Objectives The present study propose to observe the relation between the gut and synovitis in enteretic and urogenic reactive arthritis (ReA).
Methods Forty patients with ReA were included in the study according to Amor criteria: 25 patients with enteric entrance gate and 15 patients with urogenic entrance gate. We had in view the inflammatory syndrome, immune syndrome, identification of the infectious ?trigger? (serology for Yersinia, Shigella, Salmonella, Chlamydia). Concomitant were effected rectosigmoidoscopy with biopsy and synovial biopsy.
Results 75% of patients had inflammatory intestinal lesions like active and chronic colitis and proctitis. We found a correlation between persistance of the intestinal inflammation and the evolution of the inflammatory process in the joint. The immunglobulins A were increased at 50% of patients which prove the existence of a persistent antigenic stimulation to the bowel level. At 10 patients with urogenic ReA we observed a remarkable aspect: the presence of subclinical inflammatory lesions to the intestinal mucosa.
Conclusion The rectosigmoidoscopy with biopsy back the role of the bowel in ReA, even at the patients which have not obvious clinical gastrointestinal manifestations.