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Sample records for early ankylosing spondylitis

  1. Ankylosing Spondylitis

    ... DMARDs) These drugs work in different ways to control the disease process of ankylosing spondylitis. The most commonly used DMARDs for ankylosing spondylitis are sulfasalazine and methotrexate. Biologic Agents Members of this class of medications are ...

  2. Ankylosing spondylitis

    Mukesh Edavalath

    2010-01-01

    Full Text Available Ankylosing spondylitis belongs to a group of rheumatic diseases known as the spondyloarthropathies (SpA, which show a strong association with the genetic marker HLA-B27. Inflammatory back pain and stiffness are prominent early in the disease, whereas chronic, aggressive disease may produce pain and marked axial immobility or deformity. Modern medicine has no established treatment for it. From the Ayurvedic perspective, the disease can fall under amavata, which may be effectively managed when intervention is started in its early stages. Niruha basthi with Balaguduchyadi yoga, combined by Shamana treatment with Rasnerandadi kwatha and Simhanada guggulu have been found effective in curbing its progression. This article presents a single case report in which these treatments achieved considerable success.

  3. What Is Ankylosing Spondylitis?

    ... Spondylitis PDF Version Size: 135 KB November 2014 What Is Ankylosing Spondylitis? Fast Facts: An Easy-to- ... affects about twice as many men as women. What Causes Ankylosing Spondylitis? The cause of AS is ...

  4. Whole body MR imaging in ankylosing spondylitis: a descriptive pilot study in patients with suspected early and active confirmed ankylosing spondylitis

    Hodler Juerg

    2007-02-01

    Full Text Available Abstract Background Ankylosing spondylitis is a chronic inflammatory rheumatic disorder which usually begins in early adulthood. The diagnosis is often delayed by many years. MR imaging has become the preferred imaging method for detection of early inflammation of the axial skeleton in ankylosing spondylitis. The goal of this study was to assess the frequency and distribution of abnormalities on whole body MR imaging in patients with suspected early ankylosing spondylitis and with active confirmed ankylosing spondylitis. Methods Ten patients with suspected early ankylosing spondylitis and ten patients with confirmed ankylosing spondylitis were enrolled. On an 18-channel MR system, coronal and sagittal T1 weighted and STIR sequences were acquired covering the entire spine, sacrum, anterior chest wall, shoulder girdle, and pelvis. The total examination time was 30 minutes. Results In both groups inflammatory lesions of the lower thoracic spine were frequent (number of patients with suspected early/confirmed ankylosing spondylitis: 7/9. In confirmed ankylosing spondylitis the upper thoracic spine (3/6 and the lumbar spine (4/8 were more commonly involved. The inferior iliac quadrant of the sacroiliac joints was frequently altered in both groups (8/8. The superior iliac (2/5, inferior sacral (6/10 and superior sacral (3/6 quadrants were more frequently affected in confirmed ankylosing spondylitis. Abnormalities of the manubriosternal joint (2/4, the sternoclavicular joints (1/2 and hip joint effusion (4/3 were also seen. Conclusion In both suspected early ankylosing spondylitis and confirmed ankylosing spondylitis, whole body MR examinations frequently demonstrate inflammatory lesions outside the sacroiliac joints. These lesions are similarly distributed but occur less frequently in suspected early compared to confirmed ankylosing spondylitis. Due to the small sample size in this pilot study these results need to be confirmed in larger studies with

  5. Use of static lung mechanics to identify early pulmonary involvement in patients with ankylosing spondylitis.

    Aggarwal A; Gupta D; Wanchu A; Jindal S

    2001-01-01

    AIM: To assess if a detailed analysis of lung mechanics could help in early recognition of pulmonary abnormalities in patients with ankylosing spondylitis. METHODS: Static pulmonary mechanics were studied in 17 patients (16 men and one woman) of ankylosing spondylitis with no obvious clinical or radiological evidence of pulmonary involvement. Lung pressure-volume relationship was generated using a whole body plethysmograph, and a monoexponential equation fitted to this data. RESULTS: Total lu...

  6. Lung findings on high resolution CT in early ankylosing spondylitis

    Objective: Ankylosing spondylitis (AS) is a chronic inflammatory disease mainly affecting the axial skeleton and pulmonary involvement is a well known feature of the disease. The aim of this study was to investigate the pulmonary high resolution computed tomography (HRCT) findings of patients with early AS. The relationship between pulmonary function tests (PFT) and HRCT findings was also determined. Subjects and methods: Twenty-eight patients with AS (mean age 30.8±7.4 and disease duration 7.0±2.6) were included in the study. Patients with a disease duration of >10 years or had other pulmonary diseases were excluded. All patients underwent plain chest radiography (posteroanterior and lateral views), thoracic HRCT and PFT. Results: All chest radiographs were normal and HRCT revealed abnormalities in 18 patients. The most common abnormalities seen on HRCT were mosaic pattern (ten of 28), subpleural nodule (seven of 28) and parenchymal bands (five of 28). Seven of ten patients with mosaic pattern revealed air trapping areas on end expiratory scans. Twelve patients had abnormal PFT and all had restrictive type of involvement. Ten of these 12 patients had abnormal HRCT and the remaining two patients had normal HRCT. On the other hand, eight patients with normal PFT had abnormalities on HRCT. Conclusion: Patients with early AS frequently have abnormalities on HRCT, even though they have normal PFT and chest X-ray. Small airway involvement was found as frequent as interstitial lung disease in early AS

  7. Lung findings on high resolution CT in early ankylosing spondylitis

    Kiris, Adem E-mail: ademkiris@hotmail.com; Ozgocmen, Salih; Kocakoc, Ercan; Ardicoglu, Ozge; Ogur, Erkin

    2003-07-01

    Objective: Ankylosing spondylitis (AS) is a chronic inflammatory disease mainly affecting the axial skeleton and pulmonary involvement is a well known feature of the disease. The aim of this study was to investigate the pulmonary high resolution computed tomography (HRCT) findings of patients with early AS. The relationship between pulmonary function tests (PFT) and HRCT findings was also determined. Subjects and methods: Twenty-eight patients with AS (mean age 30.8{+-}7.4 and disease duration 7.0{+-}2.6) were included in the study. Patients with a disease duration of >10 years or had other pulmonary diseases were excluded. All patients underwent plain chest radiography (posteroanterior and lateral views), thoracic HRCT and PFT. Results: All chest radiographs were normal and HRCT revealed abnormalities in 18 patients. The most common abnormalities seen on HRCT were mosaic pattern (ten of 28), subpleural nodule (seven of 28) and parenchymal bands (five of 28). Seven of ten patients with mosaic pattern revealed air trapping areas on end expiratory scans. Twelve patients had abnormal PFT and all had restrictive type of involvement. Ten of these 12 patients had abnormal HRCT and the remaining two patients had normal HRCT. On the other hand, eight patients with normal PFT had abnormalities on HRCT. Conclusion: Patients with early AS frequently have abnormalities on HRCT, even though they have normal PFT and chest X-ray. Small airway involvement was found as frequent as interstitial lung disease in early AS.

  8. Alternative Treatments for Ankylosing Spondylitis

    ... fractures and neurological complications, especially in individuals with fusion (extra bone growth) due to spondylitis. — "Ankylosing Spondylitis: ... Chen. (2007) Anterior and Posterior Fixation of a Cervical Fracture Induced by Chiropractic Spinal Manipulation in Ankylosing ...

  9. Genetics Home Reference: ankylosing spondylitis

    ... A variation of the HLA-B gene called HLA-B27 increases the risk of developing ankylosing spondylitis . Although many people with ankylosing spondylitis have the HLA-B27 variation, most people with this version of the ...

  10. Role of diffusion-weighted imaging in early ankylosing spondylitis

    PAN Chu; HU Dao-yu; ZHANG Wei; LI Xiao-ming

    2013-01-01

    Background With the advanced MRI techniques,pathologic features can be detected at an early stage and quantitatively evaluated,resulting in the advantages of early diagnosis and prompt treatment.This study aimed to determine the value of diffusion-weighted MR imaging (DWl) in detection of early ankylosing spondylitis (AS) and investigate the characteristic manifestations of AS on whole body DWl (WB-DWl).Methods Twenty patients with the diagnosis of early AS,twenty patients with low back pain (LBP),and twenty-five healthy volunteers were included in this study.The subchondral bone apparent diffusion coefficients (ADC) among these groups in the bilateral ilia and sacrum along the sacroiliac joints were compared.An independent sample t-test was utilized to analyze ADC value differences among groups.P-values less than 0.05 denoted statistical significance.The mean ADC values of focal DWI lesions in AS patients were also measured.Whole body diffusion-weighted imaging was performed in fifteen additional AS patients,and analyzed with MIP and MPR techniques in comparison to conventional MR images in order to evaluate the ability to detect AS lesions with whole body DWI.Results Mean ADC values in AS patients were (0.518±0.122)x10-3 mm2/s in the ilium and (0.503±0.168)x10-3 mm2/s in the sacrum.These were significantly greater than the values measured in the ilium and sacrum of LBP patients,(0.328±0.053)x10-3 mm2/s in the ilium and (0.311±0.081)x10-3 m2/s in the sacrum,and control group,(0.325±0.015)x10-3 mm2/s in the ilium and (0.318±0.011)x10-3 mm2/s in the sacrum respectively.No statistically significant differences were found between LBP group and control group.The mean ADC value of focal DWI lesions in early AS patients was (0.899±0.265)x10-3 mm2/s,which was significantly higher than that of adjacent normal-appearance areas ((0.454±0.079)x103 mm2/s).WB-DWI detected abnormalities in the 15 additional AS patients both within the sacroiliac joints and at other sites

  11. Imaging in ankylosing spondylitis

    Østergaard, Mikkel; Lambert, Robert G W

    2012-01-01

    Imaging is an integral part of the management of patients with ankylosing spondylitis and axial spondyloarthritis. Characteristic radiographic and/or magnetic resonance imaging (MRI) findings are key in the diagnosis. Radiography and MRI are also useful in monitoring the disease. Radiography is the...

  12. Ankylosing Spondylitis: a Reflection and a Question

    Annia Deysi Hernández Martín

    2014-07-01

    Full Text Available Ankylosing spondylitis is a chronic inflammatory disease that affects the synovial membrane, joint entheses and para-articular structures of the spine, including the sacroiliac joints and limbs. We present a case of ankylosing spondylitis that had evolved for 12 years despite the relatively early diagnosis and treatment, showing flexion deformity and limitation of spinal movements. On radiological examination an early evolution to ankylosis was observed, which motivated us to make a reflection and a question.

  13. Treatment of ankylosing spondylitis

    SARI, İSMAİL; ÖZTÜRK, MEHMET AKİF; Akkoç, Nurullah

    2015-01-01

    Abstract: Ankylosing spondylitis is a chronic, inflammatory, rheumatic disease that can reduce the quality of life and increase the risk of disability and mortality. It also causes direct and indirect economic losses due to health expenses and as a result of workforce loss. Management of this disease consists of pharmacological and nonpharmacological modalities. Until recently, pharmacological treatment options have been very limited. However, development of novel biological drugs revolutioni...

  14. Use of static lung mechanics to identify early pulmonary involvement in patients with ankylosing spondylitis.

    Aggarwal A

    2001-04-01

    Full Text Available AIM: To assess if a detailed analysis of lung mechanics could help in early recognition of pulmonary abnormalities in patients with ankylosing spondylitis. METHODS: Static pulmonary mechanics were studied in 17 patients (16 men and one woman of ankylosing spondylitis with no obvious clinical or radiological evidence of pulmonary involvement. Lung pressure-volume relationship was generated using a whole body plethysmograph, and a monoexponential equation fitted to this data. RESULTS: Total lung capacity (TLC was reduced in one (5.9% and static lung compliance (Cst in nine (52.9% patients. Four (23.5% patients had normal TLC, yet Cst and shape constant (K were reduced. Five (29.4% patients had reduced TLC and Cst; four of them had low K. One (5.9% patient had normal TLC but elevated Cst and K. CONCLUSIONS: Pulmonary involvement in patients with ankylosing spondylitis is probably diffuse and begins much earlier than generally presumed. Evaluation of static lung mechanics can identify pulmonary involvement early in the course of disease in several of these patients.

  15. Cardiopulmonary Manifestations of Ankylosing Spondylitis

    Mahnaz Momeni; Nora Taylor; Mahsa Tehrani

    2011-01-01

    Ankylosing spondylitis is a chronic inflammatory condition that usually affects young men. Cardiac dysfunction and pulmonary disease are well-known and commonly reported extra-articular manifestation, associated with ankylosing spondylitis (AS). AS has also been reported to be specifically associated with aortitis, aortic valve diseases, conduction disturbances, cardiomyopathy and ischemic heart disease. The pulmonary manifestations of the disease include fibrosis of the upper lobes, intersti...

  16. Symptoms of Ankylosing Spondylitis

    ... Spondylitis About the Spondylitis Association of America Join Today Renew Your Membership Contact Us News Who We Are Major Accomplishments Publications / Educational Materials Research Advocacy Connect with Others Support Groups Message Boards / ...

  17. Diagnosis of Ankylosing Spondylitis

    ... Spondylitis About the Spondylitis Association of America Join Today Renew Your Membership Contact Us News Who We Are Major Accomplishments Publications / Educational Materials Research Advocacy Connect with Others Support Groups Message Boards / ...

  18. Current radiodiagnostic concept of ankylosing spondylitis

    Nine radiodiagnostic rules are drawn from the X-rays of 2125 ankylosing spondylitis patients. The significance of early diagnosis of the 'multicolored' sacroiliac X-ray is looked onto; the syndesmophyte, squaring-phenomen, barrel-shaped vertebra, Romanus and Andersson lesions, and the ossification of ligaments are discussed. The changes at the apophyseal and the costovertebral joints, unimportant for early diagnosis, are explored. (orig.)

  19. Early Cardiac Valvular Changes in Ankylosing Spondylitis: A Transesophageal Echocardiography Study

    Park, So-Hee; Joe, Byung-Hyun; Hwang, Hui-Jeong; Park, Chang-Bum; Jin, Eun-Sun; Cho, Jin-Man; Kim, Chong-Jin; Bae, Jong-Hoa; Lee, Sang-Hoon

    2012-01-01

    Background This study was conducted to determine the early cardiac valvular changes in young male ankylosing spondylitis (AS) patients. Methods A total of 70 AS patients on treatment without clinical cardiac symptoms were divided into group I (< 10 years, n = 50) and group II (≥ 10 years, n = 20) depending on their disease duration after first diagnosis. Twenty-five healthy volunteers were selected as control subjects. All the subjects underwent transthoracic and transesophageal echocardiography, electrocardiography, and rheumatologic evaluation for AS patients. Results The thickness of both the aortic and mitral valve was more increased in AS patients than in controls. Aortic valve thickness over 1.3 mm could predict AS with a sensitivity of 73% and specificity of 76%. The prevalence of aortic valve thickening was higher in the AS group compared to the controls. The prevalence of aortic and mitral regurgitation was very low and there was no difference between the controls and the patients. The aortic valve thickening was related to longer disease duration, high blood pressure, disease activity and inflammatory markers. Conclusion Thickening of the aortic and mitral valve was observed without regurgitation in male AS patients early in the course of their disease without clinical cardiac manifestations. This subclinical change of aorto-mitral valve in early AS should be considered and followed up to determine its prognostic implication and evolution. PMID:22509436

  20. [Diagnosis and approach in suspected ankylosing spondylitis].

    Rentsch, H U; van der Linden, S; Gerber, N

    1991-05-21

    The time interval from first clinical symptoms to definite diagnosis of ankylosing spondylitis (Morbus Bechterew) is still too long. Thus, many years for essential therapeutic interventions are unequivocally lost. Therefore, it is most important to improve early diagnosis. To this aim the diagnostic criteria recently suggested by van der Linden are useful in relatively early stages of disease (table 1). Diagnosis is based on patient history, clinical examination and radiological signs of sacroiliitis. Blood examinations for ESR, rheumatoid factors and antinuclear antibodies are important with regard to differential diagnosis. The determination of the HLA-B27 haplotype as a diagnostic tool is irrelevant on terms of single cases, because at least 8% of ankylosing spondylitis patients are HLA-B27-negative and in middle europe at least 7% of normal controls exhibit this genetic marker. PMID:2052824

  1. Cardiopulmonary Manifestations of Ankylosing Spondylitis

    Mahnaz Momeni

    2011-01-01

    Full Text Available Ankylosing spondylitis is a chronic inflammatory condition that usually affects young men. Cardiac dysfunction and pulmonary disease are well-known and commonly reported extra-articular manifestation, associated with ankylosing spondylitis (AS. AS has also been reported to be specifically associated with aortitis, aortic valve diseases, conduction disturbances, cardiomyopathy and ischemic heart disease. The pulmonary manifestations of the disease include fibrosis of the upper lobes, interstitial lung disease, ventilatory impairment due to chest wall restriction, sleep apnea, and spontaneous pneumothorax. They are many reports detailing pathophysiology, hypothesized mechanisms leading to these derangements, and estimated prevalence of such findings in the AS populations. At this time, there are no clear guidelines regarding a stepwise approach to screen these patients for cardiovascular and pulmonary complications.

  2. Pulmonary involvement in ankylosing spondylitis.

    Feltelius, N; Hedenström, H; Hillerdal, G; Hällgren, R

    1986-01-01

    Thirty two patients with ankylosing spondylitis were investigated with a set of pulmonary function tests and the results compared with those for a control population. The patients had no complaints about lung symptoms and their chest radiographs were normal. The main pathological findings were reduced lung volumes, a raised closing volume/vital capacity ratio, and a decreased volumic airway conductance. The lung volume reduction correlated with disease duration, thoracic mobility, and degree ...

  3. Early pulmonary involvement in ankylosing spondylitis: Assessment with thin-section CT

    Turetschek, Karl; Ebner, Wolfgang; Fleischmann, Dominik; Wunderbaldinger, Patrick; Erlacker, Ludwig; Zontsich, Thomas; Bankier, Alexander A

    2000-08-01

    AIM: To determine the frequency and the distribution of early pulmonary lesions in patients with ankylosing spondylitis (AS) and a normal chest X-ray on thin-section CT and to correlate the CT findings with the results of pulmonary function tests and clinical data. MATERIALS AND METHODS: Twenty-five patients with clinically proven AS and no history of smoking underwent clinical examinations, pulmonary function tests (PFT), chest radiography, and thin-section CT. Four of 25 patients (16%), who had obvious signs on plain films suggestive of pre-existing disorders unrelated to AS were excluded. RESULTS: Fifteen of 21 patients (71%) had abnormalities on thin-section CT. The most frequent abnormalities were thickening of the interlobular septa in seven of 21 patients (33%), mild bronchial wall thickening in (6/21, 29%), pleural thickening and pleuropulmonary irregularities (both 29%) and linear septal thickening (6/21, 29%). In six patients there were no signs of pleuropulmonary involvement. Eight of 15 patients (53%) with abnormal and four of six patients (67%) with normal CT findings revealed mild restrictive lung function impairment. CONCLUSION: Patients with AS but a normal chest radiograph frequently have abnormalities on thin-section CT. As these abnormalities are usually subtle and their extent does not correlate with functional and clinical data, the overall routine impact of thin-section CT in the diagnosis of AS is limited. Turetschek, K., (2000)

  4. Early pulmonary involvement in ankylosing spondylitis: Assessment with thin-section CT

    AIM: To determine the frequency and the distribution of early pulmonary lesions in patients with ankylosing spondylitis (AS) and a normal chest X-ray on thin-section CT and to correlate the CT findings with the results of pulmonary function tests and clinical data. MATERIALS AND METHODS: Twenty-five patients with clinically proven AS and no history of smoking underwent clinical examinations, pulmonary function tests (PFT), chest radiography, and thin-section CT. Four of 25 patients (16%), who had obvious signs on plain films suggestive of pre-existing disorders unrelated to AS were excluded. RESULTS: Fifteen of 21 patients (71%) had abnormalities on thin-section CT. The most frequent abnormalities were thickening of the interlobular septa in seven of 21 patients (33%), mild bronchial wall thickening in (6/21, 29%), pleural thickening and pleuropulmonary irregularities (both 29%) and linear septal thickening (6/21, 29%). In six patients there were no signs of pleuropulmonary involvement. Eight of 15 patients (53%) with abnormal and four of six patients (67%) with normal CT findings revealed mild restrictive lung function impairment. CONCLUSION: Patients with AS but a normal chest radiograph frequently have abnormalities on thin-section CT. As these abnormalities are usually subtle and their extent does not correlate with functional and clinical data, the overall routine impact of thin-section CT in the diagnosis of AS is limited. Turetschek, K., (2000)

  5. Diagnosis of Ankylosing Spondylitis

    ... Reactive Arthritis Enteropathic Arthritis Blood Work and the HLA-B27 Test First, HLA-B27 is a perfectly normal gene found in 8% ... Secondly, it is important to note that the HLA-B27 test is not a diagnostic test for ankylosing ...

  6. Isoxicam vs ketoprofen in ankylosing spondylitis

    Doury, P.; Roux, H.

    1986-01-01

    1 Isoxicam, 200 mg once daily, was compared to ketoprofen, 100 mg three times daily, in 19 patients (16 males, three females) with ankylosing spondylitis in a 30-day, double-blind study conducted in two centres.

  7. Employment perspectives of patients with ankylosing spondylitis

    Chorus, A.; Boonen, A; Miedema, H; Linden, S.

    2002-01-01

    Objectives: To assess the labour market position of patients with ankylosing spondylitis (AS) in relation to disease duration and to identify potential factors in relation to withdrawal from the labour force.

  8. Clearance of inhaled particles in ankylosing spondylitis.

    Farquhar, D R; Chamberlain, M. J.; McCain, G A; Morgan, W K

    1989-01-01

    Patients with ankylosing spondylitis may uncommonly develop apical fibrobullous lung disease, the cause of which is unknown. It is postulated here that rigidity of the thoracic cage leads to reduced apical clearance of inhaled particles and may thereby predispose to chronic infection. Deposition and clearance of inhaled technetium-99m sulphur colloid particles were studied in eight male patients with ankylosing spondylitis who had chest wall rigidity (mean (SD) chest expansion 1.8 (1.07) cm) ...

  9. Management of Pregnancy with Ankylosing Spondylitis

    Qian Zhou; Xu-ming Bian; Jun-tao Liu

    2012-01-01

    To discuss the interaction between pregnancy and ankylosing spondylitis,and the management of pregnancy with ankylosing spondylitis.Methods Twelve cases of pregnancy with ankylosing spondylitis in Peking Union Medical College Hospital from September 2004 to July 2011 were analyzed retrospectively,focusing on the arteritis condition,pregnancy complications,and outcomes.Results All the 12 patients had full-term pregnancy.Five cases gave birth naturally,and 7 cases received cesarean section for maternity factors.No adverse pregnancy outcomes were encountered.Waist pain appeared in 2 cases in the second trimester,for both of which medication failed.One of the 2 cases had natural childbirth,while the other maintained pregnancy smoothly to cesarean section.Conclusions Pregnancy monitoring can help obtain favorable pregnancy outcomes.Attention should be paid to postpartum change of the illness.

  10. Coexistence of Ankylosing Spondylitis and Klinefelter's Syndrome

    Şenol Kobak

    2013-01-01

    Full Text Available Ankylosing spondylitis is a chronic inflammatory disease characterized by inflammatory lower back pain and morning stiffness and accompanied by spine and sacroiliac joint involvement. Klinefelter's syndrome is a genetic condition that only affects males. Affected males have an extra X chromosome. This paper reports a 30-years-old male on followup with the diagnosis of Klinefelters syndrome. The patient admitted with complaints of inflammatory lower back, and neck pain and morning stiffness and was diagnosed with ankylosing spondylitis. Nonsteroidal anti-inflammatory drug and salazopyrine treatment resulted in significant regression in his complaints.

  11. Magnetic resonance imaging for ankylosing spondylitis

    Ankylosing spondylitis (AS) is the prototypical form of the spondyloarthropathies, which at a prevalence of 2% is among the most frequent rheumatic diseases. Spondyloarthropathy comprises the following five disorders: AS, reactive arthritis, psoriatic arthritis, enteropathic arthritis in Crohn's disease, and ulcerosing colitis as well as undifferentiated spondyloarthropathy. In 99% of the patients with AS initial abnormal findings affect the sacroiliac joints. The radiographic changes required for diagnosing AS occur as late as 5-9 years after the onset of clinical symptoms. MRI of the sacroiliac joints reliably demonstrates both chronic inflammatory changes (erosions, sclerotic changes, bone bridges) and acute inflammatory changes (synovitis, capsulitis, osteitis) and allows for grading the chronicity and acuity of such changes. Enthesitis of the interosseous ligaments of the retroarticular space is a manifestation of AS. Spondylodiscitis (Andersson 1937) may occur as an inflammatory or non-inflammatory process (transdiscal fatigue fracture). Inflammations of the facet and costospinal joints developing into ankylosis are typical of AS. Changes of the vertebral bodies occur as anterior (Romanus 1952), posterior, and marginal spondylitis. All forms of spondyloarthropathies are furthermore characterized by asymmetrical synovitis of the large joints, particularly of the legs (gonarthritis, coxitis, tarsitis, peripheral oligoarthritis), rheumatic fibroosteitis (pelvic enthesitis, rheumatic calcaneopathy), and peri- and synchrondritis of the public symphisis and sternal synchondrosis. Since early inflammatory changes of the spinal column and of the extravertebral localizations in AS are demonstrated by MRI before they become apparent on radiographs, and thereby the diagnostic gap could be closed, the early use of MRI for diagnostic and follow-up is commendable, when new therapeutical options like the so-called 'biologicals' are employed. (orig.)

