A Coexistence of Peripheral Spondyloarthritis and Familial Adenomatous Polyposis Rare Case Report with Treatment Contradictions and Review of the Literature

Abstract

BACKGROUND: The coexistence of familial adenomatouspolyposis and spondyloarthritis is rarely defined in literature. Theprimary aim of this presentation is to report a development ofperipheral arthritis in 3 years following colon surgery with thediagnosis of familial adenomatous polyposis (FAP). The secondaryaim is to discuss the challenge of in treatment of refractoryarthritis, which needs to be treated with biologics. However, it isnot yet known well about their safety on patients who have risks forcancer development.CASE DETAILS: A 25-year-old female patient was admitted to therheumotology outpatient clinic. The patient had undergone totalcolectomy and ileoanal anastomosis because of FAP three yearsago. On her physical examination, there was arthritis on her leftankle and enthesitis on both Achilles tendons.CONCLUSION: This case report presents a 25-year-old femalepatient with Ankylosing spondylitis (AS) and FAP whose treatmentwith biologics is critical due to the risk of cancer development dueFAP. Although the potential risk of development of malignancieswith TNF-blocking therapy seems to be no more than TNF-naïvepatients and general population. But the safety of these drugs onpatients with risks for cancer development is still unknown.