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Sharif K, Ben-Shabat N, Mahagna M, Shani U, Watad A, Cohen AD, Amital H. Inflammatory Bowel Diseases Are Associated with Polymyositis and Dermatomyositis-A Retrospective Cohort Analysis. MEDICINA (KAUNAS, LITHUANIA) 2022; 58:medicina58121727. [PMID: 36556929 PMCID: PMC9781532 DOI: 10.3390/medicina58121727] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Revised: 11/19/2022] [Accepted: 11/24/2022] [Indexed: 11/27/2022]
Abstract
Background and Objectives: Polymyositis and dermatomyositis (PM/DM) are classified as polygenic autoimmune diseases, whereas inflammatory bowel disease (IBD) is considered a polygenic autoinflammatory disease. In the literature, several cases exist reporting the co-occurrence of both conditions. At the molecular level, PM/DM and IBD share common genetic determinants including interferon regulatory factor and vitamin D receptor susceptibility loci. Accumulating evidence underline several indicators that confer poor prognosis in IBD, including antinuclear antibody positivity and the presence of other autoimmune diseases, therefore the aim of this study is to assess the association between these entities. Materials and Methods: This is a population-based retrospective study using data retrieved from a large electronic medical record in Israel, the Clalit health registry. The sample included PM/DM patients and age- and sex-frequency matched controls. The prevalence of IBD in PM/DM was compared between the two groups and logistic regression was applied to control for confounding variables. Predictors of IBD in patients with PM/DM were also explored. Results: Our study included 12,278 subjects with 2085 PM/DM patients and 10,193 age- and sex- frequency-matched controls. The incidence of IBD in patients with PM/DM was significantly higher even after controlling for various confounding variables (OR of 1.73, 95% CI 1.05-2.86, p-value = 0.033). Anti-nuclear antibodies (ANA) positivity was found to be an independent predictor for IBD diagnosis in patients with PM/DM (OR 3.67, 95% CI 1.01-13.36, p = 0.048). Conclusion: Our analysis reports an association between IBD and PM/DM. Such association could point towards a common pathophysiological background. Further research is needed to further describe the clinical courses and whether a unique therapeutic approach is warranted.
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Affiliation(s)
- Kassem Sharif
- Department of Gastroenterology, Sheba Medical Centre, Tel-Hashomer 5265601, Israel
- Department of Medicine B, Zabludowicz Center for Autoimmune Diseases, Sheba Medical Center, Tel-Hashomer 5262100, Israel
- Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv 6209813, Israel
| | - Niv Ben-Shabat
- Department of Medicine B, Zabludowicz Center for Autoimmune Diseases, Sheba Medical Center, Tel-Hashomer 5262100, Israel
- Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv 6209813, Israel
| | - Muhammad Mahagna
- Department of Medicine B, Zabludowicz Center for Autoimmune Diseases, Sheba Medical Center, Tel-Hashomer 5262100, Israel
- Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv 6209813, Israel
| | - Uria Shani
- Department of Medicine B, Zabludowicz Center for Autoimmune Diseases, Sheba Medical Center, Tel-Hashomer 5262100, Israel
- Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv 6209813, Israel
| | - Abdulla Watad
- Department of Medicine B, Zabludowicz Center for Autoimmune Diseases, Sheba Medical Center, Tel-Hashomer 5262100, Israel
- Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv 6209813, Israel
- Section of Musculoskeletal Disease, NIHR Leeds Musculoskeletal Biomedical Research Unit, Leeds Institute of Molecular Medicine, University of Leeds, Chapel Allerton Hospital, Leeds LS7 4SA, UK
| | - Arnon D. Cohen
- Chief Physicians Office, Clalit Health Services, Tel Aviv 6209813, Israel
- Siaal Research Center for Family Medicine and Primary Care, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva 8410501, Israel
| | - Howard Amital
- Department of Medicine B, Zabludowicz Center for Autoimmune Diseases, Sheba Medical Center, Tel-Hashomer 5262100, Israel
- Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv 6209813, Israel
- Correspondence: ; Tel.: +972-3-5302661; Fax: +972-3-5304796
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Sumi T, Yamada G, Yorozuya T, Tanaka Y, Tanaka Y, Sakuma Y, Takahashi H. Sarcoidosis development during ulcerative colitis remission in a patient with a susceptible human leukocyte antigen serotype. SARCOIDOSIS VASCULITIS AND DIFFUSE LUNG DISEASES 2021; 38:e2021010. [PMID: 33867794 PMCID: PMC8050618 DOI: 10.36141/svdld.v38i1.6722] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/29/2017] [Accepted: 02/21/2021] [Indexed: 11/02/2022]
Abstract
The combination of sarcoidosis and ulcerative colitis (UC) is very rare, and its pathogenesis remains unknown. Hereditary factors as well as environmental factors have been speculated, including an association with the human leucocyte antigen (HLA) genotype. A 62-year-old Japanese woman with UC presented with complaint of a cough. Abnormal shadows were evident on the chest X-ray during mesalazine therapy. Multiple indolent subcutaneous nodules were also detected. Transbronchial lung and skin biopsies showed non-caseous epithelioid granulomas, which were pathologically compatible with sarcoidosis. After steroid therapy, she became asymptomatic and the abnormal shadows and subcutaneous nodules disappeared. HLA serological typing revealed that she harbored the sarcoidosis-related HLA-DR14 allele, as well as UC-related HLA-B52 and HLA-DR15 alleles. This case suggests that a susceptible HLA genotype may influence the onset of the combination of sarcoidosis and UC.
