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Query: UMLS:C0003864 (arthritis)
69,039 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

This review focuses on the behavior and pathogenesis of selected dermatologic and rheumatologic manifestations of inflammatory bowel disease. Erythema nodosum, the most common skin lesion, correlates with activity of the bowel disease but not with its duration or extent. Resolution occurs with therapy of inflammatory bowel disease. Pyoderma gangrenosum, the most severe skin lesion, bears little relationship to the activity or extent of the colitis. Therapy is usually supportive, but dapsone and steroids appear promising. Immune and vasculitic mechanisms have been postulated for both skin lesions. Peripheral arthritis usually has its onset with or after the development of colitic symptoms. It worsens with exacerbation of bowel inflammation and responds to treatment of the bowel disease. Immune mechanisms are likely. Spondyloarthropathy usually occurs before the onset of overt intestinal disease. Its course is unrelated to the bowel inflammation, it does not respond to treatment of bowel disease, and it is associated with HLA B27.
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PMID:Selected rheumatologic and dermatologic manifestations of inflammatory bowel disease. 327 91

167 patients with Crohn's disease were investigated for joint and spine inflammation. Arthritis was observed in 23 patients (14%), sacroiliitis in 24 (14%), and sacroiliitis in combination with arthritis in 11 patients (7%). 15 patients (9%) had ankylosing spondylitis; 9 of them were HLA-B27 positive (60%). A parallel pattern in the course of bowel disease and joint inflammation was observed in 22 out of 34 patients with arthritis (59%). An association between the localization of Crohn's disease and the type of spondylarthritis could not be demonstrated. Patients with arthritis alone developed erythema nodosum (35%) or aphthous stomatitis more often (21%) than patients without spondylarthritis+ (6% and 12%, respectively). Other extra-intestinal manifestations of Crohn's disease did not reveal any association with the development of spondyloarthritis.
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PMID:Clinical features of inflammatory joint and spine manifestations in Crohn's disease. 348 46

The records of 102 children with inflammatory bowel disease (44 with ulcerative colitis, 58 with Crohn's disease) were reviewed for evidence of joint disease unassociated with erythema nodosum. Thirteen children had arthritis, four had ulcerative colitis, and nine had Crohn's disease. Arthritis tended to be pauciarticular; ankles, knees, elbows and hips were most commonly affected. In three patients arthritis preceded bowel symptoms, in two the onset of arthritis and bowel disease was concurrent, and in eight arthritis appeared after the onset of bowel symptoms. The relationship between arthritis and specific features reflecting activity and severity of the bowel disease was examined in detail. Twenty-one attacks of arthritis, ranging in duration from two days to 12 weeks (mean, 31 days) were documented. Thirteen attacks occurred when the bowel disease was symptomatic; nine occurred within one month of a flare of the bowel disease. Most exacerbations of bowel disease in patients who had arthritis were unaccompanied by joint complaints. None of the features reflecting activity or severity of the bowel disease was more common in patients with arthritis than in those without arthritis.
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PMID:Arthritis associated with inflammatory bowel disease in children. Relationship of joint disease to activity and severity of bowel lesion. 369 65

A 15-year-old girl, with synovitis of the knees and ankles for 3 years before a diagnosis of gluten-sensitive enteropathy, is described. The enteropathy was confirmed histologically and on the basis of a clinical response to a gluten-free diet. The arthritis also resolved promptly, suggesting that it was associated with the bowel disorder.
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PMID:Arthritis associated with gluten-sensitive enteropathy. 370 33

