Concurrent inflammatory bowel disease and myelodysplastic syndromes

Myelodysplastic syndromes (MDS) may be associated with inflammatory bowel d isease (IBD). We characterized the clinical features and outcomes of patien ts with concurrent PBD and MDS. Using a diagnostic index, we identified all patients with both IBD and MDS at our center between 1976 and 1997. We als o calculated an incidence rate of MDS in IBD using population-based data fr om Olmsted County, Minnesota, between 1950 and 1993. Among similar to 15,00 0 IBD patients seen, 25 (similar to 0.17%) were diagnosed with MDS. Fourtee n had Crohn's disease and 11 had ulcerative colitis. The median age at diag nosis of IBD, particularly Crohn's disease, was higher than expected. Media n age at diagnosis of MDS was typical. All but one ulcerative colitis patie nt was diagnosed before the diagnosis of MDS, while one-half of Crohn's dis ease patients were diagnosed with both ailments simultaneously. Five patien ts who had been diagnosed with IBD first were persistently anemic for at le ast 1 year prior to diagnosis of MDS. Two Crohn's disease patients had rece ived purine analogs in the past. Median follow-up after MDS diagnosis was 1 year. Seven patients died, including two who progressed to acute myeloid l eukemia. The incidence rate of MDS in IBD based on Olmsted County data was 0 cases per 100,000 person-years (95% CI, 0-55.2). The seemingly high frequ ency of myelodysplastic syndromes in a large referral-based group of patien ts with IBD suggests an association; however, an increased risk of MDS was not observed in a small regional cohort of IBD patients. Patients with MDS are diagnosed with concurrent IBD at an age older than expected. Simultaneo us diagnoses were made in one-half of Crohn's disease patients. MDS should be considered in the differential diagnosis of anemia in IBD patients.