inflamatuvar bağırsak hastalıklarında sakroileitis ve ankilozan spondilitis
Sacroileitis and ankylosing spondylitis in inflammatory bowel disease
Yazar: ALİ TÜREYEN
Danışman: UZMAN BURHAN ŞAHİN
Sağlık Bakanlığı / Ankara Türkiye Yüksek İhtisas Eğt. ve Arş. Hastanesi / Gastroenteroloji Ana Bilim Dalı
Derece: Tıpta Yan Dal Uzmanlık, 2000
Konu: Gastroenteroloji = Gastroenterology

Özet:
Amaç: ‹nflamatuar ba¤›rsak hastal›klar›nda ankilozan
spondilitis ve sacroileitis s›kl›¤›, eklem semptomlar› ile hastal›k
aktivasyonu iliflkileri ve HLA-B27 antijen pozitifli¤ini
araflt›rd›k. Yöntem: 33 ülseratif kolitli hastada (17 aktif ve 16
remusyon) ve 29 crohnlu hastada (15 aktif ve 14 remusyon)
sakroiliak eklemden üç fazl› kemik sintigrafisi ile direkt kemik
grafisi çektirdik. Tüm hastalarda ve 60 kontrol grubunda
HLA-B27 antijen çal›flt›k. Bulgular: Ülseratif kolitli 33 hastan›n 10'da (%30.3) ve crohnlu 29 hastan›n 7'de (%24.13)
sakroileitis saptad›k. Bu hastalar›n 11'i aktif (%17. 73), 6's›
remusyon (%9.68) grubunda idi. Sakroileitis teflhisini 7 hastada kemik grafisi (%41.18), 10 hastada kemik sintigrafisi (%58.
82) ile tespit ettik. Kemik grafisi ile sakroileitis tespit etti¤imiz
hastalar›n 3'ü (%17.64) ankilozan spondilitis tan›s› ald›. HLAB27 pozitifli¤i inflamatuar bar¤›rsak hastal›klar›nda 6 (%9.
67), kontrol grubunda 3(%5) idi. Bu iki grup aras›nda anlamal› fark yoktu (P>0. 05). Ankilozan spondilitisli 3 hastada
HLA-B27 pozitifdi ve bu kontrol grubuna göre anlaml› idi
(P<0. 01). Sonuç: Sakroileitisin klinik seyri ba¤›rsaktaki inflamatuar aktiviteden ba¤›ms›zd›r. ‹nflamatuar ba¤›rsak
hastal›klar› ve özellikle sakroileitis saptanm›fl olanlar ankilozan spondilits yönünden araflt›r›lmal›d›r. 
Anahtar kelimeler: Ankilozan spondilitis, Crohn hastal›¤›,
sacroileitis, ülseratif kolitis, HLA-B27.

Abstract:
Background/aims : The aim of this study was to investigate
the frequency of sacroileitis and ankylosing spondylitis in
inflammatory bowel disease and the relationship between disease activity, joint symptoms and HLA-B27 antigen positivity.
Methods: Sacroiliac joint radiography and three phase bone
scanning of 33 ulcerative colitis patients (17 active and 16 in
remission) and 29 Crohn's disease patients (15 active and 14 in
remission) was performed. HLA-B27 was determined in all
patients and 60 control subjects. Results: Sacroileitis was
found in 10 out of 33 patients with ulcerative colitis (30. 30%)
and seven out of 29 patients with Crohn's disease (24. 13%). Of
these patients, eleven had active (17.73%) disease and six were
in remission (9. 68%). The diagnosis of sacroileitis was made by
bone radiography in seven patients (41.18%) and by bone scanning in the other 10 patients (58.82%). A diagnosis of ankylosing spondylitis was made in three patients (17. 64%) who had
previously been diagnosed by bone radiography to have
sacroileitis. HLA-B27 was positive in six patients (9.67%) with
inflammatory bowel disease and three subjects (5%) of the control group. There were no significant differences between these
two groups (p>0.05). Compared to the control group, all three
patients with ankylosing spondylitis were HLA-B27 positive,
the difference being significant (p>0. 01). Conclusions: The
clinical course of sacroileitis is independent of the activitiy of
inflammatory bowel disease. Accordingly, patients with inflammatory bowel disease, especially those with sacroileitis, should
be investigated for the presence of anklylosing spondylitis. . 
Key words: Ankylosing spondylitis, Crohn's disease,
sacroileitis, ulcerative colitis, HLA-B27