The IBIS-Q [IBd Identification of Spondyloarthritis Questionnaire]: A Novel Tool to Detect Both Axial and Peripheral Arthritis in Inflammatory Bowel Disease Patients

2020 ◽  
Vol 14 (12) ◽  
pp. 1680-1686
Author(s):  
Angela Variola ◽  
Maria Elisabetta Zanolin ◽  
Giovanni Cipriano ◽  
Pierluigi Macchioni ◽  
Federica Martinis ◽  
...  
Keyword(s):  
Inflammatory Bowel Disease ◽  
Bowel Disease ◽  
Area Under The Curve ◽  
Roc Curves ◽  
Factorial Analysis ◽  
Youden Index ◽  
Patient Identification ◽  
Asas Criteria ◽  
Inflammatory Bowel ◽  
Sensitivity Specificity

Abstract Background and Aims Both peripheral and axial spondyloarthritis [SpA] occur in inflammatory bowel disease [IBD] and represent the commonest extra-intestinal manifestation. We aimed to develop an easy and quick questionnaire through psychometric analysis, to identify peripheral and axial SpA in IBD patients within an integrated combined multidisciplinary rheumatological-gastroenterology clinic. Methods Initially, SpA-IBD experts generated a 42-item list covering SpA manifestations including spinal, articular, and entheseal involvement. The new questionnaire was administered before routine clinical IBD assessment. On the same day, rheumatological assessment, blinded to both history and questionnaire results, was performed to explore the presence of the Assessment of SpondyloArthritis International Society [ASAS] criteria for SpA, diagnostic criteria for fibromyalgia [FM], and non-specific low back pain [NSLB]. Factorial analysis of questionnaire items to identify the main factors—receiver operating characteristic [ROC] curves for sensitivity/specificity and Youden index for cut-off—were performed. Results Of the 181 consecutive patients, 56 met the ASAS SpA criteria [prevalence of 30%] with 10 new cases detected [5.5%: seven peripheral and three axial]. Through the psychometric and factorial analysis, we selected 14 items for the final questionnaire [named IBIS-Q]. The IBIS-Q was quick and performed well for detection of axial SpA and peripheral SpA (area under the curve [AUC] 0.88 with 95% confidence interval [CI] 0.830.93). A cut-off of three positive questions had a sensitivity 93% and specificity 77% for SpA patient identification. Conclusions The IBIS-Q is a useful and simple tool to use in IBD clinics for SpA detection, with a good statistical performance. Further studies are needed to validate it.

scholarly journals Sphingolipid Analysis Indicate Lactosylceramide as a Potential Biomarker of Inflammatory Bowel Disease in Children

Biomolecules ◽  
2020 ◽  
Vol 10 (7) ◽  
pp. 1083
Author(s):  
Aleksandra Filimoniuk ◽  
Agnieszka Blachnio-Zabielska ◽  
Monika Imierska ◽  
Dariusz Marek Lebensztejn ◽  
Urszula Daniluk
Keyword(s):  
Inflammatory Bowel Disease ◽  
Bowel Disease ◽  
High Performance ◽  
Area Under The Curve ◽  
Study Groups ◽  
Diagnostic Value ◽  
Serum Samples ◽  
Specificity And Sensitivity ◽  
Potential Biomarker ◽  
Inflammatory Bowel

