Ulcerative colitis in a Southern European country: a national perspective

• Autor(es): Portela, F ; Magro, F ; Lago, P ; Cotter, J ; Cremers, I ; Deus, J ; Veiria, A ; Lopes, H ; Caldeira, P ; Barros, L ; Reis, J ; Carvalho, L ; Gonçalves, R ; Campos, MJ ; Ministro, P ; Duarte, MA ; Amil, J ; Rodrigues, S ; Azevedo, L ; Costa-Pereira, A
• Data: 2010
• Identificador Persistente: http://hdl.handle.net/10400.4/1113
• Origem: Repositório do Centro Hospitalar e Universitário de Coimbra
• Assunto(s): Colite Ulcerosa
• Tipo de Documento: Artigo
• Idioma: Inglês

Descrição

BACKGROUND: The incidence, prevalence, and even the clinical behavior of ulcerative colitis (UC) are highly variable in different world regions. In previous studies, Portugal was reported as having a milder clinical behavior. The aim of this study was to apply the Montreal Classification in a large group of UC Portuguese patients in order to describe their clinical characteristics and evaluate variables potentially useful for outcome prediction. METHODS: A cross-sectional study based on data collected from a nationwide online registry was undertaken. RESULTS: In all, 2863 patients with UC were included. Twenty-one percent had ulcerative proctitis, 52% left-sided colitis, and 28% extensive colitis. Sixty percent of patients had taken steroids, 14% immunosuppressors, 1% biologicals, and 4.5% were submitted to surgery. Patients with extensive colitis had more severe activity, needing more steroids, immunosuppressors, and surgery. At the time of diagnosis 61% were less than 40 years old and 5% less than 16. Younger patients also had a more aggressive initial course. Thirty-eight percent of patients had only taken salicylates during the disease course and were characterized by a lower incidence of systemic symptoms at presentation (3.8% versus 8.8%, P < 0.001), fewer extraintestinal manifestations (7.7% versus 24.0%, P < 0.001), and a higher prevalence of proctitis (32.1% versus 10.0%). CONCLUSIONS: A more aggressive phenotype was found in extensive colitis and in the initial course of younger patients, with an increased need for steroids and immunosuppressors. In addition, a significant percentage of patients, particularly with proctitis, showed a milder clinical evolution and were maintained in remission only with salicylates.