[Systematic ileocolonoscopy in seronegative spondylarthropathies]

An inflammation of the ileum was observed by Mielants and Veys in patients suffering from reactional arthritis associated to HLA B27 antigen. We thought it would be interesting to perform a systematic ileo-colonoscopy in patients suffering from seronegative spondylo-arthropathy, whether it was an axial or a peripheral form of the disease, or it was associated or not to HLA B27 antigen. The results observed in 30 patients who responded to the criteria of Wright and Moll for the diagnosis of seronegative spondylo-arthropathy, were compared to those of 18 patients suffering from various gastro-intestinal disorders. Macroscopically, a minimal abnormality (erythematous patches and/or micro-ulcerations) was observed in 10 out of 30 patients, and never in the reference group (p less than 0.02). The histological examination demonstrated, in patients suffering from spondylarthritis, a higher frequency of minimal signs of inflammation (lympho-plasmocytes infiltration) at the level of the ileum (in 18 out of 19 patients versus 11 out of 18 patients in the reference group, p less than 0.05) and at the level of the rectum (in 15 out of 19 patients, versus 8 out of 17 patients in the reference group, p less than 0.05). This study suggests therefore the presence of minimal ileorectal inflammation in patients with seronegative spondylo-arthritis, which could have an influence on the pathogenesis and/or the evolutive course of the disease.