{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T16:55:19Z","timestamp":1791219319444,"version":"4.1.0"},"reference-count":38,"publisher":"Oxford University Press (OUP)","issue":"4","license":[{"start":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T00:00:00Z","timestamp":1788307200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001659","name":"Deutsche Forschungsgemeinschaft","doi-asserted-by":"publisher","award":["CRC\/TRR241"],"award-info":[{"award-number":["CRC\/TRR241"]}],"id":[{"id":"10.13039\/501100001659","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,10,5]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Extraintestinal manifestations (EIMs) are a frequent and clinically significant feature of inflammatory bowel disease (IBD), contributing to morbidity and impaired quality of life.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To investigate the prevalence, spectrum, timing, and risk factors of EIMs in a large cohort of patients with IBD.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In this retrospective cohort study, adult patients with ulcerative colitis (UC) or Crohn\u2019s disease (CD) followed at a German tertiary referral center were included. Electronic medical records were reviewed to identify specialist-confirmed EIMs, their timing relative to IBD diagnosis, and associated demographic and disease-related factors.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 817 patients with IBD (527 CD, 290 UC) were included, with a median disease duration of 11\u2009years (IQR 6-19). EIMs were identified in 227 patients (27.8%), with rheumatologic (17.4%) and cutaneous (8.9%) manifestations being the most frequent. Most patients had one EIM (70%), while 30% developed multiple manifestations. Female sex (OR 2.88; 95% CI 2.08-4.02, P\u2009&amp;lt;\u2009.001), longer IBD duration (OR 1.02 per year; 95% CI 1.01-1.04, P\u2009=\u2009.002), and CD (OR 1.57; 95% CI 1.08-2.29, P\u2009=\u2009.018) were independently associated with EIM development. EIMs occurred before or concurrently with IBD diagnosis in 20.7% of affected patients. Kaplan\u2013Meier analysis demonstrated a continuous increase in the cumulative probability of developing EIMs over time, reaching approximately 27% at 15\u2009years of follow-up.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>EIMs affect more than one quarter of patients with IBD and may precede or coincide with intestinal disease onset. Female sex and CD appear to be independent risk factors. These findings highlight the importance of early recognition and long-term surveillance of EIMs in patients with IBD.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/crocol\/otag100","type":"journal-article","created":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T11:24:02Z","timestamp":1788521042000},"source":"Crossref","is-referenced-by-count":0,"title":["Prevalence, timing and risk factors of extraintestinal manifestations in inflammatory bowel disease: a retrospective cohort study from a German tertiary referral center"],"prefix":"10.1093","volume":"8","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7621-8100","authenticated-orcid":false,"given":"Fotios","family":"Fousekis","sequence":"first","affiliation":[{"name":"Department of Medicine 1, Uniklinikum Erlangen, Friedrich-Alexander-Universit\u00e4t Erlangen-N\u00fcrnberg , Erlangen,","place":["Germany"]},{"name":"Deutsches Zentrum Immuntherapie, Friedrich-Alexander-Universit\u00e4t Erlangen-N\u00fcrnberg , Erlangen,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Panagiotis","family":"Garantziotis","sequence":"additional","affiliation":[{"name":"Deutsches Zentrum Immuntherapie, Friedrich-Alexander-Universit\u00e4t Erlangen-N\u00fcrnberg , Erlangen,","place":["Germany"]},{"name":"Department of Medicine 3 - Rheumatology and Immunology, Uniklinikum Erlangen, Friedrich-Alexander-Universit\u00e4t Erlangen-N\u00fcrnberg , Erlangen,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andr\u00e9","family":"Jefremow","sequence":"additional","affiliation":[{"name":"Department of Medicine 