Session Type: Abstract Submissions (ACR)
The frequency of gastrointestinal (GI) involvement in spondyloarthritis (SpA) ranges from 21% to 30% and 5% to 10% are associated with inflammatory bowel disease (IBD). The percentage of patients with SpA having subclinical intestinal inflammation documented by endoscopy and histology is significative. Due to the persistent joint inflammation in these patients, as well as the established association between SpA and GI inflammation, not only endoscopic evaluation, but also measure of auto-antibodies related to IBD is recommended. To investigate whether there is an association between clinical variables and IBD autoantibodies in SpA patients receiving treatment.
Methods: A transversal observation study was designed to compare three groups of patients. Eighty one patients with SpA according to ESSG classification criteria, 14 patients with IBD (ulcerative colitis (UC) (n=8), Chron´s disease (CD) (n=1) and undifferentiated colitis (n=5) and 80 healthy subjects (HS). Anti-Saccharomyces cerevisiae IgG/IgA (ASCA), anti polymorphonuclear neutrophil P (ANCA-P), anti transglutaminase (tTG) IgG/IgA, anti deaminated gliadin peptide (DGP) IgG/IgA autoantibodies, ANAS and IgA were measured in all patients. A specific questionary was applied asking for GI symptoms in the SpA group. The association between clinical variables and auto-antibodies were evaluated using the chi square test.
81 SpA patients were included with mean age of 43 ± 13.4 years, BASFI mean 4,78 ± 1,8, and BASDAI mean 4,58 ± 1,8. 64% were men, 49,4% receiving anti-TNF, and 34.6% were HLA B27(+). In the HS, 47% were men, mean age 37,7± 13,6, IgG/IgA (tTG) was negative in 98.8%, ASCA IgG/IgA was positive in 8.8%, and 6.3% were positive for p-ANCAS.
The patients with SpA in the IgG/IgA ASCA were positive with 30.9%, pANCAS were positive by 11.1%, and the IgG/IgA (tTG) were positive by 2.5%. There was a significant difference in the frequency of autoantibodies IgG/IgA ASCA’s (p=0.008) and p-ANCAS (p= 0.001) between SpA and HS. When the questionary for GI symptoms was applied in the SpA patients, abdominal pain and discomfort were reported in 53% of patients, abdominal inflammation (51%) and diarrhea (33%). ANAS test was positive in 54.3%. A significative association was found between the presence of abdominal pain and BASDAI>4 (p=0,017), as well as between abdominal inflammation and BASDAI > 4 (p=0,008). SpA patients have higher titers of total IgA in patients with BASDAI >4 (p=0,012).
Our results shows that SpA patients have a higher presence of IgG/IgA ASCAS and p-ANCAS compared to healthy controls and IBD patients. The report of GI symptoms was associated with high disease activity; however there was not association with the presence of auto-antibodies. Therefore, it may suggest that the active search of auto-antibodies as well as the presence of gastrointestinal symptoms should be performed in Colombian SpA patients. In Colombia there is not information about this association.
D. M. Munoz C,
V. Parra I,
J. De Ávila,
A. M. Mesa,
« Back to 2013 ACR/ARHP Annual Meeting
ACR Meeting Abstracts - https://acrabstracts.org/abstract/presence-of-gastrointestinal-symptoms-and-autoantibodies-in-patients-with-spondyloarthritis-in-a-colombian-population/