Skip to main content
SpringerLink
Log in

Phänotypen und extraintestinale Manifestationen

  • Chapter
  • First Online:
Pflege bei chronisch-entzündlichen Darmerkrankungen

  • 1031 Accesses

Zusammenfassung

CED sind entzündliche Darmerkrankungen, die meist durch einen Wechsel von Krankheitsschüben und schubfreien Phasen gekennzeichnet sind und in die beiden Hauptformen Morbus Crohn und Colitis ulcerosa eingeteilt werden. Bei mehr als 10 % der CED-Patienten ist keine Zuordnung zu diesen beiden Hauptformen möglich; man spricht dann von einer Colitis indeterminata.

Den Morbus Crohn zeichnet ein diskontinuierlicher Verlauf im Gastrointestinaltrakt mit häufigem Befall des letzten Teils des Dünndarms (terminales Ileum) aus, z. T. mit dem Nachweis von Granulomen in der histologischen Untersuchung, während die Colitis ulcerosa meist vom Enddarm (Rektum) ausgehend kontinuierlich nach proximal verläuft. Die Entzündung kann beim Morbus Crohn die gesamte Darmwand erfassen (= transmurale Entzündung), während bei der Colitis ulcerosa meist nur die Darmschleimhaut betroffen ist (= mukosale Entzündung). Der Morbus Crohn lässt sich nach der sogenannten Montreal-Klassifikation in einen entzündlichen (B1), stenosierenden (B2) und penetrierenden/fistulierenden (B3) Phänotyp einteilen. Bezüglich der Erkrankungslokalisation unterscheidet man beim Morbus Crohn folgende vier Lokalisationen: L1 – terminales Ileum, L2 – Kolon, L3 – Ileum und Kolon und L4 – oberer Gastrointestinaltrakt. Die Colitis ulcerosa wird entsprechend ihrer Lokalisation in Proktitis (L1), Linksseitenkolitis (L2) und Pankolitis (L3) klassifiziert.

Beim Morbus Morbus Crohn bleibt die Erkrankungslokalisation im Krankheitsverlauf meist stabil, während sich der Phänotyp im Verlauf der Erkrankung häufig von einem inflammatorischen Phänotyp zu einem stenosierenden und penetrierenden (fistulierenden) Phänotyp ändert. Bei der Colitis ulcerosa kann die Krankheitsausdehnung vom Rektum ausgehend im Verlauf weiter nach proximal (über eine Linksseitenkolitis) bis hin zu einer kompletten Pankolitis zunehmen.

Extraintestinale Manifestationen (EIM) finden sich bei fast der Hälfte aller CED-Patienten, wobei die Diagnose eines Morbus Crohn, ein weibliches Geschlecht, ein aktiver Raucherstatus und eine lange Erkrankungsdauer sowie hohe Krankheitsaktivität Risikofaktoren für EIM sind. Am häufigsten werden EIM der Gelenke (Gelenkschmerzen = Arthralgien, Gelenkentzündungen = Arthritiden), der Haut (wie z. B. Erythema nodosum oder Pyoderma gangraenosum) oder des Auges (z. B. anteriore Uveitis) beobachtet. Klinisch imponieren diese EIM meist als Gelenkschmerzen (Arthralgien), als entzündliche Hautveränderungen oder als Rötung des Auges. EIM können gleichzeitig mit der CED auftreten, sich aber auch lange vor oder nach der Erstdiagnose der CED manifestieren. Auch nach einer Entfernung des Dickdarms (Proktokolektomie) können immer noch EIM auftreten. Bestimmte EIM korrelieren mit der CED-Aktivität, während andere EIM unabhängig von der Entzündungsaktivität des Darms sind. Aufgrund überlappender genetischer Risikofaktoren und Pathogenese-Mechanismen treten auch andere Autoimmunerkrankungen wie die Psoriasis und die ankylosierende Spondylitis bei CED-Patienten häufiger als in der Normalbevölkerung auf. Bei EIM sind insbesondere Anti-TNF-Antikörper therapeutisch wirksam, können aber in seltenen Fällen auch extraintestinale Manifestationen (wie z. B. eine Anti-TNF-induzierte Psoriasis oder ein Anti-TNF-induziertes Lupus-like-Syndrom) verursachen.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 39.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 49.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Literatur

