Article Text

PDF
AB1019 Association of inflammatory diseases – a current topic for the practitioner
  1. A Cardoneanu1,2,
  2. A Burlui1,2,
  3. C Cijevschi Prelipcean3,
  4. E Rezus1,2
  1. 1Rheumatology, University of Medicine and Pharmacy “Gr.T.Popa”
  2. 2Rheumatology Clinic, Rehabilitation Hospital
  3. 3Gastroenterology, University of Medicine and Pharmacy “Gr.T.Popa”, iasi, Romania

Abstract

Background Autoimmune, infectious, traumatic or neoplastic inflammation represents a warning for the practitioner. Numerous clinical specialties face daily with the presence of inflammation. The efforts of medical staff aim to establish the pathogenesis, the expansion and to find the most effective ways of treatment.

Objectives Our study objective is to highlight the correlations between Spondylarthropathies (SpA) and intestinal manifestations, the link between the antigen HLA B27 and joint and intestinal inflammatory changes and also the relationship between the presence of sacroiliitis and bowel disorders.

Methods The study included 42 patients (28 men, 14 women). Of the 42 patients, 31 were diagnosed with ankylosing spondylitis (AS) (according to modified New York criteria), 8 with psoriatic arthritis (PsA) (using CASPAR diagnosis criteria) and 3 patients had had reactive arthritis (ReA) (according to ASAS criteria). All subjects enrolled in the study were screened for the presence of the antigen HLA-B27. Sacroiliitis was highlighted through pelvis X-ray centered on the SI joints. All patients diagnosed with AS presented radiological sacroiliitis, only 5 cases in the group of PsA and 1 patient diagnosed with ReA. To investigate the presence of intestinal inflammation, a colonoscopy with biopsy was performed to all subjects included in the study. Among patients with AS, 5 of them had inflammatory changes suggestive of Crohn's disease (CD) and 2 for ulcerative colitis (UC). Subclinical intestinal inflammation was evidenced in 15 cases: 12 of SA group and 3 of PsA group. We also highlighted 7 cases of irritable bowel syndrome: 1 patient with PsA and 6 patients with SA.

Results After the statistical analysis of the collected data, the following statistically significant correlations were found (p<0.05): radiological sacroiliitis correlated with AS and PsA; the antigen HLA-B27 is in close relation with all 3 forms of spondylarthritis; subclinical intestinal inflammation was positively correlated with AS and PsA. No associations were found between the presence of intestinal inflammation and sacroiliitis.

Conclusions This study points the link between intestinal and joint inflammation, primarily due to a common pathogenic mechanisms. A careful monitoring and a close collaboration between gastroenterologists and rheumatologists contributes to an optimal management of these patients.

References

  1. Baeten D, de Keyser F, Mielants H, Veys EM. Ankylosing spondylitis and bowel disease. Best Pract Res Clin Rheumatol Sep 2002;16(4):537–549.

  2. Salmi M, Jalkanen S. Human leukocyte subpopulations from inflamed gut bind to joint vasculature using distinct sets of adhesion molecules. J Immunol 2001;166:4650–4657.

  3. May E, Marker-Hermann E, Wittig BM, Zeitz M, Meyer zum Buschenfelde KH, Duchmann R. Identical T-cell expansions in the colon mucosa and the synovium of a patient with enterogenic spondyloarthropathy. Gastroenterology 2000;119:1745–1755.

  4. Peeters H, vanderCruyssen B, vander Cruyssen B, Mielants H, de Vlam K, Vermeire S, et al. Clinical and genetic factors associated with sacroiliitis in Crohn's disease. J Gastroenterol Hepatol Jan 2008;23(1):132–137.

  5. de Vlam K, Mielants H, Cuvelier C, de Keyser F, Veys EM, de Vos M. Spondyloarthropathy is underestimated in inflammatory bowel disease: prevalence and HLA association. J Rheumatol Dec 2000;27(12):2860–2865.

References

Disclosure of Interest None declared

Statistics from Altmetric.com

Request permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.