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Ileal pouch arthritis

J M Axon¹, P R Hawley, E C Huskisson

¹Department of Rheumatology, St Bartholomew's Hospital, London.

British Journal of Rheumatology

|July 1, 1993

Summary

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A novel polyarthritis linked to ileal pouch-anal anastomosis (IPAA) surgery for ulcerative colitis was observed in six patients. This finding suggests a potential role for gastrointestinal antigens in the development of rheumatic diseases.

Area of Science:

Rheumatology
Gastroenterology
Immunology

Background:

The link between arthritis and intestinal inflammation is known, but the exact cause of inflammatory joint disease is unclear.
Restorative proctocolectomy with ileal pouch-anal anastomosis (IPAA) is a surgical procedure for ulcerative colitis.

Purpose of the Study:

To describe a novel form of polyarthritis observed after IPAA surgery.
To explore the potential connection between gastrointestinal antigens and rheumatic diseases.

Main Methods:

Case series of six patients who developed polyarthritis post-IPAA surgery between 1983 and 1990.
Clinical features, onset time, and treatment outcomes were analyzed.

Main Results:

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Six patients developed polyarthritis an average of 8 months after IPAA surgery.

The arthritis was acute, symmetrical, and affected peripheral and axial joints.

Three patients achieved remission with prednisolone treatment.

Conclusions:

A novel arthritis associated with IPAA surgery has been identified.
This condition may offer insights into the role of gastrointestinal antigens in rheumatic diseases.