S1151 Lymphoprolipherative Disorders Diagnosed in An Inflammatory Bowel Disease Unit

Abstract

Background: Many patients with Inflammatory Bowel Disease (IBD) complain about severe fatigue interfering with daily life, even if their disease is in remission. Therefore we performed a study to examine the prevalence and severity of fatigue in these IBD patients and to define possible determinants of fatigue. Methods: In a three month period we conducted a casecontrol study in consecutive patients at our outpatient clinic. Patients with confirmed Crohn's Disease (CD) andUlcerative Colitis (UC) were studied. Lynch syndrome gene carriers (Lynch), visiting the same out-patient clinic, served as a control group. Demographic variables, clinical history, laboratory results were obtained from the medical records. In IBD patients severity of disease was assessed by the Harvey Bradshaw Index. (Severity of) Fatigue was scored using the revised Piper Fatigue Scale (PFS), a validated questionnaire consisting of 22 numerically (0-10) scaled items, that measures four dimensions of subjective fatigue: (1) behavioral/severity; (2) affective meaning; (3)sensory and (4) cognitive/mood. Mean PFS scores were compared between the three groups for both overall score and dimensions. Within the IBD patient group we looked for possible determinants of fatigue, by comparing demographic and clinical variables between patients with a high (≥4) and low (<4) PFS score. Results: A total of 300 patients were included, of whom 222 patients (117 CD; 55 UC; 50 Lynch) returned the questionnaires. Of these patients six (3CD, 2UC, 1Lynch)were excluded because of missing data in the PFS. The remaining 216 patients (82M/134F) were included in the statistical analysis. Demographic variables were not different between groups. Mean age was 44.4±13.1 years. IBD patients scored significantly higher on the PFS than the control group, with a mean (SD) PFS score of 4.8 (2.1) for CD and 4.2 (2.3) for UC versus 2.0 (2.0) for the control group, respectively (P<0.01). This statistically significantly difference was found throughout all four dimensions. Within IBD patients, gender distribution and age did not alter PFS scores. Moreover, patients with laboratory-defined anemia or high CRP did not score differently. Only the Harvey Bradshaw index was positively correlated with the overall PFS score (r=0.37, p<0.01), and throughout all four dimensions. Conclusion: We found a high prevalence (in all dimensions) of fatigue in patients with IBD. This prevalence was significantly higher compared to the control group, for both CD and UC patients. Within the IBD group, only the Harvey Bradshaw Index correlated with the Piper Fatigue Scale.