SynthesisClinical and experimental immunology2019
Red flags for appropriate referral to the gastroenterologist and the rheumatologist of patients with inflammatory bowel disease and spondyloarthritis.
Synthesis in Clinical and experimental immunology, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers.
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Who cites it
20 citing papers in PubMed.
- Is There a Way to Break the Glass Ceiling in the Diagnosis and Treatment of Extraintestinal Manifestations (EIMs) in the Course of Inflammatory Bowel Diseases? A Comprehensive Review of Diagnosis, Pathophysiology, and Treatment of EIM.Journal of clinical medicine · 2026Review
- Impact of gastrointestinal and psychological symptoms on disease activity and functional impairment in patients with spondyloarthritis: a cross-sectional study.BMC rheumatology · 2025Article
- Joint Manifestations in Inflammatory Bowel Diseases, "Red Flags" for the Early Recognition and Management of Related Arthropathies: A Narrative Review.Journal of clinical medicine · 2025Review
- Reducing diagnostic delays of extraintestinal manifestations in inflammatory bowel disease: a comparative study of a multidisciplinary outpatient clinic versus conventional referral specialists.Therapeutic advances in gastroenterology · 2025Article
- Inflammatory Bowel Disease and Endometriosis: Diagnosis and Clinical Characteristics.Biomedicines · 2024Review
- [Fever in rheumatological diseases].Zeitschrift fur Rheumatologie · 2024Review
- Immune-Mediated Inflammatory Diseases Awareness and Management among Physicians Treating Patients with Inflammatory Bowel Disease: An IG-IBD Survey.Journal of clinical medicine · 2024Article
- Clinical and imaging findings in enteropathic spondyloarthritis with special emphasize in diagnostic delay: a cross-sectional study.Therapeutic advances in chronic disease · 2024Article
- Activity of axial spondyloarthritis after one year of anti-tumor necrosis factor therapy among patients with inflammatory bowel diseases.Clinical rheumatology · 2023Article
- Extra-musculoskeletal manifestations driving the therapeutic decision-making in patients with Spondyloarthritis: a 12-month follow-up prospective cohort study.Advances in rheumatology (London, England) · 2023Article
- Creation of an Inflammatory Bowel Disease Referral Pathway for Identifying Patients Who Would Benefit From Inflammatory Bowel Disease Specialist Consultation.Inflammatory bowel diseases · 2023Review
- Spondyloarthritis with inflammatory bowel disease: the latest on biologic and targeted therapies.Nature reviews. Rheumatology · 2023Review
- Cytokines in Spondyloarthritis and Inflammatory Bowel Diseases: From Pathogenesis to Therapeutic Implications.International journal of molecular sciences · 2023Review
- Peripheral Spondyloarthritis Presenting with Fever and Severe Systemic Inflammatory Response Mimicking Infection: A Case Series and Literature Review.Case reports in rheumatology · 2023Article
- IL-17 inhibitor-associated inflammatory bowel disease: A study based on literature and database analysis.Frontiers in pharmacology · 2023Article
- Spondyloarthropathy in Inflammatory Bowel Disease: From Pathophysiology to Pharmacological Targets.Drugs · 2022Article
- Inflammatory Bowel Disease-related Spondyloarthritis: The Last Unexplored Territory of Rheumatology.Mediterranean journal of rheumatology · 2022Review
- Inflammatory bowel disease and immune-mediated inflammatory diseases: looking at the less frequent associations.Therapeutic advances in gastroenterology · 2022Review
- Early Spondyloarthritis Clinic: Organizational Improvements in the Patient Journey.Frontiers in medicine · 2022Article
- Clinical management of the most common extra-intestinal manifestations in patients with inflammatory bowel disease focused on the joints, skin and eyes.United European gastroenterology journal · 2020Review
Corrections and comments
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Authors and funding
14 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
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.
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