Rheumatic complications of inflammatory bowel disease among Arabs: a hospital-based study in Kuwait

Aim To investigate the rheumatic complications of inflammatory bowel disease (IBD) Arab patients in relation to the clinical manifestations of IBD using the Montreal classification system in a hospital-based population in Kuwait. Method A cohort of 130 consecutive patients with IBD, either ulcerative colitis (UC) or Crohn's disease (CD) attending gastroenterology and rheumatology clinics of Kuwait University hospital from January to December 2010 were recruited. IBD diagnosis, classification, and the rheumatologic characteristics of patients were assessed and noted on a pro forma. Results In the 130 IBD patients (mean age 32.6 +/- 12.3years), 45 (34.6%) had UC and 85 (65.4%) had CD. Forty-five (34.6%) IBD patients developed rheumatic manifestations; the difference in proportion was not significant among UC and CD patients (18 [40.0%] vs. 27 [31.7%], P=0.215). Peripheral arthritis was seen in 41 (31.5%) IBD patients. Axial skeletal involvement presenting as a combination of spondyloarthritis with sacroiliitis was seen in 11 (8.5%) out of 130 IBD patients. Isolated sacroiliitis was seen in four (3.1%) IBD patients. Enthesopathy was seen in seven (5.4%) and dactylitis in two (1.5%) IBD patients. No statistically significant difference (0.05) was detected between the frequency of the rheumatic manifestations and the IBD clinical subtypes. Conclusion This study delineates the rheumatic complications in relation to clinical manifestations (phenotypes) of IBD using the Montreal classification, in a hospital-based cohort of an Arab population. The rheumatic manifestations of IBD in our study were comparable to previously published data from other parts of the world.