Epidemiology S319

immune modulatory medicines. We observed no associationwith AZA or other medication.Conclusions: In conclusion; The prevalence of anemia andiron deficiency in an out-patient IBD cohort was found to berelatively high. Anemia and iron deficiency were seemed tobe associated with ileal involvment in CD, there was a trendtowards significance in extensive colitis in UC.

P600Prevalence of anemia in children with inflammatory boweldisease in Russian FederationA. Anushenko1 *, A. Potapov1, O. Gordeeva2, E. Tsimbalova3.1Federal State Budgetary Institution “Scientific Centreof Children Health”, Gastroenterology and Hepatology,Moscow, Russian Federation, 2Federal State BudgetaryInstitution “Scientific Centre of Children Health”, ClinicalBiochemistry, Moscow, Russian Federation, 3FederalState Budgetary Institution “Scientific Centre of ChildrenHealth”, gastroenterology and hepatology, Moscow, RussianFederation

Background: Anemia is a common complication of inflammatorybowel disease, although the reported prevalence of thiscondition has been markedly variable. However, the existingdata in children are still limited. The aim of this studywas to determine and analyze the prevalence of anemia forhospitalized children patients diagnosed with IBD in 2010 2013years in Scientific Centre of Children Health in Moscow, Russia.Methods: The study included 186 children diagnosed with IBDaged 6 months to 18 years (mean age was 12±4.6 years): 94of them presented Crohn’s disease (CD) and 92 ulcerativecolitis (UC). Patients were divided into 2 groups, anemic andnon-anemic. Anemia was defined as an hemoglobin level lowerthan the normal value of the laboratory of our hospital (basedon the World Health Organization criteria). The influence oftype of IBD, age, gender, time from diagnosis, disease activity,undergoing treatment were evaluated.Results: In all, one-third of patients with IBD were anemic.There was no significant difference in prevalence of anemiabetween CD (33%) and UC (29%) patients. Mean haemoglobinin the anemic UC and CD group was 9.6 (8.5 11.0) g/dL and10.3 (9.3 10.6) g/dL respectively. Gender difference has notbeen observed among anemic IBD patients. Anemia was mostcommon in children under 3 years of age (61%). The prevalenceof anemia in older children and adolescents was 28%. Mostpatients with UC and CD had moderate form of anemia (71%with CD and 52% with UC). Anemia was more common atdiagnosis than during follow-up (45% and 28%, respectively,P= 0.001). Disease activity scores (PUCAI; PCDAI) showed aninverse correlation with hemoglobin level. Patients with mild,moderate and severe UC disease activity were anemic in 19%,44%, 62% cases respectively. The same inverse correlationwas for CD. Compared with the IBD patients who receivedcorticosteroid drugs, the children who received anti-TNF-atreatment (infliximab) with the same disease activity score hadlower rates of anemia (55% vs. 37.5%).Conclusions: Anemia was present in every third IBD patient andremains a frequently associated pathology to the inflammatorybowel disease, especially in infants and young children, thatrequires specific management.

P601Prevalence of anemia in Serbian patients with inflammatorybowel diseaseD. Mijac*, G. Jankovic, M. Krstic, D. Culafic, I. Rankovic,D. Tomic, S. Djuranovic. Belgrade University, Clinic forGastroenterology and Hepatology, Clinical Center of Serbia,Belgrade, Serbia

Background: Anemia is very common in patients withinflammatory bowel disease (IBD). Anemia in IBD is complex and

