Session Information
Session Type: Abstract Submissions (ACR)
Background/Purpose
Spondyloarthritis (SpA) are a group of chronic inflammatory rheumatic diseases. Extra-articular manifestations affect approximately 30% of patients with SpA, and gastrointestinal manifestations (GI) represents about 5 to 10%. The relationship between gut and joint inflammation suggest that there is an increase in intestinal permeability and abnormal levels of intestinal bacteria that stimulate pathologic immune responses. The persistence of joint disease activity is primarily associated with intestinal inflammation. Therefore, the aim of this study is to investigate the association between gastrointestinal symptoms, disease activity of SpA and the presence of auto-antibodies including patients with inflammatory bowel disease (IBD).
Methods
A cross sectional study was designed, including 103 patients with SpA fulfilling ESSG classification criteria and 117 healthy subjects (HS). Twenty nine patients had a diagnosis and clinical activity compatible with IBD as confirmed by histologic examination.
Anti-Saccharomyces cerevisiae IgG/IgA (ASCA), 6 antigen associated with anti polymorphonuclear neutrophil (ANCA), anti-transglutaminase (tTG) IgG/IgA, anti-deaminated gliadin peptide (DGP) IgG/IgA auto-antibodies, ANAS and IgA were measured in all patients by ELISA technique. A specific questionary was applied asking for GI symptoms in the SpA and IBD group. Descriptive epidemiology was analized and association between clinical manifestations and auto-antibodies were evaluated using Chi square test and Mann Whitney U-Test as appropriate
Results
Mean age in SpA patients was 42.2 years (SD 15.5) with a predominance of uSpA subtype (59.8 %). BASFI >4 was reported in 60.6% and BASDAI>4 in 67.7%. Respect to treatment, 49 % of patients were receiving anti-TNF therapy. HLA-B27 was positive in 39%
ASCA IgG/IgA were positive in 28.2% of SpA patients and 75.8% of them were IgG isotype. ANCA was present in 8.8 % (six antigens evaluated), celiac auto-antibodies (1%) and ANAS (49.5%). In HS, 2.6% were ASCAS positive (50% of these were IgA subtype) and 6.8% were ANCAS positive. There was a significant difference in the frequency of autoantibodies IgG/IgA ASCAS, p-ANCAS and ANAS between SpA and HS (p=<0.001), and SpA and IBD (p=<0.001). Significant association was found between BASDAI>4 and the presence of abdominal pain (p=0,003), diarrhea (p=0.017), abdominal inflammation (p=<0.001), discomfort (p=0.004) and total IgA levels (p=0.005); as well as between abdominal inflammation and BASFI > 4 (p=0.028).
Additionally, significant difference was found in the presence of abdominal pain between SpA (54.4%) and IBD (27.5%) patients (p=0.012). Both groups (SpA and IBD) had similar frequency of mucus (30% vs 31%)
Conclusion
The presence of ASCAS IgG/IgA, p-ANCAS, ANAS, IgA and the reporting of GI symptoms, are associated with higher disease activity in SpA. There are differences in the presence of GI manifestations according to SpA subtypes, but not differences between IBD and SpA regarding the presence of mucus. It may suggest that subclinical IBD should be actively screened in Colombian SpA patients probably due to environmental conditions.
Disclosure:
C. Romero Sanchez,
None;
W. Bautista-Molano,
None;
V. Parra-Izquierdo,
None;
C. Martínez,
None;
F. Garcia,
None;
J. De Avila,
None;
H. Juliao,
None;
J. M. Bello,
None;
J. Londoño,
None;
R. Valle-Oñate,
None.
« Back to 2014 ACR/ARHP Annual Meeting
ACR Meeting Abstracts - https://acrabstracts.org/abstract/do-you-assess-gastro-intestinal-auto-antibodies-and-symptoms-in-patients-with-spondyloarthritis/