Système gastro-intestinal et digestif

Abstrait

Comparison of Enteropathic Spondyloarthritis and Ankylosing Spondylitis(Differences in the Clinical Characteristics, Complaints and Gender)

Roussou E, Georgiou A and Lee R

Objectives: To assess differences in patients with Ankyosing Spondylitis (AS) and Enteropathic Spondyloarthritis (ESpA) with regards to musculoskeletal symptoms at presentation and the main musculoskeletal problems during the disease course. The patients’ demographic data and clinical characteristics were also compared.

Methods: Following clinical assessment, patients with AS and ESpA were asked to respond to a validated screening questionnaire, choosing from a list of seven musculoskeletal symptoms potentially present at disease onset (back pain, neck pain, shoulder pain, hip pain, knee pain, buttock pain, and foot pain) and another seven symptoms known to be associated with SpAs (fatigue, neck pain, upper back pain, lower back pain, stiffness, joint pains/swelling, and pain with pressure [enthesitis]). More than one symptom could be reported by each patient.

Results: In total, 124 patients were included in the study. They were 84 patients diagnosed with AS (M:F = 41:43 or 48.8%:51.2%; age = 43.4 ± 12.8 years), and 40 patients had ESpA (M:F = 9:31 or 22.5%:77.5%; age [mean ± SD] = 49.6 ± 14.1 years). In the ESpA group there were included 12 patients with Crohn’s disease and 28 patients with ulcerative colitis.

The two groups had similar disease profiles, with the only exceptions the delay in diagnosis, which was significantly shorter for ESpA than for AS (P < 0.05), and enthesitis pain, which was significantly greater for ESpA than for AS (P < 0.05). Only two patients were HLA-B27+ in the ESpA group (7.1% of those tested) compared with 37.7% in the AS group.

ESpA patients had more peripheral disease at presentation (knees, feet, shoulders) than the AS patients, although both groups reported back pain as the main symptom at disease onset (57% with entero SpA and 70% with AS).

ESpA patients continued to report joint pains as the main problem during the disease course (68.6% versus 44.9% in AS patients) compared with low back pain reported as the main problem by AS patients (57.1% for ESpA and 70.5% for AS).

Conclusion: ESpA patients had more peripheral disease at presentation and during the disease course than AS patients, a shorter delay in diagnosis, more enthesitis, and no HLA-B27 association.