commonly represents a particular example of the combinationof iron deficiency anemia and anemia of chronic diseases. Othercauses of anemia such as vitamin B (12) and folate deficiencyis the third common type of anemia that is frequently seenin Crohn’s disease (CD), while haemolysis and various othercauses like anemia induced by drugs (sulfasalazine, thiopurines)occur less frequantly in IBD patients [1]. However, the reportedprevalence of anemia has been markedly variable, ranges from16% to 74% [2].The aim of this prospective study was to analyze the associationbetween different types of anemia and IBD in Serbian tertiaryreferral center.Methods: We carried out a prospective study from June2009 to October 2013, including 301 consecutive IBD patients(M 143). Serum levels of hemoglobin, mean corpuscular volume,ferritin, transferrin saturation, folic acid, vitamin B (12),lactate dehydrogenase, haptoglobin, and C-reactive proteinwere analyzed in all patients with IBD. The hemoglobin levelswere considered according to gender.Results: 171 patients with ulcerative colitis (UC) and 130patients with CD, mean age 41±15 years (range 18 76), wereenrolled. The prevalence of anemia in total IBD patients was81% (84% for UC and 78% for CD). 89% (134) of female patientswith IBD had anemia, and 77% (110) of males.Among the 244 anemic IBD patients 206 had active disease and38 non active disease.Most of our patients with anemia had iron deficiency anemia,serum ferritin was low in 57% (139), anemia of chronic diseaseswas present in 34% (72) and folic acid was low in 10% (25).Vitamin B (12) deficiency was present in patients with CD 3%(8), while most patients with vitamin B (12) abnormalities hada prior ileal or ileocolonic resection 75% (6).Conclusions: Anemia is a frequent complication in Serbianpatients with IBD. In our study 81% IBD patients had anemia, andmore than half of these patients had iron deficiency anemia.Vitamin B (12) abnormalities are common in CD patients withprior ileal or ileocolonic resection. Our results suggest that irondeficiency is the main cause of anemia in IBD patients.

Reference(s)[1] Gasche C, Berstad A, Befrits R, Beglinger C, Dignass A,

Erichsen K, Gomollon F, Hjortswang H, Koutroubakis I,Kulnigg S, Oldenburg B, Rampton D, Schroeder O, Stein J,Travis S and Van Assche G., (2007), Guidelines on theDiagnosis and Management of Iron, Inflamm Bowel Dis.

[2] Gisbert JP, Gomollon F, (2008), Common Misconceptions inthe Diagnosis and, Am J Gastroenterol.

P602Prevalence of inflammatory bowel disease in patients withspondyloarthritis and psoriasis. The AQUILES study

I. Marín-Jimenez1 *, V. García2, M. Chaparro3, P. Lopez4,I. Moral5, P. Zarco6, A. Rodríguez de la Serna7, F. Vanaclocha8,B. Julia9, L. Cea-Calvo9, R. García de Vicuna10. 1GregorioMaranon Hospital, Gastroenterology, Madrid, Spain,2Reina Sofia Hospital, IMIBIC, UCO, Gastroenterology,Cordoba, Spain, 3La Princesa Hospital, IP and CIBERehd,Gastroenterology, Madrid, Spain, 4Alcorcon FoundationHospital, Gastroenterology, Madrid, Spain, 5Príncipe deAsturias Hospital, Gastroenterology, Madrid, Spain, 6AlcorconFoundation Hospital, Rheumatology, Madrid, Spain, 7Sant PauHospital, Rheumatology, Barcelona, Spain, 812 de OctubreHospital, Dermatology, Madrid, Spain, 9Merck Sharp & Dohmede Espana, Medical Affairs, Madrid, Spain, 10La PrincesaHospital, IISP, Rheumatology, Madrid, Spain

Objectives: To describe the baseline prevalence of inflamma-tory bowel disease (IBD) in the spondyloarthritis (SpA) andpsoriasis cohorts of the AQUILES study (a 2-year observationalstudy on 3 independent cohorts of patients with IBD, SpA or

