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[Cardio vascular disease associated with ulcerative colitis]
B Iizuka1, N Yamagishi, N Honma
1Division of Internal Medicine, Tokyo Women's Medical University.
Insights
Cardiovascular complications like Takayasu's aortitis and myopericarditis can be fatal manifestations of Inflammatory Bowel Disease (IBD). These conditions, often linked to ulcerative colitis, may arise even when gastrointestinal symptoms are inactive.
Area of Science:
- Gastroenterology and Cardiology
- Immunogenetics
Background:
- Inflammatory Bowel Disease (IBD), encompassing ulcerative colitis and Crohn's disease, can present with extraintestinal manifestations.
- Cardiovascular complications, though uncommon, represent a potentially fatal aspect of IBD.
Observation:
- Takayasu's aortitis shows a higher prevalence in Japanese patients with ulcerative colitis, suggesting immune genetic factors like HLA-B52 and DR2.
- Myopericarditis and pleuropericarditis associated with IBD are categorized by pathogenesis into drug-induced (5-ASA) and autoimmune disease.
Findings:
- Cardiovascular symptoms in IBD patients can manifest independently of active gastrointestinal disease.
- Specific immune genetic markers may predispose individuals to co-occurring IBD and cardiovascular conditions like Takayasu's aortitis.
Implications:
- Recognizing these cardiovascular complications is crucial for managing IBD patients due to therapeutic implications.
- Further research into the immune-genetic links may improve early diagnosis and treatment strategies for IBD-related cardiovascular issues.
Abstract:
Although cardiovascular complications such as Aortic syndrome (Takayasu's aortitis), Pericarditis and Myopericarditis might not be common, these complications should be noted as one of the fatal manifestation of IBD. It can be the sole or one of the several extraintestinal manifestation of either ulcerative colitis or Crohn's disease. Because of the therapeutic implications, we reviewed the literature documenting cardiovascular complication associated with ulcerative colitis. The comparatively high prevalence of Takayasu's aortitis with ulcerative colitis in Japanese patients may be explained by a immune genetic influence. HLA-B52 and DR2, were highly expressed in the patient with both disease. Myopericarditis and Pleuropericarditis associated with IBD were divided into two groups by pathogenesis, 1) drug (5-ASA)-induced disease, and 2) autoimmune disease. The cardiovascular symptom may occur while the patient's gastrointestinal disease is quiescent.