  • Allez M, Lemann M, Bonnet J, Cattan P, Jian R, Modigliani R (2002) Long term outcome of patients with active Crohn’s disease exhibiting extensive and deep ulcerations at colonoscopy. Am J Gastroenterol. 97(4):947–953

    Google Scholar 

  • Baumgart D, Phillip S (2018) Kapitel 17. Hautmanifestationen und sekundäre Manifestationen. In: Kucharzik T, Rijcken E, Bettenworth D, Senninger N (Hrsg) Therapie chronisch entzündlicher Darmerkrankungen, 1. Aufl. de Gruyter, Berlin

    Google Scholar 

  • Baumgart DC, Sandborn WJ (2012) Crohn’s disease. Lancet 380(9853):1590–1605

    Article  Google Scholar 

  • Beaugerie L, Massot N, Carbonnel F, Cattan S, Gendre JP, Cosnes J (2001) Impact of cessation of smoking on the course of ulcerative colitis. Am J Gastroenterol. 96(7):2113–2116

    Article  CAS  Google Scholar 

  • Beaugerie L, Seksik P, Nion-Larmurier I, Gendre JP, Cosnes J (2006) Predictors of Crohn’s disease. Gastroenterology. 130(3):650–656

    Article  Google Scholar 

  • Beigel F, Schnitzler F, Paul Laubender R, Pfennig S, Weidinger M, Göke B, Seiderer J, Ochsenkühn T, Brand S (2011) Formation of antinuclear and double-strand DNA antibodies and frequency of lupus-like syndrome in anti-TNF-α antibody-treated patients with inflammatory bowel disease. Inflamm Bowel Dis. 17(1):91–98

    Article  Google Scholar 

  • Beigel F, Steinborn A, Schnitzler F, Tillack C, Breiteneicher S, John JM, Van Steen K, Laubender RP, Göke B, Seiderer J, Brand S, Ochsenkühn T (2014) Risk of malignancies in patients with inflammatory bowel disease treated with thiopurines or anti-TNF alpha antibodies. Pharmacoepidemiol Drug Saf. 23(7):735–744

    Article  CAS  Google Scholar 

  • Brand S (2007) Kapitel 6.3.8. Chronisch entzündliche Darmerkrankungen: Morbus Crohn und Colitis ulcerosa. In: Göke B, Beglinger C (Hrsg) Gastroenterologie systematisch, 2. Aufl. UNI-MED, Bremen

    Google Scholar 

  • Brand S (2018) Kapitel 4. Phänotyp und Verlaufsformen. In: Kucharzik T, Rijcken E, Bettenworth D, Senninger N (Hrsg) Therapie chronisch entzündlicher Darmerkrankungen, 1. Aufl. de Gruyter, Berlin

    Google Scholar 

  • Chapelier N, Dury I, Louis E (2019) Chapter 19. Extra-intestinal manifestations. In: Sturm A, White L (Hrsg) Inflammatory bowel disease nursing manual. Springer, Switzerland

    Google Scholar 

  • Cleynen I, Boucher G, Jostins L, Schumm LP, Zeissig S, Ahmad T, Andersen V, Andrews JM, Annese V, Brand S, Brant SR, Cho JH, Daly MJ, Dubinsky M, Duerr RH, Ferguson LR, Franke A, Gearry RB, Goyette P, Hakonarson H, Halfvarson J, Hov JR, Huang H, Kennedy NA, Kupcinskas L, Lawrance IC, Lee JC, Satsangi J, Schreiber S, Théâtre E, van der Meulen-de Jong AE, Weersma RK, Wilson DC, International Inflammatory Bowel Disease Genetics Consortium, Parkes M, Vermeire S, Rioux JD, Mansfield J, Silverberg MS, Radford-Smith G, DP MG, Barrett JC, Lees CW (2016) Inherited determinants of Crohn’s disease and ulcerative colitis phenotypes: a genetic association study. Lancet 387(10014):156–167

    Article  Google Scholar 

  • Cosnes J, Beaugerie L, Carbonnel F, Gendre JP (2001) Smoking cessation and the course of Crohn’s disease: an intervention study. Gastroenterology. 120(5):1093–1099

