary sclerosing cholangitis: a pilot study. Am J Gastroenterol 1996;91:511–515.
  89. Sandborn W, Wiesner R, Tremaine W, Larusso N: Ulcerative colitis disease activity following treatment of associated primary sclerosing cholangitis with cyclosporin. Gut 1993;34:242–246.
  90. Van Thiel DH, Carroll P, Abu-Elmagd K, Rodriguez-Rilo H, Irish W, McMichael J, Starzl TE: Tacrolimus (FK 506), a treatment for primary sclerosing cholangitis: results of an open-label preliminary trial. Am J Gastroenterol 1995;90:455–459.
  91. Epstein MP, Kaplan MM: A pilot study of etanercept in the treatment of primary sclerosing cholangitis. Dig Dis Sci 2004;49:1–4.
  92. Mintz R, Feller ER, Bahr RL, Shah SA: Ocular manifestations of inflammatory bowel disease. Inflamm Bowel Dis 2004;10:135–139.
  93. Seibold F, Oneta CM, Michetti P: Traitement des pathologies intestinales inflammatoires chroniques et de leurs complications. Forum Med Suisse 2002;48:1115–1118.
  94. Soukiasian SH, Foster CS, Raizman MB: Treatment strategies for scleritis and uveitis associated with inflammatory bowel disease. Am J Ophthalmol 1994;118:601–611.
  95. Fries W, Giofre MR, Catanoso M, Lo Gullo R: Treatment of acute uveitis associated with Crohn’s disease and sacroileitis with infliximab. Am J Gastroenterol 2002;97:499–500.
  96. Smith JR, Levinson RD, Holland GN, Jabs DA, Robinson MR, Whitcup SM, Rosenbaum JT: Differential efficacy of tumor necrosis factor inhibition in the management of inflammatory eye disease and associated rheumatic disease. Arthritis Rheum 2001;45:252–257.
  97. Sfikakis PP, Theodossiadis PG, Katsiari CG, Kaklamanis P, Markomichelakis NN: Effect of infliximab on sight-threatening panuveitis in Behçet’s disease. Lancet 2001;358:295–296.
  98. Joseph A, Raj D, Dua HS, Powell PT, Lanyon PC, Powell RJ: Infliximab in the treatment of refractory posterior uveitis. Ophthalmology 2003;110:1449–1453.
  99. Suhler EB, Smith JR, Wertheim MS, Lauer AK, Kurz DE, Pickard TD, Rosenbaum JT: A prospective trial of infliximab therapy for refractory uveitis: preliminary safety and efficacy outcomes. Arch Ophthalmol 2005;123:903–912.
  100. Banares A, Abasolo L, Macarron P: Treatment of refractory posterior uveitis with anti-TNF alpha (infliximab). Arthritis Rheum 2001;44:S90.

    External Resources

  101. Braun J, Baraliakos X, Listing J, Sieper J: Decreased incidence of anterior uveitis in patients with ankylosing spondylitis treated with the anti-tumor necrosis factor agents infliximab and etanercept. Arthritis Rheum 2005;52:2447–2451.
  102. El-Shabrawi Y, Graz JH: Anti-TNF therapy with infliximab in the treatment of HLA-B27 associated acute anterior uveitis: a one year follow up. Arthritis Rheum 2001;44:S123.

    External Resources

  103. Martin TMP, Smith JRMP, Rosenbaum JTMD: Anterior uveitis: current concepts of pathogenesis and interactions with the spondyloarthropathies. Curr Opin Rheumatol 2002;14:337–341.
  104. Schreiber S: Guidelines of the DGVS. Extraintestinal manifestations. German Society of Digestive and Metabolic Diseases. Z Gastroenterol 2001;39:63–65.
  105. Dvorchik I, Subotin M, Demetris AJ, Fung JJ, Starzl TE, Wieand S, Abu-Elmagd KM: Effect of liver transplantation on inflammatory bowel disease in patients with primary sclerosing cholangitis. Hepatology 2002;35:380–384.
  106. Tung BY, Emond MJ, Haggitt RC, Bronner MP, Kimmey MB, Kowdley KV, Brentnall TA: Ursodiol use is associated with lower prevalence of colonic neoplasia in patients with ulcerative colitis and primary sclerosing cholangitis. Ann Intern Med 2001;134:89–95.


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