scholarly journals Early arthritis as a rheumatological chameleon: a description of a clinical case

2021 ◽  
Vol 15 (5) ◽  
pp. 80-84
Author(s):  
E. A. Galushko ◽  
A. V. Alekseeva ◽  
G. V. Serikova ◽  
A. S. Semashko

The article discusses the difficulties of differential diagnosis of early arthritis and inflammatory bowel diseases with a predominant clinical picture of extraintestinal manifestations, in particular, articular syndrome. The clinical observation demonstrates features of the course of such conditions, a long diagnostic search and a wide list of diseases included in differential diagnostics range.

2021 ◽  
Vol 8 (1) ◽  
pp. e000587
Author(s):  
Giacomo Caio ◽  
Lisa Lungaro ◽  
Fabio Caputo ◽  
Maria Muccinelli ◽  
Maria Caterina Marcello ◽  
...  

Inflammatory bowel diseases such as ulcerative colitis (UC) may be complicated by several extraintestinal manifestations. These involve joints, skin, eyes and less commonly lungs and heart. Myocarditis may result from the toxic effect of drugs (ie, mesalazine) commonly used for the treatment of UC or due to infections (eg, Coxsackieviruses, enteroviruses, adenovirus). Here, we report a case of a 26-year old man affected by UC and complicated by two episodes of myocarditis. Both episodes occurred during two severe exacerbations of UC. However, in both cases the aetiology of myocarditis remains uncertain being ascribable to extraintestinal manifestation, drug toxicity or both.


2021 ◽  
Vol 18 (1) ◽  
pp. 20-29
Author(s):  
S. A. Bulgakov ◽  
G. M. Chernakova ◽  
E. A. Kleshcheva ◽  
S. V. Simonova

Crohn’s disease and ulcerative colitis are chronic inflammatory bowel diseases, which are often accompanied by inflammation of other organs. This article presents modern data on etiology, pathogenesis and clinical course of inflammatory bowel diseases, as well as information on extraintestinal eye manifestations of nonspecific ulcerative colitis and Crohn’s disease. The role of microbiota, genetic factors, immune system defects in pathogenesis of intestinal inflammation and extraintestinal eye manifestations is considered. The possibility the development of ophthalmopathology not only against the background of intestinal inflammation, but also as a consequence of therapeutic and surgical methods of treatment of ulcerative colitis and Crohn’s disease is noted. The peculiarities of the course of episcleritis/scleritis, keratitis, uveitis, chorioretinitis, optical neuritis for patients with inflammatory bowel diseases are considered. The presence of these complications may reflect the activity of the underlying disease, which in some cases requires correction of therapy. Anterior uveitis and episcleritis/scleritis are the most common extraintestinal manifestations of inflammatory bowel disease. Inflammation of tissues of the posterior segment of the eye and optic nerve against the background of ulcerative colitis and Crohn’s disease are less common, but are of clinical importance, as they can catastrophically damage the structures of the eye and, as a consequence, lead to complete blindness. Considering the possibility of mild clinical symptoms and asymptomatic course of inflammation in the eye envelopes, the importance of ophthalmological examination of all patients with ulcerative colitis and Crohn’s disease is emphasized. Aspects of modern therapy of ophthalmopathology and background intestinal inflammation are highlighted. Biological preparations — antagonists of pro-inflammatory cytokines — have been identified as the most promising in the treatment of inflammatory intestinal diseases and extraintestinal manifestations. The important role of proper nutrition and biologically active supplements containing omega-3 fatty acids, vitamin D, microelements, was noted as auxiliary therapy of both intestinal and extraintestinal inflammation.


2017 ◽  
Vol 51 (1) ◽  
pp. 22-26
Author(s):  
Jelena Zivic ◽  
Dragce Radovanovic ◽  
Marko Spasic ◽  
Natasa Zdravkovic

2018 ◽  
Vol 27 (4) ◽  
pp. 433-438
Author(s):  
Cristian Tefas ◽  
Marcel Tanțău

Background & Aims: Inflammatory bowel diseases are still difficult to diagnose and differentiate in some cases despite the serological, imaging, endoscopic and histopathological armamentarium. Raman spectroscopy is a technique that could help with these shortcomings. The aim of this paper is to present the accuracy of Raman spectroscopy in the diagnosis and monitoring of patients with inflammatory bowel diseases.Methods: We identified the published manuscripts and abstracts up to the 31st of December 2017 by a systematic search of Medline, Embase, Cochrane and other trial registries.Results: Eight publications were found, showing sensitivities and specificities of Raman spectroscopy in diagnosing and differentiating inflammatory bowel diseases ranging from 82 to 99% and 57 to 99%, respectively, and accuracies of up to 95%.Conclusion: The technique has so far proven its potential in the positive and differential diagnosis of Crohn’s disease or ulcerative colitis, allowing for very rapid results with high sensitivity and specificity.


