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[Colonoscopic evaluation in patients with ankylosing spondylitis]
Haim Cesar Maleh1, Blanca Elena Rios Gomes Bica2, José Ângelo de Souza Papi3
1Programa de Pós-Graduação em Clínica Médica, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brasil.
Ankylosing spondylitis patients often have intestinal inflammation, even with normal colonoscopies. Histopathology reveals lesions in most patients, regardless of symptoms or treatment, highlighting the need for careful evaluation.
Area of Science:
- Gastroenterology
- Rheumatology
- Pathology
Background:
- Ankylosing spondylitis (AS) is associated with intestinal inflammatory lesions.
- The role of colonoscopy in AS patients requires definition.
Purpose of the Study:
- Assess colonoscopic and histopathologic changes in AS patients.
- Correlate endoscopic and microscopic findings.
- Examine associations with extra-articular manifestations, HLA-B27, BASFI, and BASDAI.
Main Methods:
- Cross-sectional study of 22 AS patients.
- Clinical assessment, BASDAI/BASFI, HLA-B27 measurement.
- Colonoscopy with biopsies from four intestinal segments.
Main Results:
- Abnormal colonoscopies in 59.1% of patients, primarily polyps.
- Histopathology showed high rates of abnormal biopsies (81-90.9%).
- No significant association between histopathology and extra-articular manifestations, BASFI, BASDAI, or HLA-B27.
Conclusions:
- Histological analysis confirmed inflammatory lesions in AS patients.
- Inflammation was present regardless of colonoscopy results, symptoms, or treatment.
- These findings underscore the subclinical intestinal involvement in AS.
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