ENTEROPATHIC SPONDYLARTHROPATHY IN CHRONI C INFLAMMATORY BOWEL-DISEASE - PREVALENCE, PATTERN OF MANIFESTATION AND HLA-ASSOCIATION

Background: Enteropathic spondylarthropathies (SpA) are the most frequ ent extraintestinal manifestation of the chronic inflammatory bowel di seases (IBD), Crohn's disease (CD) and Ulcerative Colitis (UC). It was the aim of the present study, to analyze a large number of IBD patien ts for the prevalence and pattern of joint manifestation and the assoc iation of SpA with the estend of bowel involvement and HLA-haplotype. Patients and Method: 521 patients (409 CD and 112 UC) were prospective ly analyzed over a period of one year. SpA was diagnosed on the basis of an appropriate patient history as well as clinical, radiological an d immunoserological parameters, Results: SpA was diagnosed in 10.7% of all CD and 14.4% of all UC patients. In 26.8% of all patients symptom s of SpA occured prior to and in 14.4% simultaneously with IBD. 28.1% of all patients presented with isolated peripheral arthritis, 26.8% of all patients showed an isolated involvement of the spine or sacroilii c joints and 45.1% of all patients presented with combined involvement . 2/12 UC patients with SpA suffered from rectosigmoiditis, 5/12 from partial colitis and 5/12 had pancolitis. In CD patients with SyA, 8/59 had isolated colitis, 8/59 ileocolitis and 31/59 isolated small bowel involvement There was a positive correlation between SpA and HLA-B27 (p < 0.01). Conclusion: Enteropathic spondylarthropathies are an impor tant extraintestinal manifestation of IBD. Spondylarthropathies occur irrespective of the extend of IBD and frequently become symptomatic pr ior to IBD. These and recent data describing inflammatory bowel diseas e in patients with SpA of unknown etiology suggest that both diseases have a common pathogenetic background.