  12. Infertility improved by etanercept in ankylosing spondylitis

    Rezvani Aylin; Ozaras Nihal

    2008-01-01

    The effect of TNF-α and TNF-α antagonists on semen quality in men is controversial. TNF-α levels are usually low in seminal plasma, but they tend to increase in inflammatory and infectious diseases. Etanercept is a highly-specific antagonist of TNF-α. In this report, we describe the development of pregnancy in a couple with a previously infertile husband, who received etanercept for ankylosing spondylitis.

  13. ANKYLOSING SPONDYLITIS IN THE VOLGA BULGARIA

    D. I. Abdulganieva

    2015-09-01

    Full Text Available There is much evidence that ankylosing spondylitis (AS is a disease that is also much older than early human civilizations and man as a whole. Until now, the Russia's earliest (14th c ntury archaeological finding of such a patient remains a Volga Bulgaria inhabitant suffering with AS during his life. In the Republic of Tatarstan, at the site of an ancient Bulgar settlement appearing in the early ninth century, archaeologists have discovered an unusual grave: the deceased sitting with his back against the western wall of a tomb pitand having a bronze crosslet under his fingers. According to a historical source, it was the way of burying Christian hierarchs as pastors sitting on the altar and anticipating the great assize during which the destinies of human souls should be ruled. Anthropological analysis showed that the bones belonged to a 35–45-year-old man who was 158–163 cm tall. During the examination of the remains,attention was called to the following features of the spinal structure: ankylosis of the inferior cervical and superior thoracic vertebrae (СV–ThI and inferior thoracic and lumbar spine (ThIV–LII predominantly due to ossification of the anterior longitudinal ligament. Facet vertebral joints and costotransverse joints were also ankylosed at the same levels. The man's neck was fixed in a bent-over position with the head down, the chin touching the breast bone – the socalled soliciting posture. By and large, the vertebral changes are characteristic of late (X-ray stage III spondylitis. Spinal and pelvic photos and X-films are given for demonstration. The studies conducted by historical scientists and forensic medical experts suggest that the found remains are most likely to belong to Christian Theodore nicknamed Jerusaleman, also further known as Holy Theodore philosopher Kamsky (Bulgarian, who was mentioned in the Nikon chronicle in 1323.

  14. EXPERIENCE WITH RITUXIMAB IN PATIENTS WITH ANKYLOSING SPONDYLITIS

    Mikhail Sergeyevich Protopopov

    2013-02-01

    Full Text Available Objective: to analyze the efficacy of rituximab (RTM in patients with active ankylosing spondylitis (AS resistant to conventional therapy. Subjects and methods. The trial enrolled 10 male patients with the reliable and valid diagnosis of AS who received therapy with RTM used in cases of steadily high AS activity, resistance to standard therapy, and contraindications to the use of tumor necrosis factor-α inhibitors. The number of patients meeting the Assessment of Spondyloarthritis International Society (ASAS criteria for 20% improvements 24 weeks after treatment initiation was the main indicator of therapeutic effectiveness. Results. After 24-week therapy, 7 and 4 of the 10 patients showed 20 and 40% improvements, respectively; and 2 patients had partial remission according to the ASAS criteria. During the treatment, the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI significantly decreased (p = 0.046, the Bath Ankylosing Spondylitis Functional Index (BASFI remained substantially unchanged. Treatment response did not depend on the development of an early (at 2 weeks complete depletion of CD20 lymphocytes. No significant effect could be achieved in patients with high baseline BASDAI and BASFI scores. Conclusion. RTM used patients with AS can ensure clinical improvement and even remission in a number of cases; however, it is unpromising in cases of high disease activity and severe functional failure.

  15. Height and weight are correlated with lumbar spinal bone mineral contents and densities in Chinese adolescents with early ankylosing spondylitis

    MA Xing; HU Yun-yu; MA Xiang-dong; WANG Quan-ping; LI Xiao-juan; LU Rong; WANG Jun; XU Xin-zhi

    2004-01-01

    Objective: To explore the possible factors influencing lumbar spinal bone mineral contents and bone mineral densities in Chinese adolescents with early ankylosing spondylitis(AS). Methods: Thirty-one male Chinese adolescent outpatients with early AS were included and compared with 31 age-matched male controls. Age (year), height (cm), total body weight (kg) together with body mass index (BMI, kg/m2 ) of all subjects and disease duration (month), BASMI,BASFI, BASDAI, SASSS as well as ESR (mm/h) of AS patients were obtained. Lumbar2-4 bone mineral content (L2-4BMC, g) and lumbar2-4 areal bone mineral density (L2-4 BMD, g/cm2 ) were evaluated using dual-energy X-ray absorptiometry (DEXA) with Lunar DPX-IQ device and lumbar2-4 volumetric bone mineral apparent density (L2-4 BMAD, g/cm3 )was subsequently calculated. Correlation and multiple regression analyses were performed. Results: Compared with 31 agematched male controls, AS patients had significantly lower L2-4 BMD [ (0. 984 ± 0.142) g/cm2 vs ( 1.055 ± 0. 137) g/cm2,P = 0.049 ] and L2- 4 BMAD [ (0. 1527 ± 0. 0173) g/cm3 vs (0. 1630 ± 0. 0195) g/cm3, P = 0. 032 ]. In AS patients,multiple regression analysis identified that only the factor of height was significantly correlated with L2- 4 BMC ( R = 0. 673,P = 0.000) and the factor of weight had predominant influences on L2-4 BMD ( R = 0. 620, P = 0. 000) as well as L2-4BMAD (R=0.510, P = 0.003). Conclusion: The young patients with early AS had marked reduction in lumbar spine bone mineral densities, which indicated an important primary event leading to osteoporosis. Positive effects of height and weight on lumbar spine bone mass and densities could expectantly make favorable contributions to early prevention of AS associated bone loss and subsequent osteoporosis.

  16. The scintigraphic investigation of the sacroiliac joints in ankylosing spondylitis

    Quantitative sacroiliac scintigraphy was performed in 41 patients with ankylosing spondylitis (Sp.a.) and in 90 control subjects. The sacroiliac/sacrum ratio (Intex ISG/sacrum) was calculated. We examined the correlation between activity ratio on the one hand and age, subjective complaints, erythrocyte sedimentation rate, and antiinflammatory therapy on the other. Significantly increased uptakes were found in the patient group as a whole compared with the controls. The activity index was highest in the early periods of the disease, so we conclude that scintigraphy is useful in the early diagnosis of Sp.a. (orig.)

  17. PRIMARY CEMENTLESS TOTAL HIP ARTHROPLASTY IN ANKYLOSING SPONDYLITIS

    Nageshwara Rao; Ravikumar

    2015-01-01

    INTRODUCTION Ankylosing Spondylitis (AS), family of Spondyloarthritides (SpAs), is a chronic inflammatory disease affecting the axial skeleton, the entheses and occasionally the peripheral joints. The shoulders and hips are considered axial joints and involvement occurs in up to 50% of patients and is more common than involvement of the more distal joints. Aim of our study is to evaluate outcome of Cementless Total Hip Arthroplasty (THA) in ankylosing spondylitis. MAT...

  18. Histocompatibility antigens in psoriasis, psoriatic arthropathy, and ankylosing spondylitis.

    Armstrong, R D; Panayi, G. S.; Welsh, K I

    1983-01-01

    Patients with ankylosing spondylitis, psoriatic arthritis, and psoriasis alone were typed for HLA A, B, Cw, and DR antigens, and the antigen frequencies were compared with those in a normal control population and in patients with rheumatoid arthritis. Patients with psoriasis had a significantly raised frequency of Cw6. Those with arthritis in addition to their psoriasis also had raised frequencies of B27 and DR7. Patients with ankylosing spondylitis were characterised by the expected high fre...

  19. Danish recommendations on treatment of ankylosing spondylitis and spondyloarthritis based on multinational project initiative

    Pedersen, Susanne Juhl; Madsen, Ole Rintek; Erlendsson, J.; Schiottz-Christensen, B.; Sørensen, Inge Juul; Andersen, L.S.; Østergaard, Morten

    2008-01-01

    INTRODUCTION: The multinational initiative "3e Initiative in Rheumatology - Multi-national Recommendations for the Management of Ankylosing Spondylitis 2006-7" served the primary purpose of providing specific recommendations for the management of ankylosing spondylitis and spondyloarthritis...

  20. Autophagy in the pathogenesis of ankylosing spondylitis.

    Ciccia, Francesco; Haroon, Nigil

    2016-06-01

    The pathogenesis of ankylosing spondylitis (AS) is not well understood, and treatment options have met with limited success. Autophagy is a highly conserved mechanism of controlled digestion of damaged organelles within a cell. It helps in the maintenance of cellular homeostasis. The process of autophagy requires the formation of an isolation membrane. They form double-membraned vesicles called "autophagosomes" that engulf a portion of the cytoplasm. Beyond the role in maintenance of cellular homeostasis, autophagy has been demonstrated as one of the most remarkable tools employed by the host cellular defense against bacteria invasion. Autophagy also affects the immune system and thus is implicated in several rheumatic disease processes. In this article, we explore the potential role of autophagy in the pathogenesis of AS. PMID:27075464

  1. Pulmonary involvement in ankylosing spondylitis assessed by multidetector computed tomography

    Ankylosing spondylitis (AS) may present with extra-articular involvement in the lungs. We aimed to evaluate the abnormal pulmonary multidetector computed tomography findings of patients with AS and compare them with the clinical symptoms, duration of illness, laboratory results and pulmonary function tests (PFT). We evaluated the chest multidetector computed tomography (MDCT) findings of 41 patients with ankylosing spondylitis (AS) and compared them with pulmonary function test (PFT) results, demographic characteristics, duration of illness and laboratory findings that we were able to obtain. The most common abnormalities were nodules, peribronchial thickening, pleural thickening and bronchiectasis. Abnormalities occurred in 96.87% of patients in the early AS group and 77.8% of patients in the late AS group. Patients with early AS included asymptomatic individuals with normal PFT results and abnormal MDCT findings. The use of MDCT in AS patients may be beneficial for the evaluation of pulmonary disease, even in asymptomatic patients without any PFT abnormalities and those in the early stages of the disease

  2. Hydrosyringomyelia in an Ankylosing Spondylitis Patient After Stabilization Surgery

    Deniz Oke Topcu

    2013-08-01

    Full Text Available Ankylosing Spondylitis (AS is a chronic, systemic, and autoimmune inflammatory disease which mainly affects axial skeleton. Despite current approaches in ankylosing spondylitis treatment, the disease frequently causes to thoracolumbar kyphotic deformity due to its progressive course. Many surgical procedures including decompression, stabilization and final fusion could be performed for the treatment of kyphotic deformity. Hydromyelia and syrinx are the terms used to define dilatation in central spinal cord. Some authors reported syringomyelia progression related to spinal operation. In our case; 48-year-old woman, who has been followed for ankylosing spondylitis; spinal cord injury secondary to syringomyelia was detected 7 years after stabilization surgery. Consequently, it should be kept in mind that syringomyelia, which is a rare complication, may develop in patients who underwent stabilization surgery.

  3. Integrative Structural Biomechanical Concepts of Ankylosing Spondylitis

    Alfonse T. Masi

    2011-01-01

    Full Text Available Ankylosing spondylitis (AS is not fully explained by inflammatory processes. Clinical, epidemiological, genetic, and course of disease features indicate additional host-related risk processes and predispositions. Collectively, the pattern of predisposition to onset in adolescent and young adult ages, male preponderance, and widely varied severity of AS is unique among rheumatic diseases. However, this pattern could reflect biomechanical and structural differences between the sexes, naturally occurring musculoskeletal changes over life cycles, and a population polymorphism. During juvenile development, the body is more flexible and weaker than during adolescent maturation and young adulthood, when strengthening and stiffening considerably increase. During middle and later ages, the musculoskeletal system again weakens. The novel concept of an innate axial myofascial hypertonicity reflects basic mechanobiological principles in human function, tissue reactivity, and pathology. However, these processes have been little studied and require critical testing. The proposed physical mechanisms likely interact with recognized immunobiological pathways. The structural biomechanical processes and tissue reactions might possibly precede initiation of other AS-related pathways. Research in the combined structural mechanobiology and immunobiology processes promises to improve understanding of the initiation and perpetuation of AS than prevailing concepts. The combined processes might better explain characteristic enthesopathic and inflammatory processes in AS.

  4. Ankylosing Spondylitis Associated With Bilateral TMJ Ankylosis

    Song, Ju Seop; Koh, Kwang Joon [Dept. of Oral and Maxillofacial Radiology, School of Dentistry, Chonbuk National University, Iksan (Korea, Republic of)

    2000-09-15

    A 31-year-old male with severe limitation of mouth opening was referred to our department of Chonbuk National University Hospital. The physical status of the patient was hyposthenic. Extraoral examination showed no condylar movement of the both temporomandibular joints, no pain, no faical swelling or paresthesia. Intraoral examination showed several cervical caries on the upper anterior teeth, and gingival swelling on the whole dentition. Transcranial view showed no condylar movement, and narrowing of joint spaces. Chest P-A view showed straightening of thoracic, lumbar spine, and squaring of vertebrae of the same spines. Conventional lateral radiograph of cervical spine showed calcification of the intervertebral ligament. Computed tomograph showed extensive bone formation between temporal bone and the both condylar heads. Labortory findings showed positive reaction on HLA-B27 histocompatibility antigen and increased level of IgA, IgG, ESR. Based on the clinical, radiographic, and the labortary findings, final diagnosis was made as bony ankylosis of the both temporomandibular joints secondary to ankylosing spondylitis.

  5. Investigating the genetic association between ERAP1 and ankylosing spondylitis

    Harvey, D.; Pointon, JJ; Evans, DM; Karaderi, T; Farrar, C; Appleton, LH; Sturrock, RD; Stone, MA, Charpentier G, Doggen K, Kuss O, Lindblad U, Kellner C, Nolan J, Pazderska A, Rutten G, Trento M, Khunti K; Oppermann, U.; Brown, MA; Wordsworth, BP

    2009-01-01

    A strong association between ERAP1 and ankylosing spondylitis (AS) was recently identified by the Wellcome Trust Case Control Consortium and the Australo-Anglo-American Spondylitis Consortium (WTCCC-TASC) study. ERAP1 is highly polymorphic with strong linkage disequilibrium evident across the gene. We therefore conducted a series of experiments to try to identify the primary genetic association(s) with ERAP1. We replicated the original associations in an independent set of 730 patients and 10...

  6. Perinatal characteristics, older siblings, and risk of ankylosing spondylitis

    Lindström, Ulf; Forsblad-d'Elia, Helena; Askling, Johan;

    2016-01-01

    BACKGROUND: The effect of circumstances and exposures early in life on the risk of developing ankylosing spondylitis (AS) is largely unknown. The purpose of this study was to determine whether perinatal characteristics predict development of AS. METHODS: AS cases (n = 1960; 59 % men) were defined....... Odds ratios (OR) for developing AS were determined through conditional logistic regression, with regard to: birth weight, birth order, season of birth, maternal age, gestational length, size for gestational age, type of birth, mode of delivery, congenital malformations, mothers' country of birth......, mothers' civil status and size of delivery unit. RESULTS: In the univariate analyses statistically significant increases in risk for developing AS were observed for having older siblings (OR 1.18; 95 % Cl 1.06-1.30). No association was observed for the remainder of analysed exposures, although there was a...

  7. Do sex hormones play a role in ankylosing spondylitis?

    Masi, A T

    1992-02-01

    Ankylosing spondylitis (AS) has a striking disease marker, i.e., HLA-B27, indicating the major genetic predisposition; however, expression of disease is also strongly influenced by age- and sex-related factors. Sex steroids studies suggest greater androgenicity in AS than normal control persons. Therapeutic interventions that normalize such sex steroid status have shown clinical improvements in males and females. Muscle histopathology in AS shows frequent changes early in disease consistent with neuropathic and myopathic mechanisms of a noninflammatory nature. Accepting the available, aggregate data, one may infer that sex steroid imbalance in persons susceptible to AS may target axial and proximal muscle tissues, resulting in relative functional hypertonicity. Such phenomenon, developing in preteen and younger adult ages, may contribute to peripheral and axial manifestations of enthesopathy in this disease by complex and currently unknown mechanisms. PMID:1561401

  8. Optimizing physical therapy for ankylosing spondylitis: a case study in a young football player

    Tricás-Moreno, José Miguel; Lucha-López, María Orosia; Lucha-López, Ana Carmen; Salavera-Bordás, Carlos; Vidal-Peracho, Concepción

    2016-01-01

    [Purpose] Ankylosing spondylitis is prevalent in men. Modern and expert consensus documents include physical therapy among the strategies for the treatment of ankylosing spondylitis. This study aimed to describe the physical therapy approach in an athlete with ankylosing spondylitis. [Subject and Methods] The patient, refractory to treatment with anti-inflammatory medication, showed pelvic and lumbar pain and joint, muscle, and functional disorders, which were treated with orthopedic joint mobilization, dry needling, exercise, and whole-body hyperthermia. [Results] After the treatment, pain relief, normal joint mobility, improved muscle function, and return to activities of daily living and competitive sporting activities were recorded. [Conclusion] The literature provides evidence for the use of joint mobilization techniques; however, no previous studies have used the same techniques and methods. There is no previous evidence for the use of dry needling in this pathology. Exercise therapy has a higher level of evidence, and guidelines with scientific support were followed. This research confirms the effectiveness of hyperthermia for arthritis. The early stage of ankylosing spondylitis, and the young age, good overall condition, and cooperative attitude of the patient led to positive outcomes. In conclusion, a favorable response that promoted the remission of the disease was observed. PMID:27190490

  9. Optimizing physical therapy for ankylosing spondylitis: a case study in a young football player.

    Tricás-Moreno, José Miguel; Lucha-López, María Orosia; Lucha-López, Ana Carmen; Salavera-Bordás, Carlos; Vidal-Peracho, Concepción

    2016-04-01

    [Purpose] Ankylosing spondylitis is prevalent in men. Modern and expert consensus documents include physical therapy among the strategies for the treatment of ankylosing spondylitis. This study aimed to describe the physical therapy approach in an athlete with ankylosing spondylitis. [Subject and Methods] The patient, refractory to treatment with anti-inflammatory medication, showed pelvic and lumbar pain and joint, muscle, and functional disorders, which were treated with orthopedic joint mobilization, dry needling, exercise, and whole-body hyperthermia. [Results] After the treatment, pain relief, normal joint mobility, improved muscle function, and return to activities of daily living and competitive sporting activities were recorded. [Conclusion] The literature provides evidence for the use of joint mobilization techniques; however, no previous studies have used the same techniques and methods. There is no previous evidence for the use of dry needling in this pathology. Exercise therapy has a higher level of evidence, and guidelines with scientific support were followed. This research confirms the effectiveness of hyperthermia for arthritis. The early stage of ankylosing spondylitis, and the young age, good overall condition, and cooperative attitude of the patient led to positive outcomes. In conclusion, a favorable response that promoted the remission of the disease was observed. PMID:27190490

  10. Risk factors of uveitis in ankylosing spondylitis

    Sun, Li; Wu, Rui; Xue, Qin; Wang, Feng; Lu, Peirong

    2016-01-01

    Abstract Background: Uveitis is the most common extra-articular manifestation in patients with ankylosing spondylitis (AS). The prevalence and characteristics of uveitis in AS have been studied in previous literatures, whereas its associated risk factors have not been clarified. Therefore, this study analyzed the risk factors of uveitis in patients with AS. Methods: A total of 390 patients with AS who fulfilled the modified New York criteria were enrolled from January to December in 2015. The history of uveitis was accepted only if diagnosed by ophthalmologists. The medical records of the patients were retrospectively reviewed and associated information was collected, such as disease duration, HLA-B27, and the number of peripheral arthritis. Hip-joint lesion was identified by imaging examination. Meanwhile, biochemical examinations were performed to determine the patient's physical function. Results: Of 390 patients with AS (80.5% male, mean age 33.3 years), 38 (9.7%) had experienced 1 or more episodes of uveitis. The incidence rate for hip-joint lesion was obviously higher for patients with uveitis than the nonuveitis group (44.7% vs 22.2%; P arthritis was also larger for the uveitis group than nonuveitis group (2.18 ± 0.23 vs 0.55 ± 0.04; P HLA-B27, erythrocyte sedimentation rate (ESR), and C-reactive protein (CRP) between the 2 groups. Binary logistic regression results showed that ASO (OR = 12.2, 95% CI:3.6–41.3, P arthritis (OR = 4.1, 95%CI:2.6–6.3, P arthritis, ASO, and CIC may be associated with higher rates of uveitis in AS. The results of this comprehensive analysis suggest that the possible occurrence of uveitis in AS should not be neglected if the patients have those concomitant risk factors. PMID:27428230

  11. Audiovestibular manifestations in patients with ankylosing spondylitis.

    Amor-Dorado, Juan C; Barreira-Fernandez, Maria P; Vazquez-Rodriguez, Tomas R; Gomez-Acebo, Ines; Miranda-Filloy, Jose A; Diaz de Teran, Teresa; Llorca, Javier; Gonzalez-Gay, Miguel A

    2011-03-01

    Ankylosing spondylitis (AS) is a chronic inflammatory disease of unknown origin affecting up to 1% of the population. Little is known about audiovestibular impairment in patients with AS, especially the presence of cochleovestibular dysfunction in these patients. To investigate audiovestibular manifestations in AS, we studied a series of 50 consecutive patients who fulfilled the modified New York diagnostic criteria for AS and 44 matched controls. Individuals with history of cardiovascular disease, cerebrovascular complications, peripheral artery disease, renal insufficiency, syphilis, Meniere and other vestibular syndromes, infections involving the inner ear, barotrauma, or in treatment with ototoxic drugs were excluded. Most patients with AS were men (80%). The mean age at the time of study was 52.5 years, and mean age at the onset of symptoms was 34.4 years. Twenty-nine (58%) patients showed abnormal hearing loss in the audiogram compared to only 8 (18%) controls (p < 0.001). Values of audiometric tests (pure-tone average and speech reception threshold) yielded significant differences between patients and controls (p < 0.001). It is noteworthy that the audiogram shape disclosed a predominant pattern of high-frequency sensorineural hearing loss in AS patients (50%) compared to controls (18%) (p = 0.002). Also, AS patients exhibited abnormal vestibular tests more commonly than controls. AS patients had an increased frequency of head-shaking nystagmus (20%) compared to controls (0%) (p < 0.001). Moreover, patients (26%) showed a significantly increased frequency of abnormal caloric test compared to controls (0%) (p < 0.001). Finally, a significantly increased frequency of abnormal clinical test of sensory integration and balance with a predominant vestibular loss pattern was observed in patients (36%) compared to controls (5%) (p < 0.001). In conclusion, the current study demonstrates strong evidence for inner ear compromise in patients with AS. PMID:21358443

  12. The epidemiology of extra-articular manifestations in ankylosing spondylitis

    Stolwijk, Carmen; Essers, Ivette; van Tubergen, Astrid;

    2015-01-01

    OBJECTIVE: To assess the incidence and risks of common extra-articular manifestations (EAMs), that is, acute anterior uveitis (AAU), psoriasis and inflammatory bowel disease (IBD), in patients with ankylosing spondylitis (AS) compared with population-based controls. METHODS: All incident patients...

  13. Ankylosant spondylitis association and diffuse idiopathic skeletal hyperostosis (DISH)

    We are presenting a 66 year-old patient complaining of low back pain for the last 3 months and cervical pain for the last 45 days, Review of systems showed long standing lumbar and cervical stiffness, Radiological studies were compatible with ankylosing spondylitis and DISH (Diffuse idiopathic Skeletal Hyperostosis). Associations of those diseases are uncommon and reported only few times in the literature

  14. Ankylosing spondylitis and risk of ischaemic heart disease

    Essers, Ivette; Stolwijk, Carmen; Boonen, Annelies;

    2016-01-01

    OBJECTIVE: To investigate the incidence and risk of ischaemic heart disease (IHD) and acute myocardial infarction (AMI), including the role of non-steroidal anti-inflammatory drugs (NSAID), in patients with ankylosing spondylitis (AS) compared with population controls. METHODS: All patients with...