    Article  CAS  Google Scholar 

  • Cosnes J, Cattan S, Blain A, Beaugerie L, Carbonnel F, Parc R, Gendre JP (2002) Long-term evolution of disease behavior of Crohn’s disease. Inflamm Bowel Dis. 8(4):244–250

    Article  Google Scholar 

  • Dias CC, Rodrigues PP, da Costa-Pereira A, Magro F (2015) Clinical predictors of colectomy in patients with ulcerative colitis: systematic review and meta-analysis of cohort studies. J Crohns Colitis. 9(2):156–163

    Article  Google Scholar 

  • Farmer RG, Easley KA, Rankin GB (1993) Clinical patterns, natural history, and progression of ulcerative colitis. A long-term follow-up of 1116 patients. Dig Dis Sci. 38(6):1137–1146

    Article  CAS  Google Scholar 

  • Fellermann K (2018) Kapitel 16. Gelenkmanifestationen, Osteoporose/Osteopenie. In: Kucharzik T, Rijcken E, Bettenworth D, Senninger N (Hrsg) Therapie chronisch entzündlicher Darmerkrankungen, 1. Aufl. de Gruyter, Berlin

    Google Scholar 

  • Fiorino G, Morin M, Bonovas S, Bonifacio C, Spinelli A, Germain A, Laurent V, Zallot C, Peyrin-Biroulet L, Danese S (2017) Prevalence of bowel damage assessed by cross-sectional imaging in early Crohn’s disease and its impact on disease outcome. J Crohns Colitis. 11(3):274–280

    Google Scholar 

  • Friedrich M, Diegelmann J, Beigel F, Brand S (2014a) IL-17A alone weakly affects the transcriptome of intestinal epithelial cells but strongly modulates the TNF-α-induced expression of inflammatory mediators and inflammatory bowel disease susceptibility genes. Inflamm Bowel Dis. 20(9):1502–1515

    Article  Google Scholar 

  • Friedrich M, Tillack C, Wollenberg A, Schauber J, Brand S (2014b) IL-36γ sustains a proinflammatory self-amplifying loop with IL-17C in anti-TNF-induced psoriasiform skin lesions of patients with Crohn’s disease. Inflamm Bowel Dis. 20(11):1891–1901

    Article  Google Scholar 

  • Frøslie KF, Jahnsen J, Moum BA, Vatn MH, IBSEN Group (2007) Mucosal healing in inflammatory bowel disease: results from a Norwegian population-based cohort. Gastroenterology. 133(2):412–422

    Article  Google Scholar 

  • Gasche C, Ahmad T, Tulassay Z, Baumgart DC, Bokemeyer B, Büning C, Howaldt S, Stallmach A (2015) AEGIS Study Group. Ferric maltol is effective in correcting iron deficiency anemia in patients with inflammatory bowel disease: results from a phase-3 clinical trial program. Inflamm Bowel Dis. 21(3):579–588

    Article  Google Scholar 

  • Greuter T, Rieder F, Kucharzik T, Peyrin-Biroulet L, Schoepfer AM, Rubin DT, Vavricka SR (2021) Emerging treatment options for extraintestinal manifestations in IBD. Gut. 70(4):796–802

    Article  CAS  Google Scholar 

  • Harbord M, Annese V, Vavricka SR, Allez M, Barreiro-de Acosta M, Boberg KM, Burisch J, De Vos M, De Vries AM, Dick AD, Juillerat P, Karlsen TH, Koutroubakis I, Lakatos PL, Orchard T, Papay P, Raine T, Reinshagen M, Thaci D, Tilg H, Carbonnel F, European Crohn’s and Colitis Organisation (2016) The first European evidence-based consensus on extra-intestinal manifestations in inflammatory bowel disease. J Crohns Colitis. 10(3):239–254

