Red flags for appropriate referral to the gastroenterologist and the rheumatologist of patients with inflammatory bowel disease and spondyloarthritis.
inflammatory bowel disease
red flag
spondyloarthritis
Journal
Clinical and experimental immunology
ISSN: 1365-2249
Titre abrégé: Clin Exp Immunol
Pays: England
ID NLM: 0057202
Informations de publication
Date de publication:
04 2019
04 2019
Historique:
accepted:
21
11
2018
pubmed:
17
12
2018
medline:
18
2
2020
entrez:
17
12
2018
Statut:
ppublish
Résumé
Collaboration between gastroenterologists and rheumatologists is recommended for the correct management of patients with associated spondyloarthritis (SpA) and inflammatory bowel disease (IBD). We aimed to establish the appropriateness of several red flags for a prompt specialist referral. A systematic review of the literature was performed using the GRADE method to describe the prevalence of co-existing IBD-SpA and the diagnostic accuracy of red flags proposed by a steering committee. Then, a consensus among expert gastroenterologists and rheumatologists (10 in the steering committee and 13 in the expert panel) was obtained using the RAND method to confirm the appropriateness of each red flag as 'major' (one sufficient for patient referral) or 'minor' (at least three needed for patient referral) criteria for specialist referral. The review of the literature confirmed the high prevalence of co-existing IBD-SpA. Positive and negative predictive values of red flags were not calculated, given the lack of available data. A consensus among gastroenterology and rheumatology specialists was used to confirm the appropriateness of each red flag. Major criteria to refer patients with SpA to the gastroenterologist included: rectal bleeding, chronic abdominal pain, perianal fistula or abscess, chronic diarrhoea and nocturnal symptoms. Major criteria to refer patients with IBD to the rheumatologist included: chronic low back pain, dactylitis, enthesitis and pain/swelling of peripheral joints. Several major and minor red flags have been identified for the diagnosis of co-existing IBD-SpA. The use of red flags in routine clinical practice may avoid diagnostic delay and reduce clinic overload.
Identifiants
pubmed: 30554407
doi: 10.1111/cei.13246
pmc: PMC6422654
doi:
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Systematic Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
123-138Investigateurs
Marina Beltrami
(M)
Fabrizio Bossa
(F)
Francesco Costa
(F)
Walter Fries
(W)
Mauro Galeazzi
(M)
Roberto Giacomelli
(R)
Giovanni Lapadula
(G)
Nazzarena Malavolta
(N)
Mariabeatrice Principi
(M)
Roberta Ramonda
(R)
Gabriele Riegler
(G)
Giovanni Triolo
(G)
Giorgio Zoli
(G)
Informations de copyright
© 2018 British Society for Immunology.
Références
Ann Rheum Dis. 2009 Jun;68(6):784-8
pubmed: 19147614
Am J Gastroenterol. 1996 Jan;91(1):7-10
pubmed: 8561147
Clin Rheumatol. 2015 Apr;34(4):745-53
pubmed: 24803233
Inflamm Bowel Dis. 2008 Dec;14(12):1701-6
pubmed: 18623171
Am J Med Sci. 2011 Apr;341(4):287-8
pubmed: 21358306
Aliment Pharmacol Ther. 2014 May;39(9):957-62
pubmed: 24593050
Coll Antropol. 2013 Sep;37(3):919-27
pubmed: 24308238
Ann Rheum Dis. 1980 Oct;39(5):453-6
pubmed: 7436576
Digestion. 2015;91(4):303-6
pubmed: 25925094
Hepatogastroenterology. 1986 Jun;33(3):123-7
pubmed: 3488946
Dig Dis Sci. 2014 Sep;59(9):2228-35
pubmed: 24752402
Dig Dis Sci. 2016 Jun;61(6):1772-4
pubmed: 26728477
J Rheumatol. 2002 Mar;29(3):511-5
pubmed: 11908564
Indian J Gastroenterol. 2004 May-Jun;23(3):89-90
pubmed: 15250564
J Rheumatol. 2011 Aug;38(8):1656-60
pubmed: 21632676
Rheumatol Int. 2012 Jun;32(6):1597-604
pubmed: 21328058
Autoimmun Rev. 2014 Aug;13(8):822-30
pubmed: 24726868
Int J Rheum Dis. 2014 Sep;17(7):782-9
pubmed: 24912101
Arthritis Rheum. 2000 Jun;43(6):1356-65
pubmed: 10857795
Can J Gastroenterol. 2013 Apr;27(4):199-205
pubmed: 23616957
Rheumatology (Oxford). 2009 Apr;48(4):404-9