  15. Effect of Pilates training on people with ankylosing spondylitis.

    Altan, L; Korkmaz, N; Dizdar, M; Yurtkuran, M

    2012-07-01

    The objective of this study was to investigate the effects of Pilates on pain, functional status, and quality of life in patients with ankylosing spondylitis. The study was performed as a randomized, prospective, controlled, and single-blind trial. Fifty-five participants (30 men, 25 women) who were under a regular follow-up protocol in our Rheumatology Clinic with the diagnosis of AS according to the modified New York criteria were included in the study. The participants were randomly assigned into two groups: in group I, Pilates exercise program of 1 h was given by a certified trainer to 30 participants 3 times a week for 12 weeks, and in group II, designed as the control group, 25 participants continued previous standard treatment programs. In groups, pre-(week 0) and post treatment (week 12 and week 24) evaluation was performed by one of the authors who was blind to the group allocation. Primary outcome measure was functional capacity. Evaluation was done using the Bath Ankylosing Spondylitis Functional Index (BASFI). Exploratory outcome measures were Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), Bath Ankylosing Spondylitis Metrology Index (BASMI), Chest expansion, and ankylosing spondylitis quality of life (ASQOL) questionnaire. In group I, BASFI showed significant improvement at week 12 (P = 0.031) and week 24 (P = 0.007). In group II, this parameter was not found to have significantly changed at week 12 and week 24. Comparison of the groups showed significantly superior results for group I at week 24 (P = 0.023). We suggest Pilates exercises as an effective and safe method to improve physical capacity in AS patients. Our study is the first clinical study designed to investigate the role of Pilates method in AS treatment. We believe that further research with more participants and longer follow-up periods could help assess the therapeutic value of this popular physical exercise method in AS. PMID:21499876

  16. Symptom modifiers in therapy for ankylosing spondylitis

    Vladimir Vasilyevich Badokin

    2010-06-01

    Full Text Available Based on the data available in the literature, the author gives information on the prevalence of ankylosing spondyloarthritis. The clinical picture and pathogenesis of this disease and the principles of its diagnosis and treatment are described. Particular emphasis is placed on the use of etoricoxib, a nonsteroidal anti-inflammatory drug, in ankylosing spondyloarthritis. The available data strongly prove that etoricoxib is an alternative in the treatment of inflammatory diseases of the joints and vertebral column, ankylosing spondyloarthritis in particular.

  17. Genome-wide association study of ankylosing spondylitis identifies non-MHC susceptibility loci

    Reveille, John D.; Sims, Anne-Marie; Danoy, Patrick; Evans, David M; Leo, Paul; Pointon, Jennifer J.; Jin, Rui; Zhou, Xiaodong; Bradbury, Linda A.; Appleton, Louise H; Davis, John C.; Diekman, Laura; Doan, Tracey; Dowling, Alison; Duan, Ran

    2010-01-01

    To identify susceptibility loci for ankylosing spondylitis, we undertook a genome-wide association study in 2,053 unrelated ankylosing spondylitis cases among people of European descent and 5,140 ethnically matched controls, with replication in an independent cohort of 898 ankylosing spondylitis cases and 1,518 controls. Cases were genotyped with Illumina HumHap370 genotyping chips. In addition to strong association with the major histocompatibility complex (MHC; P < 10−800), we found associa...

  18. Common MIR146A Polymorphisms in Chinese Ankylosing Spondylitis Subjects and Controls

    Niu, Zhenmin; Wang, Jiucun; Zou, Hejian; Yang, Chengde; Wei HUANG; Jin, Li

    2015-01-01

    Common polymorphisms of microRNA gene MIR146A were reported as associated with different autoimmune diseases, include systemic lupus erythematosus, psoriatic arthritis, asthma and ankylosing spondylitis. In this study we investigated MIR146A SNPs in Chinese people with ankylosing spondylitis. Three common SNPs: rs2910164, rs2431697 and rs57095329 were selected and genotyped in 611 patients and 617 controls. We found no association between these SNPs and ankylosing spondylitis in our samples.

  19. Current treatment approaches in patients with ankylosing spondylitis

    Bilal Elbey

    2015-03-01

    Full Text Available Ankylosing spondylitis (AS is a chronic, inflammatory, rheumatic disease that mainly affects sacroiliac joints and spine. AS predominantly occurs more often in males and typically begins in the second or third decade. The mainstay of therapy in AS are nonsteroidal anti-inflammatory drugs, which reduce inflammation and pain. Disease modifying antirheumatic drugs (DMARD did not have enough evidence to prove their effect in AS treatment. The use of DMARD may not sufficient to improve the treatment and symptoms. Currently, TNF-blockers such as, Golimumab Etanersept Adalimumab İnfliksimab have promising results in the treatment of AS. TNF-blockers improve the clinical signs and symptoms, and improve the patients’ physical function and quality of life. This manuscript is focused that Current pharmacological treatments in patients with ankylosing spondylitis.

  20. Detection of novel diagnostic antibodies in ankylosing spondylitis: An overview.

    Quaden, Dana H F; De Winter, Liesbeth M; Somers, Veerle

    2016-08-01

    Ankylosing spondylitis (AS) is a debilitating, chronic, rheumatic disease characterized by inflammation and new bone formation resulting in fusion of the spine and sacroiliac joints. Since early treatment is impeded by a delayed diagnosis, it is highly important to find new biomarkers that improve early diagnosis and may also contribute to a better assessment of disease activity, prognosis and therapy response in AS. Because of the absence of rheumatoid factor, AS was long assumed to have a seronegative character and antibodies are thus not considered a hallmark of the disease. However, emerging evidence suggests plasma cells and autoantibodies to be involved in the disease course. In this review, the role of B cells and antibodies in AS is discussed. Furthermore, an overview is provided of antibodies identified in AS up till now, and their diagnostic potential. Many of these antibody responses were based on small study populations and further validation is lacking. Moreover, most were identified by a hypothesis-driven approach and thus limited to antibodies against targets that are already known to be involved in AS pathogenesis. Hence, we propose an unbiased approach to identify novel diagnostic antibodies. The already successfully applied techniques cDNA phage display and serological antigen selection will be used to identify antibodies against both known and new antigen targets in AS plasma. These newly identified antibodies will enhance early diagnosis of AS and provide more insight into the underlying disease pathology, resulting in a more effective treatment strategy and eventually an improved disease outcome. PMID:27288842

  1. Polyarthritis flare in patient with ankylosing spondylitis treated with infliximab

    E. Filippucci

    2011-06-01

    Full Text Available Over the last ten years, the treatment of seronegative spondyloarthropathies has changed dramatically with the introduction of the anti-tumor necrosis factor alpha (TNFα agents. Nevertheless, there is a growing number of studies describing several adverse reactions in patients treated with biological agents. In the present report we describe the case of a 22-year-old male patient with ankylosing spondylitis who developed a “paradoxic” adverse reaction, while receiving infliximab.

  2. Surgical Treatment of Lumbar Hyperextension Injury in Ankylosing Spondylitis

    Lee, Jung Keun; Park, Ki Seok; Park, Moon Sun; Kim, Seong Min; Chung, Seung Young; Lee, Do Sung

    2013-01-01

    Ankylosing spondylitis (AS) is a chronic systemic and inflammatory rheumatic disease with a variable course of the axial skeleton. Spinal involvement may accompany ossification of the ligaments, intervertebral disc, end-plates and apophyseal structures, and seems to be "bamboo spine". Because of these natures of the spine in AS, a spinal fracture can be occurred with minor trauma or spontaneously. The fracture of the AS can cause neurological complications extremely high, so special attention...

  3. A Case of Ankylosing Spondylitis and Discussion of the Literature

    M P Ranjith; R. Divya

    2013-01-01

    Ankylosing spondylitis (AS) is a systemic inflammatory disease. Its pathogenesis has not been completely understood, but the HLA-B 27 positive immune cells are thought to be involved. Nonsteroidal anti-inflammatory agents are the first line drugs and they effectively relieve the symptoms. Biological agents such as Infliximab may help in targeting the underlying inflammatory process and have been used recently. Here, we are reporting a case of AS with established classical skeletal deformities.

  4. Cardiac Autonomic Function in Patients With Ankylosing Spondylitis

    Wei, Cheng-Yu; Kung, Woon-Man; Chou, Yi-Sheng; Wang, Yao-Chin; Tai, Hsu-Chih; Wei, James Cheng-Chung

    2016-01-01

    Abstract Ankylosing spondylitis (AS) is a chronic inflammatory disease involing spine and enthesis. The primary aim of this study is to investigate the autonomic nervous system (ANS) function and the association between ANS and the functional status or disease activity in AS. The study included 42 AS patients, all fulfilling the modified New York criteria. All the patients are totally symptom free for ANS involvement and had normal neurological findings. These AS patients and 230 healthy volunteers receive analysis of 5 minutes heart rate variability (HRV) in lying posture. In addition, disease activity and functional status of these AS patients are assessed by Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), Bath Ankylosing Spondylitis Functional Index (BASFI), and Bath Ankylosing Spondylitis Global Score (BAS-G). Both groups were age and sex-matched. Although the HRV analysis indicates that the peaks of total power (TP, 0–0.5 Hz) and high-frequency power (HF, 0.15–0.40 Hz) are similar in both groups, the activities of low-frequency power (LF, 0.04–0.15 Hz), LF in normalized units (LF%), and the ratio of LF to HF (LF/HF) in AS patients are obviously lower than healthy controls. The erythrocyte sedimentation rate and C-reactive protein revealed negative relationship with HF. The AS patients without peripheral joint disease have higher LF, TP, variance, LF%, and HF than the patients with peripheral joint disease. The AS patients without uvetis have higher HF than the patients with uvetis. The total scores of BASDI, BASFI, and BAS-G do not show any association to HRV parameters. AS patients have significantly abnormal cardiac autonomic regulation. This is closely related with some inflammatory activities. Reduced autonomic function may be one of the factors of high cardiovascular risk in AS patients. PMID:27227940

  5. Coexistence of Ankylosing Spondylitis and Neurofibromatosis Type 1

    Gundogdu, Baris; Yolbas, Servet; Yildirim, Ahmet; Gonen, Murat

    2016-01-01

    Ankylosing spondylitis (AS) is a systemic disease primarily characterized by the inflammation of sacroiliac joints and axial skeleton. Neurofibromatosis type 1 (NF1) is a multisystem genetic disease which is characterized by cutaneous findings, most importantly café-au-lait spots and axillary freckling, by skeletal dysplasia, and by the growth of both benign and malignant nervous system neoplasms, most notably benign neurofibromas. In this case report, we present a 43-year-old male with AS and NF1. PMID:27597922

  6. Coexistence of Ankylosing Spondylitis and Neurofibromatosis Type 1.

    Gundogdu, Baris; Yolbas, Servet; Yildirim, Ahmet; Gonen, Murat; Koca, Suleyman Serdar

    2016-01-01

    Ankylosing spondylitis (AS) is a systemic disease primarily characterized by the inflammation of sacroiliac joints and axial skeleton. Neurofibromatosis type 1 (NF1) is a multisystem genetic disease which is characterized by cutaneous findings, most importantly café-au-lait spots and axillary freckling, by skeletal dysplasia, and by the growth of both benign and malignant nervous system neoplasms, most notably benign neurofibromas. In this case report, we present a 43-year-old male with AS and NF1. PMID:27597922

  7. X-ray therapy in the treatment of ankylosing spondylitis

    The results of the treatment of a randomly selected series of 277 patients is presented and some consideration is given to the complications and sequelae of the X-ray therapy here described. There is particular reference to the risk of leukaemogenesis, the decline in the use of X-ray therapy and the present position in Britain of the management of ankylosing spondylitis. (orig./MG)

  8. An Epidemiological Study on Ankylosing Spondylitis in Southern Albania

    Koko, Vjollca; Ndrepepa, Ana; Skënderaj, Skënder; Ploumis, Avraam; Backa, Teuta; Tafaj, Argjend

    2014-01-01

    Objectives: To evaluate the incidence and prevalence of ankylosing spondylitis (AS) in southern Albania and to assess the association of various demographic risk factors with the severity of disease. Material and methods: This is an observational study with cross-sectional analyses, conducted in the region of Gjirokaster, between 1995 until 2011. The diagnosis of AS was based on the modified New York criteria. Data on population are obtained from the reports of the National Institute of Stati...

  9. Efficacy and Safety of Etanercept in Patients with Ankylosing Spondylitis

    Kalı, Gökhan; ERSOY, Yüksel; DURMUŞ, Bekir; Altay, Zuhal; Baysal, Özlem; ERSOY, Yasemin

    2010-01-01

    Objective: The aim of this study was to evaluate efficacy and safety of etanercept in patients with ankylosing spondylitis (AS). Material and Methods: 21 patients with AS were evaluated before and after 6 months of etanercept treatment based on the clinical and laboratory parameters. Clinical efficacy was determined using criteria defined by the asessment in AS (ASAS) International Working Group (ASAS-20 ASAS-40, ASAS-5/6, and ASAS partial remission) and BASDAI-50 responses. Results: ...

  10. Total respiratory resistance and reactance in ankylosing spondylitis and kyphoscoliosis.

    van Noord, J A; Cauberghs, M; Van de Woestijne, K P; Demedts, M

    1991-09-01

    Ankylosing spondylitis and kyphoscoliosis both alter the function of the lung by modifying the mechanical properties of the thoracic cage. The purpose of the present study was to assess the changes in total respiratory resistance (Rrs) and reactance (Xrs) in these patients and to compare these data with conventional pulmonary function tests. In 16 patients with ankylosing spondylitis and seven with kyphoscoliosis we measured lung volumes, maximal flows, diffusing capacity, airway resistance, lung compliance and Rrs and Xrs between 2-26 Hz by means of the forced oscillation technique (FOT). In the patients with ankylosing spondylitis mean total lung capacity was 83% predicted (range 60-105%). Mean values of Rrs were normal; there was a small decrease in Xrs at the lowest frequency. In the patients with kyphoscoliosis mean total lung capacity (TLC) was 41% predicted for arm span (range 26-75%). Mean Rrs was elevated with a negative frequency dependence, and mean Xrs was decreased. The observed differences in Rrs and Xrs between the two groups of patients are related to differences in severity of the restriction. There is evidence that the changes in Rrs and Xrs in both groups are mainly attributable to an increase in chest wall resistance and a decrease in chest wall compliance, while in the patients with kyphoscoliosis an increase in airway resistance and a decrease in lung compliance also intervenes. PMID:1783085

  11. Clinical feature and imaging findings of juvenile ankylosing spondylitis

    Objective: To analyze the clinical features and imaging findings of juvenile ankylosing spondylitis (JAS) in order to improve the diagnosis and the prognosis of JAS. Methods: Twelve cases were analyzed retrospectively and 14 cases, who were followed-up averagely for 2.3 years, were analyzed prospectively. Initially 10 were diagnosed as Still's disease and four were diagnosed as rheumatoid arthritis. Photography was performed in all cases, CT scan was done in 18 cases, and MRI in 8 cases. Lower extremity big joint disorders were observed in all cases and the small joints were reserved. The abnormalities of the sacroiliac joint were revealed in the early stage in 12 cases. The results were analyzed statistically. Results: The age of preliminary diagnosis was 9.3 years in average. There were statistical correlation between the age of the first episode and severity of the disease. And there were statistical correlation between the course of the illness and severity of the disease. The large joints of the lower extremities were most commonly involved. Conclusion: There were characteristic clinical features and imaging findings in the JAS. Early diagnosis and treatment improve the prognosis

  12. Carbohydrate metabolism disorders in patients with rheumatoid arthritis and ankylosing spondylitis – impact of treatment

    Piotr Dąbrowski

    2014-06-01

    Full Text Available Chronic inflammation – the crucial pathogenic mechanism of rheumatoid arthritis and ankylosing spondylitis – is the main cause of accelerated atherosclerosis, insulin resistance and well-known consequences related to it. The conservative treatment of rheumatoid arthritis and ankylosing spondylitis may provide a significant influence on glucose metabolism. The paper is a literature overview concerning insulin resistance and impaired glucose metabolism during treatment with disease-modifying drugs including biologic DMARDs (disease-modifying antirheumatic drugs, corticosteroids and commonly used non-steroidal anti-inflammatory drugs (NSAID. It has been found that the risk of carbohydrate disorders among those patients is much lower after therapy with hydroxychloroquine, methotrexate and TNF blockers – particularly with infliximab. The NSAID may play an important protective role in reducing risk of diabetes. The recent data show, contrary to general opinion, the advantageous outcome for glucose metabolism after treatment with corticosteroids, especially in the early active stage of rheumatoid arthritis.

  13. Taylor Approach of Spinal Anaesthesia in a case of Ankylosing Spondylitis for Hip Fracture Surgery

    Urmila Palaria

    2011-11-01

    Full Text Available Ankylosing Spondylitis (AS is a chronic inflammatory rheumatic disease primarily affecting the axial joints manifesting as stiffnesss of the spine. Patient with ankylosing spondylitis is a challenge to anaesthesiologists in terms of airway management and neuraxial blocks. Modified paramedian approach (Taylor approach of spinal anaesthesia can be used as an alternative to technically difficult cases in patients undergoing lower limb surgeries.

  14. MRI manifestations of lumbar active inflammation in ankylosing spondylitis

    Objective: To study the MRI manifestations of lumbar active inflammation in ankylosing spondylitis (AS), and its relationship with CT grade of sacroiliitis. Methods: 64 cases of AS accepted lumbar MR scan with sagittal STIR/SPIR and T1-weighted fat suppressed sequences after administration of GD-DTPA. MR manifestations of lumbar active inflammation including active spondylitis, spondylodiskitis, arthritis of the facet joints and enthesitis were studied. Spondylitis was especially analyzed by Berlin method. 40 cases accepted CT scan of sacroiliac joints simultaneously, classed by modified New York criteria. Correlation: analysis was made between lumbar involvement and Berlin method. Results: There were 42 cases of active spondylitis, 6 of spondylodiskitis, 37 of arthritis of the facet joints, 32 of enthesitis in all 64 cases. The positive rate of lumbar involvement in AS was 85.9%. Positive rate of Spondylitis was 65.6%. L1/2 was 34.4%, which accounted for the most in all lumbar vertebral units, but there was not statistically significance between L1/2 and other Vertebral Units (P>0.05). The mean score of L5/S1 was 1.23, which was the highest in vertebral units involved, and there was statistically significance between L5/S1 and T12/L1, L1/2, L2/ 3 (P0.05) between lumbar active inflammation and the CT grades of sacroiliitis. Conclusions: Lumbar involvement of AS is common, mostly manifested as spondylitis, arthritis of the facet joints and enthesitis, with spondylodiskitis the least. In spondylitis, L1/2 is the most. There maybe no correlation between lumbar involvement and degree of spondylitis and grade of sacroiliitis. (authors)

  15. CT evaluation of sacroiliitis: Differentiation of infectious sacroiliitis versus ankylosing spondylitis

    Park, Ga Young; Ryu, Kyung Nam; Yoon, Yup; Lee, Sang Un [Kyung Hee University Hospital, Seoul (Korea, Republic of)

    1994-05-15

    To determine the characteristic CT findings of infectious sacroiliitis and ankylosing spondylitis. We retrospectively reviewed CT findings in 10 patients with infectious sacroiliitis confirmed by culture and clinical follow ups and in 5 patients with ankylosing spondylitis by HLA-B27 typing. Mean age were 30 years in ankylosing spondylitis and 29 years in infectious sacroiliitis. CT scans were obtained with GE 9800 or Toshiba 900-S Scanner. We analyzed CT findings in regard to the morphology and degree of bone erosion, and the adjacent soft tissue change. All cases of ankylosing spondylitis had bilateral and asymmetric bone erosion, predominantly in ilium, showing subchondral sclerosis on ilium. Infectious sacroiliitis showed unilateral involvement and soft tissue swelling in 10 cases and abscess in 5 cases. We concluded that CT was useful in the differentiation between infectious sacroiliitis and ankylosing spondylitis.

  16. Low vaspin levels are related to endothelial dysfunction in patients with ankylosing spondylitis

    H.H. Wang

    2016-01-01

    Full Text Available Vaspin is a novel adipocytokine associated with glucose tolerance and chronic inflammation. Some studies reveal that vaspin may be involved in cardiovascular diseases. Our objective was to investigate the relationship between serum vaspin levels and endothelial function in patients with ankylosing spondylitis. One hundred and twenty patients with newly diagnosed ankylosing spondylitis and 100 healthy subjects were studied. Serum vaspin levels were measured with enzyme-linked immunosorbent assay. High resolution ultrasound was used to measure brachial artery diameter at rest, after reactive hyperemia (flow-mediated dilation, FMD and after sublingual glyceryltrinitrate. Serum vaspin level in patients was 1.92±1.03 ng/mL, which was significantly lower than that in healthy subjects (2.88±0.81 ng/mL. By dividing the distribution of serum vaspin levels into quartiles, FMD levels increased gradually with the increase of serum vaspin levels in patients (P<0.01. Univariate analysis showed a correlation between vaspin and FMD (r=0.73, P=0.003, low-density lipoprotein cholesterol (r=-0.45, P=0.033, high-density lipoprotein cholesterol (r=0.63, P=0.025, fasting blood glucose (r=-0.79, P=0.006, triglycerides (TG (r=-0.68, P=0.036, systolic blood pressure (r=-0.35, P=0.021, C-reactive protein (r=-0.67, P=0.011, homeostatic model assessment of insulin resistance (HOMA-IR (r=-0.77, P=0.023 and erythrocyte sedimentation rate (r=-0.88, P=0.039 in patients. Multivariate analysis indicated that serum vaspin levels were independently associated with FMD, HOMA-IR and TG in patients. Our study found that serum vaspin levels were decreased in patients with ankylosing spondylitis and were associated with FMD levels. Vaspin may serve as an independent marker for detecting early stage atherosclerosis in patients with ankylosing spondylitis.

  17. Low vaspin levels are related to endothelial dysfunction in patients with ankylosing spondylitis.

    Wang, H H; Wang, Q F

    2016-07-01

    Vaspin is a novel adipocytokine associated with glucose tolerance and chronic inflammation. Some studies reveal that vaspin may be involved in cardiovascular diseases. Our objective was to investigate the relationship between serum vaspin levels and endothelial function in patients with ankylosing spondylitis. One hundred and twenty patients with newly diagnosed ankylosing spondylitis and 100 healthy subjects were studied. Serum vaspin levels were measured with enzyme-linked immunosorbent assay. High resolution ultrasound was used to measure brachial artery diameter at rest, after reactive hyperemia (flow-mediated dilation, FMD) and after sublingual glyceryltrinitrate. Serum vaspin level in patients was 1.92±1.03 ng/mL, which was significantly lower than that in healthy subjects (2.88±0.81 ng/mL). By dividing the distribution of serum vaspin levels into quartiles, FMD levels increased gradually with the increase of serum vaspin levels in patients (PFMD (r=0.73, P=0.003), low-density lipoprotein cholesterol (r=-0.45, P=0.033), high-density lipoprotein cholesterol (r=0.63, P=0.025), fasting blood glucose (r=-0.79, P=0.006), triglycerides (TG) (r=-0.68, P=0.036), systolic blood pressure (r=-0.35, P=0.021), C-reactive protein (r=-0.67, P=0.011), homeostatic model assessment of insulin resistance (HOMA-IR) (r=-0.77, P=0.023) and erythrocyte sedimentation rate (r=-0.88, P=0.039) in patients. Multivariate analysis indicated that serum vaspin levels were independently associated with FMD, HOMA-IR and TG in patients. Our study found that serum vaspin levels were decreased in patients with ankylosing spondylitis and were associated with FMD levels. Vaspin may serve as an independent marker for detecting early stage atherosclerosis in patients with ankylosing spondylitis. PMID:27383120

  18. Continuous posterior lumbar plexus and continuous parasacral and intubation with lighted stylet for ankylosing spondylitis.