    Article  Google Scholar 

  • Heap GA, Weedon MN, Bewshea CM, Singh A, Chen M, Satchwell JB, Vivian JP, So K, Dubois PC, Andrews JM, Annese V, Bampton P, Barnardo M, Bell S, Cole A, Connor SJ, Creed T, Cummings FR, D’Amato M, Daneshmend TK, Fedorak RN, Florin TH, Gaya DR, Greig E, Halfvarson J, Hart A, Irving PM, Jones G, Karban A, Lawrance IC, Lee JC, Lees C, Lev-Tzion R, Lindsay JO, Mansfield J, Mawdsley J, Mazhar Z, Parkes M, Parnell K, Orchard TR, Radford-Smith G, Russell RK, Reffitt D, Satsangi J, Silverberg MS, Sturniolo GC, Tremelling M, Tsianos EV, van Heel DA, Walsh A, Watermeyer G, Weersma RK, Zeissig S, Rossjohn J, Holden AL, International Serious Adverse Events Consortium, IBD Pharmacogenetics Study Group, Ahmad T (2014) HLA-DQA1-HLA-DRB1 variants confer susceptibility to pancreatitis induced by thiopurine immunosuppressants. Nat Genet. 46(10):1131–1134

    Article  CAS  Google Scholar 

  • Heap GA, So K, Weedon M, Edney N, Bewshea C, Singh A, Annese V, Beckly J, Buurman D, Chaudhary R, Cole AT, Cooper SC, Creed T, Cummings F, de Boer NK, D’Inca R, D’Souza R, Daneshmend TK, Delaney M, Dhar A, Direkze N, Dunckley P, Gaya DR, Gearry R, Gore S, Halfvarson J, Hart A, Hawkey CJ, Hoentjen F, Iqbal T, Irving P, Lal S, Lawrence I, Lees CW, Lockett M, Mann S, Mansfield J, Mowat C, Mulgrew CJ, Muller F, Murray C, Oram R, Orchard T, Parkes M, Phillips R, Pollok R, Radford-Smith G, Sebastian S, Sen S, Shirazi T, Silverberg M, Solomon L, Sturniolo GC, Thomas M, Tremelling M, Tsianos EV, Watts D, Weaver S, Weersma RK, Wesley E, Holden A, Ahmad T (2016) Clinical features and HLA association of 5-aminosalicylate (5-ASA)-induced nephrotoxicity in inflammatory bowel disease. J Crohns Colitis. 10(2):149–158

    Article  Google Scholar 

  • Hedin CRH, Vavricka SR, Stagg AJ, Schoepfer A, Raine T, Puig L, Pleyer U, Navarini A, van der Meulen-de Jong AE, Maul J, Katsanos K, Kagramanova A, Greuter T, González-Lama Y, van Gaalen F, Ellul P, Burisch J, Bettenworth D, Becker MD, Bamias G, Rieder F (2019) The pathogenesis of extraintestinal manifestations: Implications for IBD research, diagnosis, and therapy. J Crohns Colitis. 13(5):541–554

    Article  CAS  Google Scholar 

  • Hueber W, Sands BE, Lewitzky S, Vandemeulebroecke M, Reinisch W, Higgins PD, Wehkamp J, Feagan BG, Yao MD, Karczewski M, Karczewski J, Pezous N, Bek S, Bruin G, Mellgard B, Berger C, Londei M, Bertolino AP, Tougas G, Travis SP, Secukinumab in Crohn’s Disease Study Group (2012) Secukinumab, a human anti-IL-17A monoclonal antibody, for moderate to severe Crohn’s disease: unexpected results of a randomised, double-blind placebo-controlled trial. Gut. 61(12):1693–1700

    Article  CAS  Google Scholar 

  • Jansen FM, Vavricka SR, den Broeder AA, de Jong EM, Hoentjen F, van Dop WA (2020) Clinical management of the most common extra-intestinal manifestations in patients with inflammatory bowel disease focused on the joints, skin and eyes. United European Gastroenterol J. 8(9):1031–1044

