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Atypical arthropathy associated with Crohn's disease
K I Norton1, A H Eichenfield, J R Rosh
1Department of Radiology, Mount Sinai Medical Center, New York, New York.
The American Journal of Gastroenterology
|June 1, 1993
Summary
This study describes three young patients with Crohn's disease and unusual joint disease patterns. These atypical enteropathic arthritis cases mimic rheumatoid arthritis, distinct from known HLA B27-negative arthropathies.
Area of Science:
- Rheumatology
- Gastroenterology
- Immunology
Background:
- Inflammatory bowel disease (IBD), such as Crohn's disease, is linked to rheumatologic conditions.
- Enteropathic arthritis, a common extraintestinal manifestation of IBD, typically presents as non-deforming peripheral arthritis or sacroiliitis, often not associated with HLA B27.
- Previous literature describes specific patterns of enteropathic arthritis, but atypical presentations remain under-documented.
Observation:
- Three patients with Crohn's disease, aged 16-31, presented with distinct joint disease patterns.
- All patients had childhood-onset bowel and joint disease.
- Laboratory tests for antinuclear antibody, rheumatoid factor, and HLA B27 antigen were negative in all cases.
Findings:
- The observed joint disease distribution and pattern closely resembled rheumatoid arthritis.
- These cases did not fit previously described enteropathic arthritis classifications.
- The rheumatologic manifestations were considered atypical for Crohn's disease.
Implications:
- These findings suggest that Crohn's disease can manifest with atypical enteropathic arthritis.
- The joint disease in these patients may represent a distinct subset of enteropathic arthritis, not merely coincident rheumatoid arthritis.
- Further research is needed to characterize these atypical presentations and their underlying mechanisms.