    Imbelloni, Luiz Eduardo; Lucena, Neli

    2015-01-01

    Ankylosing spondylitis is characterized by progressive ossification of the spinal column with resultant stiffness. Ankylosing spondylitis can present significant challenges to the anaesthetist as a consequence of the potential difficult airway and performing neuraxial blockade. We describe a case of intubation with lighted stylet, and use of the continuous lumbosacral plexus for THA and postoperative analgesia with an elastomeric pump. Key words: Airways difficult anticipated, anesthesia, ankoylosing spondylitis, arthroplasty, conduction, continuous lumbosacral plexus, hip, infusion pumps, intubation awake, replacement. PMID:25886430

  19. Vertebral locking lesion following cervical spine fracture in ankylosing spondylitis.

    Kuroiwa, Tomoyuki; Yoshii, Toshitaka; Sakaki, Kyohei; Inose, Hiroyuki; Tomizawa, Shoji; Kato, Tsuyoshi; Kawabata, Shigenori; Shinomiya, Kenichi; Okawa, Atsushi

    2012-06-01

    Spine fractures in patients with ankylosing spondylitis frequently extend to all 3 columns, which can lead to displacement and deformity with severe instability. Cervical spine fractures occasionally cause severe kyphotic deformities, such as chin-on-chest deformities. In such cases, the patients typically exhibit a chronic progression of hyperkyphosis after the traumatic event. This article describes a unique case of ankylosing spondylitis associated with an acute chin-on-chest deformity following a spine fracture due to a vertebral locking lesion.A 60-year-old man fell while walking and sustained a compression fracture of the C6 vertebra. Two weeks later, the patient acutely developed an inability to raise his head, difficulties with chewing and swallowing, and a horizontal gaze. Radiographs demonstrated a severe kyphosis in the cervical spine with a locking lesion between the anterior wall of the C5 and C6 vertebrae. The patient also presented with neurological impairment in his hands. Because the anterior approach to the spine was anatomically impossible, halo traction was initially applied under a close observation of neurological symptoms. Three days after halo traction, release of the vertebral locking lesion and realignment of the spine were seen. The patient subsequently underwent spinal fusion using a combined anterior-posterior approach.Postoperatively, neurological dysfunction improved, and solid fusion was confirmed at 6 months. In cases of acute kyphotic deformity following cervical spine fracture in ankylosing spondylitis patients, halo traction followed by circumferential spine fusion is a safe and effective approach for improving the alignment and stability of the spine. PMID:22691645

  20. The Impacts of Helicobacter Pylori Antigen Positivity on Ankylosing Spondylitis

    Esra Erkol Ižnal

    2014-12-01

    Full Text Available Aim: We aimed to clarify the impacts of H. pylori infection on disease activity and clinical findings of AS. Material and Method: Forty-eight patients with AS were included in this study. The demographic data including age, sex, durations of the disease and medication of the patients were recorded. The laboratory analysis comprised Erythrocyte sedimentation rate (ESR, C-reactive protein (CRP and H. pylori antigen determination in gaita. The disease activity, functional disability and clinical status were assessed using the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI, The Bath Ankylosing Spondylitis Functional index (BASFI and The Bath Ankylosing Spondylitis Metrology Index (BASMI respectively. We divided patients according to H. pylori antigen positivity in gaita as H. pylori positive and negative patients.Results: The mean age of patients was 41.9 11.8. CRP levels were slightly but not significantly higher in patients with positive H. pylori antigen compared to those in patients without H. pylori antigen in gaita (p=0.08. There was no significant difference in terms of ESR levels, BASDAI, BASFI and BASMI scores in patients with positive H. pylori antigen compared to those in patients with negative H. pylori antigen in gaita (p-values were >0.05 for all. In regression model BASDAI score was found to have no relationship with H. pylori antigen positivity, ESR and CRP levels (p-values were >0.05 for all. Discussion: H. pylori seemed to have probable impacts on the disease activity of AS. Studies with greater patient population and longer follow-up periods are warranted to enlighten this issue.

  1. Higher prevalence of peripheral arthritis among ankylosing spondylitis patients.

    Lee, Ji-Hyun; Jun, Jae-Bum; Jung, Sungsoo; Bae, Sang-Cheol; Yoo, Dae-Hyun; Kim, Think-You; Kim, Seong Yoon; Kim, Tae-Hwan

    2002-01-01

    This study was performed to define the clinical spectrum and disease manifestations of ankylosing spondylitis (AS) in a referral hospital setting. We identified the differences in clinical manifestations according to the sex, the age at onset, the presence of peripheral arthritis and the presence of HLA B27. A total 412 patients (357 males, 55 females) were recruited. Eighty-seven percent were men and 155 out of 412 patients (35%) were juvenile-onset. HLA B27 was detected in 385 patients (93%...

  2. Surgical outcome after spinal fractures in patients with ankylosing spondylitis

    Brilakis Emmanuel

    2009-08-01

    Full Text Available Abstract Background Ankylosing spondylitis is a rheumatic disease in which spinal and sacroiliac joints are mainly affected. There is a gradual bone formation in the spinal ligaments and ankylosis of the spinal diarthroses which lead to stiffness of the spine. The diffuse paraspinal ossification and inflammatory osteitis of advanced Ankylosing spondylitis creates a fused, brittle spine that is susceptible to fracture. The aim of this study is to present the surgical experience of spinal fractures occurring in patients suffering from ankylosing spondylitis and to highlight the difficulties that exist as far as both diagnosis and surgical management are concerned. Methods Twenty patients suffering from ankylosing spondylitis were operated due to a spinal fracture. The fracture was located at the cervical spine in 7 cases, at the thoracic spine in 9, at the thoracolumbar junction in 3 and at the lumbar spine in one case. Neurological defects were revealed in 10 patients. In four of them, neurological signs were progressively developed after a time period of 4 to 15 days. The initial radiological study was negative for a spinal fracture in twelve patients. Every patient was assessed at the time of admission and daily until the day of surgery, then postoperatively upon discharge. Results Combined anterior and posterior approaches were performed in three patients with only posterior approaches performed on the rest. Spinal fusion was seen in 100% of the cases. No intra-operative complications occurred. There was one case in which superficial wound inflammation occurred. Loosening of posterior screws without loss of stability appeared in two patients with cervical injuries. Frankel neurological classification was used in order to evaluate the neurological status of the patients. There was statistically significant improvement of Frankel neurological classification between the preoperative and postoperative evaluation. 35% of patients showed improvement

  3. Ankylosing Spondylitis and Posture Control: The Role of Visual Input

    Alessandro Marco De Nunzio

    2015-01-01

    Full Text Available Objectives. To assess the motor control during quiet stance in patients with established ankylosing spondylitis (AS and to evaluate the effect of visual input on the maintenance of a quiet posture. Methods. 12 male AS patients (mean age 50.1 ± 13.2 years and 12 matched healthy subjects performed 2 sessions of 3 trials in quiet stance, with eyes open (EO and with eyes closed (EC on a baropodometric platform. The oscillation of the centre of feet pressure (CoP was acquired. Indices of stability and balance control were assessed by the sway path (SP of the CoP, the frequency bandwidth (FB1 that includes the 80% of the area under the amplitude spectrum, the mean amplitude of the peaks (MP of the sway density curve (SDC, and the mean distance (MD between 2 peaks of the SDC. Results. In severe AS patients, the MD between two peaks of the SDC and the SP of the center of feet pressure were significantly higher than controls during both EO and EC conditions. The MP was significantly reduced just on EC. Conclusions. Ankylosing spondylitis exerts negative effect on postural stability, not compensable by visual inputs. Our findings may be useful in the rehabilitative management of the increased risk of falling in AS.

  4. Surgical Treatment of Spinal Pseudoarthrosis in Ankylosing Spondylitis

    Lih-Huei Chen

    2005-09-01

    Full Text Available Background: In ankylosing spondylitis (AS, the spine with osteoporotic changes is fragileand vulnerable to trauma. Patients may develop spinal pseudoarthrosis (SP,whose clinical features are usually misdiagnosed as a tuberculous infection.This study reports our experience with surgical treatment for SP in AS.Methods: Eight patients with AS and SP at the thoracolumbar area were treated surgicallyand followed-up for at least 3 years. All had persistent back pain andprogressive kyphosis. One patient had neurologic deficits preoperatively.Anterior debridement and interbody fusion followed by posterior stabilizationwere performed in all patients. A posterior corrective osteotomy wasadditionally done in 3 patients whose kyphotic angle exceeded 45°.Results: All patients with persistent back pain obtained significant pain relief postoperatively.On a visual analogue scale, there was an average improvement of43 points on the clinical scores. The patient with neurologic deficits showedimprovement after the operation. Solid bony fusion was achieved in an averageof 7.5 months, and correction of the kyphotic angle averaged 18.6°.Conclusions: Spinal pseudoarthrosis should be considered in patients with AS, and mustbe differentiated from tuberculous and other infections. The results of thisstudy show that pain relief and correction of the kyphotic deformity can beachieved by surgical treatment for ankylosing spondylitis complicated withpseudoarthrosis.

  5. Efficacy and safety of adalimumab in ankylosing spondylitis

    Mounach A

    2014-08-01

    Full Text Available Aziza Mounach, Abdellah El MaghraouiRheumatology Department, Military Hospital Mohammed V, Rabat, MoroccoAbstract: Ankylosing spondylitis (AS is the most common and most severe subtype of spondyloarthritis. It also may be an outcome of any of the other spondyloarthritis subtypes. AS preferentially affects the sacroiliac joints and the tip of the column, with a tendency to later ankylosis. Peripheral joints, enthesis, and other extra-articular involvement may be observed. Tumor necrosis factor (TNF inhibitors are now well-established, effective drugs in the treatment of AS symptoms. Adalimumab, which is a fully human monoclonal antibody that binds to and neutralizes TNF, has demonstrated efficacy in treating AS symptoms, including axial involvement, peripheral arthritis, enthesitis, uveitis, gut involvement, and psoriasis. Furthermore, adalimumab has showed an overall acceptable safety profile. In this paper, we review the efficacy and safety profile of adalimumab in the treatment of AS, and discuss its differences from the other anti-TNF drugs reported in the literature.Keywords: ankylosing spondylitis, spondyloarthritis, adalimumab, tumor necrosis factor-α

  6. PRIMARY CEMENTLESS TOTAL HIP ARTHROPLASTY IN ANKYLOSING SPONDYLITIS

    Nageshwara Rao

    2015-12-01

    Full Text Available INTRODUCTION Ankylosing Spondylitis (AS, family of Spondyloarthritides (SpAs, is a chronic inflammatory disease affecting the axial skeleton, the entheses and occasionally the peripheral joints. The shoulders and hips are considered axial joints and involvement occurs in up to 50% of patients and is more common than involvement of the more distal joints. Aim of our study is to evaluate outcome of Cementless Total Hip Arthroplasty (THA in ankylosing spondylitis. MATERIALS AND METHODS We prospectively and retrospectively reviewed 27 hips in 20 patients who underwent cementless THA between 2007-2013. Mean age of patient was 31.5 years. We analysed demographic data, preoperative deformity, Harris Hip Score, ambulatory status, need for walking aids. RESULTS All patients experienced significant improvement in function, range of motion, posture and ambulation. Postoperative Harris Hip Score improved from 18.95 to 89.35; 90% are completely pain free, 5% have occasional discomfort and 5% have mild-to-moderate pain. CONCLUSION Cementless THA for deformed hips in young patients with AS is worthwhile surgical intervention, as it increases the mobility of the patient, improves the ability to sit comfortably, decrases the morbidity of the disease. However, the technically demanding nature of the procedure should not be underestimated.

  7. Coexisting ankylosing spondylitis and rheumatoid arthritis: A case report with literature review

    GUO Ying-ying; YANG Li-li; CUI Hua-dong; ZHAO Shuai; ZHANG Ning

    2011-01-01

    A 30-year-old female patient with coexisting ankylosing spondylitis and rheumatoid arthritis was diagnosed and treated.The human leukocyte antigen (HLA)-B27 is a predisposing factor of ankylosing spondylitis and HLA-DR4 is a predisposing factor of rheumatoid arthritis.This patient was HLA-B27 and HLA-DR4 positive,and ankylosing spondylitis manifested before rheumatoid arthritis.After disease modifying anti-rheumatic drugs successfully arrested ankylosing spondylitis activity the patient conceived and delivered a healthy baby.One year later,she developed peripheral polyarthritis and was diagnosed with rheumatoid arthritis.We hypothesized that pregnancy may be one of the environmental factors that can activate rheumatoid arthritis,and that disease modifying anti-rheumatic drugs play an important role in keeping the disease under control.

  8. Normative values for the bath ankylosing spondylitis functional index in the general population compared with ankylosing spondylitis patients in Morocco

    Wariaghli Ghizlane

    2012-03-01

    Full Text Available Abstract Background The Bath Ankylosing Spondylitis Functional Index (BASFI has been commonly used in rheumatology to quantify functional disability in patients with Ankylosing Spondylitis (AS. Our aim was to evaluate the discriminating power of BASFI and determine the best cutoff score of this index in the general population compared with AS patients. Methods A cross-sectional study that included 200 patients suffering from AS and 223 subjects from the general population matched for age and sex was carried-out. The discriminating power of the BASFI by strata of age was evaluated by the area under the Receiver Operating Characteristic curve and the best cutoff was determined by the Youden index. Results The mean age of the general population was 39 ± 12 years. 76.7% of them were male. The median BASFI of the healthy subjects and patients was 0.2 and 4.5 (P Conclusions This study suggests that the discriminating power of BASFI is considered good at any age. The best cutoff of this index increased as age increases as functional disability is associated in part with lifestyle choices and increases with age. The cutoff values of the BASFI that we have presented could be used as a reference benchmark for both clinical practice and research.

  9. Continuous posterior lumbar plexus and continuous parasacral and intubation with lighted stylet for ankylosing spondylitis

    Imbelloni, Luiz Eduardo; Lucena, Neli

    2015-01-01

    Ankylosing spondylitis is characterized by progressive ossification of the spinal column with resultant stiffness. Ankylosing spondylitis can present significant challenges to the anaesthetist as a consequence of the potential difficult airway and performing neuraxial blockade. We describe a case of intubation with lighted stylet, and use of the continuous lumbosacral plexus for THA and postoperative analgesia with an elastomeric pump. Key words: Airways difficult anticipated, anesthesia, ank...

  10. Prevalence of HLA-B27 in Patients with Ankylosing Spondylitis in Qatar

    M. H. Abdelrahman; Mahdy, S.; I. A. Khanjar; A. M. Siam; H. A. Malallah; S. A. Al-Emadi; Sarakbi, H. A.; M. Hammoudeh

    2012-01-01

    Background and Objectives. The human leukocyte antigen HLA-B27 is a class 1 antigen of the major histocompatibility complex and is strongly associated with ankylosing spondylitis (AS). The purpose of the present study is to investigate the distribution of HLA-B27 in patients with AS of different ethnic groups in Qatar. Design and Setting. Study design was cross-sectional and the setting was rheumatology clinics of Hamad General Hospital in Qatar where most of ankylosing spondylitis patien...

  11. Outcomes of a multicentre randomised clinical trial of etanercept to treat ankylosing spondylitis.

    Calin, A; Dijkmans, B A C; Emery, P; Hakala, M.; Kalden, J; Leirisalo-Repo, M; Mola, EM; Salvarani, C.; Sanmarti, R.; Sany, J; Sibilia, J; Sieper, J; Linden, S. ven der; Veys, E; Appel, AM

    2004-01-01

    OBJECTIVE: A double blind, randomised, placebo controlled study to evaluate the safety and efficacy of etanercept to treat adult patients with ankylosing spondylitis (AS). METHODS: Adult patients with AS at 14 European sites were randomly assigned to 25 mg injections of etanercept or placebo twice weekly for 12 weeks. The primary efficacy end point was an improvement of at least 20% in patient reported symptoms, based on the multicomponent Assessments in Ankylosing Spondylitis (ASAS) response...

  12. Magnetic resonance imaging for ankylosing spondylitis; Magnetresonanztomographie bei ankylosierender Spondylitis (Morbus Struempell-Marie-Bechterew)

    Bollow, M. [Augusta-Kranken-Anstalt, Inst. fuer Radiologie, Bochum (Germany)

    2002-12-01

    Ankylosing spondylitis (AS) is the prototypical form of the spondyloarthropathies, which at a prevalence of 2% is among the most frequent rheumatic diseases. Spondyloarthropathy comprises the following five disorders: AS, reactive arthritis, psoriatic arthritis, enteropathic arthritis in Crohn's disease, and ulcerosing colitis as well as undifferentiated spondyloarthropathy. In 99% of the patients with AS initial abnormal findings affect the sacroiliac joints. The radiographic changes required for diagnosing AS occur as late as 5-9 years after the onset of clinical symptoms. MRI of the sacroiliac joints reliably demonstrates both chronic inflammatory changes (erosions, sclerotic changes, bone bridges) and acute inflammatory changes (synovitis, capsulitis, osteitis) and allows for grading the chronicity and acuity of such changes. Enthesitis of the interosseous ligaments of the retroarticular space is a manifestation of AS. Spondylodiscitis (Andersson 1937) may occur as an inflammatory or non-inflammatory process (transdiscal fatigue fracture). Inflammations of the facet and costospinal joints developing into ankylosis are typical of AS. Changes of the vertebral bodies occur as anterior (Romanus 1952), posterior, and marginal spondylitis. All forms of spondyloarthropathies are furthermore characterized by asymmetrical synovitis of the large joints, particularly of the legs (gonarthritis, coxitis, tarsitis, peripheral oligoarthritis), rheumatic fibroosteitis (pelvic enthesitis, rheumatic calcaneopathy), and peri- and synchrondritis of the public symphisis and sternal synchondrosis. Since early inflammatory changes of the spinal column and of the extravertebral localizations in AS are demonstrated by MRI before they become apparent on radiographs, and thereby the diagnostic gap could be closed, the early use of MRI for diagnostic and follow-up is commendable, when new therapeutical options like the so-called 'biologicals' are employed. (orig.) [German

  13. Multicenter validation of the value of BASFI and BASDAI in Chinese ankylosing spondylitis and undifferentiated spondyloarthropathy patients

    Lin, Zhiming; Gu, Jieruo; He, Peigen; Gao, Jiesheng; Zuo, Xiaoxia; Ye, Zhizhong; Shao, Fengmin; Zhan, Feng; Lin, Jinying; Li, Li; Wei, Yanlin; Xu, Manlong; Liao, Zetao; Lin, Qu

    2009-01-01

    The objectives of this study were to evaluate the reliability of Bath ankylosing spondylitis functional index (BASFI) and Bath ankylosing spondylitis disease activity index (BASDAI) in Chinese ankylosing spondylitis (AS) and undifferentiated spondyloarthropathy (USpA) patients. 664 AS patients by the revised New York criteria for AS and 252 USpA patients by the European Spondyloarthropathy Study Group criteria were enrolled. BASDAI and BASFI questionnaires were translated into Chinese. Partic...

  14. Clinical aspects, outcome assessment, and management of ankylosing spondylitis and postenteric reactive arthritis.

    van der Linden, S; van der Heijde, D

    2000-07-01

    The cause of ankylosing spondylitis remains unclear. Proof that this disorder is an autoimmune disease attributable to crossreactivity between bacteria and HLA-B27 is still lacking. Differences in endogenous peptide presentation by HLA-B27 subtypes might be relevant in the etiopathogenesis. Fractures of the osteoporotic spine contribute to morbidity. Spinal cord injury may occur. MR imaging enables identifying sacroiliitis earlier than plain radiography. Sweet syndrome has now been described in patients with ankylosing spondylitis and Crohn disease. Progress has been made in the assessment of ankylosing spondylitis. There are now core sets for different settings and validated instruments for functioning and disease activity that will enable demonstrating efficacy of new therapeutic interventions. The debate continues on classification of postinfectious and reactive arthritis. Bacterial antigens may be found in the inflamed joints; occasionally 16S ribosomal RNA is also demonstrated. Antibiotics seem not to be effective in postenteric reactive arthritis. More than 25 years have now elapsed since the association between ankylosing spondylitis and HLA-B27 was first described in 1973. The cause of this disease is still unknown, but a lot of progress has been made regarding the molecular structure of HLA-B27, the spectrum of disease, the clinical and radiographic assessment of ankylosing spondylitis, and its treatment. Recent advances in research on ankylosing spondylitis are reviewed here. PMID:10910177

  15. Normal anti-Klebsiella lymphocytotoxicity in ankylosing spondylitis

    Kinsella, T.D.; Fritzler, M.J.; Lewkonia, R.M.

    1986-03-01

    We compared in vitro lymphocytotoxicity (LCT) of peripheral blood lymphocytes (PBL), obtained from patients with ankylosing spondylitis (AS) and normal controls (NC). Assays were performed with antibacterial antisera prepared from AS- and NC-derived Klebsiella and coliforms Escherichia coli. LCT assessed by eosin staining was not significantly different in PBL of 12 AS patients and 28 controls when reacted with 3 Klebsiella and 1 E coli antisera. LCT assessed by /sup 51/Cr release was not significantly different for PBL of 20 age- and sex-matched pairs of AS patients and NC when reacted with 3 Klebsiella and 1 E coli antisera. Similarly, LCT-/sup 51/Cr of PBL of 15 matched AS and NC pairs was not significantly different for anti-K21, a serotype putatively implicated in Klebsiella-HLA-B27 antigenic cross-reactivity. Our results do not support the notion of molecular mimicry between Klebsiella and B27 in the pathogenesis of primary AS.

  16. Normal anti-Klebsiella lymphocytotoxicity in ankylosing spondylitis

    We compared in vitro lymphocytotoxicity (LCT) of peripheral blood lymphocytes (PBL), obtained from patients with ankylosing spondylitis (AS) and normal controls (NC). Assays were performed with antibacterial antisera prepared from AS- and NC-derived Klebsiella and coliforms Escherichia coli. LCT assessed by eosin staining was not significantly different in PBL of 12 AS patients and 28 controls when reacted with 3 Klebsiella and 1 E coli antisera. LCT assessed by 51Cr release was not significantly different for PBL of 20 age- and sex-matched pairs of AS patients and NC when reacted with 3 Klebsiella and 1 E coli antisera. Similarly, LCT-51Cr of PBL of 15 matched AS and NC pairs was not significantly different for anti-K21, a serotype putatively implicated in Klebsiella-HLA-B27 antigenic cross-reactivity. Our results do not support the notion of molecular mimicry between Klebsiella and B27 in the pathogenesis of primary AS

  17. MR imaging features of foot involvement in ankylosing spondylitis

    Objective: To determine alterations of the soft tissue, tendon, cartilage, joint space, and bone of the foot using magnetic resonance (MR) imaging in ankylosing spondylitis (AS) patients. Materials and Method: Clinical and MR examination of the foot was performed in 23 AS patients (46 feet). Ten asymptomatic volunteers (20 feet) were studied on MR imaging, as a control group. MR imaging protocol included; T1-weighted spin-echo, T2-weighted fast-field echo (FFE) and fat-suppressed short tau inversion recovery (STIR) sequences in sagittal, sagittal oblique, and coronal planes using a head coil. Specifically, we examined: bone erosions, tendinitis (acute and chronic), para-articular enthesophyte, joint effusion, plantar fasciitis, joint space narrowing, soft tissue edema, bone marrow edema, enthesopathy in the Achilles tendon and plantar fascia attachment, subchondral signal intensity abnormalities (edema and sclerosis), tenosynovitis, retrocalcaneal bursitis, subchondral cysts, subchondral fissures, and bony ankylosis. Midfoot, hindfoot, and ankle were included in examined anatomic regions. Results: Clinical signs and symptoms (pain and swelling) due to foot involvement were present in 3 (13%) of the patients while frequency of involvement was 21 (91%) with MR imaging assessment. The MR imaging findings were bone erosions (65%), Achilles tendinitis (acute and chronic) (61%), para-articular enthesophyte (48%), joint effusion (43%), plantar fasciitis (40%), joint space narrowing (40%), subchondral sclerosis (35%), soft tissue edema (30%), bone marrow edema (30%), enthesopathy of the Achilles attachment (30%), subchondral edema (26%), enthesopathy in the plantar fascia attachment (22%), retrocalcaneal bursitis (22%), subchondral cysts (17%), subchondral fissures (17%), tendinitis and enthesopathy of the plantar ligament (13%), and bony ankylosis (9%). The most common involved anatomical region was the hindfoot (83%) following by midfoot (69% ) and ankle (22

  18. MR imaging features of foot involvement in ankylosing spondylitis

    Erdem, C. Zuhal E-mail: sunarerdem@yahoo.com; Sarikaya, Selda; Erdem, L. Oktay; Ozdolap, Senay; Gundogdu, Sadi

    2005-01-01

    Objective: To determine alterations of the soft tissue, tendon, cartilage, joint space, and bone of the foot using magnetic resonance (MR) imaging in ankylosing spondylitis (AS) patients. Materials and Method: Clinical and MR examination of the foot was performed in 23 AS patients (46 feet). Ten asymptomatic volunteers (20 feet) were studied on MR imaging, as a control group. MR imaging protocol included; T1-weighted spin-echo, T2-weighted fast-field echo (FFE) and fat-suppressed short tau inversion recovery (STIR) sequences in sagittal, sagittal oblique, and coronal planes using a head coil. Specifically, we examined: bone erosions, tendinitis (acute and chronic), para-articular enthesophyte, joint effusion, plantar fasciitis, joint space narrowing, soft tissue edema, bone marrow edema, enthesopathy in the Achilles tendon and plantar fascia attachment, subchondral signal intensity abnormalities (edema and sclerosis), tenosynovitis, retrocalcaneal bursitis, subchondral cysts, subchondral fissures, and bony ankylosis. Midfoot, hindfoot, and ankle were included in examined anatomic regions. Results: Clinical signs and symptoms (pain and swelling) due to foot involvement were present in 3 (13%) of the patients while frequency of involvement was 21 (91%) with MR imaging assessment. The MR imaging findings were bone erosions (65%), Achilles tendinitis (acute and chronic) (61%), para-articular enthesophyte (48%), joint effusion (43%), plantar fasciitis (40%), joint space narrowing (40%), subchondral sclerosis (35%), soft tissue edema (30%), bone marrow edema (30%), enthesopathy of the Achilles attachment (30%), subchondral edema (26%), enthesopathy in the plantar fascia attachment (22%), retrocalcaneal bursitis (22%), subchondral cysts (17%), subchondral fissures (17%), tendinitis and enthesopathy of the plantar ligament (13%), and bony ankylosis (9%). The most common involved anatomical region was the hindfoot (83%) following by midfoot (69% ) and ankle (22

  19. Acute anterior uveitis, ankylosing spondylitis, back pain, and HLA-B27.

    Beckingsale, A. B.; Davies, J.; Gibson, J M; Rosenthal, A R

    1984-01-01

    One hundred and sixty-nine patients with acute anterior uveitis were studied for the presence of HLA-B27 tissue type, radiological evidence of ankylosing spondylitis, and a history of back pain. 60% were male; 45% were HLA-B27+. The male:female ratio in the HLA-B27+ group was the same as in the whole group. 24% had radiological evidence of ankylosing spondylitis, and, of these, 83% were HLA-B27+ while 17% were HLA-B27-. There was a definite correlation between the severity of the ankylosing s...