    Article  Google Scholar 

  • Jostins L, Ripke S, Weersma RK, Duerr RH, McGovern DP, Hui KY, Lee JC, Schumm LP, Sharma Y, Anderson CA, Essers J, Mitrovic M, Ning K, Cleynen I, Theatre E, Spain SL, Raychaudhuri S, Goyette P, Wei Z, Abraham C, Achkar JP, Ahmad T, Amininejad L, Ananthakrishnan AN, Andersen V, Andrews JM, Baidoo L, Balschun T, Bampton PA, Bitton A, Boucher G, Brand S, Büning C, Cohain A, Cichon S, D’Amato M, De Jong D, Devaney KL, Dubinsky M, Edwards C, Ellinghaus D, Ferguson LR, Franchimont D, Fransen K, Gearry R, Georges M, Gieger C, Glas J, Haritunians T, Hart A, Hawkey C, Hedl M, Hu X, Karlsen TH, Kupcinskas L, Kugathasan S, Latiano A, Laukens D, Lawrance IC, Lees CW, Louis E, Mahy G, Mansfield J, Morgan AR, Mowat C, Newman W, Palmieri O, Ponsioen CY, Potocnik U, Prescott NJ, Regueiro M, Rotter JI, Russell RK, Sanderson JD, Sans M, Satsangi J, Schreiber S, Simms LA, Sventoraityte J, Targan SR, Taylor KD, Tremelling M, Verspaget HW, De Vos M, Wijmenga C, Wilson DC, Winkelmann J, Xavier RJ, Zeissig S, Zhang B, Zhang CK, Zhao H, International IBD Genetics Consortium (IIBDGC), Silverberg MS, Annese V, Hakonarson H, Brant SR, Radford-Smith G, Mathew CG, Rioux JD, Schadt EE, Daly MJ, Franke A, Parkes M, Vermeire S, Barrett JC, Cho JH (2012) Host-microbe interactions have shaped the genetic architecture of inflammatory bowel disease. Nature. 491(7422):119–124

    Article  CAS  Google Scholar 

  • Jürgens M, Brand S, Laubender RP, Seiderer J, Glas J, Wetzke M, Wagner J, Pfennig S, Tillack C, Beigel F, Weidinger M, Schnitzler F, Kreis ME, Göke B, Lohse P, Herrmann K, Ochsenkühn T (2010) The presence of fistulas and NOD2 homozygosity strongly predict intestinal stenosis in Crohn’s disease independent of the IL23R genotype. J Gastroenterol. 45(7):721–731

    Article  Google Scholar 

  • Kevans D, Waterman M, Milgrom R, Xu W, Van Assche G, Silverberg M (2015) Serological markers associated with disease behavior and response to anti-tumor necrosis factor therapy in ulcerative colitis. J Gastroenterol Hepatol. 30(1):64–70

    Article  CAS  Google Scholar 

  • Kuisma J, Järvinen H, Kahri A, Färkkilä M (2004) Factors associated with disease activity of pouchitis after surgery for ulcerative colitis. Scand J Gastroenterol. 39(6):544–548

    Article  CAS  Google Scholar 

  • Lakatos PL, Sipeki N, Kovacs G, Palyu E, Norman GL, Shums Z, Golovics PA, Lovasz BD, Antal-Szalmas P, Papp M (2015) Risk matrix for prediction of disease progression in a referral cohort of patients with Crohn’s disease. J Crohns Colitis. 9(10):891–898

    Article  Google Scholar 

  • Langholz E, Munkholm P, Davidsen M, Binder V (1994) Course of ulcerative colitis: analysis of changes in disease activity over years. Gastroenterology. 107(1):3–11

    Article  CAS  Google Scholar 

  • Lee FI, Bellary SV, Francis C (1990) Increased occurrence of psoriasis in patients with Crohn’s disease and their relatives. Am J Gastroenterol. 85(8):962–963

    CAS  Google Scholar 

  • Lees CW, Barrett JC, Parkes M, Satsangi J (2011) New IBD genetics: common pathways with other diseases. Gut. 60(12):1739–1753

    Article  CAS  Google Scholar 

  • Lennard-Jones JE (1983) The clinical outcome of ulcerative colitis depends on how much of the colonic mucosa is involved. Scand J Gastroenterol Suppl. 88:48–53

    CAS  Google Scholar 

  • Lichtenstein GR, Olson A, Travers S, Diamond RH, Chen DM, Pritchard ML, Feagan BG, Cohen RD, Salzberg BA, Hanauer SB, Sandborn WJ (2006) Factors associated with the development of intestinal strictures or obstructions in patients with Crohn’s disease. Am J Gastroenterol. 101(5):1030–1038

    Article  Google Scholar 

  • Loly C, Belaiche J, Louis E (2008) Predictors of severe Crohn’s disease. Scand J Gastroenterol. 43(8):948–954