S320 Poster presentations

psoriasis aimed to study the incidence of these diseases over2 years).Methods: Patients aged �18 years-old with known ornewly diagnosed SpA, IBD or psoriasis were recruited fromrheumatology, IBD and dermatology offices from 15 hospitals.Clinical data were collected through direct interview andpatient’s clinical record review.Results: The SpA cohort (mean age 48 years, men: 63%) com-prised 601 patients with the following diagnoses: ankylosingspondylitis (55.1%), psoriatic arthritis (25.1%), undifferentiatedSpA (16.1%), enteropathic arthritis (2.5%), others (1.3%). Theprevalence of IBD (table) was 5.1% (95% CI: 3.7 7.2), and thespecific diagnoses were Crohn’s disease (3.0%, 95% CI: 1.9 4.7),ulcerative colitis (1.0%, 95% CI: 0.5 2.2), and undifferentiatedcolitis (1.2%, 95% CI 0.6 2.4). The prevalence of IBD was 100%in those with enteropathic arthritis and upon removal of thesepatients, the prevalence of IBD in other SpA patients was2.7% (95% CI: 1.7 4.4), with figures of 3.9%, 0.7% and 2.4%in patients with ankylosing spondylitis, psoriatic arthritis orundifferentiated SpA, respectively. The prevalence was similarin men and women (5.0% and 5.4%, p = NS), and in those withor without other extra-articular manifestations of SpA (4.9%and 6.7%, p = NS). It was slightly higher in those with SpA oflonger duration (3.5%, 4.4% and 6.9% respectively for thosewith SpA of <4 years, 4 8 years, or >8 years duration, P= NS),and in those without family history of SpA (6.4% versus 1.7%,p = 0.048). The multivariate analysis identified the absence offamily history of SpA as the only variable associated to thepresence of IBD (3.9 [95% CI: 1.1 16.7]). The psoriasis cohortcomprised 528 patients, and only 7 had IBD (prevalence 1.3%,95% CI: 0.6 2.7).

Table: Prevalence of IBD in patients with different SpAdiagnoses

All SpApatients(n = 601)

Ankylosingspondylitis(n = 332)

Psoriaticarthritis(n = 151)

Undifferentiated SpA(n = 97)

Enteropathicarthritis(n = 15)

IBD (any), n (%) 31 (5.1%) 13 (3.9%) 1 (0.7%) 1 (2.4%) 15 (100.0%)Crohn’s disease, n (%) 18 (3.0%) 7 (2.1%) 1 (0.7%) 2 (2.1%) 9 (60.0%)Ulcerative colitis, n (%) 6 (1.0%) 1 (0.3%) 0 (0.0%) 0 (0.0%) 5 (33.3%)Undifferentiated colitis, n (%) 7 (1.2%) 5 (1.5%) 0 (0.0%) 2 (2.1%) 1 (6.7%)

Conclusions: Patients with SpA have a moderate prevalence ofIBD, but higher than general population. The absence of familyhistory of SpA as the only variable associated to the presenceof IBD. The prevalence of IBD in psoriasis was low.

P603Prevalence and characteristics of extra-intestinalmanifestations in a Greek population of inflammatory boweldisease patients followed-up in tertiary centers

K. Karmiris1 *, A. Avgerinos2, A. Tavernaraki1, G.I. Mantzaris3,T. Koukouratos3, K. Oikonomou4, A. Kostas5, N. Viazis3,A. Kapsoritakis4, G. Bamias5, A. Theodoropoulou1,D.G. Karamanolis3, I.E. Koutroubakis2. 1Venizeleio GeneralHospital, Gastroenterology, Heraklion, Crete, Greece,2University Hospital, Gastroenterology, Heraklion, Crete,Greece, 3Evaggelismos Hospital, Gastroenterology, Athens,Greece, 4University Hospital, Gastroenterology, Larissa,Greece, 5Laiko Hospital, Gastroenterology, Athens, Greece

Background: Extra-intestinal manifestation (EIM) diagnosis ininflammatory bowel disease (IBD) patients is often challenging.EIMs’ natural history is not adequately elucidated. The aimof the present study was to investigate the prevalence andcharacteristics of EIMs in a population of IBD patients followed-up in tertiary centers.Methods: Data from 1274 IBD patients (females: 43.6%, Crohn’sdisease: 52.9%, median [IQR] age at IBD diagnosis: 33.1[22.9 48.5] and IBD duration until 1st EIM diagnosis: 2.7[0.3 8.1] years) have been retrospectively retrieved from