  20. MRI of cervical spine injuries complicating ankylosing spondylitis

    Koivikko, Mika P.; Koskinen, Seppo K. [Helsinki Medical Imaging Center, Helsinki University Central Hospital, Toeoeloe Hospital, Department of Radiology, Helsinki (Finland)

    2008-09-15

    The objective was to study characteristic MRI findings in cervical spine fractures complicating ankylosing spondylitis (AS). Technical issues related to MRI are also addressed. A review of 6,774 consecutive cervical spine multidetector CT (MDCT) scans obtained during 6.2 years revealed 33 ankylosed spines studied for suspected acute cervical spine injury complicating AS. Of these, 20 patients also underwent MRI. On MRI, of these 20 patients, 19 had a total of 29 cervical and upper thoracic spine fractures. Of 20 transverse fractures traversing both anterior and posterior columns, 7 were transdiskal and exhibited less bone marrow edema than did those traversing vertebral bodies. One Jefferson's, 1 atlas posterior arch (Jefferson's on MDCT), 2 odontoid process, and 5 non-contiguous spinous process fractures were detectable. MRI showed 2 fractures that were undetected by MDCT, and conversely, MDCT detected 6 fractures not seen on MRI; 16 patients had spinal cord findings ranging from impingement and contusion to complete transection. Magnetic resonance imaging can visualize unstable fractures of the cervical and upper thoracic spine. Paravertebral hemorrhages and any ligamentous injuries should alert radiologists to seek transverse fractures. Multiple fractures are common and often complicated by spinal cord injuries. Diagnostic images can be obtained with a flexible multipurpose coil if the use of standard spine array coil is impossible due to a rigid collar or excessive kyphosis. (orig.)

  1. Biomechanical assessment of balance and posture in subjects with ankylosing spondylitis

    Sawacha Zimi

    2012-08-01

    Full Text Available Abstract Background Ankylosing spondylitis is a major chronic rheumatic disease that predominantly affects axial joints, determining a rigid spine from the occiput to the sacrum. The dorsal hyperkyphosis may induce the patients to stand in a stooped position with consequent restriction in patients’ daily living activities. The aim of this study was to develop a method for quantitatively and objectively assessing both balance and posture and their mutual relationship in ankylosing spondylitis subjects. Methods The data of 12 healthy and 12 ankylosing spondylitis subjects (treated with anti-TNF-α stabilized, with a mean age of 51.42 and 49.42 years; mean BMI of 23.08 and 25.44 kg/m2 were collected. Subjects underwent a morphological examination of the spinal mobility by means of a pocket compass needle goniometer, together with an evaluation of both spinal and hip mobility (Bath Ankylosing Spondylitis Metrology Index, and disease activity (Bath Ankylosing Spondylitis Disease Activity Index. Quantitative evaluation of kinematics and balance were performed through a six cameras stereophotogrammetric system and a force plate. Kinematic models together with a test for evaluating balance in different eye level conditions were developed. Head protrusion, trunk flexion-extension, pelvic tilt, hip-knee-ankle flexion-extension were evaluated during Romberg Test, together with centre of pressure parameters. Results Each subject was able to accomplish the required task. Subjects’ were comparable for demographic parameters. A significant increment was observed in ankylosing spondylitis subjects for knee joint angle with the target placed at each eye level on both sides (p  Conclusions Our findings confirm the need to investigate both balance and posture in ankylosing spondylitis subjects. This methodology could help clinicians to plan rehabilitation treatments.

  2. Core set of recommendations for patients with ankylosing spondylitis concerning behaviour and environmental adaptations.

    Feldtkeller, Ernst; Lind-Albrecht, Gudrun; Rudwaleit, Martin

    2013-09-01

    Advice concerning behaviour and adaptations of living and working environment is considered an unmet need by patients with ankylosing spondylitis (AS). The aim of this study was to develop a core set of recommendations to be given to patients by their rheumatologists. A systematic literature research of scientific and patient-oriented literature revealed 70 raw recommendations. These recommendations were evaluated and ranked at a meeting of the Ankylosing Spondylitis International Federation (ASIF, 26 participants including 19 patients with AS, 5 rheumatologists and 2 physiotherapists from 13 countries) in November 2011. Thereafter, the 59 remaining recommendations were extensively discussed, supplemented, reworded, condensed and voted on during a meeting of local branch leaders of the AS patient organisation in Germany (Deutsche Vereinigung Morbus Bechterew, DVMB) with 80 participants (95 % of whom with AS), 2 rheumatologists and 1 occupational therapist in March 2012. The core set of final recommendations comprises (1) a general statement regarding living with AS which was considered highly important by patients and (2) the following domains: sitting position, walking, sleeping, at work, exercises, sports and recreational activities, diet and lifestyle, sexuality and pregnancy, fall prevention, car driving and advantages of membership in an AS-specific patient organisation. Most recommendations are relevant already in early disease, others concern advanced AS (e.g. fall prevention and car driving). The selected recommendations received high agreements (80-100 %). A first core set of recommendations for the behaviour and environmental adaptations of patients with AS was established under participation of many patients. PMID:23539272

  3. High-dose thalidomide increases the risk of peripheral neuropathy in the treatment of ankylosing spondylitis

    Hong-xia Xue

    2015-01-01

    Full Text Available Thalidomide is an effective drug for the treatment of ankylosing spondylitis but might induce peripheral neuropathy. This major adverse reaction has attracted much concern. The current study aimed to observe the incidence of thalidomide-induced peripheral neuropathy among ankylosing spondylitis patients for 1 year after treatment. In this study, 207 ankylosing spondylitis cases received thalidomide treatment, while 116 ankylosing spondylitis cases received other treatments. Results showed that the incidence of thalidomide-induced peripheral neuropathy in the thalidomide group was higher than that in the non-thalidomide group. There was no significant difference in the incidence of neuropathy between the < 6 months medication and ≥ 6 months medication groups. There were no differences in the mean age, gender, or daily dose between the two groups. The incidence of peripheral neuropathy among patients receiving 25, 50, 75, or 100 mg thalidomide per day was 4.6%, 8.5%, 17.1%, 21.7%, respectively. The incidence was significantly different between the groups receiving 25 mg and 100 mg thalidomide. In conclusion, thalidomide can induce peripheral neuropathy within 1 year after treatment of ankylosing spondylitis; however, age and gender have no obvious impact on the incidence of peripheral neuropathy. The incidence of peripheral neuropathy is associated with increasing daily doses of thalidomide.

  4. Is there a common pathogenesis in aggressive periodontitis & ankylosing spondylitis in HLA-B27 patient?

    Agrawal, Neeraj; Agarwal, Kavita; Varshney, Atul; Agrawal, Navneet; Dubey, Ashutosh

    2016-05-01

    HLA-B27 is having strong association to ankylosing spondylitis (AS) and other inflammatory diseases collectively known as seronegative spondyloarthropathy. In literature, although the evidence for association between AS and periodontitis as well as AS and HLA-B27 are there but the association of aggressive periodontitis in HLA-B27 positive patient with AS are not there. We hypothesize that there may be a common pathogenesis in aggressive periodontitis and ankylosing spondylitis in HLA-B27 patient. A 27-years-old female presented with the features of generalized aggressive periodontitis and difficulty in walking. On complete medical examination, ankylosing spondylitis was diagnosed with further positive HLA-B27 phenotype and negative rheumatic factor. This report may open up a new link to explore in the pathogenesis of aggressive periodontitis. PMID:27063088

  5. Risk and effect of radium-224 therapy of ankylosing spondylitis

    A total of 1426 patients suffering from Bechterew's disease who had formerly been treated with 224-Ra (up to 30 years ago), were included in an epidemiological study. The mean skeletal alpha dose amounted to 65 rad, the mean observation period was 16 years. Among the 363 mortalities recorded 3 were due to tumours in the skeletal region; of these, 2 were observed in the haemopoietic system. The types of the tumours detected deserve to be given particular attention: whereas osteosarcomas were almost the only tumours observed in a group of patients studied by Spiess, who had been treated with higher doses, no such tumour was revealed in the study population investigated here. Among the 3 tumours seen in this study group 2 were detected in the haemopoietic system as compared to 1 out of 55 tumours observed by Spiess. In contrast to this finding there was a remarkably high incidence of tumours of haemopoietic organs among the victims of Hiroshima. These results show that the relative benefits and disadvantages of the drug 224-Ra once again must be carefully considered. None of the chemical agents used in the treatment of ankylosing spondylitis is free from side-effects. A comparison of the latter with the risks involved in the use of 224-Ra leads to the conclusion that - according to the experience gained so far - 224-Ra is very useful in the treatment of this disease, if there is an absolute indication. (orig./MG)

  6. The abilities of golimumab in the therapy of ankylosing spondylitis

    Sh. F. Erdes

    2014-09-01

    Full Text Available The paper summarizes the data of the GO-RAISE trial evaluating the efficacy and tolerability of golimumab (GLM in patients with ankylosing spondylitis (AS. The trial was launched in 57 clinical centers of North America, Europe, and Asia in 2005. It enrolled 356 patients with high AS activity (BASDAI≥4 in whom previous and current therapies with nonsteroidal anti-inflammatory drugs (NSAIDs or disease-modifying anti-rheumatic drugs were ineffective. Group 1 patients received subcutaneous placebo; Group 2 had subcutaneous GLM 50 mg; Group 3 took GLM 100 mg every 4 weeks. Concomitant therapy with methotrexate, sulfasalazine, hydroxychloroquine, glucocorticoids, and NSAIDs was continued in previous doses. The investigators have concluded that GLM therapy in patients with AS gives rise to a rapid clinical and radiographic response that persists for a long time. Although no comparative trials of GLM versus other tumor necrosis factor-α (TNF-α inhibitors used to treat AS have conducted, the available data show that its efficacy and tolerability in these patients are similar to those of the TNF-α inhibitors already used in Russia. The GLM dose of 100 mg is noted to be worse tolerated than that of 50 mg with their practically equal clinical efficacy. The standard dose of GLM is 50 mg subcutaneously administered once monthly for all indications, including also for AS.

  7. The abilities of golimumab in the therapy of ankylosing spondylitis

    Sh. F. Erdes

    2014-01-01

    Full Text Available The paper summarizes the data of the GO-RAISE trial evaluating the efficacy and tolerability of golimumab (GLM in patients with ankylosing spondylitis (AS. The trial was launched in 57 clinical centers of North America, Europe, and Asia in 2005. It enrolled 356 patients with high AS activity (BASDAI≥4 in whom previous and current therapies with nonsteroidal anti-inflammatory drugs (NSAIDs or disease-modifying anti-rheumatic drugs were ineffective. Group 1 patients received subcutaneous placebo; Group 2 had subcutaneous GLM 50 mg; Group 3 took GLM 100 mg every 4 weeks. Concomitant therapy with methotrexate, sulfasalazine, hydroxychloroquine, glucocorticoids, and NSAIDs was continued in previous doses. The investigators have concluded that GLM therapy in patients with AS gives rise to a rapid clinical and radiographic response that persists for a long time. Although no comparative trials of GLM versus other tumor necrosis factor-α (TNF-α inhibitors used to treat AS have conducted, the available data show that its efficacy and tolerability in these patients are similar to those of the TNF-α inhibitors already used in Russia. The GLM dose of 100 mg is noted to be worse tolerated than that of 50 mg with their practically equal clinical efficacy. The standard dose of GLM is 50 mg subcutaneously administered once monthly for all indications, including also for AS.

  8. Leukocytoclastic Vasculitis in a Patient with Ankylosing Spondylitis

    Senol Kobak

    2014-01-01

    Full Text Available A 26-year-old male patient presented to our rheumatology clinic with pain, swelling and limitation of movement in his right ankle, and also purpuric skin lesions in the lower extremity pretibial region. He was asked questions, and he said that he had been having chronic low back pain and morning stiffness for the last few years. His physical examination revealed that he had arthritis in his right ankle, purpuric skin lesions in pretibial regions of both legs, and bilateral FABERE/FADIR positivity. The sacroiliac joint imaging and MRI revealed bilateral sacroiliitis findings, and the lateral heel imaging revealed enthesitis. HLA-B27 was positive. Skin biopsy from lower skin lesions was reported to be consistent with leukocytoclastic vasculitis. Based on clinical, laboratory, radiological, and pathological examinations, the patient was diagnosed with ankylosing spondylitis and leukocytoclastic vasculitis. Administration of corticosteroid, salazopyrin, and nonsteroid anti-inflammatory medications was started. Notable clinical and laboratory regression was observed during his checks 3 months later.

  9. Genetics of ankylosing spondylitis--insights into pathogenesis.

    Brown, Matthew A; Kenna, Tony; Wordsworth, B Paul

    2016-02-01

    Ankylosing spondylitis (AS), an immune-mediated arthritis, is the prototypic member of a group of conditions known as spondyloarthropathies that also includes reactive arthritis, psoriatic arthritis and enteropathic arthritis. Patients with these conditions share a clinical predisposition for spinal and pelvic joint dysfunction, as well as genetic associations, notably with HLA-B(*)27. Spondyloarthropathies are characterized by histopathological inflammation in entheses (regions of high mechanical stress where tendons and ligaments insert into bone) and in the subchondral bone marrow, and by abnormal osteoproliferation at involved sites. The association of AS with HLA-B(*)27, first described >40 years ago, led to hope that the cause of the disease would be rapidly established. However, even though many theories have been advanced to explain how HLA-B(*)27 is involved in AS, no consensus about the answers to this question has been reached, and no successful treatments have yet been developed that target HLA-B27 or its functional pathways. Over the past decade, rapid progress has been made in discovering further genetic associations with AS that have shed new light on the aetiopathogenesis of the disease. Some of these discoveries have driven translational ideas, such as the repurposing of therapeutics targeting the cytokines IL-12 and IL-23 and other factors downstream of this pathway. AS provides an excellent example of how hypothesis-free research can lead to major advances in understanding pathogenesis and to the development of innovative therapeutic strategies. PMID:26439405

  10. ERAP1 in the pathogenesis of ankylosing spondylitis.

    Reeves, Emma; Elliott, Tim; James, Edward; Edwards, Christopher J

    2014-12-01

    The endoplasmic reticulum aminopeptidase 1 (ERAP1) performs a major role in antigen processing, trimming N-terminally extended peptides to the final epitope for presentation by major histocompatibility complex class I molecules. Recent genome-wide association studies have identified single nucleotide polymorphisms (SNPs) within ERAP1 as being associated with disease, in particular ankylosing spondylitis (AS). AS is a polygenic chronic inflammatory disease with a strong genetic link to HLA-B27 known for over 40 years. The association of ERAP1 SNPs with AS susceptibility is only observed in HLA-B27-positive individuals, which intersect on the antigen processing pathway. Recent evidence examining the trimming activity of polymorphic ERAP1 highlights its role in generating peptides for loading onto and stabilizing HLA-B27, and the consequent alterations in the interaction of specific NK cell receptors, and the activation of the unfolded protein response as important in the mechanism of disease pathogenesis. Here, we discuss the recent genetic association findings linking ERAP1 SNPs with AS disease susceptibility and the effect of these variants on ERAP1 function, highlighting mechanisms by which AS may arise. The identification of these functional variants of ERAP1 may lead to better stratification of AS patients by providing a diagnostic tool and a potential therapeutic target. PMID:25434650

  11. Pelvic MRI findings of juvenile-onset ankylosing spondylitis.

    Yilmaz, Mehmet Halit; Ozbayrak, Mustafa; Kasapcopur, Ozgur; Kurugoglu, Sebuh; Kanberoglu, Kaya

    2010-09-01

    Ankylosing spondylitis (AS) is the most common clinical subgroup of sero-negative spondyloarthropathies. Radiographic and clinical signs of bilateral inflammatory involvement of sacroiliac joints are the gold standard for the diagnosis of juvenile AS. Although radiographic evidence of sacroiliitis is included in the definition, it is not mandatory for the diagnosis of juvenile AS. The aim of this study is to describe pelvic enthesitis-osteitis MRI findings accompanying sacroiliitis in a group of juvenile AS. Eleven patients suffering from low back pain underwent MRI of the pelvis and were enrolled in this retrospective study. The mean duration of symptoms was 12 months. The mean age of the 11 cases in our study was 12.18 years (range, 6-19). There were eight boys and three girls. Anteroposterior radiographs of the pelvis were obtained in all patients. Sacroiliac joint involvement was detected in all of the cases by pelvic MRI. Pathologic signal changes were detected in the pubic symphisis (osteitis pubis) in ten cases, trochanteric bursitis in six cases, coxofemoral joint in five cases, crista iliaca in three cases, and ischion pubis in three cases. There was increased T2 signal intensity in eight of the 11 cases (72.7%) relevant with soft tissue edema/inflammation. This high correlation between sacroiliitis and enthesitis suggests that enthesitis could be an important finding in juvenile AS. PMID:20549278

  12. Meta-analysis of differentially expressed genes in ankylosing spondylitis.

    Lee, Y H; Song, G G

    2015-01-01

    The purpose of this study was to identify differentially expressed (DE) genes and biological processes associated with changes in gene expression in ankylosing spondylitis (AS). We performed a meta-analysis using the integrative meta-analysis of expression data program on publicly available microarray AS Gene Expression Omnibus (GEO) datasets. We performed Gene Ontology (GO) enrichment analyses and pathway analysis using the Kyoto Encyclopedia of Genes and Genomes. Four GEO datasets, including 31 patients with AS and 39 controls, were available for the meta-analysis. We identified 65 genes across the studies that were consistently DE in patients with AS vs controls (23 upregulated and 42 downregulated). The upregulated gene with the largest effect size (ES; -1.2628, P = 0.020951) was integral membrane protein 2A (ITM2A), which is expressed by CD4+ T cells and plays a role in activation of T cells. The downregulated gene with the largest ES (1.2299, P = 0.040075) was mitochondrial ribosomal protein S11 (MRPS11). The most significant GO enrichment was in the respiratory electron transport chain category (P = 1.67 x 10-9). Therefore, our meta-analysis identified genes that were consistently DE as well as biological pathways associated with gene expression changes in AS. PMID:26125709

  13. Ayurvedic approach for management of ankylosing spondylitis: A case report.

    Singh, Sarvesh Kumar; Rajoria, Kshipra

    2016-03-01

    Ankylosing spondylitis (AS) is a rheumatic disease with various skeletal and extra skeletal manifestations. No satisfactory treatment is available in modern medicine for this disorder. Various Panchakarma procedures and Ayurvedic drugs have been proved useful for these manifestations. We present a case of AS, which was treated for two months with a combination of Panchakarma procedures and Ayurvedic drugs. Ayurvedic treatments, in this case, were directed toward alleviating symptoms and to reduce severe disability. The patient was considered suffering from Asthimajja gata vata (∼Vata disorder involving bone and bone marrow) and was treated with Shalishastika Pinda Svedana (sudation with medicated cooked bolus of rice) for one month and Mustadi Yapana Basti (enema with medicated milk) with Anuvasana (enema with Asvagandha oil) in 30 days schedule along with oral Ayurvedic drugs for two months. Pratimarsha nasya (nasal drops) with Anu Taila (oil) for one month was given after completion of Basti procedure. Patient's condition was assessed for symptoms of Asthimajja gata vata and core sets of Assessment of Spondylo Arthritis International Society showed substantial improvement. This study shows the cases of AS may be successfully managed with Ayurvedic treatment. PMID:27297511

  14. A case of severe ankylosing spondylitis posted for hip replacement surgery

    Nalini Kotekar

    2007-01-01

    Full Text Available A 50-year-old male patient with history of ankylosing spondylitis (AS for 30 years presented for hip replacement surgery. Airway management in ankylosing spondylitis patients presents the most serious array of intubation and airway hazards imagin-able, which is secondary to decrease in cervical spine mobility and possible temporo-mandibular joint disease. Literatures support definitive airway management and many authors consider regional anaesthesia to be contraindicated. The reasons cited include inability to gain neuraxial access and the need for urgent airway control in case of complication of regional anaesthesia.

  15. MMP mediated type V collagen degradation (C5M) is elevated in ankylosing spondylitis

    Veidal, S S; Larsen, D V; Chen, Xijuan;

    2012-01-01

    Type V collagen has been demonstrated to control fibril formation. The aim of this study was to develop an ELISA capable of detecting a fragment of type V collagen generated by MMP-2/9 and to evaluate the assay as biomarker for ankylosing spondylitis (AS).......Type V collagen has been demonstrated to control fibril formation. The aim of this study was to develop an ELISA capable of detecting a fragment of type V collagen generated by MMP-2/9 and to evaluate the assay as biomarker for ankylosing spondylitis (AS)....

  16. Diagnostic delay in patients with rheumatoid arthritis, psoriatic arthritis and ankylosing spondylitis

    Sørensen, Jan; Hetland, Merete Lund

    2014-01-01

    BACKGROUND/PURPOSE: Early diagnosis of inflammatory rheumatic diseases is important in order to improve long-term outcome. We studied whether delay in diagnosis (time between onset of symptoms and establishment of diagnosis) in patients with rheumatoid arthritis (RA), psoriatic arthritis (PSA) and...... ankylosing spondylitis (AS) changed from year 2000 to 2011. METHODS: Month and year of initial symptoms and diagnosis, gender, hospital, year of birth and date of first data entry were obtained for 13 721 patients with RA, PSA or AS who had been registered in the DANBIO registry. Time between symptom onset...... and diagnosis was modelled using generalised linear regression to predict the average duration for each calendar year of initial symptoms with adjustments for gender, year of birth and date of DANBIO entry. RESULTS: Patients with valid data (RA: 10 416 (73%); PSA: 1970 (68%); AS: 1335 (65%)) did not...

  17. MAGNETIC RESONANCE IMAGING DIAGNOSIS OF INFLAMMATORY CHANGES OF THE AXIAL SKELETON IN ANKYLOSING SPONDYLITIS

    A. V. Smirnov

    2016-01-01

    Full Text Available As of now, magnetic resonance imaging (MRI ranks high in the early diagnosis of inflammatory changes in the musculoskeletal system. The uniqueness of MRI is that this diagnostic technique can detect the signs of active and inactive inflammation at the pre-radiological stage of the disease, i.e. before the onset of radiological symptoms of sacroiliitis and the formation of spinal syndesmophytes. At the same time there is evidence that there is a temporary association between active inflammation and the development of radiological changes in the joints.The detection of bone marrow edema in the subchondral portions of bone tissue is of great importance not only for diagnosing the disease and verifying inflammatory activity, but also for predicting the development of chronic arthritis, choosing a treatment option, and evaluating the efficiency of performed therapy.Based on their long-term experience, the authors provided explanations of the MRI pattern of active and inactive chronic sacroiliitis and spondylitis, which can considerably facilitate the early diagnosis of injury to the sacroiliac joints and vertebral column in patients with ankylosing spondylitis.