An altered ceramide composition in patients with inflammatory bowel disease (IBD) has been reported recently. The aim of this study was to evaluate the concentrations of sphingolipids in the serum of treatment-naive children with newly diagnosed IBD and to determine the diagnostic value of the tested lipids in pediatric IBD. The concentrations of sphingolipids in serum samples were evaluated using a quantitative method, an ultra-high-performance liquid chromatography-tandem mass spectrometry in children with Crohn’s disease (CD) (n=34), ulcerative colitis (UC) (n = 39), and controls (Ctr) (n = 24). Among the study groups, the most significant differences in concentrations were noted for C16:0-LacCer, especially in children with CD compared to Ctr or even to UC. Additionally, the relevant increase in C20:0-Cer and C18:1-Cer concentrations were detected in both IBD groups compared to Ctr. The enhanced C24:0-Cer level was observed only in UC, while C18:0-Cer only in the CD group. The highest area under the curve (AUC), specificity, and sensitivity were determined for C16:0-LacCer in CD diagnosis. Our results suggest that the serum LacC16-Cer may be a potential biomarker that distinguishes children with IBD from healthy controls and differentiates IBD subtypes. In addition, C20:0-Cer and C18:0-Cer levels also seem to be closely connected with IBD.

scholarly journals Fecal Calprotectin in Combination With Standard Blood Tests in the Diagnosis of Inflammatory Bowel Disease in Children

2021 ◽  
Vol 8 ◽  
Author(s):  
Shaun S. C. Ho ◽  
Michael Ross ◽  
Jacqueline I. Keenan ◽  
Andrew S. Day
Keyword(s):  
Inflammatory Bowel Disease ◽  
Platelet Count ◽  
Bowel Disease ◽  
Predictive Value ◽  
Screening Test ◽  
Fecal Calprotectin ◽  
Non Invasive ◽  
Blood Tests ◽  
Inflammatory Bowel ◽  
Sensitivity Specificity

Introduction: Fecal calprotectin (FC) is a useful non-invasive screening test but elevated levels are not specific to inflammatory bowel disease (IBD). The study aimed to evaluate the sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of FC alone or FC in combination with other standard blood tests in the diagnosis of IBD.Methods: Children aged <17 years who had FC (normal range <50 μg/g) measured and underwent endoscopy over 33 months in Christchurch, New Zealand were identified retrospectively (consecutive sampling). Medical records were reviewed for patient final diagnoses.Results: One hundred and two children were included; mean age was 12.3 years and 53 were male. Fifty-eight (57%) of the 102 children were diagnosed with IBD: 49 with Crohn's disease, eight with ulcerative colitis and one with IBD-unclassified. FC of 50 μg/g threshold provided a sensitivity of 96.6% [95% confident interval (CI) 88.3–99.4%] and PPV of 72.7% (95% CI 61.9–81.4%) in diagnosing IBD. Two children with IBD however were found to have FC <50 μg/g. Sensitivity in diagnosing IBD was further improved to 98.3% (95% CI 90.7–99.1%) when including FC >50 μg/g or elevated platelet count. Furthermore, PPVs in diagnosing IBD improved when FC at various thresholds was combined with either low albumin or high platelet count.Conclusion: Although FC alone is a useful screening test for IBD, a normal FC alone does not exclude IBD. Extending FC to include albumin or platelet count may improve sensitivity, specificity, PPV and NPV in diagnosing IBD. However, prospective studies are required to validate this conclusion.

scholarly journals Anti-Saccharomyces cerevisiae mannan antibodies combined with antineutrophil cytoplasmic autoantibodies in inflammatory bowel disease: prevalence and diagnostic role

Gut ◽  
1998 ◽  
Vol 42 (6) ◽  
pp. 788-791 ◽  
Author(s):  
J-F Quinton ◽  
B Sendid ◽  
D Reumaux ◽  
P Duthilleul ◽  
A Cortot ◽  
...  
Keyword(s):  
Saccharomyces Cerevisiae ◽  
Ulcerative Colitis ◽  
Inflammatory Bowel Disease ◽  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Positive Predictive Value ◽  
Bowel Disease ◽  
Inflammatory Bowel ◽  
Sensitivity Specificity ◽  
Antineutrophil Cytoplasmic Autoantibodies

