Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2021 Aug;80(6):539-551.
doi: 10.1007/s00393-021-01014-2. Epub 2021 May 27.

[Update: enterogenic spondylarthritis]

[Article in German]
Elisabeth Märker-Hermann  1
Affiliations

[Update: enterogenic spondylarthritis]

[Article in German]
Elisabeth Märker-Hermann. Z Rheumatol. 2021 Aug.

Abstract
in English, German

Spondylarthritis (SpA) is one of the most frequent extraintestinal manifestations of chronic inflammatory bowel disease (IBD). Several arthritogenic enterobacterial infections can induce sequelae such as reactive SpA. Studies on the gut-synovium axis in view of genetic, immunological, clinical and therapeutic aspects has made enterogenic SpA a model disease of all forms of SpA. The same applies for investigating IBD, as subclinical gut inflammation seen in SpA patients has provided significant evidence for a better understanding of mucosa-associated early immune events in Crohn's disease (CD). This article summarizes the pathognomonic clinical features, diagnostic steps, differential diagnosis and current pathogenetic models of enterogenic SpA. Knowledge of pathogenetic contexts leads to concrete treatment recommendations. These vary individually depending on the underlying IBD, on the inflammatory intestinal or rheumatic activity and on the rheumatological manifestation pattern.

Spondyloarthritiden (SpA) gehören zu den häufigsten extraintestinalen Manifestationen der chronisch entzündlichen Darmerkrankungen (CED). Auch bestimmte arthritogene Enterobakterien können als Folgeerkrankung der Gastroenteritis eine reaktive enteropathische SpA auslösen. Die Erforschung der „Darm-Synovium-Achse“ unter genetischen, immunologischen, klinischen und therapeutischen Gesichtspunkten hat die enteropathische SpA zu einer Modellerkrankung der SpAs gemacht. Ähnliches gilt für die Erforschung der CED, da die subklinischen Darmentzündungen bei Patienten mit SpA dazu beigetragen haben, die Mukosa-assoziierten frühen Immunphänomene des Morbus Crohn (CD) besser zu verstehen. Dieser Beitrag stellt neben den pathognomonischen klinischen Bildern, der Diagnostik und Differenzialdiagnostik die aktuellen pathogenetischen Modelle der enteropathischen SpAs vor. Aus dem Wissen um pathogenetische Zusammenhänge ergeben sich konkrete Empfehlungen zur Therapie, wobei individuell nach der zugrunde liegenden Darmerkrankung, nach der entzündlichen intestinalen oder rheumatischen Aktivität und nach dem rheumatologischen Befallsmuster unterschieden wird.

Keywords: Chronic inflammatory bowel disease; Crohn’s disease; Enterogenic reactive arthritis; Treatment; Ulcerative colitis.

PubMed Disclaimer

Similar articles

See all similar articles

References

Literatur

    1. Rudwaleit M, Baeten D (2006) Ankylosing spondylitis and bowel disease. Best Pract Res Clin Rheumatol 20:451 - PubMed - DOI
    1. Shivashankar R, Loftus EV Jr, Tremaine WJ, Bongartz T, Harmsen WS, Zinsmeister AR (2012) Matteson EL Incidence of spondyloarthropathy in patients with Crohn’s disease: a population-based study. J Rheumatol 39:2148–2152 - PubMed - PMC - DOI
    1. Shivashankar R, Loftus EV Jr, Tremaine WJ, Harmsen WS, Zinsmeister AR, Matteson EL (2013) Incidence of Spondyloarthropathy in patients with ulcerative colitis: a population-based study. J Rheumatol 40:1153–1157 - PubMed - DOI
    1. Vavricka SR, Brun L, Ballabeni P et al (2011) Frequency and risk factors for extraintestinal manifestations in the Swiss inflammatory bowel disease cohort. Am J Gastroenterol 106:110–119 - PubMed - DOI
    1. Karreman MC, Luime JJ, Hazes JM, Weel AE (2017) The prevalence and incidence of axial and peripheral spondyloarthritis in inflammatory bowel disease: a systematic review and meta-analysis. J Crohns Colitis 11:631–642 - PubMed

LinkOut - more resources