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The evolution of spondyloarthropathies in relation to gut histology, 3: relation between gut and joint

Herman Mielants, Eric Veys, Claude Cuvelier, Martine De Vos UGent, Stefan Goemaere, L Declercq, L Schatteman, L Gyselbrecht and Dirk Elewaut UGent (1995) JOURNAL OF RHEUMATOLOGY. 22(12). p.2279-2284
abstract
Objective. To study prospectively the clinical evolution of different forms of spondyloarthropathy (SpA) in relation to the evolution of gut histology in consecutive ileocolonoscopic biopsy specimens. Methods. Ileocolonoscopy was performed in 49 patients with SpA (34 men, 15 women). They also underwent clinical, laboratory, and radiological examinations. Two to 9 years later, a 2nd and sometimes a 3rd or 4th ileocolonoscopy was performed, and the other examinations were repeated. Results. At first ileocolonoscopy, 34 patients (69%) showed inflammatory gut lesions. At the 2nd ileocolonoscopy, 16 patients (32%) were in clinical remission; none were found to have inflammatory gut lesions. Of the 33 patients with persistent locomotor inflammation, 14 had persistent inflammatory gut lesions, predominantly the chronic type. Of these 14 patients, 6 had developed inflammatory bowel disease (IBD). None of the 15 patients with an initially normal gut histology had gut inflammation at 2nd examination. Of the 9 with initially acute lesions, 3 developed chronic lesions (1 Crohn's disease). Initial chronic lesions in 25 patients persisted in 9, of whom 5 had developed IBD. Seven of the 19 patients with non-SpA ankylosing spondylitis (non-AS-SpA) developed ankylosing spondylitis (AS); all had initially presented inflammatory gut lesions, which persisted at 2nd examination. In the 11 patients with more than 2 consecutive ileocolonoscopies, clinical remission was always associated with normal gut histology, and flares of the joint disease were related temporally to the reappearance of gut inflammation. Conclusion. This study demonstrates the close relationship between gut and locomotor inflammation in SpA. Clinical remission was always associated with normal gut histology, whereas active locomotor inflammation was usually associated with the presence of gut inflammation. Absence of gut inflammation in the SpA is a good prognostic indicator, since gut inflammation or IBD never develops in these patients. Evolution of non-AS-SpA to full blown AS or of uncomplicated SpA to a farm of IBD was always associated with gut inflammation at disease onset.
Please use this url to cite or link to this publication:
author
organization
year
type
journalArticle (original)
publication status
published
subject
keyword
CLINICAL EVOLUTION, SPONDYLOARTHROPATHY, GUT INFLAMMATION, INFLAMMATORY BOWEL DISEASE, REACTIVE ARTHRITIS, DISEASE, BYPASS, IGA
journal title
JOURNAL OF RHEUMATOLOGY
J. Rheumatol.
volume
22
issue
12
pages
2279 - 2284
Web of Science type
Article
ISSN
0315-162X
language
English
UGent publication?
yes
classification
A1
id
196347
handle
http://hdl.handle.net/1854/LU-196347
date created
2004-01-14 13:42:00
date last changed
2016-12-19 15:39:01
@article{196347,
  abstract     = {Objective. To study prospectively the clinical evolution of different forms of spondyloarthropathy (SpA) in relation to the evolution of gut histology in consecutive ileocolonoscopic biopsy specimens. 
Methods. Ileocolonoscopy was performed in 49 patients with SpA (34 men, 15 women). They also underwent clinical, laboratory, and radiological examinations. Two to 9 years later, a 2nd and sometimes a 3rd or 4th ileocolonoscopy was performed, and the other examinations were repeated. 
Results. At first ileocolonoscopy, 34 patients (69\%) showed inflammatory gut lesions. At the 2nd ileocolonoscopy, 16 patients (32\%) were in clinical remission; none were found to have inflammatory gut lesions. Of the 33 patients with persistent locomotor inflammation, 14 had persistent inflammatory gut lesions, predominantly the chronic type. Of these 14 patients, 6 had developed inflammatory bowel disease (IBD). None of the 15 patients with an initially normal gut histology had gut inflammation at 2nd examination. Of the 9 with initially acute lesions, 3 developed chronic lesions (1 Crohn's disease). Initial chronic lesions in 25 patients persisted in 9, of whom 5 had developed IBD. Seven of the 19 patients with non-SpA ankylosing spondylitis (non-AS-SpA) developed ankylosing spondylitis (AS); all had initially presented inflammatory gut lesions, which persisted at 2nd examination. In the 11 patients with more than 2 consecutive ileocolonoscopies, clinical remission was always associated with normal gut histology, and flares of the joint disease were related temporally to the reappearance of gut inflammation. 
Conclusion. This study demonstrates the close relationship between gut and locomotor inflammation in SpA. Clinical remission was always associated with normal gut histology, whereas active locomotor inflammation was usually associated with the presence of gut inflammation. Absence of gut inflammation in the SpA is a good prognostic indicator, since gut inflammation or IBD never develops in these patients. Evolution of non-AS-SpA to full blown AS or of uncomplicated SpA to a farm of IBD was always associated with gut inflammation at disease onset.},
  author       = {Mielants, Herman and Veys, Eric and Cuvelier, Claude and De Vos, Martine and Goemaere, Stefan and Declercq, L and Schatteman, L and Gyselbrecht, L and Elewaut, Dirk},
  issn         = {0315-162X},
  journal      = {JOURNAL OF RHEUMATOLOGY},
  keyword      = {CLINICAL EVOLUTION,SPONDYLOARTHROPATHY,GUT INFLAMMATION,INFLAMMATORY BOWEL DISEASE,REACTIVE ARTHRITIS,DISEASE,BYPASS,IGA},
  language     = {eng},
  number       = {12},
  pages        = {2279--2284},
  title        = {The evolution of spondyloarthropathies in relation to gut histology, 3: relation between gut and joint},
  volume       = {22},
  year         = {1995},
}

Chicago
Mielants, Herman, Eric Veys, Claude Cuvelier, Martine De Vos, Stefan Goemaere, L Declercq, L Schatteman, L Gyselbrecht, and Dirk Elewaut. 1995. “The Evolution of Spondyloarthropathies in Relation to Gut Histology, 3: Relation Between Gut and Joint.” Journal of Rheumatology 22 (12): 2279–2284.
APA
Mielants, H., Veys, E., Cuvelier, C., De Vos, M., Goemaere, S., Declercq, L., Schatteman, L., et al. (1995). The evolution of spondyloarthropathies in relation to gut histology, 3: relation between gut and joint. JOURNAL OF RHEUMATOLOGY, 22(12), 2279–2284.
Vancouver
1.
Mielants H, Veys E, Cuvelier C, De Vos M, Goemaere S, Declercq L, et al. The evolution of spondyloarthropathies in relation to gut histology, 3: relation between gut and joint. JOURNAL OF RHEUMATOLOGY. 1995;22(12):2279–84.
MLA
Mielants, Herman, Eric Veys, Claude Cuvelier, et al. “The Evolution of Spondyloarthropathies in Relation to Gut Histology, 3: Relation Between Gut and Joint.” JOURNAL OF RHEUMATOLOGY 22.12 (1995): 2279–2284. Print.