[A case of ankylosing spondylitis complicating Crohn's disease]

A 20-year-old man, who had suffered from ankylosing spondylitis for about 1 year, was admitted to our hospital due to melena and syncope. Physical examination revealed tenderness of abdomen and sacroiliac joint, and decreased spinal mobility. X-ray examination showed sacroiliitis and squaring of vertebral bodies. RA test and RAHA, negative; CRP, strongly positive; HLA-B 27 positive. Intestinal barium enema revealed skipping longitudinal fissure at terminal ileum, and a biopsy specimen of the colon revealed non-caseating granuloma. The association of ankylosing spondylitis and Crohn's disease has widely been known in Europe and United States; but this is the first case reported in detail in Japan, where incidences of both diseases were much lower than those found in Caucasians.