Luiza Lazarescu
Centrul Medical Unirea, Romania
Biography
Luiza Lazarescu has graduated at Carol Davila University.of Medicine, Bucharest, specfialist in Internal Medicine from 2008 and mayor in Internal Medicine from
Abstract
Case report: We report a case of a 30-year- old woman known with Crohn disease from the age of five, who was hospitalised for pain and sweling 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 spondylarthritis was made by excluding other joint patholgy, based on the European Group cryteria for this condition.
Based on the clinical, immunological and imagistic findings, I believe that the patient has developed reactive spondylarthritis, most likely secondary to Crohn disease.
NSAIDs are the medication of choice for spondylarthritis, 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.