Author(s): Lyons JL, Rosenbaum JT
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Abstract BACKGROUND: Inflammatory bowel disease (IBD) and spondyloarthropathy (SA) such as Reiter syndrome may be characterized by diarrhea, arthritis, stomatitis, and uveitis. OBJECTIVE: To determine if the characteristics of the eye disease could help distinguish these 2 diagnoses. DESIGN: Seventeen patients with uveitis and IBD referred to a university clinic were compared retrospectively with 89 patients with uveitis and SA referred to the same clinic. RESULTS: Twelve (80\%) of the 15 patients with evaluable IBD had Crohn disease. In marked contrast to patients with SA, patients with IBD were usually female (82\%). Whereas uveitis with SA was predominantly anterior, unilateral, sudden in onset, and limited in duration, patients with IBD frequently had uveitis that was bilateral, posterior, insidious in onset, and/or chronic in duration. Results for 89\% of the patients with SA who underwent HLA-B27 typing were positive, compared with only 46\% of such patients with IBD. Episcleritis, scleritis, and glaucoma were more common among patients with IBD. Arthritis did not easily distinguish the 2 groups, as 13 (76\%) of the patients with IBD had a history of joint disease. In 10 (59\%) of the patients with IBD, the diagnosis of uveitis preceded that of IBD. CONCLUSION: The hallmarks of uveitis can often distinguish SA and IBD.
This article was published in Arch Ophthalmol
and referenced in Rheumatology: Current Research