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炎症性肠病和脊柱关节炎:关注女性患者。

Inflammatory bowel diseases and spondyloarthritis: a focus on female patients.

机构信息

Department of Surgery, Oncology, and Gastroenterology, University of Padova; Gastroenterology Unit, Azienda Ospedale - Università Padova.

Department of Surgery, Oncology, and Gastroenterology, University of Padova.

出版信息

Reumatismo. 2024 Sep 11;76(3). doi: 10.4081/reumatismo.2024.1770.

Abstract

OBJECTIVE

Ulcerative colitis and Crohn's disease are chronic inflammatory diseases and represent the two most important types of inflammatory bowel diseases (IBD), while spondyloarthritis (SpA) comprises a heterogeneous group of systemic inflammatory chronic rheumatic diseases, including peripheral SpA and axial SpA. Joint manifestations are the most commonly observed extraintestinal manifestations, and they can precede or not the diagnosis of IBD. Notably, in women, misdiagnoses of IBD as irritable bowel syndrome and SpA as fibromyalgia are common, leading to delayed diagnoses, increased disease burden, and poorer prognoses. This narrative review emphasizes the critical role of diagnostic tools in facilitating early referrals of IBD patients with suspected SpA and vice versa to rheumatologists and gastroenterologists, respectively. Special attention is given to the multidisciplinary approach for more effective management of these conditions, particularly in female patients.

METHODS

In this narrative review, we critically evaluated the literature on this topic, focusing on papers written in English that address female issues in IBD and SpA.

RESULTS

IBD and SpA are chronic inflammatory disorders often occurring in the same patients. Female patients are often misdiagnosed, and this delay in diagnosis is associated with a higher disease burden and a poorer prognosis.

CONCLUSIONS

A multidisciplinary approach is needed to enable early referral between gastroenterologists and rheumatologists, as this means a better prognosis for patients with a reduction in the economic and social burden associated with IBD and SpA.

摘要

目的

溃疡性结肠炎和克罗恩病是慢性炎症性疾病,代表了炎症性肠病(IBD)的两种最重要的类型,而脊柱关节炎(SpA)则包含了一组异质性的全身性炎症性慢性风湿性疾病,包括外周 SpA 和中轴型 SpA。关节表现是最常见的肠外表现,它们可以先于或不先于 IBD 的诊断。值得注意的是,在女性中,IBD 被误诊为肠易激综合征,SpA 被误诊为纤维肌痛症很常见,这导致了诊断延迟、疾病负担增加和预后较差。本叙述性综述强调了诊断工具在促进疑似 SpA 的 IBD 患者和相反地分别向风湿病学家和胃肠病学家的早期转介中的关键作用。特别关注多学科方法,以更有效地管理这些疾病,特别是在女性患者中。

方法

在本叙述性综述中,我们批判性地评估了关于这一主题的文献,重点关注那些针对 IBD 和 SpA 中女性问题的英文论文。

结果

IBD 和 SpA 是慢性炎症性疾病,常发生在同一患者中。女性患者常被误诊,这种诊断延迟与更高的疾病负担和更差的预后相关。

结论

需要采用多学科方法,在胃肠病学家和风湿病学家之间进行早期转介,因为这意味着可以为患者带来更好的预后,减轻与 IBD 和 SpA 相关的经济和社会负担。

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