Background—Perinuclear antineutrophil cytoplasmic autoantibodies (pANCA) are a well recognised marker for ulcerative colitis. Antibodies to oligomannosidic epitopes of the yeastSaccharomyces cerevisiae (ASCA) are a new marker associated with Crohn’s disease.Aims—To assess the value of detecting pANCA and/or ASCA for the diagnosis of ulcerative colitis and Crohn’s disease.Methods—Serum samples were obtained from 100 patients with Crohn’s disease, 101 patients with ulcerative colitis, 27 patients with other miscellaneous diarrhoeal illnesses, and 163 healthy controls. Determination of pANCA and ASCA was performed using the standardised indirect immunofluorescence technique and an ELISA, respectively.Results—The combination of a positive pANCA test and a negative ASCA test yielded a sensitivity, specificity, and positive predictive value of 57%, 97%, and 92.5% respectively for ulcerative colitis. The combination of a positive ASCA test and a negative pANCA test yielded a sensitivity, specificity, and positive predictive value of 49%, 97%, and 96% respectively for Crohn’s disease. Among patients with miscellaneous non-inflammatory bowel disorders, three were ASCA positive and two were pANCA positive. One control was ASCA positive. The presence of ASCA in patients with Crohn’s disease was associated with small bowel involvement.Conclusion—ASCA and pANCA are strongly associated with Crohn’s disease and ulcerative colitis, respectively. Combination of both tests could help the diagnosis of inflammatory bowel disease.

scholarly journals P140 Predicting Non-Responsiveness to Iron Therapy in Anaemic Children with Inflammatory Bowel Disease

2021 ◽  
Vol 15 (Supplement_1) ◽  
pp. S226-S226
Author(s):  
N Bevers ◽  
A Aliu ◽  
A Rezazadeh Ardabili ◽  
B Winkens ◽  
M Raijkmakers ◽  
...  
Keyword(s):  
Inflammatory Bowel Disease ◽  
Prediction Model ◽  
Sensitivity And Specificity ◽  
Bowel Disease ◽  
Area Under The Curve ◽  
Iron Therapy ◽  
Z Score ◽  
Inflammatory Bowel ◽  
Basic Prediction

Abstract Background Anaemia negatively impacts physical fitness and quality-of-life, and therapy is aimed at normalization of haemoglobin (Hb) levels. In the majority of patients with inflammatory bowel disease (IBD) anaemia has a mixed aetiology resulting from chronic inflammation and iron deficiency. A considerable proportion of patients will fail to respond to iron therapy, but it has been difficult to identify non-responders at baseline with currently used iron indicators. Hepcidin is a peptide hormone involved in iron homeostasis. Upregulation leads to decreased iron availability, whereas downregulation facilitates iron absorption and release from macrophages to allow for erythropoiesis. We evaluated commonly used iron indicators (ferritin and transferrin saturation [TSAT]) and emerging biomarkers (soluble transferrin receptor [sTfR] and hepcidin levels) at baseline to predict non-responsiveness to iron therapy in anaemic children with IBD. Methods We performed a prospective multi-centre cohort study among patients with IBD and anaemia (defined as Hb > 2 standard deviations (SD) below the reference mean according to WHO cut-offs). We assessed iron indicators, sTfR, and hepcidin at baseline and again one month after the initiation of oral or intravenous iron therapy. Therapy was given according to international guidelines. Primary outcome was based on the change of Hb z-score (one month after treatment vs baseline) divided by baseline SD, where non-responsiveness was defined as a standardised change score of less than 1. Hepcidin was expressed as z-score to allow correction for age and gender. Baseline data of ferritin and TSAT were used to construct a basic logistic regression model. Hepcidin and/or sTfR were then added to the basic prediction model (models [M] 1–3). Optimal sensitivity and specificity were identified using the Youden’s J Index. Results Of 40 anaemic IBD patients (mean age 12.8 years; mean Hb z-score -3.1 SD), sixteen (40%) were non-responsive to iron therapy one month after initiation. The basic prediction model yielded an area under the curve (AUC) of 0.69. Figure 1 shows that adding sTfR, hepcidin or both to the model increased the AUC to 0.78 (M1), 0.82 (M2), and 0.90 (M3), respectively. For model 3, sensitivity and specificity at the optimal cut-off value were 94% and 71%, respectively. Figure 1: Receiver operating characteristic (ROC) curves representing the accuracy of iron therapy non-responsiveness. AUC, area under the curve; CI, confidence interval Conclusion Based on prediction quality of the models, triaging with a strategy that involves baseline ferritin, TSAT, sTfR, and hepcidin is preferred to assess non-responsiveness to iron therapy in anaemic children with IBD.

