Successful treatment with tofacitinib in Spondyloarthritis associated Uveitis

Abstract

A 55-year-old patient with a diagnosis of UAU is referred by Ophthalmology to define probable association with an underlying systemic disease and initiation of immunosuppressive therapy due to insufficient response to local treatment with eye drops (anterior chamber cells grade 2+). On physical examination, the patient presented in addition to uveitis, left sacroiliitis, right plantar fasciitis and bilateral inflammation of the Achilles tendon. The MRI showed unilateral sacroiliitis. Elevated ESR and positive HLA-B35 and HLA-B44 were found in the laboratory. Colonoscopy step biopsy showed histology suggestive of ulcerative colitis (UC) despite the fact that the patient had no symptoms. The clinical picture was interpreted as UAU secondary to axial spondyloarthritis (SpA) associated with colonic mucosal inflammation (asymptomatic UC?).