Early diagnosis of axial spondylarthritis in infectious bowel diseases

Abstract

Introduction. Despite numerous clinical studies on the frequency, pathogenetic mechanisms and clinical characteristics of axial spondyloarthritis (SpAx) in infectious bowel diseases (IBD) and intestinal damage in ankylosing spondylitis (SA), there are currently a number of unresolved problems, especially the problem of early diagnosis of arthropathies. Purpose. Determination of peculiarities of early manifestations of axial arthropathies in IBD to improve early diagnosis and identify clinical variants with the development of algorithm for the early detection of SpAax in IBD. Material and methods. During the years 2015-2021, 141 patients were examined, of which 50 patients with SA and 91 patients with IBD from the Republican Clinical Hospital "Timofei Moşneaga”. According to the mediation of the inflammatory response patients with IBD were divided into 2 groups: the first - Yersinia enterocolitica or Campylobacter jejuni (Y±C) , the second - Salmonella enteritidis or Shigella flexneri (S±Sh). Results. In patients with IBD, the following clinical variants of arthropathies have been identified: SpAax - 28,6%, SA - 15,4%; arthralgia - 38.5%, arthritis - 13.2%. Conventional radiography and MRI of SI joints increased the incidence of SpA from 6.6% to 28.6%. In patients with IBD and axial arthropathies, arthralgia, arthritis and uveitis were the frequent manifestations and the possibility of detecting axSpA was higher in the presence of arthritis. Conclusions.Our study allowed us to establish the parameters and the diagnosis of (S±Sh), in the presence of which special attention should be paid to patients with IBD in case of suspicion of SpA.