Lyons J L, Rosenbaum J T
Casey Eye Institute, Oregon Health Sciences University, Portland, USA.
Arch Ophthalmol. 1997 Jan;115(1):61-4. doi: 10.1001/archopht.1997.01100150063010.
Inflammatory bowel disease (IBD) and spondyloarthropathy (SA) such as Reiter syndrome may be characterized by diarrhea, arthritis, stomatitis, and uveitis.
To determine if the characteristics of the eye disease could help distinguish these 2 diagnoses.
Seventeen patients with uveitis and IBD referred to a university clinic were compared retrospectively with 89 patients with uveitis and SA referred to the same clinic.
Twelve (80%) of the 15 patients with evaluable IBD had Crohn disease. In marked contrast to patients with SA, patients with IBD were usually female (82%). Whereas uveitis with SA was predominantly anterior, unilateral, sudden in onset, and limited in duration, patients with IBD frequently had uveitis that was bilateral, posterior, insidious in onset, and/or chronic in duration. Results for 89% of the patients with SA who underwent HLA-B27 typing were positive, compared with only 46% of such patients with IBD. Episcleritis, scleritis, and glaucoma were more common among patients with IBD. Arthritis did not easily distinguish the 2 groups, as 13 (76%) of the patients with IBD had a history of joint disease. In 10 (59%) of the patients with IBD, the diagnosis of uveitis preceded that of IBD.
The hallmarks of uveitis can often distinguish SA and IBD.
炎症性肠病（IBD）和反应性关节炎（SA）如赖特综合征可能表现为腹泻、关节炎、口腔炎和葡萄膜炎。
确定眼部疾病的特征是否有助于区分这两种诊断。
对转诊至大学诊所的17例葡萄膜炎合并IBD患者与89例葡萄膜炎合并SA患者进行回顾性比较。
15例可评估的IBD患者中有12例（80%）患有克罗恩病。与SA患者形成鲜明对比的是，IBD患者通常为女性（82%）。SA患者的葡萄膜炎主要为前部、单侧、起病突然且病程有限，而IBD患者的葡萄膜炎常为双侧、后部、起病隐匿和/或病程慢性。89%接受HLA - B27分型的SA患者结果为阳性，而IBD患者中此类患者仅为46%。巩膜外层炎、巩膜炎和青光眼在IBD患者中更为常见。关节炎不易区分这两组，因为13例（76%）IBD患者有关节疾病史。在10例（59%）IBD患者中，葡萄膜炎的诊断先于IBD。
葡萄膜炎的特征通常可区分SA和IBD。
