Extraintestinal manifestations and complications in inflammatory bowel diseases

Table 1 Extraintestinal symptoms in inflammatory bowel disease

Extraintestinal manifestations	Extraintestinal complications
Musculosceletal diseases
Peripheral Arthritis	Drug-induced osteoporosis and osteonecrosis
Ankylosing spondylitis	Bacterial infection of joints (fistulization, immunosuppression)
Isolated sacroiliitis	Septic arthritis
Metastatic Crohn’s disease
Mucocutaneous diseases
Erythema nodosum	Anal fissures
Pyoderma gangraenosum	Fistulas
Aphthous stomatitis/oral ulceration
Psoriasis?	Acrodermatitis enteropathica (Zinc deficiency)
Epidermolysis bullosa acquisita?	Purpura (Vitamin C and K deficiency)
Sweet Syndrome?	Glossitis (Vitamin B or Zinc deficiency)
Erythema exsudativum multiforme?	Hair loss (protein deficiency)
	Brittle nail (protein deficiency)
	Perlèche (Iron deficiency)
	Candidiasis (Zinc deficiency, immunosuppression)
	Mucositis/stomatitis (methotrexate)
	Drug-induced rash, allergic exanthema
	Moon-face, acne, stretch marks, skin atrophy (steroid treatment)
Ocular diseases
Anterior Uveitis	Night blindness Vitamin A deficiency
Conjunctivitis	Kerathopathy Vitamin A deficiency
Iritis	Opportunistic infections (immunosuppressants)
Skleritis/Episcleritis
Hepatobiliary diseases
Primary sclerosing cholangitis	Gall stones in Crohn’ disease
Granulomatous Crohn’s hepatitis	Fatty liver
Autoimmune chronic active hepatitis?
Biliary cirrhosis?
Pancreatic diseases
Acute pancreatitis	Drug-induced pancreatitis (5-ASA, azathioprine)
Chronic pancreatitis, exocrine insufficiency	Biliary pancreatitis in Crohn’s disease
	Duodenal involvement in Crohn’s disease
Blood and vascular diseases
Thrombembolic events	Anemia (Iron-, folate-, vitamin B12-deficiency)
Autoimmune hemolytic anemia?	Thrombocytosis, leucocytosis
Thrombocytopenic purpura (Moschcowitz Syndrome)?	Hypercoagulation: venous thrombosis, thrombembolism
Renal diseases
Tubular proteinuria	Nephrolithiasis (oxalate stones, uric acid stones)
Glomerulonephritis?	Local affection involving the urethro-genital system
	Acute interstitial nephritis (drug related SASP, 5-ASA)
Interstitial nephritis?	Drug-induced renal insufficiency (5-ASA, SASP, cyclosporine)
	Renal amyloidosis
Bronchopulmonary diseases
Chronic bronchitis/bronchiolitis/bronchiectasis	Drug-induced hypersensitivity pneumonitis
Acute laryngotracheitis/tracheal stenosis	Drug related pulmonary fibrosis (methotrexate)
Bronchiolitis obliterans organizing pneumonia	Drug-induced pleuritis
Pleuritis/serositis	Opportunistic infections (immunosuppression)
Cardiac diseases
Pericarditis	Drug-induced pericarditis (5-ASA)
Myocarditis?/perimyocarditis
Neurological diseases
Demyelinating diseases including multiple sclerosis	Peripheral neuropathy (Vitamin B12 deficiency)
Optic neuritis, sensorial hearing loss	Drug-induced leucencephalopathia (natalizumab, infliximab)
Myasthenia gravis?	Drug-induced polyneuropathia (metronidazole)