Background:Ulcerative colitis (UC) is considered as a systemic autoimmune disease with lesions of the colon mucosa. The current of UC is often accompanied by different extra-intestinal manifestations. Their frequency, according to various studies, varies widely – from 25 to 60 %. It is a serious problem that affects the quality of life and the effectiveness of therapy [1, 2]. Rheumatological manifestations, in particular, damage to the joints and spine, are one of the extra-intestinal manifestations and they are of particular importance. To date, the relationship between UC and joint damage has not been fully studied. These diseases can occur independently in the body or have a common autoimmune or inflammatory nature. It is believed that having common pathogenetic mechanisms of development, UC and joint damage can be different clinical forms of the same disease.Objectives:To evaluate the frequency of clinical manifestations of joint damage in patients with ulcerative colitis.Methods:The study was conducted at the gastroenterological Department of the Hospital №25 (Russia, Volgograd). Archived data from the case histories of 69 patients with a confirmed diagnosis of ulcerative colitis were analyzed, including 58 men (30.4%) with an average age of 33.4 years, and 38 women (69.5%) with an average age of 37.6 years.Results:Among 48 patients with UC, extra-intestinal manifestations were detected in 40 (41.6%) patients. A total lesion of the large intestine was found in 20 patients (20.8%), left-sided colitis in 14 (14, 6%), proctosigmoiditis in 6 (6.25%). The diagnosis was made for the first time in 4 patients (4.16%), 36 patients (37.5%) were admitted to the hospital again due to an exacerbation of the disease. Among the extra-intestinal manifestations, joint lesions prevailed: 20 patients (20.8%) showed clinical signs of peripheral arthritis, spondyloarthritis was detected in 8 patients (8.3 %), and 6 patients (6.25 %) had symptoms of unilateral sacroiliitis. 4 (4.16%) patients were diagnosed with nodular erythema. Primary sclerosing cholangitis was detected in two patients (2.08%).Conclusion:The development of extra-intestinal manifestations in UC is largely determined by the course of the disease and the length of the inflammatory process in the colon. More than a third of patients with UC revealed extra-intestinal manifestations, among which the most common signs of joint damage were present, which necessitates timely diagnosis of extra-intestinal manifestations and involvement of a rheumatologist in the management of this category of patients.References:[1]Knyazev O. V. et al. Epidemiologi of inflammatory bowel disease. Yesterdey, today, tomorrow. Eksperimental’naya i Klinicheskaya Gastroenterologiya 2017; 139 (3): 4–12 (In Russ.)[2]Sadygova G.G. Extraintestinal manifestations of inflammatory bowel diseases: arthropathy and arthritis. Ross z gastroenterol gepatol koloproktol 2016; 26(6):101-5 (In Russ.)Disclosure of Interests:None declared
The combination of inflammatory bowel diseases with lesions of the spine and joints is an topical problem for modern medicine. A case of combination of ulcerative colitis and sacroiliitis is presented. The patient is recommended the therapy of genetically engineered biologic drugs.
Introduction. Ankylosing spondylitis and Crohn's disease are chronic recurrent autoimmune diseases. In case of a combined course their activity tends to progress, regardless of the phase of the underlying disease.The aim of the study. To analyze the combination of ankylosing spondylitis and Crohn's disease, issues of its diagnosis and selection of therapy.Results. The combination of ankylosing spondylitis and Crohn's disease tend to progress independently, regardless of the phase of the underlying disease. The main problem that complicates diagnosis is the lack of a unifed approach to the defnition of extra skeletal and extraintestinal manifestations.Conclusion. The management of patients with a combination of ankylosing spondylitis and Crohn's disease is a common problem of rheumatologists and gastroenterologists. An interdisciplinary approach will allow timely diagnosis of extra-skeletal and extra-intestinal manifestations and correct therapy.
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