Cargando…
Pyoderma Gangrenosum Is Associated With Increased Risk of Inflammatory Pouch-Related Complications: A Retrospective Cohort Study
BACKGROUND: Pyoderma gangrenosum (PG) is a rare, neutrophilic dermatosis that is a well-established extraintestinal manifestation (EIM) of inflammatory bowel disease. The clinical implications of developing PG in patients with ulcerative colitis (UC) who undergo total proctocolectomy colectomy and i...
Autores principales: | , , , , , , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Oxford University Press
2023
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10474334/ https://www.ncbi.nlm.nih.gov/pubmed/37663924 http://dx.doi.org/10.1093/crocol/otad024 |
_version_ | 1785100468648673280 |
---|---|
author | Panganiban, Ronaldo Paolo Tuan, Alyssa Hart, Maxwell Pelton, Mathew Mikhail, Daniella Akhtar, Sarah Bogale, Kaleb Deiling, Susan Zhou, Shouhao Coates, Mathew D Yochum, Gregory S Koltun, Walter |
author_facet | Panganiban, Ronaldo Paolo Tuan, Alyssa Hart, Maxwell Pelton, Mathew Mikhail, Daniella Akhtar, Sarah Bogale, Kaleb Deiling, Susan Zhou, Shouhao Coates, Mathew D Yochum, Gregory S Koltun, Walter |
author_sort | Panganiban, Ronaldo Paolo |
collection | PubMed |
description | BACKGROUND: Pyoderma gangrenosum (PG) is a rare, neutrophilic dermatosis that is a well-established extraintestinal manifestation (EIM) of inflammatory bowel disease. The clinical implications of developing PG in patients with ulcerative colitis (UC) who undergo total proctocolectomy colectomy and ileal pouch anal anastomosis (TPC-IPAA) surgery remain unknown. METHODS: Study participants were selected from patients enrolled in the Carlino Family Inflammatory Bowel and Colorectal Disease Biobank between 1998 and 2021 with a pre-colectomy diagnosis of UC and who underwent TPC-IPAA surgery. A retrospective study comparing patients with PG and those without PG was performed. The outcomes measured included the development of pouchitis, pouchitis classification, presence of pouch fistula, anal fistula, anal stenosis, and pouch failure. RESULTS: In this study, 357 IPAA patients were included, 10 of whom suffered PG. Patients with PG and without PG had similar demographics and clinical characteristics. Both groups had similar rates of pouchitis (80% in PG patients and 64% in patients without PG, P = .504). However, IPAA patients with PG had a higher risk of developing pouch fistula (50% vs 10%, P = .002), anal fistula (40% vs 12%, P = .031), and Crohn’s-like disease of the pouch (70% vs 15%, P = .003) compared to patients without PG. Patients who developed PG prior to their first episode of pouchitis were more likely to eventually experience pouch failure (odds ratio: 20.7, 95% confidence interval: 3.9, 110.7, q = 0.003 after false discovery rate adjustment). CONCLUSIONS: Among UC patients who undergo TPC-IPAA surgery, the development of PG portends poor pouch outcomes and is predictive of pouch failure. |
format | Online Article Text |
id | pubmed-10474334 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | Oxford University Press |
record_format | MEDLINE/PubMed |
spelling | pubmed-104743342023-09-03 Pyoderma Gangrenosum Is Associated With Increased Risk of Inflammatory Pouch-Related Complications: A Retrospective Cohort Study Panganiban, Ronaldo Paolo Tuan, Alyssa Hart, Maxwell Pelton, Mathew Mikhail, Daniella Akhtar, Sarah Bogale, Kaleb Deiling, Susan Zhou, Shouhao Coates, Mathew D Yochum, Gregory S Koltun, Walter Crohns Colitis 360 Observations and Research BACKGROUND: Pyoderma gangrenosum (PG) is a rare, neutrophilic dermatosis that is a well-established extraintestinal manifestation (EIM) of inflammatory bowel disease. The clinical implications of developing PG in patients with ulcerative colitis (UC) who undergo total proctocolectomy colectomy and ileal pouch anal anastomosis (TPC-IPAA) surgery remain unknown. METHODS: Study participants were selected from patients enrolled in the Carlino Family Inflammatory Bowel and Colorectal Disease Biobank between 1998 and 2021 with a pre-colectomy diagnosis of UC and who underwent TPC-IPAA surgery. A retrospective study comparing patients with PG and those without PG was performed. The outcomes measured included the development of pouchitis, pouchitis