Department of Internal Medicine, National Cheng Kung University Hospital, Tainan, Taiwan.
Pathology, National Cheng Kung University Hospital, Tainan, Taiwan.
Sci Rep. 2017 Oct 13;7(1):13165. doi: 10.1038/s41598-017-13573-z.
Despite a high prevalence of ankylosing spondylitis (AS) in Han Chinese, the clinical experience remains very limited in the extra-articular presentation of inflammatory bowel disease (IBD). A monocentric retrospective study was performed for the AS-associated IBD manifestation. This study analyzed AS patients fulfilling the 1984 revised New York diagnostic criteria, excluding those who had the onset of IBD before or concurrently with the diagnosis of AS, for their demographic, clinical, laboratory, radiological, pathological and medication data, particularly in the usage of anti-TNF monoclonal antibody. Among 988 AS patients with 19.8% female, 4 (0.4%) had the overt IBD presentation, one female and 3 male aged 28 to 47 years (38.8 ± 4.6), all ulcerative colitis with the characteristic histopathological findings. At the onset of colitis, all had a long-term disease duration of 10 to 25 years (17.5 ± 6.5) and high BASDAI 7.5 to 8.8 (8.2 ± 0.5) with the hip joint involvement. There were recurrent flares of colitis despite the treatment with corticosteroids and messalazopyrin/salazopyrin, and no relapses of IBD were observed for 6.0 ± 1.1 years after the adalimumab (ADA) therapy. In this retrospective cohort, we demonstrate the rarity of AS-associated IBD manifestation in Han Chinese with a beneficent effect from the ADA therapy.
尽管强直性脊柱炎(AS)在汉族人群中的患病率较高,但在炎症性肠病(IBD)的关节外表现方面,临床经验仍然非常有限。本研究进行了一项单中心回顾性研究,以分析与 AS 相关的 IBD 表现。该研究分析了符合 1984 年修订的纽约诊断标准的 AS 患者,排除了那些在 AS 诊断之前或同时出现 IBD 的患者,以评估其人口统计学、临床、实验室、影像学、病理学和药物治疗数据,尤其是抗 TNF 单克隆抗体的使用情况。在 988 例 AS 患者中,女性占 19.8%(4 例),其中有 4 例(0.4%)表现为明显的 IBD,1 例女性和 3 例男性,年龄为 28 至 47 岁(38.8±4.6),均为溃疡性结肠炎,具有特征性的组织病理学表现。在结肠炎发病时,所有患者的疾病病程均长达 10 至 25 年(17.5±6.5),BASDAI 评分为 7.5 至 8.8(8.2±0.5),髋关节受累。尽管接受了皮质类固醇和美沙拉嗪/柳氮磺胺吡啶治疗,但结肠炎仍反复发作,阿达木单抗(ADA)治疗后 6.0±1.1 年未观察到 IBD 复发。在本回顾性队列中,我们证明了汉族人群中 AS 相关 IBD 表现的罕见性,ADA 治疗具有良好的疗效。