  18. Serum homocysteine level in patients with ankylosing spondylitis.

    Başkan, Bedriye Mermerci; Sivas, Filiz; Aktekin, Lale Akbulut; Doğan, Yasemin Pekin; Ozoran, Kürşat; Bodur, Hatice

    2009-10-01

    In this study serum homocystein (Hcy) level was measured and its relationship with disease activity criteria and treatment protocols was investigated in ankylosing spondylitis (AS) patients. Ninety-two AS patients and 58 healthy individuals were recruited. Erythrocyte sedimentation rate and serum C-reactive protein were determined. Bath AS disease activity index and Bath AS functional index were calculated. Serum Hcy levels >15 micromol/l were considered as hyperhomocysteinemia. The mean serum homocysteine levels were 14.40 and 12.60 micromol/l in patients with AS and the control group, respectively, and the difference between two groups was significant. While there was no significant difference between the sulfasalazine (SSZ) group with 14.25 micromol/l mean Hcy level and the methotrexate (MTX)/SSZ group with 16.05 micromol/l, there was a statistically significant difference between the Hcy levels of these two groups and Hcy level of 12.15 micromol/l of the non-steroidal anti-inflammatory drugs group, and 12.60 micromol/l Hcy level of the control group. Mean serum Hcy level was 13.65 micromol/l in patients with active AS and 14.60 micromol/l in patients with inactive AS, and there was no significant difference between the groups. In our study serum Hcy level was found to be significantly higher in patients with AS than in healthy control subjects. Especially for the AS patients receiving MTX and SSZ treatment without folic acid supplementation, addition of folic acid to their therapy may decrease the risk of cardiovascular disease which in turn decreases the mortality in these patients, but further prospective studies are needed for supporting these results. PMID:19288264

  19. Resolution of inflammation following treatment of ankylosing spondylitis is associated with new bone formation

    Pedersen, Susanne J; Chiowchanwisawakit, Praveena; Lambert, Robert G W; Østergaard, Mikkel; Maksymowych, Walter P

    2011-01-01

    To test the hypothesis that in patients with ankylosing spondylitis (AS) a vertebral corner inflammatory lesion (CIL) visible on magnetic resonance imaging (MRI) that completely resolves following treatment with anti-tumor necrosis factor-α (TNF-α) agents is more likely to develop into a de novo...

  20. Validity of ankylosing spondylitis and undifferentiated spondyloarthritis diagnoses in the Swedish National Patient Register

    Lindström, U; Exarchou, S; Sigurdardottir, V; Sundström, B; Askling, J; Eriksson, J K; Forsblad-d'Elia, H; Turesson, C; Kristensen, L E; Jacobsson, L

    2015-01-01

    OBJECTIVES: Epidemiological studies of spondyloarthritis (SpA), using ICD codes from the Swedish National Patient Register (NPR), offer unique possibilities but hinge upon an understanding of the validity of the codes. The aim of this study was to validate the ICD codes for ankylosing spondylitis...

  1. Resolution of inflammation following treatment of ankylosing spondylitis is associated with new bone formation

    Pedersen, Susanne J; Chiowchanwisawakit, Praveena; Lambert, Robert G W; Østergaard, Mikkel; Maksymowych, Walter P

    2011-01-01

    To test the hypothesis that in patients with ankylosing spondylitis (AS) a vertebral corner inflammatory lesion (CIL) visible on magnetic resonance imaging (MRI) that completely resolves following treatment with anti-tumor necrosis factor-a (TNF-a) agents is more likely to develop into a de novo...

  2. Why golimumab in the treatment of psoriatic arthritis, ankylosing spondylitis and rheumatoid arthritis?

    M. Rossini

    2015-03-01

    Full Text Available Golimumab is an anti-TNF monoclonal antibody administred subcutaneously once a month and produced with an innovative technology that minimizes immunogenicity. This paper reviews and updates the main studies on the efficacy, safety and pharmacoeconomic aspects of treatment with golimumab of psoriatic arthritis, ankylosing spondylitis and rheumatoid arthritis.

  3. Baseline predictors of response to TNF-α blocking therapy in ankylosing spondylitis

    Arends, Suzanne; van der Veer, Eveline; Kallenberg, Cees G. M.; Brouwer, Elisabeth; Spoorenberg, Anneke

    2012-01-01

    PURPOSE OF REVIEW: Identifying the characteristics of patients with ankylosing spondylitis (AS) before start of treatment which are able to predict a beneficial response to tumor necrosis factor-alpha (TNF-α) blocking therapy is relevant, especially in view of the high costs and potential side-effec

  4. Is nephrolithiasis an unrecognized extra-articular manifestation in ankylosing spondylitis?

    Jakobsen, Ane Krag; Jacobsson, Lennart T H; Patschan, Oliver;

    2014-01-01

    BACKGROUND: Ankylosing spondylitis (AS) is associated with several extra-articular manifestations. Nephrolithiasis (NL) has not been recognized as one of those, however, several factors known to increase the risk of NL are at play in AS patients. The objective was to estimate rates and predictors...

  5. Spinal pseudo arthrosis in the ankylosing spondylitis: complications with infectious discytis simulation

    A case is presented of radiological signs typical of spinal pseudo arthrosis in a patient with ankylosing spondylitis. The radiological signs (plain radiology, computerized tomography and magnetic resonance) are described, and the recognition of this disorder and its differentiation with respect to infectious spondilodiscitis is discussed. (Author) 11 refs

  6. Outcomes of a multicentre randomised clinical trial of etanercept to treat ankylosing spondylitis.

    Calin, A.; Dijkmans, B.A.C.; Emery, P; Hakala, M; Kalden, J; Leirisalo-Repo, M; Mola, EM; Salvarani, C; Sanmarti, R; Sany, J; Sibilia, J; Sieper, J.; Linden, S. ven der; Veys, E; Appel, AM; Fatenejad, S

    2004-01-01

    OBJECTIVE: A double blind, randomised, placebo controlled study to evaluate the safety and efficacy of etanercept to treat adult patients with ankylosing spondylitis (AS). METHODS: Adult patients with AS at 14 European sites were randomly assigned to 25 mg injections of etanercept or placebo twice w

  7. Major histocompatibility complex associations of ankylosing spondylitis are complex and involve further epistasis with ERAP1

    Cortes, Adrian; Pulit, Sara L; Leo, Paul J; Pointon, Jenny J; Robinson, Philip C; Weisman, Michael H; Ward, Michael; Gensler, Lianne S; Zhou, Xiaodong; Garchon, Henri-Jean; Chiocchia, Gilles; Nossent, Johannes; Lie, Benedicte A; Førre, Øystein; Tuomilehto, Jaakko; Laiho, Kari; Bradbury, Linda A; Elewaut, Dirk; Burgos-Vargas, Ruben; Stebbings, Simon; Appleton, Louise; Farrah, Claire; Lau, Jonathan; Haroon, Nigil; Mulero, Juan; Blanco, Francisco J; Gonzalez-Gay, Miguel A; Lopez-Larrea, C; Bowness, Paul; Gaffney, Karl; Gaston, Hill; Gladman, Dafna D; Rahman, Proton; Maksymowych, Walter P; Crusius, J Bart A; van der Horst-Bruinsma, Irene E; Valle-Oñate, Raphael; Romero-Sánchez, Consuelo; Hansen, Inger Myrnes; Pimentel-Santos, Fernando M; Inman, Robert D; Martin, Javier; Breban, Maxime; Wordsworth, Bryan Paul; Reveille, John D; Evans, David M; de Bakker, Paul I W; Brown, Matthew A

    2015-01-01

    Ankylosing spondylitis (AS) is a common, highly heritable, inflammatory arthritis for which HLA-B*27 is the major genetic risk factor, although its role in the aetiology of AS remains elusive. To better understand the genetic basis of the MHC susceptibility loci, we genotyped 7,264 MHC SNPs in 22,64

  8. Comparative efficacy of infliximab and adalimumab in patients with ankylosing spondylitis

    Tatyana Valentinovna Mezenova

    2012-01-01

    Full Text Available Objective: to study the comparative efficacy of the genetically engineered biological agents infliximab (INF and adalimumab (ADA in patients with ankylosing spondylitis (AS. Subjects and methods. The study included 86 patients with active AS who had failed to achieve remission with the maximal tolerated doses of nonsteroidal anti-inflammatory drugs, sulfasalazine, methotrexate, and glucocorticoids. The patients were divided into 2 groups: 1 53 patients (mean age 35±9 years, disease duration 13.9±7.5 years took INF; 2 33 patients (mean age 35±12 years; disease duration 9.1±6.7 years received ADA. Therapeutic effectiveness was evaluated by Bath Ankylosing Spondylitis Disease Activity Index (BASDAI, and Ankylosing Spondylitis Disease Activity Score (ASDAS, Bath Ankylosing Spondylitis Functional Index (BASFI, Bath Ankylosing Spondylitis Metrology Index (BASMI scores, ASsessments in Ankylosing Spondylitis (ASAS remission criteria, vertebral index changes, laboratory parameters, and HLA-B27 typing. INF was administered at a dose of 3—5 mg/kg body weight (300—400 mg at 0, 2, and 6 weeks and then every 8 weeks, ADA was given in a dose of 40 mg once every 2 weeks. Therapeutic effectiveness was evaluated every 12 weeks. Results. At 48 weeks of therapy, there was a 50% decrease in BASDAI scores in 64 and 60% of the patients in the INF and ADA groups, respectively. ASDAS dropped in 69% and reached its minimal value in 51% in the INF group; those in the ADA group were 54 and 66%, respectively. The mean BASFI score was almost halved in both INF and ADA groups; its low score was recorded in 67 and 60%, respectively. Both groups showed a significant increase in the spine range of motion after 12 weeks of therapy. By the end of the study, there was a significant improvement of locomotion (BASMI as compared to the baseline values: from 19.4±8.1 to 13.6±4.8 and from 17.3±6.2 to 15.9±7.3, respectively. According to the ASAS criteria, partial remission

  9. Long-term safety and efficacy of etanercept in the treatment of ankylosing spondylitis

    Senabre-Gallego JM

    2013-09-01

    Full Text Available José Miguel Senabre-Gallego,1 Carlos Santos-Ramirez,2 Gregorio Santos-Soler,1 Esteban Salas-Heredia,1 Mabel Sánchez-Barrioluengo,3 Xavier Barber,4 José Rosas1 On behalf of the AIRE-MB group 1Rheumatology, Hospital Marina Baixa, Villajoyosa, 2Rheumatology, Hospital Marina Salud, Denia, 3INGENIO (Instituto de Gestión de la Inovación y del Conocimiento (CSIC [Consejo Superior de Investigaciones Científicas]-UPV [Universidad Politécnica de Valencia], Universitat Politècnica de València, Valencia, 4CIO (Centro de Investigación Operativa-UMH (Universidad Miguel Hernández, Universidad Miguel Henández, Elche, Spain Abstract: To date, anti-tumor necrosis factor alfa (anti-TNF-α therapy is the only alternative to nonsteroidal anti-inflammatory drugs for the treatment of ankylosing spondylitis. Etanercept is a soluble TNF receptor, with a mode of action and pharmacokinetics different to those of antibodies and distinctive efficacy and safety. Etanercept has demonstrated efficacy in the treatment of ankylosing spondylitis, with or without radiographic sacroiliitis, and other manifestations of the disease, including peripheral arthritis, enthesitis, and psoriasis. Etanercept is not efficacious in inflammatory bowel disease, and its efficacy in the treatment of uveitis appears to be lower than that of other anti-TNF drugs. Studies of etanercept confirmed regression of bone edema on magnetic resonance imaging of the spine and sacroiliac joint, but failed to reduce radiographic progression, as do the other anti-TNF drugs. It seems that a proportion of patients remain in disease remission when the etanercept dose is reduced or administration intervals are extended. Etanercept is generally well tolerated with an acceptable safety profile in the treatment of ankylosing spondylitis. The most common adverse effect of etanercept treatment is injection site reactions, which are generally self-limiting. Reactivation of tuberculosis, reactivation of

  10. Assessment of subclinical atherosclerosis in ankylosing spondylitis: correlations with disease activity indices

    F.M. Perrotta

    2013-07-01

    Full Text Available The aim of the study was to evaluate atherosclerosis in ankylosing spondylitis (AS through the assessment of morphological and functional measures of subclinical atherosclerosis. Twenty patients [M/F=12/8, age (median/range 43.5/28-69 years; disease duration (median/range 9.7/1-36 years] with AS classified according to modified New York criteria and twenty age and sex related healthy controls with negative past medical history for cardiovascular events were enrolled in the study. In all patients and controls, the intima-media thickness (IMT of common carotid artery, carotid bulb and internal carotid artery, and the flow-mediated dilatation (FMD of non-dominant arm brachial artery were determined, using a sonographic probe Esaote GPX (Genoa, Italy. Furthermore, we assess the main disease activity and disability indices [bath ankylosing spondylitis disease activity index, ankylosing spondylitis disease activity score-eritrosedimentation rate (ASDAS-ESR, ASDAS-C-reactive protein (CRP, bath ankylosing spondylitis metrology index, bath ankylosing spondylitis functional index and acute phase reactants. Plasmatic values of total cholesterol, low-density lipoprotein, high-density lipoprotein, triglyceride and homocysteine were carried out in all twenty patients. IMT at carotid bulb was significant higher in patients than in controls (0.67 mm vs 0.54 mm; P=0.03. FMD did not statistically differ between patients and controls (12.5% vs 15%; P>0.05. We found a correlation between IMT at carotid bulb and ESR (rho 0.43; P=0.04. No correlation was found between FMD and disease activity and disability indices. This study showed that in AS patients, without risk factors for cardiovascular disease, carotid bulb IMT, morphological index of subclinical atherosclerosis, is higher than in controls.

  11. Aortic valve replacement and ascending aorta replacement in ankylosing spondylitis: report of three surgical cases and review of the literature.

    Kawasuji, M; Hetzer, R; Oelert, H; Stauch, G; Borst, H G

    1982-10-01

    Out of 887 consecutive patients who underwent aortic valve replacement between January 1976 and December 1981 at Hannover Medical School Hospital, 3 patients had severe aortic valve insufficiency associated with ankylosing spondylitis (Morbus Bechterew). One of them had huge aneurysmatic dilatation of the ascending aorta and successfully underwent replacement of the ascending aorta by a vascular prosthesis. Microscopical examination of the resected aortic wall showed characteristic findings of aortitis in ankylosing spondylitis. The 3 patients are in good clinical condition at 5 and 6 months, and 2 1/2 years, respectively, after uneventful surgery. It is concluded that aortic valve replacement in patients with ankylosing spondylitis can be performed feasibly and clinical results have been satisfactory. The risk of aneurysmatic dilatation of the ascending aorta resulting from aortitis associated with ankylosing spondylitis is emphasized. PMID:6183782

  12. Airtraq® optical laryngoscope for tracheal intubation in patients with severe ankylosing spondylitis: A report of two cases

    Qazi Ehsan Ali; Syed Hussain Amir; Obaid Ahmed Siddiqui; Abu Nadeem; Abdulla Zoheb Azhar

    2012-01-01

    Airway management in patients of ankylosing spondylitis remains a challenge for anaesthesiologists. Many new airway devices have been used for securing airway in these patients. The Airtraq® optical laryngoscope is one of the new rigid laryngoscopes with a proximal view finder that reflects an image transferred from the distal tip of the blade through a series of lenses, prisms and mirrors. We report two cases of ankylosing spondylitis who were scheduled for total hip replacement and subtotal...

  13. Therapy of ankylosing spondylitis and other spondyloarthritides: established medical treatment, anti-TNF-α therapy and other novel approaches

    Braun, Juergen; Sieper, Joachim

    2002-01-01

    Therapeutic options for patients with more severe forms of spondyloarthritis (SpA) have been rather limited in recent decades. There is accumulating evidence that anti-tumor-necrosis-factor (anti-TNF) therapy is highly effective in SpA, especially in ankylosing spondylitis and psoriatic arthritis. The major anti-TNF-α agents currently available, infliximab (Remicade®) and etanercept (Enbrel®), are approved for the treatment of rheumatoid arthritis (RA) in many countries. In ankylosing spondyl...

  14. Identification of Potential Transcriptomic Markers in Developing Ankylosing Spondylitis: A Meta-Analysis of Gene Expression Profiles

    Fang Fang; Jian Pan; Lixiao Xu; Gang Li; Jian Wang

    2015-01-01

    The goal of this study was to identify potential transcriptomic markers in developing ankylosing spondylitis by a meta-analysis of multiple public microarray datasets. Using the INMEX (integrative meta-analysis of expression data) program, we performed the meta-analysis to identify consistently differentially expressed (DE) genes in ankylosing spondylitis and further performed functional interpretation (gene ontology analysis and pathway analysis) of the DE genes identified in the meta-analys...

  15. Clinical features of Crohn disease concomitant with ankylosing spondylitis

    Liu, Song; Ding, Jie; Wang, Meng; Zhou, Wanqing; Feng, Min; Guan, Wenxian

    2016-01-01

    Abstract Extraintestinal manifestations (EIMs) cause increased morbidity and decreased quality of life in Crohn disease (CD). Ankylosing spondylitis (AS) belongs to EIMs. Very little is known on the clinical features of CD concomitant with AS. This study is to investigate the clinical features of CD patients with AS. We retrospectively collected all CD patients with AS in our hospital, and established a comparison group (CD without AS) with age, sex, and duration of Crohn disease matched. Clinical information was retrieved for comparison. Eight CD + AS patients were identified from 195 CD patients. Sixteen CD patients were randomly selected into comparison group. All CD + AS patients were male, HLA-B27 (+), and rheumatoid factor (−) with an average age of 40.8 ± 4.52 years. Significant correlation between disease activity of CD and AS was revealed (r = 0.857, P = 0.011). Significant correlation between disease activity of CD and functional limitation associated with AS was identified (r = 0.881, P < 0.01). C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), and globulin were positively correlated to Crohn disease activity index (CDAI), Bath AS disease activity index, and Bath AS functional index(BASFI) scores (r = 0.73–0.93, P < 0.05). Albumin was negatively associated with CDAI and BASFI (r = −0.73 to −0.91, P < 0.05). The ratio of albumin to globulin (Alb/Glo) was significantly related to all 3 scores (r = −0.81 to −0.91, P < 0.05). Male predominance with a 4.12% concomitant incidence of AS is observed in CD patients. Disease activity of CD correlates with disease activity of AS and functional limitation caused by AS. CRP, ESR, and Alb/Glo may serve as biomarkers for disease activity and functional limitation in CD patients concomitant with AS, although future studies are expected. PMID:27428240

  16. Early diagnostic value of MRI in sacroiliac joint of ankylosing spondylitis%MRI在强直性脊柱炎骶髂关节中的早期诊断价值

    周应平; 李曼; 罗光银; 李松

    2013-01-01

    Objective To investigate the early diagnostic value of MRI in sacroiliac joint(SIJ) change of ankylosing spondylitis(AS). Methods The MRI manifestation of SIJ in 15 patients of AS with clinical definite diagnosis and treatment during June 2012 to September 2013 were reviewed,and the analysis was focused on the imaging findings of osteochondral,joint space,bone marrow and ligament attachment,and the control study was done by using the DR/CT classification criteria. Results MRI had the advantage on“three line display anatomy”of SIJ,and was very sensitive to the changes in early erosion of cartilage and marrow oedema,and the early diagnosis sensitivity of MRI increased by one to two levels compared with CT,and is easy to found the early lesion of adjacent joint,sclerotin and attachment. Conclusion MRI has higher early clinical diagnosis value on the imaging performance of SIJ in AS.%目的:探讨强直性脊柱炎(AS)骶髂关节(SIJ)改变的MRI早期诊断价值。方法回顾2012年6月~2013年9月临床明确诊治的15例AS患者SIJ的MRI表现,重点分析其骨软骨、关节间隙、骨髓、韧带附着处等的影像学征象,采用DR/CT分级标准进行对照研究。结果 MRI对SIJ“三线解剖”显示有优势,对软骨的早期侵蚀和骨髓炎性水肿的变化极敏感,早期诊断较CT敏感一至二个级别,并易于早期发现毗邻关节、骨质、附着处病变。结论MRI对AS的SIJ影像表现具有较高的临床早期诊断价值。

  17. Ankylosing spondylitis and HLA-B27: restriction fragment length polymorphism and sequencing of an HLA-B27 allele from a patient with ankylosing spondylitis

    1993-01-01

    Two groups of patients with ankylosing spondylitis (AS) from England and Poland were examined for restriction fragment length polymorphisms (RFLPs) associated with the disease. No preferential association was found between the 9.2 kb PvuII fragment in HLA-B27 positive patients with AS compared with HLA-B27 healthy subjects as had been previously reported. In the English group, however, a 14 kb PvuII fragment was more common in HLA-B27 positive subjects with AS than in normal controls. Also 4....

  18. Predictive factors for partial remission according to the Ankylosing Spondylitis Assessment Study working group in patients with ankylosing spondylitis treated with anti-TNFα drugs

    F.M. Perrotta

    2014-11-01

    Full Text Available The objective of this study was to evaluate the predictive factors for achieving partial remission (PR in patients with ankylosing spondylitis (AS treated with anti-TNFα. We longitudinally enrolled in a multi-center study 214 AS patients, classified according to New York criteria, treated with anti-TNFα drugs adalimumab (ADA, etanercept (ETA and infliximab (INF with at least 12 months of follow up. PR was reached when the score was <20 mm (on a visual analogue scale of 0-100 mm in each of the following 4 domains: 1 patient global assessment (in the last week; 2 pain (spinal pain; 3 function [measured by the bath ankylosing spondylitis functional index (BASFI]; 4 inflammation [mean of intensity and duration of morning stiffness, from the bath ankylosing spondylitis disease activity index (BASDAI]. Two hundred fourteen AS patients (M/F=160/54; median age/range=43.2/19-78 years; median disease duration/ range=96/36-189 months were treated with ADA (15.8%, ETA (28.9% and INF (55.1%. At 12 and 24 months, high serum level of C reactive protein (CRP (≥2 vs ≤0.8 mg/dL were associated with higher rate of PR in AS patients treated with anti-TNFα drugs. At 24 months, PR was associated with shorter disease duration (≤36 vs ≥189 months and higher erythrosedimentation rate (ESR values (≥45 vs ≤17 mm/h. In male patients lower bath ankylosing spondylitis metrology index (BASMI (≤2 vs ≥6 and absence of psoriasis were associated with higher PR rate only at 12 months. Other parameters assessed before treatment, such as BASDAI, BASFI, peripheral arthritis, inflammatory bowel disease and uveitis were not associated with PR. Our long-term longitudinal study in a setting of clinical practice showed that inflammatory parameters (i.e. CRP, ESR and disease duration represent the most important predictive variables to achieve PR with an anti-TNFα treatment.

  19. Spine inflammatory changes in patients with ankylosing spondylitis assessed by magnetic resonance image

    A G Bochkova

    2008-01-01

    Full Text Available Objective. To develop the optimal mode of spine evaluation with magnetic resonance image (MRl in pts with ankylosing spondylitis (AS and to study relationship between MR! signs of spinal inflammatory lesions (IL, spondylitis duration and clinical features of AS activity. Material and methods. MRl was performed in 36 pts (22 male, 14 female fulfilling the modified NY criteria of AS. Median age of pis was 26 years (range 19 - 55, Median AS duration - 8 years (range 1,8 - 24. 34 (97% pts were HLA-B27 positive. 21 (64% pts had high AS activity - median BASDAI 40 (range 10 - 77. 92% of pts had inflammatory spine pain (VAS>20 mm and 61% of pts had night pain. Median inflammatory pain duration had been defined separately for every part of the spine assessed by MRl. Median duration of axial pain was 36 months (range: 1-240. MR-scanning (Magnetom Symphony, Siemens, 1.5 T was performed inTl, T2 and T2-FS (fat signal suppression modes. IL scoring was done only in 29 pts evaluated in both sagittal and axial planes. We used two scoring methods: 1 individual IL score of the each spine element (vertebral bodies, processes, arches, zygapophyseai, costovertebral and costotransverse joints, ligaments, and 2 separate IL scoring in the vertebral bodies and posterior spinal elements in order "yes/no”. Results. 50 MRl images of different parts of the spine (8 cervical, 30 thoracic and 12 lumbar have been obtained in 36 pts. Spine IL were found in 35 pts. 26% of all IL were revealed in axial planes. 3 pts with short AS duration had IL only on axial slices (zygapophyseai lumbar joints, costotransverse joints, processes. IL were revealed more often in thoracic (average score: 7.1, than in lumbar (3.7 and cervical (2.1 spine. In most (26 from 29 pts, 90% pts IL were found in painful parts of spine. There was no IL score difference between pts(n=12 with low (BASDAI <40 and high (BASDAI>40; n=17 AS activity. Me and range were 4 (1.8-10.3 and 6 (4-16, respectively; p=0

  20. Unexpected Beneficial Response to Etanercept Therapy in a Hemodialysis Patient with Ankylosing Spondylitis

    Mehmet Tuğrul SEZER

    2014-01-01

    Full Text Available Erythropoietin (EPO defi ciency is the main cause of renal anemia. However, chronic infl ammation may be one of the important causes for EPO resistance in patients with renal anemia. Inhibition of erythropoiesis by cytokines such as tumour necrosis factor alpha (TNF-α may play an important role. Etanercept, a recombinant dimeric fusion protein consisting of a TNF-α receptor ligand-binding region linked to the Fc portion of human IgG, is approved for use in the treatment of ankylosing spondylitis. Here, we present an end-stage renal failure patient with ankylosing spondylitis treated by etanercept and observed no need for erythropoietin during etanercept treatment.

  1. A Literature Review of Total Hip Arthroplasty in Patients with Ankylosing Spondylitis: Perioperative Considerations and Outcome.

