CLINICALLY SILENT INFLAMMATORY GUT LESIONS IN UNDIFFERENTIATED SPONDYLOARTHROPATHIES

Gastrointestinal inflammation or infection can be associated with vari ous forms of arthristis, such as, acute reactive arthritis triggered b y enteritis due to gram-negative bacteria or ankylosing spondylitis an d peripheral arthritis in relation to Crohn's disease and ulcerative c olitis. Using colonoscopy, we have found a high prevalence of clinical ly silent inflammatory lesions in 38 patients (24 males and 14 females ) affected by undifferentiated spondyloarthropathies (SpA). Microscopi c inflammatory lesions were present in all the patients. Three pattern s of nonspecific chronic inflammatory alterations were observed. No di fference was noted between patients taking or not taking nonsteroidal anti-inflammatory drugs. Direct immunofluorescence demonstrated the pr esence of IgG, IgA, IgM, C3, C4 and fibrinogen in 75% of the specimens examined. The finding of chronic inflammatory gut lesions hypothesize s that a local activation of the immune system depending on the persis tence of intestinal microbial antigens or toxins, due to impaired elim ination or increased exposition, may have a part in the pathogenesis o f SpA.