scholarly journals Development and validation of multivariable prediction models for adverse COVID-19 outcomes in patients with IBD

BMJ Open ◽  
2021 ◽  
Vol 11 (11) ◽  
pp. e049740
Author(s):  
John Sperger ◽  
Kushal S Shah ◽  
Minxin Lu ◽  
Xian Zhang ◽  
Ryan C Ungaro ◽  
...  
Keyword(s):  
Inflammatory Bowel Disease ◽  
Mechanical Ventilation ◽  
Bowel Disease ◽  
Area Under The Curve ◽  
Composite Outcome ◽  
Risk Calculator ◽  
Data Set ◽  
Test Set ◽  
Icu Admission ◽  
Inflammatory Bowel

ObjectivesDevelop an individualised prognostic risk prediction tool for predicting the probability of adverse COVID-19 outcomes in patients with inflammatory bowel disease (IBD).Design and settingThis study developed and validated prognostic penalised logistic regression models using reports to the international Surveillance Epidemiology of Coronavirus Under Research Exclusion for Inflammatory Bowel Disease voluntary registry from March to October 2020. Model development was done using a training data set (85% of cases reported 13 March–15 September 2020), and model validation was conducted using a test data set (the remaining 15% of cases plus all cases reported 16 September–20 October 2020).ParticipantsWe included 2709 cases from 59 countries (mean age 41.2 years (SD 18), 50.2% male). All submitted cases after removing duplicates were included.Primary and secondary outcome measuresCOVID-19 related: (1) Hospitalisation+: composite outcome of hospitalisation, ICU admission, mechanical ventilation or death; (2) Intensive Care Unit+ (ICU+): composite outcome of ICU admission, mechanical ventilation or death; (3) Death. We assessed the resulting models’ discrimination using the area under the curve of the receiver operator characteristic curves and reported the corresponding 95% CIs.ResultsOf the submitted cases, a total of 633 (24%) were hospitalised, 137 (5%) were admitted to the ICU or intubated and 69 (3%) died. 2009 patients comprised the training set and 700 the test set. The models demonstrated excellent discrimination, with a test set area under the curve (95% CI) of 0.79 (0.75 to 0.83) for Hospitalisation+, 0.88 (0.82 to 0.95) for ICU+ and 0.94 (0.89 to 0.99) for Death. Age, comorbidities, corticosteroid use and male gender were associated with a higher risk of death, while the use of biological therapies was associated with a lower risk.ConclusionsPrognostic models can effectively predict who is at higher risk for COVID-19-related adverse outcomes in a population of patients with IBD. A free online risk calculator (https://covidibd.org/covid-19-risk-calculator/) is available for healthcare providers to facilitate discussion of risks due to COVID-19 with patients with IBD.

scholarly journals Diagnostic Accuracy of Non-Invasive Imaging for Detection of Colonic Inflammation in Patients with Inflammatory Bowel Disease: A Systematic Review and Meta-Analysis

Diagnostics ◽  
2021 ◽  
Vol 11 (10) ◽  
pp. 1926
Author(s):  
Meshari T. Alshammari ◽  
Rebecca Stevenson ◽  
Buraq Abdul-Aema ◽  
Guangyong Zou ◽  
Vipul Jairath ◽  
...  
Keyword(s):  
Inflammatory Bowel Disease ◽  
Diagnostic Accuracy ◽  
Disease Activity ◽  
Bowel Disease ◽  
Meta Analysis ◽  
Roc Curves ◽  
Colonic Disease ◽  
Non Invasive ◽  
Us Studies ◽  
Inflammatory Bowel

