P334 Respiratory Manifestations and Association Between Disease Activity in Patients with Inflammatory Bowel Disease in a Reference Center in Salvador, Bahia, Brazil.
Fortes, F.(1,2)*;Gonçalves, J.(3);Nery, E.(4);Arenas, L.(4);Mota, J.(1);Pimentel, A.(1);Almeida, N.(5);Santos, A.M.(3);Surlo, V.(5);Santana, G.(4);
(1)Roberto Santos General Hospital, Departament of Gastroenterology, Salvador, Brazil;(2)Federal University of Bahia, Posgraduate program in medicine and health, Salvador, Brazil;(3)Bahia School of Medicine and Public Health, Medicine, Salvador, Brazil;(4)Bahia State University, Medicine, Salvador, Brazil;(5)Roberto Santos General Hospital, Department of Gastroenterology, Salvador, Brazil;
Background
Inflammatory bowel diseases (IBD) are chronic diseases that may have a variety of extraintestinal manifestations(EIM), including pulmonary1. Although less frequent than other types of EIM, these alterations have been increasingly. Manifestations present with a wide variety of phenotypes, which can affect different parts of the respiratory system2. As most of these patients are asymptomatic, this type of manifestation is less diagnosed than the other extraintestinal manifestations3,4.
Methods
Cross-sectional, analytical, single-center study, carried out from April/2021 to October/2022, with the application of a questionnaire and review of medical records of patients from an outpatient clinic specialized in IBD in Salvador/BA, at Hospital Geral Roberto Santos(HGRS). Approved by the HGRS Research Ethics Committee. Inclusion criteria: patients ≥18 years old, diagnosed with IBD and signed the informed consent form. Dyspnea symptoms were evaluated using the Modified Medical Research Council Dyspnea Scale(mMRC), dry or productive cough, chest pain and hemoptysis. The clinical activity of the IBD was evaluated using the Harvey-Bradshaw Index in CD and the Lichtiger Index in UC. To test the association between the presence of respiratory manifestations and the clinical activity of the IBD, the chi-square test was used. Significant associations were considered at p < 0.05.
Results
Total of 255 patients were included, 47.1% with CD and 52.9% with UC, 44 had respiratory symptoms. Table 1 shows the general and clinical characteristics. Current treatments: mesalazine suppository and oral(63,2%), azathioprine(29.8%), infliximab(17.3%), sulfasalazine(15.7%), adalimumab(8.6%), prednisone(7.5%), ustekinumab(1.6%), methotrexate(1.6%), vedolizumab(0.8%), tacrolimus or cyclosporine(0.4%), tofacitinib(0.4%). Most of these patients(70.6%) were in clinical remission of IBD at the time the questionnaire was collected, while a minority (29.5%) were in clinical activity. In the 44 patients with respiratory symptoms, the majority are female(77.3%). Patients in clinical remission had respiratory symptoms in 12.9%(22/171), while patients in active remission had respiratory symptoms in 26.2%(22/74). Dyspnea was the most frequent symptom. Statistically significant association was found between the presence of respiratory manifestations and clinical activity(p=0.008). No difference in relation to the type of IBD, nor for medication. Table 2 shows association between disease activity and the presence of respiratory symptoms.
Conclusion
The frequency of respiratory symptoms was high in patients with IBD, with a higher prevalence in patients with active disease. This finding draws attention to a possible mechanism associated with the IBD activity.