    Article  CAS  Google Scholar 

  • Louis E, Collard A, Oger AF, Degroote E, Aboul Nasr El Yafi FA, Belaiche J (2001) Behaviour of Crohn’s disease according to the Vienna classification: changing pattern over the course of the disease. Gut. 49(6):777–782

    Article  CAS  Google Scholar 

  • Martin TM, Smith JR, Rosenbaum JT (2002) Anterior uveitis: current concepts of pathogenesis and interactions with the spondyloarthropathies. Curr Opin Rheumatol. 14(4):337–341

    Article  Google Scholar 

  • Meucci G, Vecchi M, Astegiano M, Beretta L, Cesari P, Dizioli P, Ferraris L, Panelli MR, Prada A, Sostegni R, de Franchis R (2000) The natural history of ulcerative proctitis: a multicenter, retrospective study. Gruppo di Studio per le Malattie Infiammatorie Intestinali (GSMII). Am J Gastroenterol. 95(2):469–473

    Article  CAS  Google Scholar 

  • Mintz R, Feller ER, Bahr RL, Shah SA (2004) Ocular manifestations of inflammatory bowel disease. Inflamm Bowel Dis. 10(2):135–139

    Article  Google Scholar 

  • Nunes T, Etchevers MJ, García-Sánchez V, Ginard D, Martí E, Barreiro-de Acosta M, Gomollón F, Arroyo M, Bastida G, Gonzalez B, Monfort D, García-Planella E, Figueroa C, Panés J, Sans M (2016) Impact of smoking cessation on the clinical course of Crohn’s disease under current therapeutic algorithms: a multicenter prospective study. Am J Gastroenterol. 111(3):411–419

    Article  CAS  Google Scholar 

  • Orchard TR, Wordsworth BP, Jewell DP (1998) Peripheral arthropathies in inflammatory bowel disease: their articular distribution and natural history. Gut. 42(3):387–391

    Article  CAS  Google Scholar 

  • Peeters H, Vander Cruyssen B, Laukens D, Coucke P, Marichal D, Van Den Berghe M, Cuvelier C, Remaut E, Mielants H, De Keyser F, Vos MD (2004) Radiological sacroiliitis, a hallmark of spondylitis, is linked with CARD15 gene polymorphisms in patients with Crohn’s disease. Ann Rheum Dis. 63(9):1131–1134

    Article  CAS  Google Scholar 

  • Ryan JD, Silverberg MS, Xu W, Graff LA, Targownik LE, Walker JR, Carr R, Clara I, Miller N, Rogala L, Bernstein CN (2013) Predicting complicated Crohn’s disease and surgery: phenotypes, genetics, serology and psychological characteristics of a population-based cohort. Aliment Pharmacol Ther. 38(3):274–283

    Article  CAS  Google Scholar 

  • Safroneeva E, Vavricka S, Fournier N, Seibold F, Mottet C, Nydegger A, Ezri J, Straumann A, Rogler G, Schoepfer AM, Swiss IBD Cohort Study Group (2015) Systematic analysis of factors associated with progression and regression of ulcerative colitis in 918 patients. Aliment Pharmacol Ther. 42(5):540–548

    Article  CAS  Google Scholar 

  • Scarpa M, Ruffolo C, Bertin E, Polese L, Filosa T, Prando D, Pagano D, Norberto L, Frego M, D’Amico DF, Angriman I (2007) Surgical predictors of recurrence of Crohn’s disease after ileocolonic resection. Int J Colorectal Dis. 22(9):1061–1069

    Article  Google Scholar 

  • Schnitzler F, Fidder H, Ferrante M, Noman M, Arijs I, Van Assche G, Hoffman I, Van Steen K, Vermeire S, Rutgeerts P (2009) Mucosal healing predicts long-term outcome of maintenance therapy with infliximab in Crohn’s disease. Inflamm Bowel Dis. 15(9):1295–1301

    Article  Google Scholar 

  • Schnitzler F, Friedrich M, Wolf C, Angelberger M, Diegelmann J, Olszak T, Beigel F, Tillack C, Stallhofer J, Göke B, Glas J, Lohse P, Brand S (2014) The NOD2 p.Leu1007fsX1008 mutation (rs2066847) is a stronger predictor of the clinical course of Crohn’s disease than the FOXO3A intron variant rs12212067. PLoS One 9(11):e108503