    Putnis, S E; Wartemberg, G K; Khan, W S; Agarwal, S

    2015-01-01

    Ankylosing spondylitis is a spondyloarthropathy affecting the sacro-iliac joints with subsequent progression to the spine and the hip joints. The hip joints are affected by synovitis, enthesial inflammation, involvement of medullary bone, progressive degeneration and secondary osteoarthritis. Clinical presentation is usually in the form of pain and stiffness progressing to disabling fixed flexion contractures and in some instances, complete ankylosis. Hip arthroplasty should be considered for hip pain, postural and functional disability, or pain in adjacent joints due to hip stiffness. We conducted a literature review to determine peri-operative considerations and outcome in ankylosing spondylitis patients undergoing hip arthroplasty. In this review, we have discussed pre-operative surgical planning, thromboprophylaxis, anaesthetic considerations and heterotopic ossification. Outcomes of arthroplasty include range of movement, pain relief, survivorship and complications. PMID:26587066

  2. Correlation of histopathological findings and magnetic resonance imaging in the spine of patients with ankylosing spondylitis

    Appel, Heiner; Loddenkemper, Christoph; Grozdanovic, Zarko; Ebhardt, Harald; Dreimann, Marc; Hempfing, Axel; Stein, Harald; Metz-Stavenhagen, Peter; Rudwaleit, Martin; Sieper, Joachim

    2006-01-01

    Ankylosing spondylitis (AS) is a chronic inflammatory disease which affects primarily the sacroiliac joints and the spine. In patients with active disease, magnetic resonance imaging (MRI) of the spine shows areas of bone marrow edema, the histopathological equivalent of which is unknown. In this study we correlate inflammation in the spine of patients with AS as revealed by histological examination with bone marrow edema as detected by MRI. We have compared the histopathological findings of ...

  3. Clinical effect analysis of ankylosing spondylitis treated by Chinese medical syndrome differentiation

    冯兴华

    2013-01-01

    Objective To evaluate the curative effect and safety of Bushen Qiangji Decoction (BQD) and Qingre Qiangji Decoction (QQD) in treating ankylosing spondylitis (AS) patients,and to verify the clinical utility of AS syndrome differentiation and treatment scheme[Shen-deficiency induced stasis obstruction syndrome (SDISOS) and dampness-heat obstruction syndrome (DHOS) being two basic syndrome types,Shen invigorating blood activating method (SIBAM) and heat clearing dampness resolving meth-

  4. Opinion of patients with ankylosing spondylitis on risk factors impairing their quality of life

    Kucharz, Eugene J; Kotulska, Anna; Kopeć-Mędrek, Magdalena; Widuchowska, Małgorzata

    2012-01-01

    We studied 54 patients with ankylosing spondylitis with questionnaire in order to determine their view on threat to quality of their life related to the disease. We have show that pain and significant disability are the main threats associated with the disease in view of the patients. Social aspects (losing of job or decreasing of income) are also important for the patients, while management of the disease is not considered as arduous. The results of patients’ opinion may be helpful in design...

  5. The prevalence of clinically diagnosed ankylosing spondylitis and its clinical manifestations

    Exarchou, Sofia; Lindström, Ulf; Askling, Johan;

    2015-01-01

    had a higher prevalence of ankylosing spondylitis (0.23% versus 0.14%, P < 0.001), a higher frequency of anterior uveitis (25.5% versus 20.0%, P < 0.001) and were more likely to receive tumor necrosis factor inhibitors than women (15.6% versus 11.8% in 2009, P < 0.001). Women were more likely than men...

  6. Ankylosing spondylitis associated with Sweet’s syndrome: a case report

    Mansouri Samia; Abourazzak Fatima Ezzahra; Aradoini Nassira; Bettioui Asmae; Fourtassi Maryam; Tahiri Latifa; Mernissi Fatima Zahra; Tizniti Siham; Harzy Taoufik

    2013-01-01

    Abstract Introduction Sweet’s syndrome is an acute neutrophilic dermatosis characterized by a diffuse dermal infiltrate of mature neutrophils. In most cases, it occurs as an isolated phenomenon (idiopathic Sweet’s syndrome) but it can be drug induced or associated with a variety of underlying diseases such as infections, neoplasms, and chronic inflammatory diseases. The association between Sweet’s syndrome and ankylosing spondylitis is rare. Only a few cases have been reported in the literatu...

  7. THE THYROID GLAND STATUS IN PATIENTS WITH ANKYLOSING SPONDYLITIS DURING STANDARD THERAPY AND BIOLOGICAL THERAPY

    G. R. Akhunova; F V Valeeva; I. G. Salikhov

    2014-01-01

    Aim. To evaluate the condition of the thyroid gland in patients with ankylosing spondylitis (AS) during standard therapy and biologicaltherapy (infliximab).Subjects and methods. Twenty-six patients with AS were examined; some of them received biological therapy with infliximab, while the others took non-steroidal anti-inflammatory drugs. The structuralunctional state of thyroid gland was evaluated in all patients. The effect of therapy was evaluated by the ASAS criteria. The efficiency of the...

  8. Association of IL23R and ERAP1 genes with ankylosing spondylitis in a Portuguese population

    Pimentel-Santos, FM; Ligeiro, D; Matos, M.; Mourão, AF; Sousa, E; Pinto, P.; Ribeiro, A.; M.Sousa; Barcelos, A; Godinho, F; Cruz, M; Fonseca, JE; Guedes-Pinto, H; Trindade, H.; Evans, DM

    2009-01-01

    OBJECTIVE: Association between ankylosing spondylitis (AS) and two genes, ERAP1 and IL23R, has recently been reported in North American and British populations. The population attributable risk fraction for ERAP1 in this study was 25%, and for IL23R, 9%. Confirmation of these findings to ERAP1 in other ethnic groups has not yet been demonstrated. We sought to test the association between single nucleotide polymorphisms (SNPs) in these genes and susceptibility to AS among a Portuguese popul...

  9. Association of ERAP1 Allelic Variants with Risk of Ankylosing Spondylitis

    Zvyagin, I.; Dorodnykh, V.; Mamedov, I.; Staroverov, D.; Bochkova, A.; Rebrikov, D.; Lebedev, Y.

    2010-01-01

    Ankylosing spondylitis (AS) belongs to a group of autoimmune diseases affecting the axial skeleton. Beside the hla-b*27 allele, several other human genes that control the variety processes of immune homeostasis are considered to be associated with AS manifestation in different human populations. Among strong associated non-MHC genes erap 1 encoding the endoplasmic reticulum aminopeptidase 1 isoform was recently identified by single nucleotide polymorphisms (SNPs) meta analysis. In our study w...

  10. Association between ERAP1 gene polymorphisms and ankylosing spondylitis susceptibility in Han population

    Wang, Jian; Li, Hang; Wang, Jianwei; Gao, Xiang

    2015-01-01

    Purposes: The present study was designed to investigate the relationship between endoplasmic reticulum amino peptidase 1 (ERAP1) gene polymorphisms and ankylosing spondylitis (AS) in Han population of Shaanxi province. Methods: 100 AS patients and 100 healthy people were enrolled in present study as case and control groups respectively, and the control group was matched with the case group by age and gender. ERAP1 gene rs27434 and rs7711564 polymorphisms were test by TaqMan probe genotyping m...

  11. The genetic basis of ankylosing spondylitis: new insights into disease pathogenesis

    Tsui FW; Tsui HW; Akram A; Haroon N; Inman RD

    2014-01-01

    Florence WL Tsui,1,2 Hing Wo Tsui,1 Ali Akram,1,3 Nigil Haroon,1–3 Robert D Inman1–3 1Genetics and Development Division, Toronto Western Research Institute, University Health Network, 2Department of Immunology, 3Institute of Medical Science, University of Toronto, Toronto, ON, Canada Abstract: Ankylosing spondylitis (AS) is a complex disease involving multiple risk factors, both genetic and environmental. AS patients are predominantly young men, and the disease is characterized b...

  12. The genetic basis of ankylosing spondylitis: new insights into disease pathogenesis

    Tsui, Florence

    2014-01-01

    Florence WL Tsui,1,2 Hing Wo Tsui,1 Ali Akram,1,3 Nigil Haroon,1–3 Robert D Inman1–3 1Genetics and Development Division, Toronto Western Research Institute, University Health Network, 2Department of Immunology, 3Institute of Medical Science, University of Toronto, Toronto, ON, Canada Abstract: Ankylosing spondylitis (AS) is a complex disease involving multiple risk factors, both genetic and environmental. AS patients are predominantly young men, and the disease is charact...

  13. Immunogenetic Study in Chinese Population with Ankylosing Spondylitis: Are There Specific Genes Recently Disclosed?

    Jiayu Zhai; Ju Rong; Qiuxia Li; Jieruo Gu

    2013-01-01

    Purpose. Ankylosing spondylitis (AS) is a systemic, autoimmune disease resulting in the destruction of the affected joints. Over the past 5 years, several new genes or genetic regions associated with AS have been identified in the Chinese population. This paper aims to discuss the major findings and related potential mechanisms of these studies in our population. Recent Findings. In recent years, due to the rapid advances in computational genetics and technology, there has been an increasing ...

  14. Functionally distinct ERAP1 allotype combinations distinguish individuals with Ankylosing Spondylitis

    Reeves, Emma; Colebatch-Bourn, Alexandra; Elliott, Tim; Edwards, Christopher J.; James, Edward

    2014-01-01

    The immune system performs surveillance to identify infected or cancerous cells through recognition of small protein fragments called antigenic peptides on their surface. To do this, the peptides must be cut to a specific length by an enzyme called endoplasmic reticulum aminopeptidase 1 (ERAP1). Variation in this enzyme has recently been linked to the inflammatory rheumatic disease Ankylosing Spondylitis (AS). We have found that ERAP1 is highly polymorphic in humans and that specific combinat...

  15. Progress in spondylarthritis. Progress in studies of the genetics of ankylosing spondylitis

    Brown, Matthew A.

    2009-01-01

    The advent of high-throughput SNP genotyping methods has advanced research into the genetics of common complex genetic diseases such as ankylosing spondylitis (AS) rapidly in recent times. The identification of associations with the genes IL23R and ERAP1 have been robustly replicated, and advances have been made in studies of the major histocompatibility complex genetics of AS, and of KIR gene variants and the disease. The findings are already being translated into increased understanding of ...

  16. The effect of physical activity and motivation on function in ankylosing spondylitis: a cohort study

    Brophy, S.; Cooksey, R.; Davies, H; Dennis, M.H.; Zhou, S. M.; Siebert, S.

    2013-01-01

    OBJECTIVES: Exercise is reported to improve function for people with ankylosing spondylitis (AS) but it is not clear if this effect is causal or if patients with milder disease find it easier to exercise. This study examines the effect of exercise and motivation to exercise on function, while controlling for disease severity. METHODS: Participants who were members of an existing AS cohort were asked about physical activity, motivation to exercise, function, and disease severity. Path anal...

  17. Successful management of a cervical fracture in a patient with ankylosing spondylitis by a posterior approach

    Neeraj Patni

    2015-01-01

    Full Text Available Patients with ankylosing spondylitis (AS are at an increased risk of spinal fractures due to the altered spinal biomechanics. Moreover, it is difficult to treat these fractures due to the combination of ankylosis and osteoporosis. We report successful management of a C6-C7 vertebral fracture in a patient with AS. The patient improved in his neurological status and a good fusion was seen at a follow-up of 24 months.

  18. Absence of impaired lymphocyte transformation to Klebsiella spp. in ankylosing spondylitis.

    Kinsella, T D; Lanteigne, C; Fritzler, M. J.; Lewkonia, R M

    1984-01-01

    We have evaluated claims that impaired peripheral blood lymphocyte (PBL) transformation can occur with Klebsiella spp. in patients with ankylosing spondylitis (AS). PBL of four AS patients were cultured in vitro with autogenous faecal klebsiella, as were the PBL of age (+/- 3 years) and sex-matched pairs of 15-20 AS and normal controls cultured with heterogeneous AS-derived klebsiella and control bacterial isolates. Three of four AS patients responded to their own isolates, and no significant...

  19. Faecal carriage of klebsiella by patients with ankylosing spondylitis and rheumatoid arthritis.

    Warren, R. E.; Brewerton, D A

    1980-01-01

    In consecutive samples submitted to a clinical microbiology laboratory 22 out of 99 from outpatients and 23 out of 51 from inpatients yielded Klebsiella sp. A clinical reassessment of outpatients with ankylosing spondylitis (AS) and rheumatoid arthritis (RA) who had not been inpatients within the last year was made for disease activity and drug requirements. 124 patients with AS and 92 with RA were requested at assessment to submit a stool specimen for klebsiella examination, this being carri...

  20. Indirect and direct costs of treating patients with ankylosing spondylitis in the Brazilian public health system

    Valderilio Feijó Azevedo; Chayanne N. Rossetto; Lorencetti, Pedro G.; Mariana Y. Tramontin; Bruna Fornazari; Denizar V. Araújo

    2016-01-01

    ABSTRACT Introduction: Patients with Ankylosing Spondylitis (AS) require a team approach from multiple professionals, various treatment modalities for continuous periods of time, and can lead to the loss of labour capacity in a young population. So, it is necessary to measure its socio-economic impact. Objectives: To describe the use of public resources to treat AS in a tertiary hospital after the use of biological medications was approved for treating spondyloarthritis in the Health Public...

  1. Fecal calprotectin is associated with disease activity in patients with ankylosing spondylitis

    Arzu Duran; Senol Kobak; Nazime Sen; Seniha Aktakka; Tennur Atabay; Mehmet Orman

    2016-01-01

    Calprotectin is one of the major antimicrobial S100 leucocyte proteins. Serum calprotectin levels are associated with certain inflammatory diseases such as rheumatoid arthritis, systemic lupus erythematosus and inflammatory bowel disease. The aim of this study was to investigate serum and fecal calprotectin levels in patients with ankylosing spondylitis (AS) and show their potential relations to the clinical findings of the disease. Fifty-one patients fulfilling the New York criteria of AS and...

  2. The role of HLA-B27 molecules in the pathogenesis of ankylosing spondylitis

    R. Pala

    2011-09-01

    Full Text Available Ankylosing Spondylitis (AS is characterised by the strongest association with an HLA antigen ever described for any disease. It represents therefore the ideal model for the understanding of the link between immune-mediated diseases and the HLA system. The role of HLA-B27 in the pathogenesis of AS will be discussed focusing on the recently described higher expression of these molecules in patients with AS compared with healthy controls.

  3. Prospects for the use of celecoxib in patients with ankylosing spondylitis: impact on retarding disease progression

    Yulia Leonidovna Korsakova

    2012-09-01

    Full Text Available Ankylosing spondylitis (AS is one of the major inflammatory diseases that affect the vertebral column and joints. The first-line drugs for the treatment of this disease are now nonsteroidal anti-inflammatory drugs (NSAIDs that not only reduce painful sensations and rigidity, but also retard the radiological progression of AS. Celecoxib is one of the effective and safe NDAIDs that are promising for the treatment of AS.

  4. Immunogenicity does not influence treatment with etanercept in patients with ankylosing spondylitis

    Vries, de, P.M.; Horst-Bruinsma, van der, I.E.; Nurmohamed, M.T.; Aarden, L; Stapel, S.N.; Peters, M J L; Denderen, van, J.C.; Dijkmans, B A C; Wolbink, G

    2009-01-01

    Background: Immunogenicity, specifically the onset of antibodies against tumour necrosis factor (TNF) blocking agents, seems to play an important role in non-response to treatment with these drugs. Objectives: To assess the relation of clinical response of ankylosing spondylitis (AS) to etanercept with etanercept levels, and the presence of antibodies to etanercept. Methods: Patients with AS were treated with etanercept 25 mg twice weekly, according to the international Assessment in Ankylosi...

  5. Immunogenicity does not influence treatment with etanercept in patients with ankylosing spondylitis

    Vries, de, P.M.; Horst-Bruinsma, van der, I.E.; Nurmohamed, M.T.; AARDEN, L. A.; Stapel, S.O.; Peters, M J L; Denderen, van, J.C.; Dijkmans, B A C; Wolbink, G.J.

    2009-01-01

    BACKGROUND: Immunogenicity, specifically the onset of antibodies against tumour necrosis factor (TNF) blocking agents, seems to play an important role in non-response to treatment with these drugs. OBJECTIVES: To assess the relation of clinical response of ankylosing spondylitis (AS) to etanercept with etanercept levels, and the presence of antibodies to etanercept. METHODS: Patients with AS were treated with etanercept 25 mg twice weekly, according to the international Assessment in Ankylosi...

  6. Tramadol/acetaminophen combination as add-on therapy in the treatment of patients with ankylosing spondylitis.

    Chang, Jhi-Kai; Yu, Chen-Tung; Lee, Ming-Yung; Yeo, Kj; Chang, I-Chang; Tsou, Hsi-Kai; Wei, James Cheng-Chung

    2013-03-01

    This study aimed to determine the safety and efficacy of tramadol 37.5 mg/acetaminophen 325 mg combination tablets (Ultracet®) in patients with ankylosing spondylitis (AS). This was a 12-week, randomized, double-blind, placebo-controlled study. Sixty patients with active AS according to the Modified New York Criteria were enrolled. Active disease was defined by Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) for more than 3 at randomization. Subjects were randomized equally into two groups: the treatment group received aceclofenac plus Ultracet® one tablet twice a day, and the control group received aceclofenac plus placebo for 12 weeks. The primary endpoint was a difference of Assessment in Ankylosing Spondylitis (ASAS20) response criteria between two groups at week 12. At week 12, ASAS20 was achieved by 53.3 % of the aceclofenac plus Ultracet group and 31 % of the aceclofenac alone group (p = 0.047). For the pain visual analogue scale at week 12, there was a reduction of 45.6 % in aceclofenac plus Ultracet group and 25.7 % in the aceclofenac alone group (p = 0.087). There was no statistically significant difference between two groups in BASDAI, Bath Ankylosing Spondylitis Functional Index, Bath Ankylosing Spondylitis Global Index, Physician Global Assessment, spinal mobility, ESR, hs-CRP, and Ankylosing Spondylitis Quality of Life Questionnaire. A slight increase in total adverse events was noted with dizziness (7.5 vs 1.5 %), vertigo (4.5 vs 1.5 %), and nausea/vomiting (6 vs 0 %) in the Ultracet arm compared to placebo. The tramadol 37.5 mg/acetaminophen 325 mg combination tablet (Ultracet®) might has additional effect to nonsteroidal anti-inflammatory drugs in the treatment of patients with ankylosing spondylitis. It showed marginal benefit in pain and disease activity. However, a slight increase in minor adverse events was noted. PMID:23192419

  7. Usage of Conventional PCR Technology for the Detection of HLA-B27 Allele: A Significant Molecular Marker of Ankylosing Spondylitis

    Sharma, Narotam; Sharma, Veena; Masood, Tariq; Nautiyal, Satish Chandra; Sailwal, Shivani; Singh, Rajesh K.; Kushwaha, Rajeev K.; R. K. Singh

    2012-01-01

    Ankylosing spondylitis is a chronic inflammatory disease that has been linked to the human leukocyte antigen class I allele HLA-B27. More than 90 % of patients with ankylosing spondylitis possess the HLA-B27 allele, but only 1 % of people with HLA-B27 develop the disease. Ankylosing spondylitis predominately affects young males. The present study was planned to find out the involvement of HLA-B27 specific allele in relation to age and sex in symptomatic suspected patients of ankylosing spondy...

  8. Clinical Features in Juvenile-Onset Ankylosing Spondylitis Patients Carrying Different B27 Subtypes

    Yikun Mou

    2015-01-01

    Full Text Available Background. Ankylosing spondylitis (AS is a common rheumatic disease and is characterized by inflammation of the axial skeleton. HLA-B27 is strongly associated with AS. Juvenile-onset AS (JAS with disease onset before 16 years of age differs from adult-onset AS (AAS in many respects. Objective. To compare the clinical features in JAS with different B27 subtypes and analyze the differences between JAS and AAS. Methods. 145 JAS and 360 AAS patients were included. The demographic data, clinical manifestations, laboratory markers, Bath AS indices, and B27 subtypes were recorded. Results. Peripheral arthritis, enthesitis, BASDAI, ESR, and CRP were significantly higher in JAS patients with HLA-B*2704 than those with B27-negative. Enthesitis and ESR were significantly higher in patients with HLA-B*2705 than those with B27-negative. The onset age of HLA-B*2715 group was much earlier than the other groups. The peripheral arthritis, enthesitis, and hip joint involvement in JAS with HLA-B*2704 were significantly higher than those in AAS with HLA-B*2704. Conclusion. JAS with different B27 subtypes had similar features in most of manifestations; JAS and AAS patients with the same subtype could have distinctive courses. Early diagnosis, hip detection, and control of systemic active inflammation in JAS patients will be helpful for improving the prognosis.

  9. Airway Management in a Patient with Severe Ankylosing Spondylitis Causing Bamboo Spine: Use of Aintree Intubation Catheter.

    Ul Haq, Muhammad Irfan; Shamim, Faisal; Lal, Shankar; Shafiq, Faraz

    2015-12-01

    Management of a case of ankylosing spondylitis can be very challenging as the airway and the central neuraxial blockade are extremely difficult to handle. Fiberoptic intubation may lead to predictable success in the face of difficult airway. We are presenting a new technique of fiberoptic intubation in a young patient, suffering from severe ankylosing spondylitis, came for total hip replacement surgery. There was anticipated difficult airway due to severe limitation in neck movement and it was successfully managed by using Aintree Intubation Catheter (AIC) with intubating fiberoptic bronchoscope. PMID:26691367

  10. Airtraq® optical laryngoscope for tracheal intubation in patients with severe ankylosing spondylitis: A report of two cases

    Qazi Ehsan Ali

    2012-01-01

    Full Text Available Airway management in patients of ankylosing spondylitis remains a challenge for anaesthesiologists. Many new airway devices have been used for securing airway in these patients. The Airtraq® optical laryngoscope is one of the new rigid laryngoscopes with a proximal view finder that reflects an image transferred from the distal tip of the blade through a series of lenses, prisms and mirrors. We report two cases of ankylosing spondylitis who were scheduled for total hip replacement and subtotal thyroidectomy and were successfully intubated using the Airtraq® laryngoscope.

  11. Association study of ankylosing spondylitis and polymorphisms in ERAP1 gene in Zhejiang Han Chinese population.

    Liu, Yangbo; Li, Liangda; Shi, Shanfen; Chen, Xin; Gao, Jianqing; Zhu, Minyu; Yuan, Jiandong

    2016-02-01

    The susceptibility loci of ERAP1 polymorphisms have been found to be strongly associated with ankylosing spondylitis (AS). The researches in multiple ethnic cohorts suggested that the population attributable risk in ERAP1 polymorphisms is at a high significance level. This study was undertaken to estimate the prevalence and incidence of subsets of AS and investigate the specific variants of ERAP1 polymorphisms in AS susceptibility, in the Han ethnic Chinese population in Zhejiang Province. AS patients were selected, diagnosed, and confirmed by a qualified rheumatologist. The basal clinical and demographic characteristics were compared with all subjects. Genotypes for eight selected single nucleotide polymorphisms (SNPs) in ERAP1 gene (rs27038, rs27037, rs27434, rs27980, rs7711564, rs30187, rs10050860, and rs17482078) were determined by using the Sequenom MassARRAY iPLEX platform in Zhejiang Han Chinese population. Association analyses were performed on the whole genotyped data set in 707 unrelated ankylosing spondylitis cases and 837 ethnically matched controls. We observed the strongest association between AS and HLA-B27, which confers over 90 % of ankylosing spondylitis cases. Moreover, we found three loci of ERAP1 polymorphisms were at a high significance level (rs27037 P = 0.00451; rs27434 P = 0.00012; rs27980 P = 0.00682) with AS in Zhejiang population. We also confirmed polymorphism locus of ERAP1 previously reported association with AS (rs27434; P = 5.3 × 10(-12)). Our results indicated a difference in the mechanism of susceptibility loci in subsets of Zhejiang Han Chinese population and provided further evidence that rs27434 is the key polymorphism associated with AS in ERAP1 gene. PMID:26350268

  12. TREATMENT OF ANKYLOSING SPONDYLITIS BASED ON ALLOPATHIC AND AYURVEDIC SYSTEM OF MEDICINE

    A.KRISHNA SAILAJA

    2015-01-01

    Full Text Available Ankylosing spondylitis previously known as Bechterew's disease and Marie-Strümpell disease. It is a chronic inflammatory disease of the axial skeleton with variable involvement of peripheral joints and nonarticular structures. AS is a form of spondyloarthritis, a chronic, inflammatory arthritis where immune mechanisms are thought to play a key role. It mainly affects joints in the spine and the sacroiliac joint in the pelvis and can cause eventual fusion of the spine. The treatment of ankylosing spondylitis typically involves the use of medications to reduce inflammation, suppress immunity to stop progression of the disease, physical therapy, and exercise. Medications decrease inflammation in the spine and other joints. Physical therapy and exercise help to improve posture, spine mobility, and lung capacity. Ayurveda offers excellent therapies for treating Ankylosing spondylitis. The treatment comprises of a series of purification procedures for Detoxification through world renowned Ayurveda Panchakarma therapies along with the administration of researched medicines internally In these article treatment strategies for western system of medicine and Indian system of medicine was explained in detail. The main mechanisms involved in treating the conditions such as fever, back pain, swelling at various joints, stiffness in neck and back bone was explained. Different medicines used for the treatment of symptoms and their mechanism of action was explained properly. Strict diet restrictions along with life style modification are essential parts of the therapy. Following the diet as advised not only helps in recovering fast but also in prevents further worsening of the condition. The importance of diet in treating the condition was also explained.