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Affiliation(s)
- Toshiyuki Sumi
- Department of Pulmonary Medicine, Steel Memorial Muroran Hospital, Japan.,Department of Respiratory Medicine and Allergology, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Gen Yamada
- Department of Respiratory Medicine and Allergology, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Takafumi Yorozuya
- Department of Respiratory Medicine and Allergology, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Yusuke Tanaka
- Department of Respiratory Medicine and Allergology, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Yasumasa Tanaka
- Department of Pulmonary Medicine, Steel Memorial Muroran Hospital, Japan
| | - Yuji Sakuma
- Department of Molecular Medicine, Research Institute for Frontier Medicine, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Hiroki Takahashi
- Department of Respiratory Medicine and Allergology, Sapporo Medical University School of Medicine, Sapporo, Japan
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Jiang Y, Rim DS, Rodgers B, Ahlawat S. Sarcoidosis is associated with lower risks of penetrating disease and colectomy in hospitalized patients with inflammatory bowel disease. JGH OPEN 2020; 4:1199-1206. [PMID: 33319056 PMCID: PMC7731821 DOI: 10.1002/jgh3.12423] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/03/2020] [Accepted: 09/20/2020] [Indexed: 11/16/2022]
Abstract
Background and Aim Inflammatory bowel disease (IBD) and sarcoidosis, primarily considered distinct entities, share commonalties in pathophysiology and clinical manifestations. This study aimed to examine the in‐hospital outcomes of patients with concurrent IBD and sarcoidosis. Methods The National Inpatient Sample was used to identify hospitalized adult patients with IBD and sarcoidosis from 2010 to 2014. Primary outcomes were in‐hospital mortality, rates of septic shock, acute renal failure, respiratory failure, length of stay, and total hospitalization charges. Secondary outcomes were IBD‐specific complications and surgery interventions. Results A total of 3995 patients with IBD and coexisting sarcoidosis (IBD/sarcoidosis), of which 2500 patients had Crohn's disease with coexisting sarcoidosis (Crohn's disease [CD]/sarcoidosis) and 1495 patients had ulcerative colitis with coexisting sarcoidosis (ulcerative colitis [UC]/sarcoidosis), were included. Patients with IBD/sarcoidosis had a lower risk of penetrating disease (adjusted odds ratio [aOR] 0.3, 95% confidence interval [CI] 0.16–0.55, P < 0.0001) and colectomy (aOR 0.48, 95% CI 0.27–0.84, P < 0.05). Subgroup analysis demonstrated lower rates of colectomy when comparing CD/sarcoidosis (P < 0.05) and UC/sarcoidosis (P = 0.0003) versus CD or UC alone. There was no difference in mortality. Conclusion IBD/sarcoidosis is associated with lower risks of penetrating disease and colectomy when compared to patients with IBD alone.
