title: [Enteropathic spondylarthritis in chronic inflammatory bowel diseases: prevalence, manifestation pattern and HLA association].
abstract: BACKGROUND
  Enteropathic spondylarthropathies (SpA) are the most frequent extraintestinal manifestation of the chronic inflammatory bowel disease (IBD), Crohn's disease (CD) and Ulcerative Colitis (UC). It was the aim of the present study, to analyze a large number of IBD patients for the prevalence and pattern of joint manifestation and the association of SpA with the extend of bowel involvement and HLA-haplotype.
  
  
  METHODS
  521 patients (409 CD and 112 UC) were prospectively analyzed over a period of one year. SpA was diagnosed on the basis of an appropriate patient history as well as clinical, radiological and immunoserological parameters.
  
  
  RESULTS
  SpA was diagnosed in 10.7% of all CD and 14.4% of all UC patients. In 26.8% of all patients symptoms of SpA occurred prior to and in 14.4% simultaneously with IBD. 28.1% of all patients presented with isolated peripheral arthritis, 26.8% of all patients showed an isolated involvement of the spine or sacroiliic joints and 45.1% of all patients presented with combined involvement. 2/12 UC patients with SpA suffered from rectosigmoiditis, 5/12 from partial colitis and 5/12 had pancolitis. In CD patients with SpA, 8/59 had isolated colitis, 8/59 ileocolitis and 31/59 isolated small bowel involvement. There was a positive correlation between SpA and HLA-B27 (p < 0.01).
  
  
  CONCLUSIONS
  Enteropathic spondylarthropathies are an important extraintestinal manifestation of IBD. Spondylarthropathies occur irrespective of the extend of IBD and frequently become symptomatic prior to IBD. These and recent data describing inflammatory bowel disease in patients with SpA of unknown etiology suggest that both diseases have a common pathogenetic background.
authors.affiliation: I. Medizinische Klinik und Poliklinik, Johannes-Gutenberg-Universität, Mainz.
authors.forename: U
authors.initials: U
authors.lastname: Protzer
authors.forename: R
authors.initials: R
authors.lastname: Duchmann
authors.forename: T
authors.initials: T
authors.lastname: Höhler
authors.forename: W
authors.initials: W
authors.lastname: Hitzler
authors.forename: K
authors.initials: K
authors.lastname: Ewe
authors.forename: R
authors.initials: R
authors.lastname: Wanitschke
authors.forename: K H
authors.initials: KH
authors.lastname: Meyer zum Büschenfelde
authors.forename: E
authors.initials: E
authors.lastname: Märker-Hermann
mesh_terms: D000328:Adult; D003424:Crohn Disease / Q000175:diagnosis* / Q000276:immunology; D005260:Female; D015796:HLA-B27 Antigen / Q000032:analysis; D015395:Histocompatibility Antigens Class I / Q000032:analysis*; D000949:Histocompatibility Antigens Class II / Q000032:analysis*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010003:Osteoarthritis / Q000175:diagnosis* / Q000276:immunology; D012446:Sacroiliac Joint / Q000276:immunology; D013131:Spine / Q000276:immunology; D013167:Spondylitis, Ankylosing / Q000175:diagnosis* / Q000276:immunology
chemical_list: D015796:HLA-B27 Antigen; D015395:Histocompatibility Antigens Class I; D000949:Histocompatibility Antigens Class II
vernacular_title: Enteropathische Spondarthritiden bei chronisch entzündlichen Darmerkrankungen: Prävalenz, Befallsmuster und HLA-Assoziation.