Seronegative spondyloarthropathies and allergic diseases in patients with ulcerative colitis

Abstract

Seronegative spondyloarthropathy (SpA) and allergic diseases are frequently observed in Ulcerative Colitis (UC). The aim of this study was to evaluate possible relationships between SpA, allergic contact dermatitis (ACD) and IgE-mediated allergic disease (AD) in patients with UC. Fifty consecutive UC patients were graded with clinical, endoscopic and histologic activity scores and classified on the basis of Rachmilewitz and Truelove & Richard criteria. The rheumatologic evaluation included history and physical examination. Axial and peripheral joint involvement was confirmed by radiographic and scintiscan examination. SpA was diagnosed according to the ESSG criteria. The allergologic evaluation included personal history of allergy, prick and patch exposition to airborne, food and contact allergens. AD was confirmed by specific provocation tests, while ACD was determined by using the European Standard Series. Fifty healthy subjects served as controls. Fourteen patients (28%) and 1 control subject (2%) showed SpA (p<0.001). Diagnosis of rhinitis, conjunctivitis or asthma was made in 19 patients (38%) and 6 controls (12%) (p=0.01), while ACD was found in 10 (20%) and 3 (6%) (p=0.03), respectively. Only 2 patients had a concurrence of SpA and AD (p=0.03), while SpA and ACD coexisted in 5 (p=n.s.). No patients contemporarily showed AD and ACD (p=0.008). Notwithstanding the high frequency of AD, SpA and ACD found in UC, the concurrence of AD with SpA or ACD is an unusual finding, while SpA and ACD may coexist. These data seem to indicate that AD and SpA, as well as AD and ACD, are strongly polarized conditions tending to mutual exclusion.