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Inflammatory bowel diseases and spondyloarthropathies: From pathogenesis to treatment

World Journal of Gastroenterology 2019年第18期25卷 2162-2176页

作者： George E Fragoulis Christina Liava Dimitrios Daoussis Euangelos Akriviadis Alexandros Garyfallos Theodoros Dimitroulas First Department of Propaedeutic Internal Medicine National and Kapodistrian University of Athens"Laiko" General Hospital Institute of Infection Immunity & Inflammation University of Glasgow 4~(th) Department of Internal Medicine Hippokration Hospital School of Medicine Aristotle University of Thessaloniki Department of Internal Medicine Division of Rheumatology Patras University Hospital

spondyloarthropathies(SpA) include many different forms of inflammatory arthritis and can affect the spine(axial SpA) and/or peripheral joints(peripheral SpA) with Ankylosing spondylitis(AS) being the prototype of the former. Extraarticular manifestations, like uveitis, psoriasis and inflammatory bowel disease(IBD) are frequently observed in the setting of SpA and are, in fact, part of the SpA classification criteria. Bowel involvement seems to be the most common of these manifestations. Clinically evident IBD is observed in 6%-14% of AS patients, which is significantly more frequent compared to the general population. Besides, it seems that silent microscopic gut inflammation, is evident in around 60% in AS patients. Interestingly, occurrence of IBD has been associated with AS disease activity. For peripheral SpA, two different forms have been proposed with diverse characteristics. Of note, SpA(axial or peripheral) is more commonly observed in Crohn's disease than in ulcerative colitis. The common pathogenetic mechanisms that explain the link between IBD and SpA are still ill-defined. The role of dysregulated microbiome along with migration of T lymphocytes and other cells from gut to the joint("gut-joint" axis) has been recognized, in the context of a genetic background including associations with alleles inside or outside the human leukocyte antigen system. Various therapeutic modalities are available with monoclonal antibodies against tumour necrosis factor, interleukin-23 and interleukin-17, being the most effective. Both gastroenterologists and rheumatologists should be alert to identify the coexistence of these conditions and ideally follow-up these patients in combined clinics.

关键词： spondyloarthropathies Axial spondyloarthropathies Peripheral spondyloarthropathies Ankylosing spondylitis Inflammatory bowel disease

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Potential of (18)~F-FDG-PET as a valuable adjunct to clinical and response assessment in rheumatoid arthritis and seronegative spondyloarthropathies

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World Journal of Radiology 2012年第12期4卷 462-468页

作者： Vishu Vijayant Manjit Sarma Hrushikesh Aurangabadkar Lata Bichile Sandip Basu Radiation Medicine Centre of Bhabha Atomic Research Centre Tata Memorial Centre Annexe Parel Mumbai 400012 India Department of Medicine Seth Gordhandas Sunderdas Medical College and King Edward Memorial Hospital Parel Mumbai 400012 India

AIM: To evaluate the role of fluorine-18-labeled fluorodeoxyglucose positron emission tomography (18F-FDG PET) in various rheumatic diseases and its potential in the early assessment of treatment response in a limited number of patients. METHODS: This study involved 28 newly diagnosed patients, of these 17 had rheumatoid arthritis (RA) and 11 had seronegative spondyloarthropathy (SSA). In the SSA group, 7 patients had ankylosing spondylitis, 3 had psoriatic arthritis, and one had non-specific SSA. Patients with RA were selected as per the American College of Rheumatology criteria. One hour after FDG injection, a whole body PET scan was performed from the skull vertex to below the knee joints using a GE Advance dedicated PET scanner. Separate scans were acquired for both upper and lower limbs. Post-treatment scans were performed in 9 patients in the RA group (at 6-9 wk from baseline) and in 1 patient with psoriatic arthropathy. The pattern of FDG uptake was analysed visually and quantified as maximum standardized uptake value (SUVmax) in a standard region of interest. Metabolic response on the scan was assessed qualitatively and quantitatively and was correlated with clinical assessment. RESULTS: The qualitative FDG uptake was in agreement with the clinically involved joints, erythrocyte sedimentation rate, C-reactive protein values and the clinical assessment by the rheumatologist. All 17 patients in the RA group showed the highest FDG avidity in painful/swollen/tender joints. The uptake pattern was homogeneous, intense and poly-articular in distribution. Hypermetabolism in the regional nodes (axillary nodes in the case of upper limb joint involvement and inguinal nodes in lower limb joints) was a constant feature in patients with RA. Multiple other extra-articular lesions were also observed including thyroid glands (in associated thyroiditis) and in the subcutaneous nodules. Treatment response was better appreciated using SUVmax values than visual interpretation, w

