PDF(Pubmed)
Abstract：
Extra-intestinal manifestations (EIMs) are a common complication of inflammatory bowel diseases (IBD), affecting up to half of the patients. Despite their high prevalence, information on standardised definitions, diagnostic strategies, and treatment targets is limited.
As a starting point for a national EIM study network, an interdisciplinary expert panel of 12 gastroenterologists, 4 rheumatologists, 3 ophthalmologists, 6 dermatologists, and 4 patient representatives was assembled. Modified Delphi consensus methodology was used. Fifty-four candidate items were derived from the literature review and expert opinion focusing on five major EIMs (erythema nodosum, pyoderma gangrenosum, uveitis, peripheral arthritis, and axial arthritis) were rated in three voting rounds.
For use in a clinical practice setting and as part of the creation of a prospective registry of patients with EIMs, the panel developed definitions for erythema nodosum, pyoderma gangrenosum, uveitis, peripheral arthritis, and axial arthritis; identified the appropriate and optimal subspecialists to diagnose and manage each; provided methods to monitor disease course; offered guidance regarding monitoring intervals; and defined resolution and recurrence.
Consensus criteria for appropriate and optimal means of diagnosing and monitoring five EIMs have been developed as a starting point to inform clinical practice and future trial design. Key findings include straightforward diagnostic criteria, guidance regarding who can appropriately and optimally diagnose each, and monitoring options that include patient and physician-reported outcomes. These findings will be used in a national multicenter study network to optimise the management of EIMs.
As a starting point for a national EIM study network, an interdisciplinary expert panel of 12 gastroenterologists, 4 rheumatologists, 3 ophthalmologists, 6 dermatologists, and 4 patient representatives was assembled. Modified Delphi consensus methodology was used. Fifty-four candidate items were derived from the literature review and expert opinion focusing on five major EIMs (erythema nodosum, pyoderma gangrenosum, uveitis, peripheral arthritis, and axial arthritis) were rated in three voting rounds.
For use in a clinical practice setting and as part of the creation of a prospective registry of patients with EIMs, the panel developed definitions for erythema nodosum, pyoderma gangrenosum, uveitis, peripheral arthritis, and axial arthritis; identified the appropriate and optimal subspecialists to diagnose and manage each; provided methods to monitor disease course; offered guidance regarding monitoring intervals; and defined resolution and recurrence.
Consensus criteria for appropriate and optimal means of diagnosing and monitoring five EIMs have been developed as a starting point to inform clinical practice and future trial design. Key findings include straightforward diagnostic criteria, guidance regarding who can appropriately and optimally diagnose each, and monitoring options that include patient and physician-reported outcomes. These findings will be used in a national multicenter study network to optimise the management of EIMs.
摘要：
肠外表现（EIM）是炎症性肠病（IBD）的常见并发症，影响了一半的患者。尽管他们的患病率很高，关于标准化定义的信息，诊断策略，治疗目标有限。
作为国家EIM研究网络的起点，一个由12名胃肠病学家组成的跨学科专家小组，4位风湿病学家,3位眼科医生,6名皮肤科医生，并召集了4名患者代表。使用改进的德尔菲共识方法。54个候选项目来自文献综述和专家意见，重点是五个主要的EIM（结节性红斑，坏疽性脓皮病,葡萄膜炎,外周关节炎,和轴性关节炎）在三轮投票中进行了评级。
为了在临床实践中使用，并作为创建EIM患者前瞻性注册的一部分，小组开发了结节性红斑的定义，坏疽性脓皮病,葡萄膜炎,外周关节炎,和轴性关节炎；确定了诊断和管理每种疾病的适当和最佳专家；提供了监测疾病进程的方法；提供了有关监测间隔的指导；以及定义的分辨率和复发。
已制定了诊断和监测五种EIM的适当和最佳方法的共识标准，作为指导临床实践和未来试验设计的起点。关键发现包括直接的诊断标准，关于谁可以适当和最佳地诊断每个人的指导，和监测选项，包括患者和医生报告的结果。
作为国家EIM研究网络的起点，一个由12名胃肠病学家组成的跨学科专家小组，4位风湿病学家,3位眼科医生,6名皮肤科医生，并召集了4名患者代表。使用改进的德尔菲共识方法。54个候选项目来自文献综述和专家意见，重点是五个主要的EIM（结节性红斑，坏疽性脓皮病,葡萄膜炎,外周关节炎,和轴性关节炎）在三轮投票中进行了评级。
为了在临床实践中使用，并作为创建EIM患者前瞻性注册的一部分，小组开发了结节性红斑的定义，坏疽性脓皮病,葡萄膜炎,外周关节炎,和轴性关节炎；确定了诊断和管理每种疾病的适当和最佳专家；提供了监测疾病进程的方法；提供了有关监测间隔的指导；以及定义的分辨率和复发。
已制定了诊断和监测五种EIM的适当和最佳方法的共识标准，作为指导临床实践和未来试验设计的起点。关键发现包括直接的诊断标准，关于谁可以适当和最佳地诊断每个人的指导，和监测选项，包括患者和医生报告的结果。
