Dr. Seidman replies.

Abstract

We are pleased to note the interest that Van Hoovels and colleagues have for our SpACE Capsule study1, and read with interest their investigation of the clinical utility of assaying fecal calprotectin (FC) to assist in the diagnosis of spondyloarthritis (SpA)2. Rheumatologists traditionally proclaim that the extraarticular manifestations of SpA include inflammatory bowel disease (IBD)3. IBD, including Crohn disease (CD) and ulcerative colitis, are analogously associated with various extraintestinal manifestations (EIM). The most common EIM is articular involvement, reported in 16–33% of patients with IBD4. Thus, gastroenterologists often decree SpA as an EIM of IBD. Regardless of which side of this “chicken and egg” debate one adheres to, the unifying message is that SpA and IBD often coexist and need to be assessed, because jointly they modify management strategies5,6. FC is established as an excellent biomarker of intestinal inflammation7. Van Hoovels, et al investigated the value of FC in diagnosing … Address correspondence to Dr. E. Seidman. E-mail: ernest.seidman{at}mcgill.ca