Revmatološke manifestacije pri kroničnih vnetnih črevesnih boleznih - kdaj pomisliti nanje in kako voditi zdravljenje? = Rheumatic manifestations in chronic inflammatory enteropathic diseases - when to consider them and how to plan the treatment
Golja, Mojca, 1943-
Chronic inflammatory enteropathic diseases, such as Crohn's disease and ulcerative colitis, are manifested by various rheumatic symptoms and syndromes. Enteropathic spondyloarthritides are a group of ...rheumatic diseases which can combine with inflammatory enteropathic diseases; they belong to a large group of seronegative spondyloarthritides. Peripheral arthritis, saeroiliitis and spondylitis are the most common rheumatological conditions, which can appear simultaneously or after the beginning of an inflammatory bowel disease, but rarely will rheumatic manifestations precede an enteropathic disease. The etiopathogenesis of enteropathic spondyloarthritidesis not yet clear; several genes and environmental factors probably play an important role. Because of inflammatory changes in the enteric mucous membrane, which normally acts as a barrier to various bacteria,toxins and other substances, the local immune response is altered. Ingenetically predisposed persons, such changes can cause rheumatic and other extraintestinal manifestations: in patients with inflammatory enteropathic disease, the presence of the HLA-B27 antigen increases the risk of developing spondylitis, which is indistinguishable from idiopathic ankylosing spondylitis. Peripheral arthritis is usually less severe compared with rheumatoid arthritis, and transient - no permanent changes of joint structuresappear. The treatment of enteropathic spondyloarthritides is primarily symptomatic. Non-steroidal anti-rheumatic drugs are used as analgesic and anti-inflammatory agents. The use of sulphasalazine is indicatedespecially in peripheral arthritis.
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