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Der Klinikarzt 2020; 49(12): 530-537
DOI: 10.1055/a-1290-2546
Schwerpunkt

Extraintestinale Manifestationen chronisch entzündlicher Darmerkrankungen

Fokus auf Gelenke und Haut
Verena von Felbert
1   Klinik für Dermatologie und Allergologie, Hautklinik Universitätsklinikum Aachen
,
Thomas Rauen
2   Sektion Rheumatologie in der Klinik für Nieren- und Hochdruckkrankheiten, rheumatologische und immunologische Erkrankungen (Medizinische Klinik II), Universitätsklinikum Aachen
,
Stefanie Tischendorf
3   Klinik für Gastroenterologie, Stoffwechselerkrankungen und Internistische Intensivmedizin (Medizinische Klinik III), Universitätsklinikum Aachen
,
Maximilian Hatting
3   Klinik für Gastroenterologie, Stoffwechselerkrankungen und Internistische Intensivmedizin (Medizinische Klinik III), Universitätsklinikum Aachen
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ZUSAMMENFASSUNG

Chronisch entzündliche Darmerkrankungen (CED) manifestieren sich auch außerhalb des Gastrointestinaltraktes. Die Differenzialdiagnostik ist herausfordernd, denn die extraintestinalen Manifestationen (EIM) müssen von Medikamentennebenwirkungen und eigenständigen Krankheitsentitäten abgegrenzt werden. Dies trifft insbesondere für den Befall der Leber, des Bewegungsapparates und der Haut zu. Häufig sind Leberwerterhöhungen medikamentös-toxisch bedingt. Die primär sklerosierende Cholangitis stellt eine prognoserelevante Differenzialdiagnose dar, die häufig mit CED assoziiert ist. Ein Befall des Achsenskeletts muss von degenerativem Rückenschmerz, Osteoporose und einer rheumatischen Grunderkrankung abgegrenzt werden. Die Beteiligung der Haut bei CED kann sich im Rahmen klassischer Befunde wie dem Erythema nodosum manifestieren. Häufig ist die Diagnosestellung aber schwierig und es müssen medikamenteninduzierte Hautveränderungen ausgeschlossen bzw. identifiziert werden. Nicht zuletzt ist auch das Risiko für Hauttumoren unter Immunsuppression erhöht. Die komplexe Diagnostik der extraintestinalen Manifestation erfordert deshalb eine enge interdisziplinäre Zusammenarbeit.



Publication History

Article published online:
15 December 2020

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