Enteropathic spondyloarthritis: from diagnosis to treatment

Clin Dev Immunol. 2013;2013:631408. doi: 10.1155/2013/631408. Epub 2013 Apr 15.

Abstract

Enteropathic arthritis (EA) is a spondyloarthritis (SpA) which occurs in patients with inflammatory bowel diseases (IBDs) and other gastrointestinal diseases. Diagnosis is generally established on the medical history and physical examination. It was, generally, made according to the European Spondyloarthropathy Study Group (ESSG) criteria. Rheumatic manifestations are the most frequent extraintestinal findings of IBD with a prevalence between 17% and 39%, and IBD is associated, less frequently, with other rheumatic disease such as rheumatoid arthritis, Sjogren syndrome, Takayasu arteritis, and fibromyalgia. Although the pathogenesis of EA has not been plainly clarified, the most popular theory supposes that joint inflammation occurs in genetically predisposed subjects with bacterial gut infections, provided an important evidence for a possible relationship between inflammation of the gut mucosa and arthritis. The management of patients with EA requires an active cooperation between the gastroenterologist and rheumatologist.

Publication types

  • Review

MeSH terms

  • Anti-Inflammatory Agents / therapeutic use
  • Gastrointestinal Tract / drug effects
  • Gastrointestinal Tract / immunology
  • Gastrointestinal Tract / pathology*
  • Gene Expression
  • Genetic Predisposition to Disease
  • HLA-B27 Antigen / genetics
  • HLA-B27 Antigen / immunology
  • Humans
  • Inflammatory Bowel Diseases / complications
  • Inflammatory Bowel Diseases / diagnosis*
  • Inflammatory Bowel Diseases / drug therapy
  • Inflammatory Bowel Diseases / pathology
  • Intestinal Mucosa / drug effects
  • Intestinal Mucosa / immunology
  • Intestinal Mucosa / pathology*
  • Joints / drug effects
  • Joints / immunology
  • Joints / pathology*
  • Spondylarthritis / complications
  • Spondylarthritis / diagnosis*
  • Spondylarthritis / drug therapy
  • Spondylarthritis / pathology

Substances

  • Anti-Inflammatory Agents
  • HLA-B27 Antigen