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Pyoderma Gangrenosum in Inflammatory Bowel Disease: A Systematic Review and Meta-Analysis
Pyoderma Gangrenosum in Inflammatory Bowel Disease: A Systematic Review and Meta-Analysis
- Source :
- Digestive Diseases and Sciences. 65:2675-2685
- Publication Year :
- 2020
- Publisher :
- Springer Science and Business Media LLC, 2020.
-
Abstract
- Pyoderma gangrenosum (PG) is an uncommon but severe extra-intestinal manifestation (EIM) of inflammatory bowel disease (IBD). The incidence and risk factors for PG are disputed. To assess the incidence of PG and identify factors associated with PG in IBD patients. A search of electronic databases (Ovid and PubMed) was conducted between 1966 and 2019. Studies that calculated the incidence of PG in IBD patient cohorts were included. Patient demographics, IBD subtype, and EIM presence were recorded. A review of our institutional database of 1057 IBD patients was conducted. A multivariate regression model and meta-analysis were conducted to identify risk factors for PG. A random effects model was used to combine the data of included studies. Fourteen studies were included in addition to 1057 IBD patients and 26 PG cases from the Louisville cohort. In total, there were 379 cases of PG in the cumulative cohort of 61,695 IBD patients. The PG incidence in individual studies ranged from 0.4 to 2.6%. In the institutional cohort, ocular EIMs and a permanent stoma were significant risk factors for PG. In the meta-analysis, PG was associated with female gender (RR = 1.328, 95% CI 1.161–1.520), Crohn’s disease (RR = 1.193, 95% CI 1.001–1.422), erythema nodosum (RR = 9.281, 95% CI 6.081–14.164), and ocular EIM (RR = 4.55, 95% CI 3.04–6.81). There was study heterogeneity when assessing IBD subtype, ocular, and joint EIMs. There are conflicting data on the incidence and risk factors for PG. This meta-analysis confirms an association between PG and female gender, Crohn’s disease, erythema nodosum, and ocular EIM that have been described in smaller studies.
- Subjects :
- Erythema nodosum
medicine.medical_specialty
Physiology
business.industry
Incidence (epidemiology)
Gastroenterology
Disease
Hepatology
medicine.disease
Inflammatory bowel disease
digestive system diseases
03 medical and health sciences
0302 clinical medicine
030220 oncology & carcinogenesis
Internal medicine
Meta-analysis
Cohort
Medicine
030211 gastroenterology & hepatology
business
Pyoderma gangrenosum
Subjects
Details
- ISSN :
- 15732568 and 01632116
- Volume :
- 65
- Database :
- OpenAIRE
- Journal :
- Digestive Diseases and Sciences
- Accession number :
- edsair.doi...........d3ab7d4efd774f6f293949fa2ef21e25
- Full Text :
- https://doi.org/10.1007/s10620-019-05999-4