    Article  Google Scholar 

  • Schnitzler F, Friedrich M, Angelberger M, Diegelmann J, Stallhofer J, Wolf C, Dütschler J, Truniger S, Olszak T, Beigel F, Tillack C, Lohse P, Brand S (2020) Development of a uniform, very aggressive disease phenotype in all homozygous carriers of the NOD2 mutation p.Leu1007fsX1008 with Crohn’s disease and active smoking status resulting in ileal stenosis requiring surgery. PLoS One 15(7):e0236421

    Article  CAS  Google Scholar 

  • Seiderer J, Brand S, Herrmann KA, Schnitzler F, Hatz R, Crispin A, Pfennig S, Schoenberg SO, Göke B, Lohse P, Ochsenkuhn T (2006a) Predictive value of the CARD15 variant 1007fs for the diagnosis of intestinal stenoses and the need for surgery in Crohn’s disease in clinical practice: results of a prospective study. Inflamm Bowel Dis. 12(12):1114–1121

    Article  Google Scholar 

  • Seiderer J, Zech CJ, Diebold J, Schoenberg SO, Brand S, Tillack C, Göke B, Ochsenkühn T (2006b) Nodular regenerative hyperplasia: a reversible entity associated with azathioprine therapy. Eur J Gastroenterol Hepatol. 18(5):553–555

    Article  Google Scholar 

  • Silverberg MS, Satsangi J, Ahmad T, Arnott ID, Bernstein CN, Brant SR, Caprilli R, Colombel JF, Gasche C, Geboes K, Jewell DP, Karban A, Loftus EV Jr, Peña AS, Riddell RH, Sachar DB, Schreiber S, Steinhart AH, Targan SR, Vermeire S, Warren BF (2005) Toward an integrated clinical, molecular and serological classification of inflammatory bowel disease: report of a Working Party of the 2005 Montreal World Congress of Gastroenterology. Can J Gastroenterol. 19(Suppl A):5A–36A

    Article  Google Scholar 

  • Solberg IC, Vatn MH, Høie O, Stray N, Sauar J, Jahnsen J, Moum B, Lygren I, IBSEN Study Group (2007) Clinical course in Crohn’s disease: results of a Norwegian population-based ten-year follow-up study. Clin Gastroenterol Hepatol. 5(12):1430–1438

    Article  Google Scholar 

  • Solberg IC, Lygren I, Cvancarova M, Jahnsen J, Stray N, Sauar J, Schreiber S, Moum B, Vatn MH, IBSEN Study Group (2009a) Predictive value of serologic markers in a population-based Norwegian cohort with inflammatory bowel disease. Inflamm Bowel Dis. 15(3):406–414

    Article  Google Scholar 

  • Solberg IC, Lygren I, Jahnsen J, Aadland E, Høie O, Cvancarova M, Bernklev T, Henriksen M, Sauar J, Vatn MH, Moum B, IBSEN Study Group (2009b) Clinical course during the first 10 years of ulcerative colitis: results from a population-based inception cohort (IBSEN Study). Scand J Gastroenterol. 44(4):431–440

    Article  Google Scholar 

  • Sutherland LR, Ramcharan S, Bryant H, Fick G (1990) Effect of cigarette smoking on recurrence of Crohn’s disease. Gastroenterology. 98(5 Pt 1):1123–1128

    Article  CAS  Google Scholar 

  • Taleban S, Li D, Targan SR, Ippoliti A, Brant SR, Cho JH, Duerr RH, Rioux JD, Silverberg MS, Vasiliauskas EA, Rotter JI, Haritunians T, Shih DQ, Dubinsky M, Melmed GY, McGovern DP (2016) Ocular manifestations in inflammatory bowel disease are associated with other extra-intestinal manifestations, gender, and genes implicated in other immune-related traits. J Crohns Colitis. 10(1):43–49

    Article  Google Scholar 

  • Tarrant KM, Barclay ML, Frampton CM, Gearry RB (2008) Perianal disease predicts changes in Crohn’s disease phenotype-results of a population-based study of inflammatory bowel disease phenotype. Am J Gastroenterol. 103(12):3082–3093

    Article  Google Scholar 

  • Tibble JA, Sigthorsson G, Bridger S, Fagerhol MK, Bjarnason I (2000) Surrogate markers of intestinal inflammation are predictive of relapse in patients with inflammatory bowel disease. Gastroenterology. 119(1):15–22