Endoscopy is the gold standard for objective assessment of colonic disease activity in inflammatory bowel disease (IBD). Non-invasive colonic imaging using bowel ultrasound (US), computed tomography (CT), and magnetic resonance imaging (MRI) may have a role in quantifying colonic disease activity. We reviewed the diagnostic accuracy of these modalities for assessment of endoscopically or histopathologically defined colonic disease activity in IBD. We searched Embase, MEDLINE, and the Web of Science from inception to 20 September 2021. QUADAS-2 was used to evaluate the studies’ quality. A meta-analysis was performed using a bivariate model approach separately for MRI and US studies only, and summary receiver operating characteristic (ROC) curves were obtained. CT studies were excluded due to the absence of diagnostic test data. Thirty-seven studies were included. The mean sensitivity and specificity for MRI studies was 0.75 and 0.91, respectively, while for US studies it was 0.82 and 0.90, respectively. The area under the ROC curves (AUC) was 0.88 (95% CI, 0.82 to 0.93) for MRI, and 0.90 (95% CI, 0.75 to 1.00) for US. Both MRI and US show high diagnostic accuracy in the assessment of colonic disease activity in IBD patients.

scholarly journals Effect of sequential eradication therapy on serum osteoprotegerin levels in patients with Helicobacter pylori infection and co-existing inflammatory bowel disease

2021 ◽  
Vol 49 (11) ◽  
pp. 030006052110606
Author(s):  
Hussam Murad ◽  
Misbahuddin Rafeeq ◽  
Mahmoud Mosli ◽  
Mamdouh Gari ◽  
Mohammed Basheikh
Keyword(s):  
Inflammatory Bowel Disease ◽  
Helicobacter Pylori ◽  
Bowel Disease ◽  
Eradication Therapy ◽  
Area Under The Curve ◽  
Control Group ◽  
Characteristic Analysis ◽  
Cross Sectional ◽  
Inflammatory Bowel ◽  
H Pylori

Objective To investigate the effect of sequential Helicobacter pylori eradication therapy on serum osteoprotegerin levels in patients with H. pylori infection and co-existing inflammatory bowel disease (IBD). Methods Three groups of patients were involved in this observational cross-sectional study: IBD (n = 83), H. pylori infection (HP, n = 68), and H. pylori infection with co-existing IBD (HP + IBD, n = 52). These groups were compared with a normal control group (NC, n = 50). Serum osteoprotegerin, serum bone alkaline phosphatase (BALP), and fecal calprotectin (FC) levels were measured. Results Serum osteoprotegerin levels were significantly correlated with the simple endoscopic score for Crohn’s disease and Mayo score for ulcerative colitis. The receiver operating characteristic analysis of osteoprotegerin revealed high values for the area under the curve, sensitivity, and specificity. Discriminant analysis illustrated that osteoprotegerin levels significantly differentiated patients with IBD from healthy controls. Osteoprotegerin and FC levels distinguished the IBD and HP + IBD groups from the NC and HP groups. Conclusions Sequential eradication therapy did not affect serum osteoprotegerin levels in patients with H. pylori infection and co-existing IBD. Serum osteoprotegerin elevation might be a marker for IBD development in patients with past or current H. pylori infection.

scholarly journals A comparison of diagnostic performance between two quantitative rapid fecal calprotectin assays in detecting active inflammatory bowel disease

