• The Journal of Korean Medicine
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• v.33 no.1
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• pp.107-120
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• 2012

Objectives: Clinically, patients with dyspepsia often complain of several gastrointestinal (GI) and extra-GI symptoms. However, there have been few studies investigating the relationship between GI symptoms and extra-GI symptoms. The aim of this study was to characterize the clinical features of the 991 outpatients with GI and extra-GI symptom and the relationships between GI and extra-GI symptoms. Methods: 991 patients newly visiting Weedahm Oriental Hospital for GI symptoms were included. Those who had disorders caused by the hepatobiliary-pancreatic system were excluded. The 991 outpatients were interviewed with a standardized questionnaire inquiring about demography, past medical history, past institutional care, GI symptoms and extra-GI symptoms. Results: Among 991 patients, 780 (78.7%) had more than three GI symptoms and 451 (45.5%) had more than five. Among 991 patients, 545 (55.0%) had more than three extra-GI symptoms and 285 (28.8%) had more than five. There was a statistically significant correlation between GI symptoms and extra-GI symptoms such as headache, fatigue, forgetfulness, eyeball pain, unrest, dizziness, muscle pain, chest pain, and dyspnea. Conclusions: We found that there was statistically significant correlation between GI symptoms and extra-GI symptoms, which suggests the possibility of main common pathophysiology between GI symptoms and extra-GI symptoms. Further studies will be required to elucidate the main common pathophysiology between GI symptoms and extra-GI symptoms.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.23 no.3
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• pp.297-303
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• 2020

The musculoskeletal system can be involved as an extra-intestinal manifestation of inflammatory bowel disease. Among these, myositis in ulcerative colitis (UC) is very rare. A 14-year-old girl was admitted due to severe shoulder tenderness. She had complained of left jaw pain and swelling for the past 10 days. Inflammatory markers were elevated with no evidence of infectious etiology. Myositis was suspected by shoulder magnetic resonance imaging. Three days after admission, she developed hematochezia. Muscle biopsy and colonoscopy was performed due to worsening left mandibular area pain and persistent hematochezia. Colonoscopy showed consistent findings with UC. She was finally diagnosed with UC with myositis as an extra-intestinal manifestation. She showed a dramatic response to UC treatment. Gastrointestinal symptoms were well-controlled. After 14 months, UC symptoms and muscle pain were aggravated, which were relieved after steroid and cyclosporin treatment. We report a unique case of UC initially presented with myositis, preceding gastrointestinal symptoms.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.24 no.2
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• pp.197-206
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• 2021

Purpose: Celiac disease (CD) is a common autoimmune disease with extra-intestinal manifestations, including neurological disorders. There are few reports to assess various factors in increasing the chances of developing neurological disorders in CD, so we designed this study. Methods: All patients with CD at any age who had been referred to the Celiac Clinic were evaluated for neurological problems. CD was defined as IgA anti-transglutaminase antibodies (anti-tTG) of 18 IU/mL or higher in serology and Marsh type I or more severe in histopathological evaluation. Logistic regression analysis was used to evaluate the impact of various independent variables on the neurological manifestations. Results: A total of 540 patients enrolled in this study. A 360 (66.7%) of patients were children. A 64.8% and 35.2% were female and male, respectively. Overall, 34.1% of patients had neurological manifestation, including headache, neuropathy, epilepsy, and ataxia. The odds of developing neurological manifestations in children were significantly lower than in adults (odds ratio [OR], 0.66; 95% confidence interval [CI], 0.45-0.96; p=0.03) and in patients with gastrointestinal (GI) symptoms significantly higher than in the group without GI manifestations (OR, 1.77; 95% CI, 1.18-2.63; p=0.005). Other variables, including Marsh classification (OR, 0.44; 95% CI, 0.18-1.11; p=0.08) and anti-tTG levels (OR, 1.00; 95% CI, 0.999-1.001; p=0.59) did not significantly increase the chances of developing neurological disorders. Conclusion: Our study showed that increasing age and the presence of GI symptoms, but not serological and histological findings, could increase the chances of developing neurological diseases in CD patients.