S1876 Extraintestinal Manifestations and Inflammatory Bowel Disease Severity

Introduction: Inflammatory bowel disease (IBD), including Crohn’s disease (CD) and ulcerative colitis (UC), involves chronic inflammation and can cause extraintestinal manifestations (EIMs). Pediatric studies show EIMs are linked to more severe disease, higher rates of biologic use, surgery, and relapse. In adults, early identification of severe IBD is limited, yet crucial for timely aggressive therapy. Biomarkers like peripheral eosinophilia have been proposed to help identify patients at risk for worse outcomes. We conducted a retrospective study to compare clinical characteristics and peripheral eosinophilia of IBD patients with EIMs and those without EIMs. Methods: This retrospective study aimed to evaluate the clinical characteristics of adult patients diagnosed with IBD, with a focus on comparing individuals presenting with at least one EIM to those without EIMs. Additionally, peripheral blood eosinophil levels were analyzed and compared between the 2 groups. We studied adults aged 18 to 99 years with a confirmed pathologic diagnosis of IBD. Data were collected and analyzed through electronic medical record review from patients who received care between November 1, 2020, and November 30, 2024, at University of Kentucky clinics and hospitals. Results: Out of 286 charts reviewed, 111 patients had a confirmed diagnosis of IBD. EIMs were present in 23.4% of patients, with peripheral arthropathy being the most common (n = 16), followed by axial arthropathy (n = 7), uveitis (n = 4), and primary sclerosing cholangitis (n = 2). Compared to patients without EIMs, those with EIMs had lower rates of colorectal surgery (26.9% vs 48.2%), higher average eosinophil counts (0.47 vs 0.35 × 10⁹/L), and fewer hospitalizations (15 vs 86 total visits). Perianal disease was less frequent in the EIM group (15.4% vs 24.7%), while the use of 2 or more biologics was more common (46.2% vs 32.6%). Peripheral arthropathy was the most prevalent EIM among both UC and CD patients. Conclusion: Our retrospective study shows there may be an association between eosinophilia and EIM. Unlike the pediatric data, EIM were not associated with more severe IBD outcomes. However, patients with EIM more commonly used 2 or more biologics. Of the 111 with confirmed IBD, 23.4% had documented evidence of EIM. This is consistent with the percentage reported in the literature of 24-40%. The association between IBD severity and biomarkers such as peripheral eosinophilia is notable and merits further study.