1, Uniklinikum Erlangen, Friedrich-Alexander-Universit\u00e4t Erlangen-N\u00fcrnberg , Erlangen,","place":["Germany"]},{"name":"Deutsches Zentrum Immuntherapie, Friedrich-Alexander-Universit\u00e4t Erlangen-N\u00fcrnberg , Erlangen,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5257-9171","authenticated-orcid":false,"given":"Christina","family":"Bergmann","sequence":"additional","affiliation":[{"name":"Deutsches Zentrum Immuntherapie, Friedrich-Alexander-Universit\u00e4t Erlangen-N\u00fcrnberg , Erlangen,","place":["Germany"]},{"name":"Department of Medicine 3 - Rheumatology and Immunology, Uniklinikum Erlangen, Friedrich-Alexander-Universit\u00e4t Erlangen-N\u00fcrnberg , Erlangen,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Gabriella","family":"Raimondo","sequence":"additional","affiliation":[{"name":"Deutsches Zentrum Immuntherapie, Friedrich-Alexander-Universit\u00e4t Erlangen-N\u00fcrnberg , Erlangen,","place":["Germany"]},{"name":"Department of Medicine 3 - Rheumatology and Immunology, Uniklinikum Erlangen, Friedrich-Alexander-Universit\u00e4t Erlangen-N\u00fcrnberg , Erlangen,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andreas","family":"Ramming","sequence":"additional","affiliation":[{"name":"Deutsches Zentrum Immuntherapie, Friedrich-Alexander-Universit\u00e4t Erlangen-N\u00fcrnberg , Erlangen,","place":["Germany"]},{"name":"Department of Medicine 3 - Rheumatology and Immunology, Uniklinikum Erlangen, Friedrich-Alexander-Universit\u00e4t Erlangen-N\u00fcrnberg , Erlangen,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Georg","family":"Schett","sequence":"additional","affiliation":[{"name":"Deutsches Zentrum Immuntherapie, Friedrich-Alexander-Universit\u00e4t Erlangen-N\u00fcrnberg , Erlangen,","place":["Germany"]},{"name":"Department of Medicine 3 - Rheumatology and Immunology, Uniklinikum Erlangen, Friedrich-Alexander-Universit\u00e4t Erlangen-N\u00fcrnberg , Erlangen,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Markus F","family":"Neurath","sequence":"additional","affiliation":[{"name":"Department of Medicine 1, Uniklinikum Erlangen, Friedrich-Alexander-Universit\u00e4t Erlangen-N\u00fcrnberg , Erlangen,","place":["Germany"]},{"name":"Deutsches Zentrum Immuntherapie, Friedrich-Alexander-Universit\u00e4t Erlangen-N\u00fcrnberg , Erlangen,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8556-8433","authenticated-orcid":false,"given":"Raja","family":"Atreya","sequence":"additional","affiliation":[{"name":"Department of Medicine 1, Uniklinikum Erlangen, Friedrich-Alexander-Universit\u00e4t Erlangen-N\u00fcrnberg , Erlangen,","place":["Germany"]},{"name":"Deutsches Zentrum Immuntherapie, Friedrich-Alexander-Universit\u00e4t Erlangen-N\u00fcrnberg , Erlangen,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,9,2]]},"reference":[{"key":"2026100512021009500_otag100-B1","doi-asserted-by":"publisher","first-page":"20629","DOI":"10.1007\/s10620-020-06424-x","article-title":"Extra intestinal manifestations may increase the risk of synchronous and metachronous development of other extraintestinal manifestations in patients with Crohn\u2019s disease","volume":"15","author":"Ozkahraman","year":"2025","journal-title":"Sci Rep"},{"key":"2026100512021009500_otag100-B2","doi-asserted-by":"publisher","first-page":"2014","DOI":"10.1007\/s10620-020-06424-x","article-title":"Extraintestinal manifestations in patients with inflammatory bowel disease: study based on the ENEIDA Registry","volume":"66","author":"Algaba","year":"2021","journal-title":"Dig Dis Sci"},{"key":"2026100512021009500_otag100-B3","doi-asserted-by":"publisher","first-page":"230","DOI":"10.1093\/ibd\/izad061","article-title":"Prevalence of extraintestinal manifestations in inflammatory bowel disease: a systematic review and meta-analysis","volume":"30","author":"Kilic","year":"2024","journal-title":"Inflamm Bowel Dis"},{"key":"2026100512021009500_otag100-B4","doi-asserted-by":"publisher","first-page":"315","DOI":"10.1053\/j.gastro.2024.02.026","article-title":"Comprehensive association analyses of extraintestinal