Abstract: HLA-B27 Associated Spondyloarthropathy, Vasculitis, and Amyloid Enteropathy: Response to Infliximab

HLA-B27 Associated Spondyloarthropathy, Vasculitis, and Amyloid Enteropathy: Response to Infliximab

LISA K. STAMP and JOHN L. O'DONNELL

ABSTRACT.

In 2000 we described a patient with HLA-B27 associated spondyloarthropathy (SpA) and severe ascending aortitis requiring surgical intervention. Despite continued immunosuppressive therapy she developed narrowing of the distal part of the right subclavian artery and proximal axillary artery secondary to active vasculitis. In addition, biopsy-proven amyloid gastroenteropathy developed causing persistent diarrhea and iron deficiency anemia. Treatment with infliximab resulted in resolution of joint symptoms and rapid improvement in laboratory markers of inflammation. Diarrhea settled more gradually, such that her bowel habit had normalized 16 months after therapy commenced. (J Rheumatol 2005;32:382-5)

Key Indexing Terms:

AORTITIS
HLA-B27
SPONDYLOARTHROPATHY
INFLIXIMAB
AMYLOIDOSIS

From the Department of Medicine and Health Sciences, Christchurch School of Medicine, Otago University; and Department of Rheumatology, Immunology and Allergy Department, Christchurch Public Hospital, Christchurch, New Zealand.

L.K. Stamp, FRACP, PhD; J.L. O'Donnell, FRACP, FRCPA.

Address reprint requests to Dr. L. Stamp, Department of Medicine and Health Sciences, Christchurch School of Medicine, PO Box 4345, Christchurch, New Zealand. E-mail: lisa.stamp@cdhb.govt.nz

Submitted May 26, 2004; revision accepted September 29, 2004.