PLoS ONE ◽  
2021 ◽  
Vol 16 (8) ◽  
pp. e0255974
Author(s):  
Jong-Mi Lee ◽  
Joo Hee Jang ◽  
Ji Hyeong Ryu ◽  
Jaeeun Yoo ◽  
Bo-In Lee ◽  
...  
Keyword(s):  
Ulcerative Colitis ◽  
Inflammatory Bowel Disease ◽  
Bowel Disease ◽  
Diagnostic Performance ◽  
Area Under The Curve ◽  
Fecal Calprotectin ◽  
Test Results ◽  
Rapid Assays ◽  
Endoscopic Score ◽  
Inflammatory Bowel

Background Fecal calprotectin (FC) is widely used for the diagnosis and monitoring disease activity of inflammatory bowel disease (IBD). Quantitative rapid assays can be a reliable alternative to the time-consuming assay. This study aimed to evaluate and compare the diagnostic performance of two quantitative rapid FC assays (Ichroma calprotectin, and Buhlmann Quantum blue). Methods A total of 192 patients were included in this study; 84 patients with IBD (67 ulcerative colitis and 17 Crohn’s disease) and 108 patients with non-IBD. We compared quantitative FC levels in different disease statuses and evaluated the correlation between the FC results of the two FC kits. Diagnostic performances in predicting active IBD were evaluated in reference to different cut-off levels. Results The FC levels in 45 patients with active IBD as defined by endoscopic score were significantly higher compared to the inactive IBD and other diseases (P<0.05). Although the two assays’ results correlated (r = 0.642, P < 0.001), a significant deviation was observed (y (Buhlmannn) = -45.2 +8.9X (Ichroma)). The Diagnostic performances in predicting active IBD were comparable as area under the curve (AUC), 0.812, cut-off, 50, sensitivity, 64.4%, and specificity, 85.0% for iChroma assay and AUC, 0.826, cut-off, 100, sensitivity, 84.4%, and specificity 61.9% for Buhlmann Quantum Blue assay. FC levels using a cut-off of > 250 μg/g confirmed 85.7% (iChroma) and 64.1% (Buhlmann) of active IBD patients. Conclusion The results of the two rapid FC assays iChroma and Buhlmann showed a significant correlation, but the two test results were not interchangeable. With optimized cut-off values, rapid FC tests could be helpful in the diagnosis of IBD and differentiating active IBD from inactive or organic bowel disease.

scholarly journals P339 Assessment of DNA-thioguanine nucleotide identifies patients at risk of thiopurine-induced leukopoenia in inflammatory bowel disease

2020 ◽  
Vol 14 (Supplement_1) ◽  
pp. S325-S326
Author(s):  
X Zhu ◽  
K Chao ◽  
X Gao ◽  
M Huang ◽  
X D Wang
Keyword(s):  
Inflammatory Bowel Disease ◽  
Bowel Disease ◽  
Roc Curves ◽  
Blood Samples ◽  
Clinical Toxicity ◽  
Thiopurine Therapy ◽  
Thioguanine Nucleotide ◽  
Patients At Risk ◽  
Inflammatory Bowel ◽  
The Impact

Abstract Background Thiopurine drugs plays an important role for immunosuppressive therapy in inflammatory bowel disease. The molecular mechanism of the thiopurine toxicity is primarily mediated by DNA-incorporated thioguanine nucleotides (DNA-TGN). The aim of this study was to assess the impact of DNA-TGN levels on thiopurine-induced toxicity. Methods Patients over 18 years who were diagnosed with IBD and prescribed on thiopurines from February 2019 to August 2019 were recruited. All of them were genotyped with NUDT15 R139C before the thiopurine therapy. A novel assay was established to measure levels of DNA-TGN in blood leucocytes. The DNA-TGN and 6TGN levels were correlated with clinical toxicity. Results 185 patients with Crohn’s disease and 5 patients with ulcerative colitis were included in this study. DNA-TGN and 6TGN levels could be quantified in 229 patients’ blood samples. Thiopurine-induced leukopoenia (TIL) arose in 19 individuals with the median 6TGN level of 308.0 pmol/8×108 RBC which was not significantly different from the patients without TIL (p = 0.050). However, there was a significant association between DNA-TGN levels and TIL. Patients who developed TIL were identified with a higher DNA-TGN levels compared with those who did not (p = 0.00030, 456.9 (63.3–879.2) vs. 268.9 (45.6–916.8) fmol/μg DNA). The area under the ROC curves of the continuous DNA-TGN concentration to predict TIL was 0.75 (95% CI: 0.63~0.87) and almost 84% (16/19) of the TIL could be explained based on the DNA-TGN cut-off value of 343.9 fmol/μg DNA Conclusion This study shows that quantification of DNA-TGN levels can be applied to gauge thioprine therapy and avoid TIL after pre-genotyping NUDT15 R139C in inflammatory bowel disease patients.

