GUT INFLAMMATION IN PSORIATIC-ARTHRITIS - A PROSPECTIVE ILEOCOLONOSCOPIC STUDY

Objective. Some forms of psoriatic arthritis (PsA) are classified as s pondylarthropathy, and subclinical gut inflammation is found in spondy larthropathies. Our study was designed to determine if inflammatory gu t lesions were also present in PsA, and if the prevalence of subclinic al gut involvement was different in the subgroups of this disease. The relationship with HLA subtypes was also determined. Methods. Ileocolo noscopy was performed on 64 patients with PsA (37 men, 27 women). Resu lts. Inflammatory gut lesions were found in 10 of the 64 patients (16% ): in 3 of the 15 patients (20%) with oligoarthritis and in 7 of the 2 3 patients (30%) with axial involvement. None of the 26 patients with polyarthritis showed these lesions. The prevalence of HLA-B27, Bw62, a nd B17 was significantly raised in our total group of patients with Ps A. HLA-B27 and Bw62 were significantly more prevalent in patients with gut inflammation, 60 and 50%, respectively.Conclusion. Gut inflammati on is only present in PsA subgroups that belong to the spondylarthropa thy concept. This suggests that the gut plays a role in the pathogenes is of locomotor inflammation in these subgroups. The prevalence of gut inflammation in psoriatic spondylarthropathy is significantly lower t han in nonpsoriatic spondylarthropathies. Consequently, not only the g ut but also the skin may be a portal of entry for causative antigens i n PsA.