manifestations in inflammatory bowel disease","volume":"167","author":"Khrom","year":"2024","journal-title":"Gastroenterology"},{"key":"2026100512021009500_otag100-B5","doi-asserted-by":"publisher","first-page":"329","DOI":"10.1038\/nri3661","article-title":"Cytokines in inflammatory bowel disease","volume":"14","author":"Neurath","year":"2014","journal-title":"Nat Rev Immunol"},{"key":"2026100512021009500_otag100-B6","doi-asserted-by":"publisher","first-page":"1118","DOI":"10.1053\/j.gastro.2021.07.042","article-title":"Extraintestinal manifestations of inflammatory bowel disease: current concepts, treatment, and implications for disease management","volume":"161","author":"Rogler","year":"2021","journal-title":"Gastroenterology"},{"key":"2026100512021009500_otag100-B7","doi-asserted-by":"publisher","first-page":"848","DOI":"10.3109\/00365521.2016.1140807","article-title":"Association of extraintestinal manifestations and anaemia with disease outcomes in patients with inflammatory bowel disease","volume":"51","author":"Vegh","year":"2016","journal-title":"Scand J Gastroenterol"},{"key":"2026100512021009500_otag100-B8","doi-asserted-by":"publisher","first-page":"585","DOI":"10.1038\/nrgastro.2013.117","article-title":"Extraintestinal manifestations and complications in IBD","volume":"10","author":"Ott","year":"2013","journal-title":"Nat Rev Gastroenterol Hepatol"},{"key":"2026100512021009500_otag100-B9","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1093\/ecco-jcc\/jjad108","article-title":"ECCO guidelines on extraintestinal manifestations in inflammatory bowel disease","volume":"18","author":"Gordon","year":"2024","journal-title":"J Crohns Colitis"},{"key":"2026100512021009500_otag100-B10","doi-asserted-by":"publisher","first-page":"1982","DOI":"10.1097\/MIB.0000000000000392","article-title":"Extraintestinal manifestations of inflammatory bowel disease","volume":"21","author":"Vavricka","year":"2015","journal-title":"Inflamm Bowel Dis"},{"key":"2026100512021009500_otag100-B11","doi-asserted-by":"publisher","first-page":"110","DOI":"10.1038\/ajg.2010.343","article-title":"Frequency and risk factors for extraintestinal manifestations in the swiss inflammatory bowel disease cohort","volume":"106","author":"Vavricka","year":"2011","journal-title":"Am J Gastroenterol"},{"key":"2026100512021009500_otag100-B12","doi-asserted-by":"publisher","first-page":"1794","DOI":"10.1097\/MIB.0000000000000429","article-title":"Chronological order of appearance of extraintestinal manifestations relative to the time of IBD diagnosis in the swiss inflammatory bowel disease cohort","volume":"21","author":"Vavricka","year":"2015","journal-title":"Inflamm Bowel Dis"},{"key":"2026100512021009500_otag100-B13","doi-asserted-by":"publisher","first-page":"806","DOI":"10.1136\/bmj.39335.541782.AD","article-title":"Strengthening the reporting of observational studies in epidemiology (STROBE) statement: guidelines for reporting observational studies","volume":"335","author":"von Elm","year":"2007","journal-title":"BMJ"},{"key":"2026100512021009500_otag100-B14","doi-asserted-by":"publisher","first-page":"17463","DOI":"10.3748\/wjg.v20.i46.17463","article-title":"Extraintestinal manifestations in a large series of italian inflammatory bowel disease patients","volume":"20","author":"Zippi","year":"2014","journal-title":"World J Gastroenterol"},{"key":"2026100512021009500_otag100-B15","doi-asserted-by":"publisher","first-page":"259","DOI":"10.2147\/CEG.S136383","article-title":"Characterization and prevalence of spondyloarthritis and peripheral arthritis among patients with inflammatory bowel disease","volume":"10","author":"Malaty","year":"2017","journal-title":"Clin Exp Gastroenterol"},{"key":"2026100512021009500_otag100-B16","doi-asserted-by":"publisher","first-page":"e0211554","DOI":"10.1371\/journal.pone.0211554","article-title":"The appearance of joint manifestations in the swiss inflammatory bowel disease cohort","volume":"14","author":"Hiller","year":"2019","journal-title":"PLoS