Clinical features of Crohn disease concomitant with ankylosing spondylitis

Liu, Song; Ding, Jie; Wang, Meng; Zhou, Wenyuan; Feng, Min; Guan, Wenxian

doi:10.1097/md.0000000000004267

Cited by 17 publications

(18 citation statements)

References 38 publications

(39 reference statements)

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“…Two factors predictive of CD in association with SpA were higher disease activity, as reflected by the BASDAI, and increased FCP when not taking NSAID. Our findings are thus in keeping with other studies 44,50 . Anti-TNF therapy has been shown to induce and maintain remission of CD, while at the same time treating severe active SpA 51 , suggesting that it should be the preferred drug for the treatment of active and severe SpA associated with active or quiescent CD.…”

Section: Kopylov Et Al: the Space Capsule Studysupporting

confidence: 83%

Detection of Crohn Disease in Patients with Spondyloarthropathy: The SpACE Capsule Study

Kopylov

Starr²,

Watts³

et al. 2018

J Rheumatol

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Objective.Inflammatory bowel disease (IBD) is generally reported to be associated with spondylarthropathies (SpA) in 5%–15% of cases. Systematic colonoscopic assessment by protocol demonstrated mucosal inflammation characteristic of Crohn disease (CD) in up to one-third of patients with SpA. Video capsule endoscopy (CE) is a superior diagnostic tool to detect small bowel mucosal disease. Our study compared the accuracy of CE to standard colonoscopy for detection of inflammatory bowel lesions in patients with SpA, and to describe predictors of small bowel inflammation (SBI) in this cohort.Methods.Prospective cross-sectional study of adult patients followed for SpA. Patients were evaluated by CE and standard colonoscopy with biopsies. SBI was quantified using the Lewis Score. Additional screening tests included fecal calprotectin (FCP), C-reactive protein (CRP), and a diagnostic panel of serologic, inflammatory and genetic tests (SGI).Results.There were 64 patients recruited (53% female, mean age 42 ± 13 yrs). Chronic gastrointestinal (GI) symptoms were present in 57%. CE revealed significant SBI in 27/64 (42.2%), compared to 7/64 (10.9%) by standard colonoscopy (p = 0.035). Elevated FCP was associated with small bowel CD (OR 4.5, 95% CI 1.01–19.9; p = 0.042). No correlation was observed with presence of GI symptoms, CRP, or SGI results. Finding CD led to a change in management in 65.2% of cases.Conclusion.CE uncovered SBI consistent with CD in 42.2% of patients with SpA, with a significant incremental yield over colonoscopy of 31%. FCP levels were significantly correlated with CE results, while GI symptoms and SGI results were poor predictors of SBI.

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Section: Kopylov Et Al: the Space Capsule Studysupporting

confidence: 83%

Detection of Crohn Disease in Patients with Spondyloarthropathy: The SpACE Capsule Study

Kopylov

Starr²,

Watts³

et al. 2018

J Rheumatol

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“…The most altered biological signs in our patients were:  CRP >11mg/L, Vs 1h (>7mm); 2h (>11mm) with nonsignificant association as reported by 14,15 .…”

Section: Discussionsupporting

confidence: 41%

Association of Inflammatory Pathologies and Crohn's Disease: A Retrospective Study in the West Algerian Region

Benaissa

Kanoun

Zemri

et al. 2020

J. Drug Delivery Ther.

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Background: Crohn's disease is a chronic and recurrent inflammatory bowel disease that progresses slowly. Also CD patients have a large number of extra-intestinal manifestations. Objective: we sought to define the possible associations between inflammatory pathology and localization and on the other hand, inflammatory pathologies and the disease behavior Methods: A retrospective analytical study was carried out at the level of gastric and general surgery services of Western Algerian University Hospital of Sidi Bel Abbes region, during the period 2007-2019. Results Our study was based on a total sample of 295 cases involving 114 females (38.6%) and 181 males (61.4%) with a sex ratio of (1.58). The location of the disease at the time of diagnosis was dominated by the ileo-caecal location (55.3%), of which 64.4% were associated with inflammatory pathology (IP). The majority of patients diagnosed with Crohn's disease had an inflammatory behavior and this for all age groups. The appendix, the ulcer and inflammatory anemia are most associated with Crohn’s disease. For inflammatory extra-intestinal manifestations, only group of patients with arthralgia had significantly higher rates in the 20-60 age groups. The mainly noted risk factors were appendectomy with (17.3%), smoking (22.4%) with a highly significant association, and alcoholism (6.1%). Conclusion According to our results the association of inflammatory pathology and crohn disease is more frequent in male and dominated by arthralgia as extra-intestinal manifestations lesions. Keywords: Crohn disease; Inflammatory pathology; disease behavior; inflammatory extra-intestinal manifestation.

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“…and ). Then, 378 full texts were assessed for eligibility and, finally, 78 papers were included in the qualitative and quantitative analysis: 67 for the analysis of the prevalence of co‐existing IBD‐SpA (Tables and ) and only 11 for the diagnostic accuracy of red flags .…”

Section: Resultsmentioning

confidence: 99%

Red flags for appropriate referral to the gastroenterologist and the rheumatologist of patients with inflammatory bowel disease and spondyloarthritis

Felice

Leccese

Scudeller

et al. 2019

Clinical and Experimental Immunology

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Collaboration between gastroenterologists and rheumatologists is recommended for the correct management of patients with associated spondyloarthritis (SpA) and inflammatory bowel disease (IBD). We aimed to establish the appropriateness of several red flags for a prompt specialist referral. A systematic review of the literature was performed using the GRADE method to describe the prevalence of co-existing IBD-SpA and the diagnostic accuracy of red flags proposed by a steering committee. Then, a consensus among expert gastroenterologists and rheumatologists (10 in the steering committee and 13 in the expert panel) was obtained using the RAND method to confirm the appropriateness of each red flag as 'major' (one sufficient for patient referral) or 'minor' (at least three needed for patient referral) criteria for specialist referral. The review of the literature confirmed the high prevalence of co-existing IBD-SpA. Positive and negative predictive values of red flags were not calculated, given the lack of available data. A consensus among gastroenterology and rheumatology specialists was used to confirm the appropriateness of each red flag. Major criteria to refer patients with SpA to the gastroenterologist included: rectal bleeding, chronic abdominal pain, perianal fistula or abscess, chronic diarrhoea and nocturnal symptoms. Major criteria to refer patients with IBD to the rheumatologist included: chronic low back pain, dactylitis, enthesitis and pain/swelling of peripheral joints. Several major and minor red flags have been identified for the diagnosis of co-existing IBD-SpA. The use of red flags in routine clinical practice may avoid diagnostic delay and reduce clinic overload.

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Clinical features of Crohn disease concomitant with ankylosing spondylitis

Cited by 17 publications

References 38 publications

Detection of Crohn Disease in Patients with Spondyloarthropathy: The SpACE Capsule Study

Detection of Crohn Disease in Patients with Spondyloarthropathy: The SpACE Capsule Study

Association of Inflammatory Pathologies and Crohn's Disease: A Retrospective Study in the West Algerian Region

Red flags for appropriate referral to the gastroenterologist and the rheumatologist of patients with inflammatory bowel disease and spondyloarthritis

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