关键词： Rheumatoid arthritis Ankylosing spondylitis Psoriatic arthritis Seronegative spondyloarthropathies Fluorine-18-labeled fluorodeoxyglucose positron emission tomography Axillary node Treatment monitoring

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Chronic Inflammatory Rheumatic Diseases in Rheumatological Practice in Lomé(Togo)

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Open Journal of Rheumatology and Autoimmune Diseases 2022年第1期12卷 9-20页

作者： Kodjo Kakpovi Sadat Oniankitan Komi C. Tagbor Koulouktsoa Kondian Viwalé ES Koffi-Tessio Awaki-Esso Atake Lamine Mamadou Diallo Pahimi Yibe Erika Djougnwe Mba Moubarak Tiadjeri Eyram Fianyo Prénam Houzou Owonayo Oniankitan Moustafa Mijiyawa Rheumatology Department Regional Teaching Hospital of Kara Kara Togo Rheumatology Department University Teaching Hospital Sylvanus Olympio Lomé Togo Rheumatology Department Hospital of Be Lomé Togo Rheumatology Department University Teaching Hospital of Kara Kara Togo

Chronic inflammatory rheumatism is a pathology of variable frequency and severity with a significant impact on the socio-economic, personal and family level. Study Aim: To describe the epidemiological, clinical, laboratory, radiological, therapeutic and evolutive features of chronic inflammatory rheumatic diseases in rheumatological practice in Togo. Patients and Methods: This was a multicenter cross-sectional study conducted from January 2011 to December 2019 on patients examined in the three rheumatology departments in Lomé (Togo). Patients 18 years old and above who have presented joint pain with or without synovitis, and/or rachialgia (back pain) for at least three months were included. The diagnosis of chronic inflammatory rheumatic diseases was made according to international consensus criteria. Results: Out of the 20333 patients whose files were collected during our study period, 290 (1.43%) suffered from chronic inflammatory rheumatic diseases. There were 226 (77.93%) females and 64 (22.07%) males. The mean age of the patients was 42.79 ± 15.18 years. The mean duration of symptoms was 40.80 ± 54.09 months. Arthritis (67.24%) was the main reason for consultation, followed by joint pain (31.38%). rheumatoid arthritis (41.03%), unclassified chronic inflammatory rheumatic diseases (38.62%), spondyloarthropathies (15.17%) and systemic lupus erythematosus (2.41%) were the major clinical forms. The immunological tests performed in 13.79% of cases were positive in 52.94% of cases. Carpitis (57.55%) and diffuse osteoporosis (45.28%) were the commonest radiographic features of the hands. 289 patients (99.66%) received symptomatic treatments such as NSAIDs (73.36%) and corticosteroids (51.90%) and 90 patients (31.03%) were treated with synthetic DMARDs such as methotrexate (88.89%). The outcome was favorable in 27.93% of cases. Conclusion: Chronic inflammatory rheumatic diseases are common diseases in rheumatological practice in Togo that deserve special attention. The

关键词： Chronic Inflammatory Rheumatic Diseases Rheumatoid Arthritis spondyloarthropathies Sub-Saharan Africa

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