Uveitis associated with inflammatory bowel disease compared with uveitis associated with spondyloarthropathy
J. L. Lyons and J. T. Rosenbaum
Casey Eye Institute, Oregon Health Sciences University, Portland, USA.
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.
