Joint Manifestations in Gastrointestinal Diseases

Abstract

This review addresses the clinical picture of rheumatic diseases seen in Whipple’s disease, gluten-sensitive enteropathy, pseudomembranous colitis, collagenous colitis and that developing after enteric infections and intestinal bypass operations for morbid obesity. These disorders examplify the interplay between antigen entrance through the gastrointestinal canal, specific bacterial properties and genetic host factors such as HLA B27. In most cases such an interplay results in formation of circulating immune complexes causing the development of peripheral joint disease.

Microscopic, lymphocytic and collagenous colitis

“…Of particular interest is enteropathic arthritis and various other connective tissue disorders and autoimmune conditions. The enteropathic arthritis is usually seronegative for rheumatoid factor, non-destructive and may be oligoarticular or polyarticular, and precede the colonic symptoms by many years 39 . In one survey it was reported to occur in 7% of patients with collagenous colitis 40 .…”