    Article  CAS  Google Scholar 

  • Tillack C, Ehmann LM, Friedrich M, Laubender RP, Papay P, Vogelsang H, Stallhofer J, Beigel F, Bedynek A, Wetzke M, Maier H, Koburger M, Wagner J, Glas J, Diegelmann J, Koglin S, Dombrowski Y, Schauber J, Wollenberg A, Brand S (2014) Anti-TNF antibody-induced psoriasiform skin lesions in patients with inflammatory bowel disease are characterised by interferon-γ-expressing Th1 cells and IL-17A/IL-22-expressing Th17 cells and respond to anti-IL-12/IL-23 antibody treatment. Gut. 63(4):567–577

    Article  CAS  Google Scholar 

  • Ungaro R, Mehandru S, Allen PB, Peyrin-Biroulet L, Colombel JF (2017) Ulcerative colitis. Lancet. 389(10080):1756–1770

    Article  Google Scholar 

  • Vavricka SR, Brun L, Ballabeni P, Pittet V, Prinz Vavricka BM, Zeitz J, Rogler G, Schoepfer AM (2011) Frequency and risk factors for extraintestinal manifestations in the Swiss inflammatory bowel disease cohort. Am J Gastroenterol. 106(1):110–119

    Article  Google Scholar 

  • Waterman M, Knight J, Dinani A, Xu W, Stempak JM, Croitoru K, Nguyen GC, Cohen Z, McLeod RS, Greenberg GR, Steinhart AH, Silverberg MS (2015) Predictors of outcome in ulcerative colitis. Inflamm Bowel Dis. 21(9):2097–2105

    Article  Google Scholar 

  • Wolf M, Rubin J, Achebe M, Econs MJ, Peacock M, Imel EA, Thomsen LL, Carpenter TO, Weber T, Brandenburg V, Zoller H (2020) Effects of iron isomaltoside vs ferric carboxymaltose on hypophosphatemia in iron-deficiency anemia: Two randomized clinical trials. JAMA. 323(5):432–443

    Article  Google Scholar 

  • Wright EK, Kamm MA, De Cruz P, Hamilton AL, Ritchie KJ, Krejany EO, Leach S, Gorelik A, Liew D, Prideaux L, Lawrance IC, Andrews JM, Bampton PA, Jakobovits SL, Florin TH, Gibson PR, Debinski H, Macrae FA, Samuel D, Kronborg I, Radford-Smith G, Selby W, Johnston MJ, Woods R, Elliott PR, Bell SJ, Brown SJ, Connell WR, Day AS, Desmond PV, Gearry RB (2015) Measurement of fecal calprotectin improves monitoring and detection of recurrence of Crohn’s disease after surgery. Gastroenterology. 148(5):938–947

    Article  CAS  Google Scholar 

  • Yates VM, Watkinson G, Kelman A (1982) Further evidence for an association between psoriasis, Crohn’s disease and ulcerative colitis. Br J Dermatol. 106(3):323–330

    Article  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Chefarzt der Klinik für Gastroenterologie und Hepatologie, Chairman des Departement Innere Medizin, Kantonsspital St. Gallen, St. Gallen, Schweiz

    Stephan Brand

Authors
  1. Stephan Brand
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Stephan Brand .

Editor information

Editors and Affiliations

  1. Klinik für Innere Medizin mit schwerpunkt Gastroenterologie, DRK Kliniken Berlin, Berlin, Deutschland

    Andreas Sturm

Rights and permissions

Reprints and permissions

Copyright information

© 2023 Der/die Autor(en), exklusiv lizenziert an Springer-Verlag GmbH, DE, ein Teil von Springer Nature

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Brand, S. (2023). Phänotypen und extraintestinale Manifestationen. In: Sturm, A. (eds) Pflege bei chronisch-entzündlichen Darmerkrankungen. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-64938-1_5

Download citation

  • DOI: https://doi.org/10.1007/978-3-662-64938-1_5

  • Published:

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-662-64937-4

  • Online ISBN: 978-3-662-64938-1

  • eBook Packages: Medicine (German Language)

Publish with us

Policies and ethics

Search

Navigation