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80例克罗恩病的风湿性表现

[Rheumatic manifestations in 80 cases of Crohn's disease].

作者信息

Deshayes P, Geffroy Y, Houdent C, Hetcketsweiler P, Colin R, Cavelier B, Monconduit M, Ropartz C

出版信息

Rev Rhum Mal Osteoartic. 1976 May;43(5):345-55.

PMID:1084009
Abstract

Out of a series of 80 patients suffering from Crohn's disease, 31 presented rheumatic manifestations. In 16 subjects this took the form of synovitis closely dependent on the enteritic evolution, which developed after the alimentary symptoms, and which worsened as they did and sometimes regressed as they did following medical or surgical treatment. In combination with erythema nodosum, aphtosis, and conjunctivitis, synovitis appears to be the expression of an immune response to the enteritic lesion. Three cases of chronic polyarthitis and 6 cases of asymptomatic sacro-ileitis were also observed, and 6 cases of spondylarthritis of a minor radiological type were observed that evolved independently of the Crohn's disease. Typing according to the HLA system using 26 antigens was carried out in 44 subjects; no difference in phenotype frequency was found between a control group (blood donors) and the group of subjects with Crohn's disease alone; however, the antigen W 17 was found significantly more frequently in those subjects with peripheral arthritis and the antigen W 27 was found more frequently in those with spondylarthritis. These findings suggest, although it is not certain, the existence of genetic susceptibility to rheumatic manifestations in certain sites in patients with Crohn's disease.

摘要

在80例克罗恩病患者中,31例出现了风湿性表现。16例患者表现为与肠道炎症进展密切相关的滑膜炎,该滑膜炎在消化道症状出现后发生,随消化道症状加重而加重,有时在接受药物或手术治疗后随消化道症状缓解而消退。滑膜炎与结节性红斑、口疮及结膜炎并存,似乎是对肠道病变的免疫反应表现。还观察到3例慢性多关节炎和6例无症状骶髂关节炎,以及6例放射学表现较轻的脊柱关节炎,这些脊柱关节炎的发展与克罗恩病无关。对44例患者采用26种抗原进行了HLA系统分型;在对照组(献血者)和仅患克罗恩病的患者组之间,未发现表型频率有差异;然而,在外周关节炎患者中发现抗原W17的频率显著更高,在脊柱关节炎患者中发现抗原W27的频率更高。这些发现提示,虽然尚不确定,但克罗恩病患者在某些部位存在对风湿性表现的遗传易感性。

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