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Ulcerative colitis in a Southern European country: A national perspective

2009; Oxford University Press; Volume: 16; Issue: 5 Linguagem: Inglês

10.1002/ibd.21119

1536-4844

Francisco Portela, Fernando Magro, Paula Lago, José Cotter, Isabelle Cremers, João Deus, Ana Vieira, H. Lopes, Paulo Caldeira, Luísa Leite Barros, Jorge dos Reis, Lina Carvalho, Raquel Gonçalves, Mário Júlio Campos, Paula Ministro, Maria Antónia Duarte, Jorge Amil, Susana Rodrigues, Luís Filipe Azevedo, Altamiro Costa‐Pereira,

Diagnosis and treatment of tuberculosis

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.A cross-sectional study based on data collected from a nationwide online registry was undertaken.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%).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.