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Repeat ileocolonoscopy in reactive arthritis.

H Mielants, E M Veys, R Joos

    The Journal of Rheumatology
    |June 1, 1987
    PubMed
    Summary
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    Inflammatory gut lesions are common in HLA-B27 related diseases like ankylosing spondylitis (AS). Gut inflammation often resolves when joint inflammation is in remission, suggesting a link between gut permeability and joint disease.

    Area of Science:

    • Gastroenterology
    • Rheumatology
    • Immunology

    Background:

    • HLA-B27 related diseases, including reactive arthritis and ankylosing spondylitis (AS), are associated with peripheral arthritis.
    • Gut inflammation is frequently observed in patients with these conditions.

    Purpose of the Study:

    • To investigate the relationship between joint inflammation and gut inflammation in HLA-B27 related diseases.
    • To assess the resolution of gut lesions following clinical remission of joint disease.

    Main Methods:

    • Ileocolonoscopy and biopsy were performed on patients with HLA-B27 related disease, reactive arthritis, and AS with peripheral arthritis.
    • Follow-up ileocolonoscopies were conducted on a subset of patients to monitor changes in gut inflammation.
    • Histological analysis of biopsy specimens assessed the presence and extent of inflammatory lesions.

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    Main Results:

    • Inflammatory lesions in the ileum were detected in 71% and 60% of patients with reactive arthritis and AS, respectively.
    • In patients who achieved clinical remission of joint disease, gut inflammatory lesions resolved in 6 out of 7 cases.
    • Patients with active joint disease consistently showed inflammatory gut lesions, which resolved in one case after achieving remission possibly due to sulfasalazine treatment.

    Conclusions:

    • A strong correlation exists between articular inflammation and gut inflammation in HLA-B27 related diseases.
    • The findings support the hypothesis that gut permeability and exogenous triggers play a role in maintaining joint inflammation in these conditions.