pubmed: 19208685
Am J Gastroenterol. 2009 Sep;104(9):2233-40
pubmed: 19513023
Semin Arthritis Rheum. 2016 Feb;45(4):400-3
pubmed: 26601781
Ethn Dis. 2008 Spring;18(2 Suppl 2):S2-225-9
pubmed: 18646354
Int J Technol Assess Health Care. 1986;2(1):53-63
pubmed: 10300718
Am J Gastroenterol. 2015 May;110(5):716-24
pubmed: 25916225
Clin Rheumatol. 2000;19(6):445-9
pubmed: 11147753
Ann Rheum Dis. 2015 Jul;74(7):1373-8
pubmed: 24658834
Arthritis Rheum. 2005 Dec 15;53(6):850-5
pubmed: 16342091
Rheumatology (Oxford). 2009 Jul;48(7):812-6
pubmed: 19447774
J Rheumatol. 1976 Jun;3(2):196-200
pubmed: 950636
Ann Rheum Dis. 2009 Jun;68(6):770-6
pubmed: 19297345
Clin Rheumatol. 1985 Mar;4(1):76-82
pubmed: 3157530
Joint Bone Spine. 2015 Oct;82(5):345-51
pubmed: 26190454
Am J Gastroenterol. 2011 Jan;106(1):110-9
pubmed: 20808297
Skeletal Radiol. 1990;19(3):207-10
pubmed: 2333561
Rheumatol Int. 2009 Jun;29(8):955-7
pubmed: 19082597
Gut. 1970 Sep;11(9):748-54
pubmed: 5473606
Eur J Gastroenterol Hepatol. 2007 Jan;19(1):73-8
pubmed: 17206080
Am J Med Sci. 2011 Apr;341(4):289-92
pubmed: 21372663
Reumatol Clin. 2016 Jan-Feb;12(1):22-6
pubmed: 25683367
Rheumatol Int. 2006 May;26(7):663-8
pubmed: 16136311
Gastroenterol Hepatol. 2018 Jan;41(1):54-62
pubmed: 28882616
Ann Rheum Dis. 2004 May;63(5):535-43
pubmed: 15082484
J Rheumatol. 2000 Dec;27(12):2860-5
pubmed: 11128677
Ann Rheum Dis. 2011 Jan;70(1):25-31
pubmed: 21109520
Inflamm Bowel Dis. 2012 Sep;18(9):1655-62
pubmed: 22114016
Clin Imaging. 1995 Oct-Dec;19(4):258-62
pubmed: 8564870
BMJ. 2008 May 17;336(7653):1106-10
pubmed: 18483053
Arthritis Care Res (Hoboken). 2013 Mar;65(3):448-53
pubmed: 22833469
Abdom Imaging. 2012 Jun;37(3):326-37
pubmed: 22160373
Aliment Pharmacol Ther. 2009 Jan;29(2):193-7
pubmed: 18945256
Gut. 1998 Mar;42(3):387-91
pubmed: 9577346
Dig Liver Dis. 2017 Dec;49(12):1298-1305
pubmed: 28822731
Ann Rheum Dis. 2013 Oct;72(10):1646-53
pubmed: 23139266
J Crohns Colitis. 2017 May 1;11(5):631-642
pubmed: 28453761
J Rheumatol. 2003 Mar;30(3):518-22
pubmed: 12610811
Inflamm Bowel Dis. 2015 Aug;21(8):1794-800
pubmed: 26020601
J Med Life. 2015 Jul-Sep;8(3):319-25
pubmed: 26351533
J Rheumatol. 1992 Mar;19(3):373-7
pubmed: 1578450
Medicine (Baltimore). 2016 Jul;95(28):e4267
pubmed: 27428240
Rheumatology (Oxford). 2016 Oct;55(10):1820-5
pubmed: 27354690
Ital J Gastroenterol Hepatol. 1997 Dec;29(6):520-4
pubmed: 9513826
Dig Liver Dis. 2009 Aug;41(8):565-9
pubmed: 19278908
Rheumatology (Oxford). 2014 Feb;53(2):353-60
pubmed: 24196385
Endoscopy. 2005 Dec;37(12):1165-9
pubmed: 16329011
Dig Liver Dis. 2002 Nov;34(11):781-6
pubmed: 12546513
Ann Rheum Dis. 1978 Feb;37(1):33-5
pubmed: 629601
Scand J Gastroenterol. 2001 Dec;36(12):1307-13
pubmed: 11761022
Rheumatology (Oxford). 2015 Apr;54(4):633-40
pubmed: 25234663
Clin Exp Rheumatol. 1988 Jul-Sep;6(3):221-5
pubmed: 3180544
Am J Public Health. 1986 Jul;76(7):766-72
pubmed: 3521341
Dis Colon Rectum. 1994 Dec;37(12):1307-9
pubmed: 7995164
J Korean Med Sci. 1998 Feb;13(1):39-43
pubmed: 9539317
J Crohns Colitis. 2015 Mar;9(3):276-83
pubmed: 25547976
J Rheumatol. 1991 May;18(5):696-8
pubmed: 1865416
Clin Rheumatol. 2008 Apr;27(4):503-9
pubmed: 18097711
Clin Rheumatol. 2018 Apr;37(4):1037-1044
pubmed: 29204760
Indian J Gastroenterol. 2015 Sep;34(5):387-94
pubmed: 26614005
J Gastroenterol Hepatol. 2008 Jan;23(1):132-7
pubmed: 17725592
Clin Exp Rheumatol. 2014 Nov-Dec;32(6):949-52
pubmed: 25152017
Am J Gastroenterol. 2001 Apr;96(4):1116-22
pubmed: 11316157
Rheumatol Int. 2012 Sep;32(9):2837-42
pubmed: 21879376
Indian J Gastroenterol. 1991 Jul;10(3):88-9
pubmed: 1916969
J Crohns Colitis. 2016 Feb;10(2):166-75
pubmed: 26512134
Rheumatology (Oxford). 2007 Aug;46(8):1309-15
pubmed: 17526930
Eur J Gastroenterol Hepatol. 2012 Dec;24(12):1424-9
pubmed: 22895389
J Crohns Colitis. 2015 Aug;9(8):601-6
pubmed: 25908718
Ann Rheum Dis. 2004 Sep;63(9):1131-4
pubmed: 15308523