One"},{"key":"2026100512021009500_otag100-B17","doi-asserted-by":"publisher","first-page":"7604939","DOI":"10.1155\/2019\/7604939","article-title":"Frequency of hepatobiliary manifestations and concomitant liver disease in inflammatory bowel disease patients","volume":"2019","author":"Silva","year":"2019","journal-title":"Biomed Res Int"},{"key":"2026100512021009500_otag100-B18","doi-asserted-by":"publisher","first-page":"91","DOI":"10.1097\/MEG.0000000000000747","article-title":"Primary sclerosing cholangitis in the swiss inflammatory bowel disease cohort study: prevalence, risk factors, and long-term follow-up","volume":"29","author":"Fraga","year":"2017","journal-title":"Eur J Gastroenterol Hepatol"},{"key":"2026100512021009500_otag100-B19","doi-asserted-by":"publisher","first-page":"1288","DOI":"10.1111\/jgh.12947","article-title":"Appearance of hepatobiliary diseases in a population-based cohort with inflammatory bowel diseases (inflammatory bowel disease cohort of the Uppsala region)","volume":"30","author":"Ronnblom","year":"2015","journal-title":"J Gastroenterol Hepatol"},{"key":"2026100512021009500_otag100-B20","doi-asserted-by":"publisher","first-page":"1865","DOI":"10.1053\/j.gastro.2021.08.032","article-title":"Prevalence of primary sclerosing cholangitis in patients with inflammatory bowel disease: a systematic review and meta-analysis","volume":"161","author":"Barberio","year":"2021","journal-title":"Gastroenterology"},{"key":"2026100512021009500_otag100-B21","doi-asserted-by":"publisher","first-page":"2499","DOI":"10.1016\/j.cgh.2025.11.020","article-title":"Prevalence and outcomes of primary sclerosing cholangitis in inflammatory bowel disease: a multinational study across asia","volume":"24","author":"Akiyama","year":"2026","journal-title":"Clin Gastroenterol Hepatol"},{"key":"2026100512021009500_otag100-B22","doi-asserted-by":"publisher","first-page":"35","DOI":"10.1016\/j.jaut.2013.07.005","article-title":"Geoepidemiology of primary sclerosing cholangitis: a critical review","volume":"46","author":"Tanaka","year":"2013","journal-title":"J Autoimmun"},{"key":"2026100512021009500_otag100-B23","doi-asserted-by":"publisher","first-page":"360","DOI":"10.1093\/ecco-jcc\/jjad157","article-title":"Prevalence of hepatobiliary manifestations in inflammatory bowel disease: a GRADE assessed systematic review and meta-analysis of more than 1.7 million patients","volume":"18","author":"Beheshti Maal","year":"2024","journal-title":"J Crohns Colitis"},{"key":"2026100512021009500_otag100-B24","doi-asserted-by":"publisher","first-page":"e0210436","DOI":"10.1371\/journal.pone.0210436","article-title":"Occurrence of skin manifestations in patients of the swiss inflammatory bowel disease cohort study","volume":"14","author":"Roth","year":"2019","journal-title":"PLoS One"},{"key":"2026100512021009500_otag100-B25","doi-asserted-by":"publisher","first-page":"481","DOI":"10.1007\/s40257-022-00689-w","article-title":"Cutaneous manifestations of inflammatory bowel disease: a basic overview","volume":"23","author":"Pagani","year":"2022","journal-title":"Am J Clin Dermatol"},{"key":"2026100512021009500_otag100-B26","doi-asserted-by":"publisher","first-page":"442","DOI":"10.1093\/ecco-jcc\/jjx178","article-title":"Cutaneous morbidity among inflammatory bowel disease patients: a cohort study","volume":"12","author":"Vide","year":"2018","journal-title":"J Crohns Colitis"},{"key":"2026100512021009500_otag100-B27","doi-asserted-by":"publisher","first-page":"2280","DOI":"10.1016\/j.cgh.2024.05.013","article-title":"Sex-Related differences in the phenotype and course of inflammatory bowel disease: SEXEII study of ENEIDA","volume":"22","author":"Gargallo-Puyuelo","year":"2024","journal-title":"Clin Gastroenterol Hepatol"},{"key":"2026100512021009500_otag100-B28","doi-asserted-by":"publisher","first-page":"77","DOI":"10.3390\/diagnostics9030077","article-title":"Prevalence of oral lesions and correlation with intestinal symptoms of inflammatory bowel disease: a systematic review","volume":"9","author":"Lauritano","year":"2019","journal-title":"Diagnostics (Basel)"},{"key":"2026100512021009500_otag100-B29","doi-asserted-by":"publisher","first-page":"40","DOI":"10.1111\/apt.13217","article-title":"Review article: non-malignant oral manifestations in inflammatory bowel diseases","volume":"42","author":"Katsanos","year":"2015","journal-title":"Aliment Pharmacol Ther"},{"key":"2026100512021009500_otag100-B30","doi-asserted-by":"publisher","first-page":"1832","DOI":"10.1093\/ibd\/izaa359","article-title":"Ocular manifestations of inflammatory bowel disease","volume":"27","author":"Shah","year":"2021","journal-title":"Inflamm Bowel Dis"},{"key":"2026100512021009500_otag100-B31","doi-asserted-by":"publisher","first-page":"e485","DOI":"10.1111\/aos.15793","article-title":"Differences in the prevalence of uveitis between crohn\u2019s disease and ulcerative colitis: a systematic review and meta-analysis","volume":"102","author":"Lin","year":"2024","journal-title":"Acta Ophthalmol"},{"key":"2026100512021009500_otag100-B32","doi-asserted-by":"publisher","first-page":"220","DOI":"10.1093\/ibd\/izaf213","article-title":"Incidence of ocular manifestation after adult-onset inflammatory bowel disease: a 20-year population-based cohort study","volume":"32","author":"Yanai","year":"2026","journal-title":"Inflamm Bowel Dis"},{"key":"2026100512021009500_otag100-B33","doi-asserted-by":"publisher","first-page":"300","DOI":"10.3109\/00365521.2014.991752","article-title":"Extraintestinal manifestations in crohn\u2019s disease and ulcerative colitis: results from a prospective, population-based european inception cohort","volume":"50","author":"Isene","year":"2015","journal-title":"Scand J Gastroenterol"},{"key":"2026100512021009500_otag100-B34","doi-asserted-by":"publisher","first-page":"1041","DOI":"10.1016\/S2468-1253(24)00159-6","article-title":"Sex and gender in inflammatory bowel disease outcomes and research","volume":"9","author":"Andersen","year":"2024","journal-title":"Lancet Gastroenterol Hepatol"},{"key":"2026100512021009500_otag100-B35","doi-asserted-by":"publisher","first-page":"415","DOI":"10.1038\/s41575-025-01038-y","article-title":"Influence of biological sex in inflammatory bowel diseases","volume":"22","author":"Tshikudi","year":"2025","journal-title":"Nat Rev Gastroenterol Hepatol"},{"key":"2026100512021009500_otag100-B36","doi-asserted-by":"publisher","first-page":"559","DOI":"10.1038\/s41577-024-01008-6","article-title":"Strategies for targeting cytokines in inflammatory bowel disease","volume":"24","author":"Neurath","year":"2024","journal-title":"Nat Rev Immunol"},{"key":"2026100512021009500_otag100-B37","doi-asserted-by":"publisher","first-page":"933357","DOI":"10.3389\/fmed.2022.933357","article-title":"The impact of biologic therapies on extra-intestinal manifestations in inflammatory bowel disease: a multicenter study","volume":"9","author":"Ferretti","year":"2022","journal-title":"Front Med (Lausanne)"},{"key":"2026100512021009500_otag100-B38","doi-asserted-by":"publisher","first-page":"1876","DOI":"10.1093\/ibd\/izy065","article-title":"Extraintestinal manifestations in vedolizumab and anti-TNF-treated patients with inflammatory bowel disease","volume":"24","author":"Dubinsky","year":"2018","journal-title":"Inflamm Bowel Dis"}],"container-title":["Crohn\u2019s &amp; Colitis 360"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/crohnscolitis360\/article-pdf\/8\/4\/otag100\/70922635\/otag100.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/crohnscolitis360\/article-pdf\/8\/4\/otag100\/70922635\/otag100.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T16:02:17Z","timestamp":1791216137000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/crohnscolitis360\/article\/doi\/10.1093\/crocol\/otag100\/8779988"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,2]]},"references-count":38,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2026,10,5]]}},"URL":"https:\/\/doi.org\/10.1093\/crocol\/otag100","relation":{},"ISSN":["2631-827X"],"issn-type":[{"value":"2631-827X","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2026,10]]},"published":{"date-parts":[[2026,9,2]]},"article-number":"otag100"}}