Extraintestinal Manifestations of UC - Part II
Eye Manifestations
Episcleritis - Episcleritis is a condition in which the sclera (white part of the eye) becomes red. It may be painless or associated with some mild discomfort and tearing. Vision is not affected. Therapy consists of treating the underlying disorder (ie; UC) or steroid eye drops. For more information and photos -http://www.revoptom.com/handbook/sect2f.htm
Uveitis and Iritis - Uveitis and iritis refer to inflammation of deeper structures of the eye. Symptoms are more severe than episcleritis and consist of eye pain, blurred vision, sensitivity to light, and headache. The onset of eye symptoms associated with visual changes warrants immediate referral to an ophthalmologist. Treatment includes topical or systemic steroid therapy. For more information and photos - http://www.revoptom.com/handbook/oct02_sec4_6.htm
Liver (Hepatobiliary) Manifestations
Primary sclerosing cholangitis (PSC) – PSC is chronic liver disease in which the ducts of the liver become scarred and fibrotic. Over time, the liver itself becomes scarred and eventually results in liver failure. There is a well-recognized association between PSC and IBD. It is estimated that 4-5% of patients with IBD have PSC; it is more commonly seen in individuals with UC than Crohn’s disease. Patients typically present with weight loss, fatigue, jaundice and itching. At present, there are no medications that can cure PSC. Ultimately, patients who develop severe complications of chronic liver disease require liver transplantation.
Hematologic Manifestations
Thrombophilia - Patients with IBD have a predilection to the development of blood clots known as thrombophilia. The thrombophilia associated with IBD is believed to be due to abnormal levels of circulating factors enhancing clot formation, elevated numbers of platelets, and/or underlying genetic mutations. Most commonly, blood clots occur in the legs, however, they can also form in the brain, lung, liver and upper extremities.