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  • Case Study
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Granulomatous ileitis in a patient with ankylosing spondylitis

Abstract

Background A 21-year-old white male with a 3-year history of back pain presented with a 6-month history of weight loss (without significant gastrointestinal symptoms), lethargy and left hip pain, and diarrhea that had lasted 4 days.

Investigations Barium follow-through, upper and lower gastrointestinal endoscopy and biopsies, capsule enteroscopy, CT of the chest and abdomen, measurement of the concentration of fecal calprotectin, intestinal absorption permeability test and wireless capsule endoscopy.

Diagnosis Ankylosing spondylitis associated with ileitis of spondylarthropathy.

Management Sulfasalazine and elemental diet, steroids, physiotherapy and bilateral hip replacement.

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Figure 1: Histological image from the ileal biopsy of a 21-year-old patient taken at diagnosis of ankylosing spondylitis associated with ileitis of spondylarthropathy
Figure 2: Wireless capsule enteroscopy images used in the differential diagnosis of ileitis

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Correspondence to Ingvar Bjarnason.

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Adebayo, D., Popat, R., Thjodleifsson, B. et al. Granulomatous ileitis in a patient with ankylosing spondylitis. Nat Rev Gastroenterol Hepatol 4, 347–351 (2007). https://doi.org/10.1038/ncpgasthep0836

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  • DOI: https://doi.org/10.1038/ncpgasthep0836

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