Gastrointestinally mediated food allergy causing Spondyloarthritis-like disease

Raithel M, Finzel S, Heussinger N*, Rieker RJ and Baenkler HW

Gastrointestinally-mediated food allergy (GMA) incidentally may cause non-erosive oligoarthritis.

A 56-year-old woman with seronegative spondyloarthritis observed arthritic flares following ingestion of certain foods. Blood analyses were unremarkable. Segmental gut lavage revealed plasmacellular infiltrates and eosinophilia in terminal ileum. Food allergen-specific IgE-analysis of lavage fluid showed significant polyvalent intestinal IgE-sensitization (>0.35kU/mg protein) towards wheat, rye, egg, soybean, pork, beef, nuts. Repeated exposure to the aforementioned foods caused arthritis within 48 hours; elimination diet engendered long-term remission. Seronegative local IgE-mediated GMA (type I) was diagnosed.

Especially seronegative rheumatoid arthritis and undifferentiated oligoarthritis should be scrutinized for food-related muscoloskeletal symptoms before initiating immunosuppression. 

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Published on: Jul 15, 2020 Pages: 49-53

Full Text PDF Full Text HTML DOI: 10.17352/2455-2283.000078
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