Husic Rusmir, Lackner Angelika, Kump Patrizia Katharina, Högenauer Christoph, Graninger Winfried, Dejaco Christian
Department of Rheumatology and Immunology, Medical University Graz, Graz, Austria.
Department of Gastroenterology and Hepatology, Medical University Graz, Graz, Austria.
Front Med (Lausanne). 2021 Feb 12;8:637459. doi: 10.3389/fmed.2021.637459. eCollection 2021.
Inflammatory bowel disease (IBD) is closely associated with spondylarthritis (SpA) and enthesitis, as an important feature of SpA, is a common extraintestinal manifestation of IBD. Enthesitis may be clinically silent in a high proportion of patients with IBD without clinical signs or a diagnosis of SpA. The aim of this study was to compare the prevalence of ultrasound (US) verified enthesitis in IBD patients with and without SpA, with patients with irritable bowel syndrome (IBS) and healthy subjects (HC) serving as controls. IBD patients with or without SpA, patients with IBS and HC were prospectively recruited and clinically assessed. Ultrasound examination was performed at 14 entheses. The ultrasound abnormalities were scored according to the Madrid Ankylosing Spondylitis Enthesitis Index (MASEI). We included 33 IBD patients without SpA, 14 IBD patients with SpA, 26 IBS patients and 18 HC. Higher MASEI scores were found in patients with IBD without SpA [median 21.0 range (8.0-53.0)] and IBD associated SpA [33.0 (8-50)] than in IBS patients [10.5 (0-42.0)- < 0.001 for both comparison] and HC [12.0 (2.0-38.0)- < 0.01]. PD, enthesophytes and erosions were more common in patients with IBD with or without SpA as compared to IBS patients and HC. IBD patients with SpA compared to IBD without SpA demonstrated significant higher prevalence of erosion and structural irregularity and consequently significant higher MASEI ( < 0.05 for all comparison). Ultrasound verified enthesitis is more common in patients with IBD with or without SpA as compared to patients with IBS or HC.
炎症性肠病（IBD）与脊柱关节炎（SpA）密切相关，附着点炎作为SpA的一个重要特征，是IBD常见的肠外表现。在很大一部分无临床体征或未诊断为SpA的IBD患者中，附着点炎可能在临床上并无表现。本研究的目的是比较有和无SpA的IBD患者中经超声（US）证实的附着点炎的患病率，以肠易激综合征（IBS）患者和健康受试者（HC）作为对照。前瞻性招募了有或无SpA的IBD患者、IBS患者和HC，并进行临床评估。在14个附着点进行超声检查。根据马德里强直性脊柱炎附着点炎指数（MASEI）对超声异常进行评分。我们纳入了33例无SpA的IBD患者、14例有SpA的IBD患者、26例IBS患者和18例HC。无SpA的IBD患者[中位数21.0，范围（8.0 - 53.0）]和IBD相关SpA患者[33.0（8 - 50）]的MASEI评分高于IBS患者[10.5（0 - 42.0），两组比较均P < 0.001]和HC[12.0（2.0 - 38.0），P < 0.01]。与IBS患者和HC相比，有或无SpA的IBD患者中血流信号增多、骨赘和侵蚀更常见。与无SpA的IBD患者相比，有SpA的IBD患者侵蚀和结构不规则的患病率显著更高，因此MASEI也显著更高（所有比较均P < 0.05）。与IBS患者或HC相比，经超声证实的附着点炎在有或无SpA的IBD患者中更常见。