2019 ◽  
Vol 20 (20) ◽  
pp. 5026 ◽  
Author(s):  
Francesco Cappello ◽  
Francesca Rappa ◽  
Federica Canepa ◽  
Francesco Carini ◽  
Margherita Mazzola ◽  
...  

Dysbiosis has been associated with the onset of several chronic autoimmune or inflammatory pathologies (e.g., inflammatory bowel diseases—IBD), because of its primary role in the establishment of a chronic inflammatory process leading to tissue damage. Inflammatory bowel diseases can even involve areas far away from the gut, such as the extraintestinal manifestations involving the oral cavity with the onset of aphthous-like ulcers (ALU). Studies carried out on animal models have shown that intestinal dysbiosis may be related to the development of autoimmune diseases, even if the mechanisms involved are not yet well known. The aim of this paper is to verify the hypothesis that in inflammatory bowel diseases patients, aphthous-like ulcers are the result of the concomitance of intestinal dysbiosis and other events, e.g., the microtraumas, occurring in the oral mucosa, and that ex adiuvantibus therapy with probiotics can be employed to modify the natural course of the aphthous-like ulcers.


2019 ◽  
Vol 95 (3) ◽  
pp. 34-39
Author(s):  
A. N. Mareeva ◽  
G. L. Katunin ◽  
A. B. Rubtsov

This paper describes a clinical case of secondary syphilis, which was manifested exclusively by syphilitic alopecia.We describe the details of the clinical picture, as well as a differential diagnosis of syphilitic alopecia and alopecia areata on the basis of trichoscopy data.For a patient with scalp lesions typical of syphilis (focal form of alopecia), the trichoscopic picture was represented by hairs broken at different heights from 1 to 5 mm, “empty” follicles (“yellow” dots), anisotrichosis due to the loss of terminal hair. The eyebrow trichoscopy showed “yellow dots”, vellus hairs, hair thinning due to the loss of bristly hair. A comparison of the trichoscopic pictures for alopecia areata and syphilitic areata have revealed the absence in the latter of a number of signs typical of the former, such as pencil-point, ex clamation-point, zigzag, monilethrix and tulip hairs.Patients with a clinical picture of focal, diffuse or mix ed alopecia should be tested for syphilis using serological methods.


2004 ◽  
Vol 61 (5) ◽  
pp. 557-559 ◽  
Author(s):  
Milos Pavlovic ◽  
Rados Zecevic ◽  
Lidija Zolotarevski

Psoriasis has been consistently associated with arthritis and inflammatory bowel diseases, though there have been reports on patients with psoriasis and other autoimmune dermatoses. Sometimes, sharply demarcated scaly plaques located over extensor surfaces in patients with dermatomyositis may clinically resemble psoriatic lesions. Histologic findings of interface dermatitis, typical for dermatomyositis, help clinicians to rule out psoriasis. A patient is presented with dermatomyositis in which psoriatic lesions developed over the extremities and lower trunk. Histological examination confirmed the diagnosis of psoriasis. Both diseases have run independent courses. It is prudent to include psoriasis in the differential diagnosis of scaly eruptions occurring in dermatomyositis patients.


2020 ◽  
Vol 92 (2) ◽  
pp. 4-11
Author(s):  
A. I. Parfenov ◽  
A. V. Kagramanova ◽  
O. V. Knyazev

The article is devoted to the current data regarding the pathogenesis, classification and frequency of extraintestinal manifestations (EIMs) in inflammatory bowel diseases. We discuss two distinct theories of EIMs pathogenesis. First, EIMs arise from an extension of antigen-specific immune responses from the intestine to non-intestinal sites. Second, EIMs are independent inflammatory events initiated or perpetuated by the presence of IBD or by shared genetic or environmental risk factors in the host. These mechanisms are not mutually exclusive and may contribute to varying degrees in different EIMs. Early diagnosis of EIMs contributes to prevention disability and enhancement of quality of life of IBD patients. It is concluded that treatment of extraintestinal manifestations should be carried out taking into account the course of the IBD and the multidisciplinary approach, which requires close cooperation of doctors of various specialties. Assessment of prognostic markers and predictors for EIM in IBD will be part of a future investigation.


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