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Pain Management 2018
Internal Medicine 2018
International Journal of Anesthesiology & Pain Medicine
ISSN: 2471-982X
Page 58
March 26-28, 2018
Vienna, Austria
JOINT EVENT
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E d i t i o n o f I n t e r n a t i o n a l C o n f e r e n c e o n
Internal Medicine and Patient Care
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E d i t i o n o f I n t e r n a t i o n a l C o n f e r e n c e o n
Pain Management
Volume 4
Background:
Crohn’s disease is an auto-immune condition where
immunological inflammation may affect other organs apart from
the intestines, such as the joints. These are disorders that develop
secondarily to the inflammatory bowel disease (IBD), but appear
independently of IBD exacerbations. One of these conditions is
classified as seronegative spondylarthritis, sometimes called
enteropathic arthritis.
Case report:
We report a case of a 30-year- old woman known
with Crohn’s disease from the age of five, who was hospitalized
for pain and swelling in the sacroiliac joints. She had been in
treatment with adalimumab 40 mg twice daily, prior to hospital
admission. The MRI investigation of sacroiliac joints revealed
bilateral reduction in joint spaces, but no bone edema or other
significant changes. Blood tests showed chronic anemia (Hb 11.4
g/dl and Ht 35.7%) with normal ESR and C-reactive protein and
negative HLA- B27 phenotyping. The diagnosis of seronegative
spondyloarthritis was made by excluding other joint pathology,
based on the European group criteria for this condition.
Results & Conclusion:
Based on the clinical, immunological
and imagistic findings, I believe that the patient has developed
reactive spondylarthritis, most likely secondary to Crohn’s
disease. Nonsteroidal anti-inflammatory drugs (NSAIDs) are
the medication of choice for spondyloarthritis; however we
chose to avoid them while IBD is active and refer the patient
for physiotherapy. The patient has concomitantly continued her
treatment with adalimumab. She has had a good result after
the first sessions of physiotherapy, with reduced swelling and
recovered mobility in her joints.
Biography
Luiza Lazarescu has graduated at Carol Davila University of Medicine, Bu-
charest, and Specialist in Internal Medicine from 2008 and Mayor in Internal
Medicine from 2016.
luiza_lazarescu@yahoo.comSeronegative spondyloarthritis secondary to Crohn disease: a
case report
Luiza Lazarescu
Centrul Medical Unirea, Bucuresti
Luiza Lazarescu, Int J Anesth Pain Med 2018, Volume 4
DOI: 10.21767/2471-982X-C1-003