Journals / Turkish Journal of Gastroenterology / 2002 / Cilt: 13 - Sayı: 3
İnflamatuar bağırsak hastalıklarında sakroileitis, ankilozan spondilitis sıklığı ve HLA-B27 birlikteliği
- Pages
- 125–129
- DOI
- —
Abstract
Background/aims : The aim of this study was to investigate the frequency of sacroileitis and ankylosing spondylitis in inflammatory bowel disease and the relationship between disease activity, joint symptoms and HLA-B27 antigen positivity. Methods: Sacroiliac joint radiography and three phase bone scanning of 33 ulcerative colitis patients (17 active and 16 in remission) and 29 Crohn's disease patients (15 active and 14 in remission) was performed. HLA-B27 was determined in all patients and 60 control subjects. Results: Sacroileitis was found in 10 out of 33 patients with ulcerative colitis (30. 30%) and seven out of 29 patients with Crohn's disease (24. 13%). Of these patients, eleven had active (17.73%) disease and six were in remission (9. 68%). The diagnosis of sacroileitis was made by bone radiography in seven patients (41.18%) and by bone scanning in the other 10 patients (58.82%). A diagnosis of ankylosing spondylitis was made in three patients (17. 64%) who had previously been diagnosed by bone radiography to have sacroileitis. HLA-B27 was positive in six patients (9.67%) with inflammatory bowel disease and three subjects (5%) of the control group. There were no significant differences between these two groups (p>0.05). Compared to the control group, all three patients with ankylosing spondylitis were HLA-B27 positive, the difference being significant (p>0. 01). Conclusions: The clinical course of sacroileitis is independent of the activitiy of inflammatory bowel disease. Accordingly, patients with inflammatory bowel disease, especially those with sacroileitis, should be investigated for the presence of anklylosing spondylitis. .
Özet
Amaç: İnflamatuar bağırsak hastalıklarında ankilozan spondilitis ve sacroileitis sıklığı, eklem semptomları ile hastalık aktivasyonu ilişkileri ve HLA-B27 antijen pozitifliğini araştırdık. Yöntem: 33 ülseratif kolitli hastada (17 aktif ve 16 remusyon) ve 29 crohnlu hastada (15 aktif ve 14 remusyon) sakroiliak eklemden üç fazlı kemik sintigrafisi ile direkt kemik grafisi çektirdik. Tüm hastalarda ve 60 kontrol grubunda HLA-B27 antijen çalıştık. Bulgular: Ülseratif kolitli 33 hastanın 10'da (%30.3) ve crohnlu 29 hastanın 7'de (%24.13) sakroileitis saptadık. Bu hastaların 11'i aktif (%17. 73), 6'sı remusyon (%9.68) grubunda idi. Sakroileitis teşhisini 7 hastada kemik grafisi (%41.18), 10 hastada kemik sintigrafisi (%58. 82) ile tespit ettik. Kemik grafisi ile sakroileitis tespit ettiğimiz hastaların 3'ü (%17.64) ankilozan spondilitis tanısı aldı. HLA-B27 pozitifliği İnflamatuar bağırsak hastalıklarında 6 (%9. 67), kontrol grubunda 3(%5) idi. Bu iki grup arasında anlamalı fark yoktu (P>0. 05). Ankilozan spondilitisli 3 hastada HLA-B27 pozitifti ve bu kontrol grubuna göre anlamlı idi (P<0. 01). Sonuç: Sakroileitisin klinik seyri bağırsaktaki İnflamatuar aktiviteden bağımsızdır. İnflamatuar bağırsak hastalıkları ve özellikle sakroileitis saptanmış olanlar ankilozan spondilits yönünden araştırılmalıdır.