scholarly journals P284 Disentangling fibromyalgia from spondyloarthopathy in the patient with inflammatory bowel disease

2020 ◽  
Vol 14 (Supplement_1) ◽  
pp. S294-S294
Author(s):  
A Variola ◽  
E Bertolini ◽  
M Di Ruscio ◽  
F Vernia ◽  
A Geccherle ◽  
...  
Keyword(s):  
Inflammatory Bowel Disease ◽  
Ankylosing Spondylitis ◽  
Disease Activity ◽  
Bowel Disease ◽  
Tender Joint Count ◽  
Diagnostic Purpose ◽  
Acr Criteria ◽  
Asas Criteria ◽  
Inflammatory Bowel ◽  
The Impact

Abstract Background Joint pain is common in subjects affected by Inflammatory bowel disease (IBD) and is linked to several factors including spondyloarthritis (SpA), drug therapy, concomitant osteoarthritis and fibromyalgia (FM). The primary aim of this study was to estimate the prevalence of primary FM and concomitant FM and SpA in a cohort of IBD patients. The secondary aim was to assess the impact of FM on clinimetric scores and ultrasonographic features. Methods Consecutive cases with IBD attending two IBD Units were assessed by a rheumatologist for ASAS criteria for SpA or the 2010 ACR criteria for FM. The rheumatological assessment included a 66 swollen joint count (SJC) and 68 tender joint count (TJC), Maastricht Ankylosing Spondylitis Score (MASES), Leeds Enthesitis Index (LEI) and the FM tender points examination, the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) and Bath Ankylosing Spondylitis Functional Index (BASFI). One hundred and fifty-eight patients seen at Reggio Emilia centre underwent US entheseal examination. MRI and HLA-B27 determination were requested if needed for diagnostic confirmation. Results 301 patients were enrolled with 148 completing the clinical and imaging/laboratory assessment if requested for diagnostic purpose. A total of 37 IBD patients (12%) met the ACR criteria for FM: 27 patients (9%) presented the criteria for primary FM and 10 patients (3.3%) presented FM and SpA. Patients who met FM criteria were mostly female (81%, p &lt; 0.001), slightly older, with longer duration of disease; no correlation with smoking, sedentary job, body mass index (BMI) or psoriasis. Of note FM patients presented higher LEI, BASDAI and BASFI scores than SpA patients. At US examination patients who satisfied ASAS criteria for SpA had significantly higher mean enthesis/patient PD positive as compared with IBD and FM group (p &lt; 0.001 for the two comparison) and had more patients with at least one PD positive enthesis (p &lt; 0.001 and p = 0.028 respectively). Acute entheseal lesions had a higher prevalence in the ASAS+ group as compared with the other two groups (p = 0.002 vs. IBD group and p = 0.009 vs. FM group). Chronic entheseal lesions had the same prevalence in the three groups of patients. Conclusion FM is common among IBD patients and more prevalent in females and patients aged ≥ 45 years old. In this subgroup of patients SpA disease activity indices performed poorly for distinguishing patients with disease activity from those with functional impairment. On the contrary, US examination showed a promising discriminating capacity in SpA patients.

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