Patients with Crohn's disease (n = 22), ulcerative colitis (n = 5), inactive Whipple's disease (n = 1), irritable bowel syndrome (n = 2), arthritis (n = 1) and Yersinia infections (n = 2) were examined with 111In-oxine labelled "mixed" leukocyte preparations (n = 12) or with 111In-oxine labelled "pure" granulocyte preparations (n = 21). Compared with barium enemas of the gut and colonoscopy, performed within of one week in 31 patients there was a correct location of infiltrated bowel segments in 24 patients (78%). The scan diagnosed more infiltrated segments in 4 patients (13%). In 3 patients it failed to diagnose one inflamed segment. In 24 patients the faecal 111In-excretion was expressed as percentage of the reinjected 111In-activity. All patients with non inflammatory bowel diseases and patients with inactive inflammatory bowel diseases excreted less than 2% of the reinjected 111In-activity. All but one female patient with active bowel disease excreted more than 2%. In 24 patients the correlation of ESR, CDAI and A.I. was available. There was a good correlation between ESR (r = 0.77, P less than 0.001), A.I. (r = 0.61, p less than 0.001) and the %-faecal faecal excretion. The 111In-labelling of white blood cells, especially of granulocytes, seems to be a reliable alternative method to localize infiltrated bowel segments and to assess disease activity in patients with inflammatory bowel diseases, compared to usually performed radiological, endoscopical and clinical methods.
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PMID:[111In-oxine marked leukocytes: a method for diagnosing the location and evaluating the activity of Crohn disease and ulcerative colitis]. 393 91

A patient with Cronkhite-Canada syndrome and an erosive arthritis whose course correlated with the activity of his bowel disease is described. We found no previous description of articular manifestations in any patients with this syndrome. Cronkhite-Canada syndrome should be added to the differential diagnosis of erosive arthritis in the appropriate clinical setting.
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PMID:Erosive arthritis in Cronkhite-Canada syndrome. 401 92

Of 12 patients with inflammatory bowel disease (IBD) and ankylosing spondylitis (AS) or sacroiliitis (SI), only 4 (32%) had HLA-B27. Family studies revealed 3 B27-negative relatives with AS, 1 with SI, 1 with SI and IBD, and 1 with IBD alone. HLA haplotypes did not segregate with disease. These data suggest a non-HLA linked genetic predisposition to IBD which also confers susceptibility to spondylitis, even in the absence of expression of bowel disease.
Arthritis Rheum 1980 Dec
PMID:The spondylitis of inflammatory bowel disease. Evidence for a non-HLA linked axial arthropathy. 645 May 95

In an analysis of a consecutive series of 133 patients with a diagnosis of Crohn's disease established preoperatively and in which early surgical intervention was the prevailing policy, the median time between diagnosis and operation was short. For patients with predominantly small-bowel disease it was 4 months and for patients with predominantly colonic involvement 8 months. The frequencies of preoperative and early postoperative complications were low compared with those in other reports. Local complications, such as intra-abdominal fistulae and abscesses, were preoperatively seen in only 4% of the patients. Arthritis, iritis, or erythema nodosum was not seen in patients with predominantly small-bowel disease. The early postoperative death rate was 1.5%, the late mortality rate related to Crohn's disease 2.3%. In conclusion, early resectional surgery seems to be justified as one form of treatment for Crohn's disease in that it diminishes the rate of serious complications. The risk of recurrence is, however, not influenced by early surgical intervention.
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PMID:Pre- and post-operative complications in Crohn's disease with special reference to duration of preoperative disease history. 671 32

A review of our records disclosed eight children with pyoderma gangrenosum. All had associated inflammatory bowel disease, and four had arthritis. In three patients the bowel disease was severe and required resection of portions of the affected bowel. The cutaneous lesions had a chronic course (average duration, 2 1/2 years), and systemic therapy was required in seven cases. Previously reported cases of pyoderma gangrenosum in children are reviewed, and the management of this skin disorder in childhood is discussed.
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PMID:Pyoderma gangrenosum in childhood. 672 42

Pyoderma gangrenosum is most commonly associated with inflammatory bowel disease and rheumatoid arthritis, but it has been associated with various haematological malignancies. A 54-year-old man with no history of bowel disease or arthritis presented with a leg ulcer, which healed after treatment. Results of bone marrow aspiration were compatible with primary thrombocythaemia. Seven weeks later there were pronounced recurrence of the ulceration and pyoderma gangrenosum was diagnosed. The appearance of pyoderma gangrenosum associated with blood disorders may differ from that associated with bowel and joint disease.
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PMID:Pyoderma gangrenosum associated with primary thrombocythaemia. 681 Oct 33


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