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Affiliation(s)
- Yi Jiang
- Department of Medicine Rutgers New Jersey Medical School Newark New Jersey USA
| | - Daniel S Rim
- Department of Medicine Rutgers New Jersey Medical School Newark New Jersey USA
| | - Brandon Rodgers
- Department of Medicine Rutgers New Jersey Medical School Newark New Jersey USA
| | - Sushil Ahlawat
- Division of Gastroenterology and Hepatology Rutgers New Jersey Medical School Newark New Jersey USA
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Rayamajhi SJ, Gorla AKR, Basher RK, Sood A, Mittal BR. Unsuspected Active Ulcerative Colitis in a Patient With Dermatomyositis: A Rare Association Detected on 18F-FDG PET/CT During the Search for an Occult Malignancy. Indian J Nucl Med 2017; 32:130-132. [PMID: 28533643 PMCID: PMC5439209 DOI: 10.4103/0972-3919.202238] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Dermatomyositis is an inflammatory myopathy with the characteristic features of skin rash and myopathy. We here present a known case of dermatomyositis evaluated with 18F-FDG PET/CT for the presence of any occult malignancy. The scan was negative for the presence of any malignancy. However, it revealed multiple intensely FDG avid colonic strictures that were later proven on colonoscopic biopsy to be ulcerative colitis. Also, a well-known association of bilateral sacroilitis was simultaneously demonstrated on the scan. The present case demonstrates that 18F-FDG PET/CT imaging can serve as a one-stop shop imaging modality in dermatomyositis by facilitating detection of occult primary if any and by providing insight into other rare systemic associations.
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Affiliation(s)
| | | | | | - Ashwani Sood
- Department of Nuclear Medicine, PGIMER, Chandigarh, India
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Park CH, Myong NH, Joo HD, Kang MI. Dermatomyositis: A Rare Extra-intestinal Manifestation of Ulcerative Colitis. JOURNAL OF RHEUMATIC DISEASES 2016. [DOI: 10.4078/jrd.2016.23.3.183] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Affiliation(s)
- Chang Hyun Park
- Department of Internal Medicine, Dankook University Medical College, Cheonan, Korea
| | - Na Hye Myong
- Department of Pathology, Dankook University Medical College, Cheonan, Korea
| | - Hyun Don Joo
- Department of Internal Medicine, Dankook University Medical College, Cheonan, Korea
| | - Mi Il Kang
- Department of Internal Medicine, Dankook University Medical College, Cheonan, Korea
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Awano N, Fukuda K, Sakayori M, Kondoh K, Ono R, Moriya A, Ando T, Kumasaka T, Takemura T, Ikushima S. Sarcoid Myositis with Anti-Ku Antibody Consistent with both Sarcoidosis and Polymyositis. Intern Med 2016; 55:2049-53. [PMID: 27477413 DOI: 10.2169/internalmedicine.55.5816] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
We herein describe a case of sarcoid myositis with anti-Ku antibody positivity. Pathological findings of the muscle were compatible with sarcoidosis, but could not be completely distinguished from myositis diseases that arise from other causes. According to a physical examination, pathological findings, the detection of anti-Ku antibody and the human leukocyte antigen (HLA)-DPB1 allele, we strongly suspected that the patient developed both sarcoidosis and polymyositis. Sarcoidosis is often complicated by autoimmune diseases. This case suggests the possibility that sarcoidosis and other autoimmune diseases may have common causal genetic factors.
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Affiliation(s)
- Nobuyasu Awano
- Department of Respiratory Medicine, Japanese Red Cross Medical Center, Japan
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Morís G. Inflammatory bowel disease: An increased risk factor for neurologic complications. World J Gastroenterol 2014; 20:1228-1237. [PMID: 24574797 PMCID: PMC3921505 DOI: 10.3748/wjg.v20.i5.1228] [Citation(s) in RCA: 64] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2013] [Revised: 12/21/2013] [Accepted: 01/05/2014] [Indexed: 02/06/2023] Open
Abstract
Only a very few systematic studies have investigated the frequency of neurologic disorders in patients with Crohn’s disease (CD) and ulcerative colitis (UC), which are the two main types of inflammatory bowel disease (IBD). Results have been inconsistent and variable, owing to differences in case-finding methods and evaluated outcomes in different studies. The most frequent neurologic manifestations reported in CD and UC populations are cerebrovascular disease (with either arterial or venous events), demyelinating central nervous system disease, and peripheral neuropathy (whether axonal or demyelinating); however, the literature describes numerous nervous system disorders as being associated with IBD. The pathogenesis of nervous system tissue involvement in IBD has yet to be elucidated, although it seems to be related to immune mechanisms or prothrombotic states. The recently-introduced tumor necrosis factor (TNF) inhibitors have proven successful in controlling moderate to severe IBD activity. However, severe neurologic disorders associated with TNF inhibitors have been reported, which therefore raises concerns regarding the effect of anti-TNF-α antibodies on the nervous system. Although neurological involvement associated with IBD is rarely reported, gastroenterologists should be aware of the neurologic manifestations of IBD in order to provide early treatment, which is crucial for preventing major neurologic morbidity.
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Current World Literature. Curr Opin Rheumatol 2009; 21:85-92. [DOI: 10.1097/bor.0b013e32832355a7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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