medical records and registered according to a pre-definedprotocol. Prevalence of EIMs as well as the impact of certaindemographic and IBD characteristics were studied.Results: Four hundred fourteen patients exhibited at leastone EIM (32.5%, median [IQR] age at 1st EIM diagnosis: 35.0[23.5 48.0] years, mean number of different EIMs/patient1.61±0.04). In particular, 313/406 (77.1%) developed atleast one arthritic EIM (peripheral arthritis: 164/312 [52.6%],ankylosing spondylitis: 23/312 [7.4%], sacroileitis: 63/312[20.2%]), 160/408 (39.2%) at least one dermatologic EIM(erythema nodosum: 71/160 [44.4%], pyoderma gangrenosum:9/160 [5.6%], psoriasis: 36/160 [22.5%], Sweet’s syndrome:2/160 [1.3%], hydradenitis suppurativa: 3/160 [1.9%], aphthousstomatitis: 54/160 [33.8%]), 40/408 (9.8%) at least oneophthalmologic EIM (episcleritis: 8/40 [20%], scleritis: 1/40[2.5%], anterior uveitis: 27/40 [67.5%], posterior uveitis: 5/40[12.5%]), 4/408 (1%) PSC, 8/408 (2%) deep vein thrombosis,20/408 (4.9%) at least one pneumonological EIM (pulmonaryembolism: 3/20 [15%] and in non smokers asthma: 14/20[70%] and bronchiectasis/chronic bronchitis: 3/20 [15%]) and22/409 (5.4%) an EIM which was characterized as rare bythe treating physician. One hundred thirteen out of 405patients (27.9%) developed an EIM before IBD diagnosis (Crohn’sdisease: 82.3%, p < 0.0001) and in 124/214 (57.9%) EIM wasassociated with active IBD. Patients with a prior EIM diagnosishad their IBD diagnosed in an older age (median [IQR]age: 39.9 [27.6 51.9] vs 28.7 [20.9 42.4] years, p < 0.0001).EIMs were more frequent in females (58.2%, p < 0.0001), inCrohn’s disease (67.9%, p < 0.0001), in non-smokers (63.8%,p = 0.001) and in patients with a history of a major IBD surgery(p = 0.017), appendectomy (p < 0.0001) and/or tonsilectomy(p < 0.0001).Conclusions: About one third of IBD patients in our populationdeveloped at least one EIM. Of those, more than one fourthhad their EIM diagnosed before IBD. EIMs were present morefrequently in females, Crohn’s disease patients, non-smokersand surgeries related either directly or indirectly with IBD.

P604Prevalence and characteristics of dermatologicmanifestations in a Greek population of inflammatory boweldisease patients followed-up in tertiary centers

K. Karmiris1 *, A. Avgerinos2, A. Tavernaraki1, G.I. Mantzaris3,T. Koukouratos3, K. Oikonomou4, A. Kostas5, N. Viazis3,A. Kapsoritakis4, G. Bamias5, A. Theodoropoulou1,D.G. Karamanolis3, I.E. Koutroubakis2. 1Venizeleio GeneralHospital, Gastroenterology, Heraklion, Crete, Greece,2University Hospital, Gastroenterology, Heraklion, Crete,Greece, 3Evaggelismos Hospital, Gastroenterology, Athens,Greece, 4University Hospital, Gastroenterology, Larissa,Greece, 5Laiko Hospital, Gastroenterology, Athens, Greece

Background: Skin represents the second more frequent siteof extra-intestinal manifestations (EIMs) in inflammatory boweldisease (IBD) patients. Epidemiological studies on dermatologicmanifestations (DMs) are scarce. The aim of the present studywas to investigate the prevalence and characteristics of DMs ina population of IBD patients followed-up in tertiary centers.Methods: Data from 1274 IBD patients (females: 43.6%,Crohn’s disease [CD]: 52.9%, median [IQR] age at IBDdiagnosis: 33.1 [22.9 48.5] and IBD duration until 1st EIMdiagnosis: 2.7 [0.3 8.1] years) have been retrospectivelyretrieved from medical records and registered according toa pre-defined protocol. Prevalence of DMs as well as theimpact of certain demographic and IBD characteristics werestudied.Results: One hundred sixty patients exhibited at least one DM(39.2% among EIMs, 12.6% of the total cohort, females: 56.3%,smokers: 34.4%, CD: 67.5%, median [IQR] age at IBD diagnosis:29.7 [22.1 43.5], median [IQR] age at 1st DM diagnosis: