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Clinical and genetic factors associated with sacroiliitis in Crohn's disease

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Abstract
Background and Aim: Radiographic sacroiliitis (SI), often asymptomatic, is considered the most frequent extra-intestinal manifestation (EIM) of Crohn's disease (CD). Data on the association of SI with other clinical features of CD are limited. Association of SI with CARD15 polymorphisms has recently been suggested. In a multicenter study, we investigated the association of SI in CD patients with clinical phenotypes, other EIM and CARD15 polymorphisms. Methods: Radiographs of the sacroiliac joints were taken in 251 CD patients from three Belgian university hospitals and scored by two blinded rheumatologists. Clinical features were obtained from medical records. Forty-three percent of patients carried at least one CARD15 polymorphism. Results: Sacroiliitis, defined as the presence of at least grade 2 unilateral changes, was diagnosed in 65 of the 244 scorable radiographs (27%). Only 16 of these patients were previously diagnosed with ankylosing spondylitis (AS). HLA-B27 positivity was observed in 53% of patients with AS and 7% of patients with radiographic SI. In univariate and multivariate analysis, associations between the presence of SI and peripheral arthritis (P = 0.005) and between AS and uveitis (P = 0.005) were found. No associations with other recorded clinical features or with CARD15 polymorphisms were observed. Conclusion: We confirm the high prevalence of radiographic sacroiliitis in a multicenter CD cohort. Uveitis is only associated with AS whereas all patients with SI are more prone to develop peripheral arthritis during their disease course, suggesting similar pathogenetic mechanisms in the development of these EIM. The previously reported association between SI and CARD15 polymorphisms was not confirmed.
Keywords
CARD15, association, Crohn's disease, extra-intestinal manifestation, sacroiliitis, INFLAMMATORY-BOWEL-DISEASE, ANKYLOSING-SPONDYLITIS, EXTRAINTESTINAL MANIFESTATIONS, ULCERATIVE-COLITIS, SYNOVIAL-FLUID, SPONDYLOARTHROPATHY, PREVALENCE, GUT, COMPLICATIONS, SCINTIGRAPHY

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Chicago
Peeters, Harald, Bert Vander Cruyssen, Herman Mielants, Kurt De Vlam, Severine Vermeire, Edouard Louis, Paul Rurgeerts, Jacques Belaiche, and Martine De Vos. 2008. “Clinical and Genetic Factors Associated with Sacroiliitis in Crohn’s Disease.” Journal of Gastroenterology and Hepatology 23 (1): 132–137.
APA
Peeters, Harald, Vander Cruyssen, B., Mielants, H., De Vlam, K., Vermeire, S., Louis, E., Rurgeerts, P., et al. (2008). Clinical and genetic factors associated with sacroiliitis in Crohn’s disease. JOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY, 23(1), 132–137.
Vancouver
1.
Peeters H, Vander Cruyssen B, Mielants H, De Vlam K, Vermeire S, Louis E, et al. Clinical and genetic factors associated with sacroiliitis in Crohn’s disease. JOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY. 2008;23(1):132–7.
MLA
Peeters, Harald, Bert Vander Cruyssen, Herman Mielants, et al. “Clinical and Genetic Factors Associated with Sacroiliitis in Crohn’s Disease.” JOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY 23.1 (2008): 132–137. Print.
@article{393948,
  abstract     = {Background and Aim: Radiographic sacroiliitis (SI), often asymptomatic, is considered the most frequent extra-intestinal manifestation (EIM) of Crohn's disease (CD). Data on the association of SI with other clinical features of CD are limited. Association of SI with CARD15 polymorphisms has recently been suggested. In a multicenter study, we investigated the association of SI in CD patients with clinical phenotypes, other EIM and CARD15 polymorphisms.
Methods: Radiographs of the sacroiliac joints were taken in 251 CD patients from three Belgian university hospitals and scored by two blinded rheumatologists. Clinical features were obtained from medical records. Forty-three percent of patients carried at least one CARD15 polymorphism.
Results: Sacroiliitis, defined as the presence of at least grade 2 unilateral changes, was diagnosed in 65 of the 244 scorable radiographs (27\%). Only 16 of these patients were previously diagnosed with ankylosing spondylitis (AS). HLA-B27 positivity was observed in 53\% of patients with AS and 7\% of patients with radiographic SI. In univariate and multivariate analysis, associations between the presence of SI and peripheral arthritis (P = 0.005) and between AS and uveitis (P = 0.005) were found. No associations with other recorded clinical features or with CARD15 polymorphisms were observed.
Conclusion: We confirm the high prevalence of radiographic sacroiliitis in a multicenter CD cohort. Uveitis is only associated with AS whereas all patients with SI are more prone to develop peripheral arthritis during their disease course, suggesting similar pathogenetic mechanisms in the development of these EIM. The previously reported association between SI and CARD15 polymorphisms was not confirmed.},
  author       = {Peeters, Harald and Vander Cruyssen, Bert and Mielants, Herman and De Vlam, Kurt and Vermeire, Severine and Louis, Edouard and Rurgeerts, Paul and Belaiche, Jacques and De Vos, Martine},
  issn         = {0815-9319},
  journal      = {JOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY},
  keyword      = {CARD15,association,Crohn's disease,extra-intestinal manifestation,sacroiliitis,INFLAMMATORY-BOWEL-DISEASE,ANKYLOSING-SPONDYLITIS,EXTRAINTESTINAL MANIFESTATIONS,ULCERATIVE-COLITIS,SYNOVIAL-FLUID,SPONDYLOARTHROPATHY,PREVALENCE,GUT,COMPLICATIONS,SCINTIGRAPHY},
  language     = {eng},
  number       = {1},
  pages        = {132--137},
  title        = {Clinical and genetic factors associated with sacroiliitis in Crohn's disease},
  url          = {http://dx.doi.org/10.1111/j.1440-1746.2007.05108.x},
  volume       = {23},
  year         = {2008},
}

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