How is human leukocyte antigen (HLA) B27–associated inflammatory bowel disease (IBD) diagnosed?

Answer

Radiograph findings of involved peripheral joints are usually normal except for soft tissue swelling. An occasional patient with recurrent disease may show small bony erosions and joint space narrowing. Spine films show changes indistinguishable from ankylosing spondylitis. Blood work, including white blood cell (WBC) count, red blood cell (RBC) count, and erythrocyte sedimentation rate, usually reflect the intestinal disease.

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Media Gallery

Reactive arthritis, acute conjunctivitis. Courtesy of Paul Dieppe, BSc, MD, FRCP, FFPHM.
Anterior chamber fibrin collection in ankylosing spondylitis. Courtesy of Paul Dieppe, BSc, MD, FRCP, FFPHM.
Acute anterior uveitis in ankylosing spondylitis. Courtesy of Paul Dieppe, BSc, MD, FRCP, FFPHM.
Ankylosing spondylitis disease progression. Courtesy of Paul Dieppe, BSc, MD, FRCP, FFPHM.
Reactive arthritis. Involvement of knee (left) and conjunctivitis (right). Courtesy of Paul Dieppe, BSc, MD, FRCP, FFPHM.

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Author

Huy D Nguyen, MD, MBA Resident Physician, Department of Ophthalmology, University of Texas Health Science Center at San Antonio School of Medicine

Huy D Nguyen, MD, MBA is a member of the following medical societies: American Academy of Ophthalmology, American Medical Association, Association for Research in Vision and Ophthalmology, Texas Medical Association

Disclosure: Nothing to disclose.

Coauthor(s)

Yousef Salem MD Candidate, University of Texas Health Science Center at San Antonio, Long School of Medicine

Disclosure: Nothing to disclose.

Jeong-Hyeon Sohn, MD Associate Professor of Ophthalmology, Chief, Retina Division, Director, Surgical Retina and Vitreous Fellowship Program, Medical Director, TDI Ophthalmology Clinic, Department of Ophthalmology, UT Health San Antonio

Jeong-Hyeon Sohn, MD is a member of the following medical societies: American Academy of Ophthalmology, American Medical Association, American Society of Retina Specialists, American Uveitis Society, Association for Research in Vision and Ophthalmology

Disclosure: Nothing to disclose.

Specialty Editor Board

Simon K Law, MD, PharmD Clinical Professor of Health Sciences, Department of Ophthalmology, Jules Stein Eye Institute, University of California, Los Angeles, David Geffen School of Medicine

Simon K Law, MD, PharmD is a member of the following medical societies: American Academy of Ophthalmology, Association for Research in Vision and Ophthalmology, American Glaucoma Society

Disclosure: Nothing to disclose.

R Christopher Walton, MD Adjunct Professor, Department of Ophthalmology, University of Texas Health Science Center at San Antonio

R Christopher Walton, MD is a member of the following medical societies: American Academy of Ophthalmology, American Uveitis Society

Disclosure: Nothing to disclose.

Chief Editor

Andrew A Dahl, MD, FACS Assistant Professor of Surgery (Ophthalmology), New York College of Medicine (NYCOM); Director of Residency Ophthalmology Training, The Institute for Family Health and Mid-Hudson Family Practice Residency Program; Staff Ophthalmologist, Telluride Medical Center

Andrew A Dahl, MD, FACS is a member of the following medical societies: American Academy of Ophthalmology, American College of Surgeons, American Intraocular Lens Society, American Medical Association, American Society of Cataract and Refractive Surgery, Contact Lens Association of Ophthalmologists, Medical Society of the State of New York, New York State Ophthalmological Society, Outpatient Ophthalmic Surgery Society

Disclosure: Nothing to disclose.

Additional Contributors

John D Sheppard, Jr, MD, MMSc Professor of Ophthalmology, Microbiology and Molecular Biology, Clinical Director, Thomas R Lee Center for Ocular Pharmacology, Ophthalmology Residency Research Program Director, Eastern Virginia Medical School; President, Virginia Eye Consultants

John D Sheppard, Jr, MD, MMSc is a member of the following medical societies: American Academy of Ophthalmology, American Society for Microbiology, American Society of Cataract and Refractive Surgery, American Uveitis Society, Association for Research in Vision and Ophthalmology

Disclosure: Serve(d) as a director, officer, partner, employee, advisor, consultant or trustee for: 1-800-DOCTORS; AbbVie; Alcon; Aldeyra; Allergan; Alphaeon; ArcScan; Baush+Lomb; Bio-Tissue; Clearside; EyeGate; Hovione; Mededicus; NovaBay; Omeros; Pentavision; Portage; Santen; Science Based Health; Senju; Shire; Sun Pharma; TearLab;TearScience;Topivert<br/>Serve(d) as a speaker or a member of a speakers bureau for: AbbVie; Alcon; Allergan; Bausch+Lomb; Bio-tissue; EyeGate;Hovione;LayerBio; NovaBay;Omeros;Portage; Santen; Shire; Stemnion; Sun Pharma;TearLab;TearScience; Topivert <br/>Received research grant from: Alcon; Aldeyra; allergan; Baush+ Lomb; EyeGate; Hovione; Kala; Ocular Therapeutix;Pfizer; RPS; Santen;Senju;Shire;Topcon; Xoma.

Anna Luisa Di Lorenzo, MBBCh Clinical Assistant Professor, Department of Ophthalmology, Kresge Eye Institute, Wayne State University School of Medicine; Consulting Staff, Somerset Ophthalmology

Anna Luisa Di Lorenzo, MBBCh is a member of the following medical societies: American Academy of Ophthalmology, American College of Physicians, American Medical Association, American Society of Cataract and Refractive Surgery, Association for Research in Vision and Ophthalmology, Michigan Society of Eye Physicians & Surgeons, Michigan State Medical Society, Oakland County Medical Society, Women in Ophthalmology, Inc

Disclosure: Nothing to disclose.

How is human leukocyte antigen (HLA) B27–associated inflammatory bowel disease (IBD) diagnosed?

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