classification, presence of pouch fistula, anal fistula, anal stenosis, and pouch failure. RESULTS: In this study, 357 IPAA patients were included, 10 of whom suffered PG. Patients with PG and without PG had similar demographics and clinical characteristics. Both groups had similar rates of pouchitis (80% in PG patients and 64% in patients without PG, P = .504). However, IPAA patients with PG had a higher risk of developing pouch fistula (50% vs 10%, P = .002), anal fistula (40% vs 12%, P = .031), and Crohn’s-like disease of the pouch (70% vs 15%, P = .003) compared to patients without PG. Patients who developed PG prior to their first episode of pouchitis were more likely to eventually experience pouch failure (odds ratio: 20.7, 95% confidence interval: 3.9, 110.7, q = 0.003 after false discovery rate adjustment). CONCLUSIONS: Among UC patients who undergo TPC-IPAA surgery, the development of PG portends poor pouch outcomes and is predictive of pouch failure. Oxford University Press 2023-05-14 /pmc/articles/PMC10474334/ /pubmed/37663924 http://dx.doi.org/10.1093/crocol/otad024 Text en © The Author(s) 2023. Published by Oxford University Press on behalf of Crohn's & Colitis Foundation. https://creativecommons.org/licenses/by/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Observations and Research Panganiban, Ronaldo Paolo Tuan, Alyssa Hart, Maxwell Pelton, Mathew Mikhail, Daniella Akhtar, Sarah Bogale, Kaleb Deiling, Susan Zhou, Shouhao Coates, Mathew D Yochum, Gregory S Koltun, Walter Pyoderma Gangrenosum Is Associated With Increased Risk of Inflammatory Pouch-Related Complications: A Retrospective Cohort Study |
title | Pyoderma Gangrenosum Is Associated With Increased Risk of Inflammatory Pouch-Related Complications: A Retrospective Cohort Study |
title_full | Pyoderma Gangrenosum Is Associated With Increased Risk of Inflammatory Pouch-Related Complications: A Retrospective Cohort Study |
title_fullStr | Pyoderma Gangrenosum Is Associated With Increased Risk of Inflammatory Pouch-Related Complications: A Retrospective Cohort Study |
title_full_unstemmed | Pyoderma Gangrenosum Is Associated With Increased Risk of Inflammatory Pouch-Related Complications: A Retrospective Cohort Study |
title_short | Pyoderma Gangrenosum Is Associated With Increased Risk of Inflammatory Pouch-Related Complications: A Retrospective Cohort Study |
title_sort | pyoderma gangrenosum is associated with increased risk of inflammatory pouch-related complications: a retrospective cohort study |
topic | Observations and Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10474334/ https://www.ncbi.nlm.nih.gov/pubmed/37663924 http://dx.doi.org/10.1093/crocol/otad024 |
work_keys_str_mv | AT panganibanronaldopaolo pyodermagangrenosumisassociatedwithincreasedriskofinflammatorypouchrelatedcomplicationsaretrospectivecohortstudy AT tuanalyssa pyodermagangrenosumisassociatedwithincreasedriskofinflammatorypouchrelatedcomplicationsaretrospectivecohortstudy AT hartmaxwell pyodermagangrenosumisassociatedwithincreasedriskofinflammatorypouchrelatedcomplicationsaretrospectivecohortstudy AT peltonmathew pyodermagangrenosumisassociatedwithincreasedriskofinflammatorypouchrelatedcomplicationsaretrospectivecohortstudy AT mikhaildaniella pyodermagangrenosumisassociatedwithincreasedriskofinflammatorypouchrelatedcomplicationsaretrospectivecohortstudy AT akhtarsarah pyodermagangrenosumisassociatedwithincreasedriskofinflammatorypouchrelatedcomplicationsaretrospectivecohortstudy AT bogalekaleb pyodermagangrenosumisassociatedwithincreasedriskofinflammatorypouchrelatedcomplicationsaretrospectivecohortstudy AT deilingsusan pyodermagangrenosumisassociatedwithincreasedriskofinflammatorypouchrelatedcomplicationsaretrospectivecohortstudy AT zhoushouhao pyodermagangrenosumisassociatedwithincreasedriskofinflammatorypouchrelatedcomplicationsaretrospectivecohortstudy AT coatesmathewd pyodermagangrenosumisassociatedwithincreasedriskofinflammatorypouchrelatedcomplicationsaretrospectivecohortstudy AT yochumgregorys pyodermagangrenosumisassociatedwithincreasedriskofinflammatorypouchrelatedcomplicationsaretrospectivecohortstudy AT koltunwalter pyodermagangrenosumisassociatedwithincreasedriskofinflammatorypouchrelatedcomplicationsaretrospectivecohortstudy |