  13. Indirect and direct costs of treating patients with ankylosing spondylitis in the Brazilian public health system

    Valderilio Feijó Azevedo

    2016-04-01

    Full Text Available ABSTRACT Introduction: Patients with Ankylosing Spondylitis (AS require a team approach from multiple professionals, various treatment modalities for continuous periods of time, and can lead to the loss of labour capacity in a young population. So, it is necessary to measure its socio-economic impact. Objectives: To describe the use of public resources to treat AS in a tertiary hospital after the use of biological medications was approved for treating spondyloarthritis in the Health Public System, establishing approximate values for the direct and indirect costs of treating this illness in Brazil. Material and methods: 93 patients selected from the ambulatory spondyloarthritis clinic at the Hospital de Clínicas of the Federal University of Paraná between September 2011 and September 2012 had their direct costs indirect treatment costs estimation. Results: 70 patients (75.28% were male and 23 (24.72% female. The mean age was 43.95 years. The disease duration was calculated based on the age of diagnosis and the mean was 8.92 years (standard deviation: 7.32; 63.44% were using anti-TNF drugs. Comparing male and female patients the mean BASDAI was 4.64 and 5.49 while the mean BASFI was 5.03 and 6.35 respectively. Conclusions: The Brazilian public health system's spending related to ankylosing spondylitis has increased in recent years. An important part of these costs is due to the introduction of new, more expensive health technologies, as in the case of nuclear magnetic resonance and, mainly, the incorporation of anti-TNF therapy into the therapeutic arsenal. The mean annual direct and indirect cost to the Brazilian public health system to treat a patient with ankylosing spondylitis, according to our findings, is US$ 23,183.56.

  14. Endothelial dysfunction in ankylosing spondylitis associated with reduced endothelial progenitor cell population

    Pawan Krishan

    2015-06-01

    Full Text Available Background: Endothelial dysfunction, and cardiovascular (CV morbidity and mortality have been documented in patients with ankylosing spondylitis (AS. Endothelial progenitor cells (EPCs have reparative potential in overcoming the endothelial dysfunction and reducing cardiovascular risk. Aim: To investigate the relationship between endothelial function and EPCs in patients with AS in a cross-sectional study. Methods: Circulating EPCs (CD34+/CD133+ were isolated and quantified from peripheral blood samples of AS (n23 and healthy controls (n=20 matched for age and sex. Endothelium-depended vascular function, i.e. flow-mediated dilation (FMD, was assessed for all subjects. Disease activity was evaluated using Bath Ankylosing Spondylitis Disease Activity Index (BASDAI. Functional ability was monitored using Bath Ankylosing Spondylitis Functional Index (BASFI. All subjects were free of any other known traditional CV risk factors. Results: AS patients had depleted level of circulating %EPCs (0.028 ± 0.001% versus 0.045 ± 0.011%, P <0.001 and reduced FMD% (6.77 ± 2.15 versus 10.06 ± 0.55, P <0.001 than healthy controls. Circulating EPC population significantly positively correlated with FMD% (r 0.538, P = 0.008. Levels of CD34+/CD133+ putative cells showed a significant inverse correlation with disease duration (P = 0.01, BASDAI (P = 0.04, ESR (P = 0.002 and CRP (P = 0.007. Conclusion: AS patients, free of any other known CV risk factors, demonstrated depleted levels of EPCs and reduced endothelial function. These alterations may cause further deterioration of endothelial function in AS patients. EPC would possibly serve as a novel therapeutic target for preventing cardiovascular risk in AS.

  15. Sugammadex use in difficult intubation due to ankylosing spondylitis and severe restrictive respiratory disease

    Yakup Tomak

    2012-09-01

    Full Text Available We describe anesthesia management of a 50-year-old man scheduled for thoracic spinal reconstruction, presenting with severe restrictive respiratory disease and difficult airway due to ankylosing spondilitis. The patient was unable to extend his head, had difficulty in breathing and sleeping in supine position due to thoracal deformities. The patient was intubated using intubating laryngeal mask airway to overcome the difficulties of limited mouth opening and head extension. He was extubated following administration of sugammadex to obtain optimal conditions in terms of respiratory muscle function and to prevent hypersecretion and bronchospasm. J Clin Exp Invest 2012; 3 (3: 398-400Key words: Restrictive lung disease, airway management, laryngeal masks, sugammadex, ankylosing spondylitis

  16. LLLT for the management of patients with ankylosing spondylitis.

    Stasinopoulos, D; Papadopoulos, K; Lamnisos, D; Stergioulas, A

    2016-04-01

    This study aimed to compare the effectiveness of the combined low-level laser therapy (LLLT) and passive stretching with combined placebo LLLT laser and the same passive stretching exercises in patients suffering from Αnkylosing spondylitis. Forty-eight patients suffering from Αnkylosing spondylitis participated in the study and were randomized into two groups. Group A (n = 24) was treated with a λ = 820 Ga-Al-As laser CW, with power intensity = 60 mW/cm(2), energy per point in each session = 4.5 J, total energy per session = 27.0 J, in contact with specific points technique, plus passive stretching exercises. Group B (n = 24), received placebo laser plus the same passive stretching exercises. Both groups received 12 sessions of laser or placebo within 8 weeks; two sessions per week (weeks 1-4) and one session per week (weeks 5-8). Pain and function scales were completed before the treatment, at the end of the fourth and eighth week of treatment, and 8 weeks after the end of treatment (follow-up). Group A revealed a significant improvement after 8 weeks of treatment in all pain and function scales. At 8-week follow-up, the improvement remained only for the pain, while for all other function outcomes the differences were not statistically significant. The results suggested that after an 8-week treatment and after a follow-up, the combination of LLLT and passive stretching exercises decreased pain more effectively than placebo LLLT along with the same passive stretching exercises in patients with Αnkylosing spondylitis. Future studies are needed to establish the relative and absolute effectiveness of the above protocol. PMID:26796709

  17. Effectiveness of ultrasound treatment applied with exercise therapy on patients with ankylosing spondylitis: a double-blind, randomized, placebo-controlled trial.

    Şilte Karamanlioğlu, Duygu; Aktas, Ilknur; Ozkan, Feyza Unlu; Kaysin, Meryem; Girgin, Nuray

    2016-05-01

    The aim of our study was to evaluate effectiveness of ultrasound treatment applied with exercise therapy in patients with ankylosing spondylitis. Fifty-two patients, who were diagnosed according to modified New York criteria, were aged 25-60, and have spine pain, were randomly assigned to two groups. Ultrasound (US) and exercise therapy were applied to treatment group (27); placebo US treatment and exercise therapy were applied to control group (25). Patients were evaluated before treatment, at the end of treatment, and 4 weeks after the treatment. Daily and night pain, morning stiffness, patient global assessment (PGA), doctor global assessment (DGA), Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), Bath Ankylosing Spondylitis Functional Index (BASFI), Bath Ankylosing Spondylitis Metrology Index (BASMI), Ankylosing Spondylitis Quality of Life (ASQoL) questionnaire, Ankylosing Spondylitis Disease Activity Score (ASDAS) erythrocyte sedimentation rate (ESR), and ASDAS C-reactive protein (CRP) were used as clinical parameters. In US group, all parameters showed significant improvements at 2 and 6 weeks, in comparison with the baseline. In placebo US group, significant improvement was obtained for all parameters (except tragus-to-wall distance and modified Schober test at 2 weeks and lumbar side flexion and modified Schober test at 6 weeks). Comparison of the groups showed significantly superior results of US group for parameters of BASMI (p exercise in patients with ankylosing spondylitis. PMID:26923690

  18. Major histocompatibility complex associations of ankylosing spondylitis are complex and involve further epistasis with ERAP1

    Cortes, Adrian; Pulit, Sara L.; Leo, Paul J.; Pointon, Jenny J; Robinson, Philip C; Weisman, Michael H.; Ward, Michael; Gensler, Lianne S.; Zhou, Xiaodong; Garchon, Henri-Jean; Chiocchia, Gilles; Nossent, Johannes; Benedicte A Lie; Forre, Øystein; Tuomilehto, Jaakko

    2015-01-01

    Ankylosing spondylitis (AS) is a common, highly heritable, inflammatory arthritis for which HLA-B*27 is the major genetic risk factor, although its role in the aetiology of AS remains elusive. To better understand the genetic basis of the MHC susceptibility loci, we genotyped 7,264 MHC SNPs in 22,647 AS cases and controls of European descent. We impute SNPs, classical HLA alleles and amino-acid residues within HLA proteins, and tested these for association to AS status. Here we show that in a...

  19. Association between endoplasmic reticulum aminopeptidase-1 (ERAP-1) and susceptibility to ankylosing spondylitis in Iran.

    Mahdi Mahmoudi; Ahmad Reza Jamshidi; Ali Akbar Amirzargar; Elham Farhadi; Keramat Nourijelyani; Sasan Fallahi; Mona Oraei; Sahar Noori; Mohammad Hossein Nicknam

    2012-01-01

    Ankylosing Spondylitis (AS) is an inflammatory arthritis, which affects mainly spine and sacroiliac joints. According to recent studies, ERAP1 is the second most common candidate gene for  AS susceptibility after HLA-B27. The  aim of this study was to  determine the association of ERAP1 gene polymorphisms with AS in Iranian population.The study group comprised 387 Iranian AS patients and 316 healthy controls from Iran.Using Real Time PCR allelic discrimination method,  we genotyped four SNPs ...

  20. Correlation of immunoglobulin and C reactive protein levels in ankylosing spondylitis and rheumatoid arthritis.

    Sanders, K M; Hertzman, A; Escobar, M R; Littman, B H

    1987-01-01

    Serum C reactive protein (CRP), IgG, and IgA levels were measured in 22 patients with ankylosing spondylitis (AS) and in 20 patients with rheumatoid arthritis (RA) to study the regulation of these proteins in inflammatory disease states. In both RA and AS the mean CRP, IgG, and IgA levels were raised above normal values. Although IgA and CRP levels showed a significant positive correlation in RA (r = 0.53, p = 0.02), there was no correlation between these values in AS (r = 0.24, p = 0.29). Th...

  1. Chronic Liver Failure after Treatment with Infliximab for Ankylosing Spondylitis in a Patient with Hepatitis B

    2013-01-01

    A 50-year-old man with ankylosing spondylitis was treated successfully with inlfiximab, who was also a HBV carrier for about twenty-ifve years. After injection with inlfiximab for four times, he developed jaundice and HBV DNA was detectable in serum. Serum aminotransferase and total bilirubin levels were higher than normal. Then he was hospitalized and treated with entacavir and Chinese herb medicine. But his liver damage aggravated and was diagnosed as acute on chronic liver failure. Finally, liver transplantation was carried out and he was cured successfully.

  2. Life events influence the development of ankylosing spondylitis: A case-control study

    Apurva

    2015-03-01

    Full Text Available We are reporting a small pilot case-control study exploring the role of stressors of day-to-day life in triggering ankylosing spondylitis (AS and the effect of various coping strategies adopted by the patients. We consider AS as a good model to study the hypothesis due to its close association with the well-described genetic marker, HLA B27. The onset of rheumatic diseases has been commonly observed. However, the role of stress and stressful life events in the development of rheumatic disease is a matter of debate. Though there are explainable hypothesis, clinical evidence on this association is limited

  3. HLA class I associations of ankylosing spondylitis in the white population in the United Kingdom.

    M A Brown; Pile, K D; Kennedy, L G; Calin, A.; Darke, C; Bell, J.; Wordsworth, B P; Cornélis, F

    1996-01-01

    OBJECTIVE: To investigate the HLA class I associations of ankylosing spondylitis (AS) in the white population, with particular reference to HLA-B27 subtypes. METHODS: HLA-B27 and -B60 typing was performed in 284 white patients with AS. Allele frequencies of HLA-B27 and HLA-B60 from 5926 white bone marrow donors were used for comparison. HLA-B27 subtyping was performed by single strand conformation polymorphism (SSCP) in all HLA-B27 positive AS patients, and 154 HLA-B27 positive ethnically mat...

  4. Development of a PCR method to detect HLA-B27 in ankylosing spondylitis

    Nätterkvist, Ylva

    2012-01-01

    The aim of the project was to develop a PCR method to detect HLA-B27 at the Immunology Department of St. James hospital in Dublin. The HLA-B27 gene is common among patients with ankylosing spondylitis (AS). Ninety percent of patients with AS have the HLA-B27 gene and it is therefore counted as a risk factor and could be used as part of the diagnosis. Twenty-two frozen blood samples from patients with AS or suspected AS were donated from the rheumatology department at St. James hospital. PCR i...

  5. Corrective surgery for deformity of the upper cervical spine due to ankylosing spondylitis

    Bin Lin

    2014-01-01

    Full Text Available Rotational and flexion deformity of C1-C2 due to ankylosing spondylitis is rare. We did surgical correction in one such case by lateral release, resection of the posterior arch of C1 and mobilization of the vertebral arteries, wedge osteotomy of the lateral masses of C1 and internal fixation under general anesthesia. There were no vascular and neurological complications during the surgery. After operation the atlantoaxial rotational deformity was corrected and the normal cervical lordosis was restored. At 1 year followup his visual field and feeding became normal and internal fixation was stable.

  6. The comparative analysis of X-ray characteristics of juvenile and adult ankylosing spondylitis

    Objective: To compare the juvenile and adult ankylosing spondylitis characterized by X-ray findings. Methods: The diagnosis of juvenile ankylosing spondylitis (JAS) 61 cases, by the onset of a stratified random sample of adult ankylosing spondylitis (AS) 61 examples for the control to observe the lesion invaded sacroiliac joints, hip joints and spine X-ray findings for statistical analysis. Results: (1) lesion classification: sacroiliac joint class II in childhood was 25 (23.4%), more than nine in adult (7.7%). Class IV inl3 (12.1%) children, less than (43.6%) in adult, there was a significant difference between them; class III in children was 19 (46.3%), less than 34 in adult (43.6%), there was a significant difference between them. Vertebral facet grade m was three cases (16.7%) and class IV was seven cases (38.9%) in children, which were less than that in adult; (2) X-ray findings: widening of sacroiliac joint space was detected in 37 (34.6%) children, more than 13 in adult (11.1%). In young group, joint space narrowing was found in 35 (32.8%) the disappearance of joint space in 13 (12.1%), and the lower edge of articular ligament calcification in 4 (3.7%), which were less than that in adult group, which was 71 (60.7%), 54 (46.2%), 42 (35.9%) respectively. There was a significant difference. Hip joint space narrowing in 15 (36.6%) children, significantly less than that in 39. adult (65.3%). 18 cases of children with violations of the spine (29.3%) less than 47 cases of adult (77.0%), and small joint capsule calcification in 1 case (5.6%), lateral margin of disc calcification in 1 case (5.6%), anterior longitudinal ligament calcification in 1 case (5.6%) in young group, which was much less than that of 28 (59.6%), 22 (46.8%), 20 (42.6%)in adult group. Conclusion: In juvenile ankylosing spondylitis disease, the X-ray findings of sacroiliac joint, spinal and hip are less severe than that in adult. (authors)

  7. Biologics Use in Asian Indian Patients with Ankylosing Spondylitis: A Physician’s Perspective

    Bhakuni, Darshan; Marwaha, Vishal; Hande, Vivek; Bagga, Garvit

    2016-01-01

    Introduction Ankylosing Spondylitis (AS) with non-steroidal anti-inflammatory drug (NSAID) therapeutic failure is treated with biologics. Aim To compare the clinical outcomes of different biologics for Asian Indian patients with AS who have NSAID therapeutic failure. Materials and Methods Thirty-five AS patients with NSAID failure were administered Etanercept (n=15) (50mg SQ, weekly) or Infliximab (n=20) (5mg/kg IV every 2nd month) based on patient convenience or physician discretion as per 2015 ACR/SAA/SPARTAN recommendations. Baseline demographic details, time to diagnosis, disease duration, presence of low backache, early morning stiffness, peripheral joint and extraarticular involvement, ESR, CRP values and HLA-B27 score were obtained. Baseline values of scores of BASMI-3 and MASES were calculated. To monitor the disease activity, BASDAI and ASDAS-ESR scores were recorded at baseline, and after 6 months and 12 months of therapy initiation. Statistical Analysis Comparison of means: independent samples t-test; comparison of parameters over time: repeated measures ANOVA. Results Both groups were comparable in all parameters at therapy initiation except in the baseline BASMI-3 score which was significantly higher in patients who received Etanercept. Over 12 months of treatment, the reduction in disease activity, as evidenced by reduction in the mean BASDAI and ASDAS-ESR scores was statistically significant for all patients when considered together, as well as when Etanercept and Infliximab were considered separately (p<0.0001 in all cases). However, there was no statistically significant difference in the magnitude of reduction in the mean BASDAI and ASDAS-ESR scores between patients who received Etanercept and those who received infliximab (p=0.696 and 0.618 respectively). Conclusion Etanercept and Infliximab offer statistically similar reduction in disease severity in Asian Indian AS patients with NSAID failure. Further studies with larger sample size are

  8. Lung parenchyma changes in ankylosing spondylitis: demonstration with high resolution CT and correlation with disease duration

    Senocak, Oezlem E-mail: emine.senocak@deu.edu.tr; Manisali, Metin; Oezaksoy, Dinc; Sevinc, Can; Akalin, Elif

    2003-02-01

    Objective: To analyze the spectrum of the lung parenchyma changes in ankylosing spondylitis (AS) with high resolution computed tomography (HRCT) and correlate the findings with disease duration. Material and methods: Twenty patients (18 male, 2 female) with the diagnosis of AS according to New York criteria were included in the study. None of the patients had history of tuberculosis, prolonged inorganic dust exposure and hospitalization for pneumonia. Seven of the patients were smokers, three patients were ex-smokers, and 10 patients were nonsmokers. The patients were assigned to three groups depending on disease duration. Group 1: patients with disease duration {<=}5 years (n: four patients), group 2: patients with disease duration {>=}6 years but {<=}10 years (n: four patients), group 3: patients with disease duration {>=}11 years (n: 12 patients). HRCT and pulmonary function tests (PFT) were performed in all patients. Results: HRCT demonstrated pathology in 17 patients (85%). Two patients in group 1, 4 patients in group 2 and 11 patients in group 3 had pulmonary parenchyma changes. Emphysema (9/20), septal thickening (9/20) and pleural thickening (9/20) were the most common changes followed by nodule (8/20) and subpleural band formation (7/20). Three patients had apical fibrosis (AF). Septal and pleural thickening (both 4/10) were the most common changes when only nonsmokers were considered. Among nine patients with emphysema three were nonsmokers. Conclusion: There is a wide spectrum in pulmonary parenchyma changes in AS. These changes begin in early stages of the disease and increase with disease duration. Although smoking complicates the spectrum of changes in pulmonary parenchyma, they are predominately in the form of interstitial inflammation.

  9. Assessment of left ventricular function by tissue Doppler imaging in patients with ankylosing spondylitis

    Osman Kuloglu

    2012-05-01

    Full Text Available Ankylosing spondylitis (ASpis a chronic, inflammatory and systemic disease affecting pericardium, myocardium and the conduction system of the heart. In this study, we aimed to analyse left ventricular systolic and diastolic functions using tissue Doppler imaging (TDI. 30 patients with ASp and 30 healthy volunteers having the similar demographic characteristics were included. Left ventricular systolic and diastolic functions were assessed by using two dimensional (2D echocardiography, M-mode, pulsed-wave (PW and tissue Doppler echocardiography. The peak systolic velocity (Sm, early diastolic myocardial peak velocity (m, late diastolic myocardial peak velocity (Am, isovolumic acceleration (IVA, myocardial precontraction time (PCTm, myocardial contraction time (CTm, myocardial relaxation time (RTm, and myocardial performance index (MPI were measured at septal and lateral mitral annulus. In conventional echocardiography, end-diastolic interventricular septum and posterior wall diameters were higher in patients with ASp than the control group. The ratio of E/A was significantly lower and deceleration time was significantly prolonged in patients with ASp, but mitral E and A velocities, isovolumic relaxation time and MPI were similar in patient and control group (P>0.05. Left ventricular lateral and septal wall tissue Doppler echocardiography showed that Em, Em/Am ratio and CTm were significantly lower, IVRTm was longer and MPI was higher in patients with ASp. No significant differences were detected between the groups for IVA, Sm, Am, PCTm, PCTm/CTm ratio (P>0.05. We have demonstrated that in patients with ASp, diastolic functions were impaired but systolic functions were preserved by using TDI.

  10. Is there a preferred method for scoring activity of the spine by magnetic resonance imaging in ankylosing spondylitis?

    van der Heijde, Désirée; Landewé, Robert; Hermann, Kay-Geert; Rudwaleit, Martin; Østergaard, Mikkel; Oostveen, Ans; O'Connor, Phil; Maksymowych, Walter P; Lambert, Robert G; Lukas, Cédric; Jurik, Anne Grethe; Boers, Maarten; Baraliakos, Xenofon; Braun, Jürgen; NN, NN

    2007-01-01

    This report summarizes the discussion during a module update at OMERACT 8 on scoring methods for activity in the spine on magnetic resonance imaging. The conclusion was that the 3 available scoring methods are all very good with respect to discrimination and feasibility: the Ankylosing Spondylitis...

  11. Clinical response, drug survival and predictors thereof in 432 ankylosing spondylitis patients after switching tumour necrosis factor α inhibitor therapy

    Glintborg, Bente; Østergaard, Mikkel; Krogh, Niels Steen; Tarp, Ulrik; Manilo, Natalia; Loft, Anne Gitte Rasmussen; Hansen, Annette; Schlemmer, Annette; Fana, Victoria; Lindegaard, Hanne M; Nordin, Henrik; Rasmussen, Claus; Ejstrup, Leif; Jensen, Dorte Vendelbo; Petersen, Peter Mosborg; Hetland, Merete Lund

    2013-01-01

    OBJECTIVE: To investigate frequencies and reasons for switching, treatment responses and drug survival in patients with ankylosing spondylitis (AS) switching tumour-necrosis-factor-α inhibitor (TNFi) treatment in routine clinical care. METHODS: AS patients were identified in the Danish nationwide...

  12. Clinical course and signs in patients with uveitis associated with ankylosing spondylitis

    Refik Oltulu

    2013-09-01

    Full Text Available Aim: To evaluate clinical course and signs in patients withuveitis associated ankylosing spondylitis (AS.Methods: In this retrospective study we evaluated thepatients who were diagnosed as uveitis related to AS andfollowed up at the Ophthalmology Department of NecmettinErbakan University Hospital between May 2009 andJune 2012. Demographical features and clinical courseswere assessed.Results: Seventeen eyes of 13 patients were includedin the study. Nine patients (69.2% were male and four(30.8% were female. The mean age at presentation was38.54±9.61 years (range 28-63. Bilateral involvementwas observed in four (30.8% patients. The mean followuptime was 17.46±11.86 months (range 3-36. The meannumber of attacks was 1.15±0.37 (range 1-2. Posteriorsegment manifestation accompanied anterior uveitis inthree eyes (17.6%. Posterior synechia developed in one(7.7% and cataract in one patient (7.7%, cystoid macularedema in two patients (15.4%, and epiretinal membranein one patient (%7.7. The mean final visual acuitywas 0.975±0.07 (range 0.2-1.0.Conclusion: The prognosis of anterior uveitis associatedwith AS is good if the treatment is administered at theappropriate time. However, the posterior segment complicationsmay develop in these patients, treatment andfollow-up should be done in co-operation with the departmentof rheumatology.Key words: Ankylosing spondylitis, uveitis, rheumatology,clinical course

  13. The genetic basis of ankylosing spondylitis: new insights into disease pathogenesis

    Tsui FW

    2014-05-01

    Full Text Available Florence WL Tsui,1,2 Hing Wo Tsui,1 Ali Akram,1,3 Nigil Haroon,1–3 Robert D Inman1–3 1Genetics and Development Division, Toronto Western Research Institute, University Health Network, 2Department of Immunology, 3Institute of Medical Science, University of Toronto, Toronto, ON, Canada Abstract: Ankylosing spondylitis (AS is a complex disease involving multiple risk factors, both genetic and environmental. AS patients are predominantly young men, and the disease is characterized by inflammation and ankylosis, mainly at the cartilage–bone interface and enthesis. HLA-B27 has been known to be the major AS-susceptibility gene for more than 40 years. Despite advances made in the past few years, progress in the search for non-human leukocyte antigen susceptibility genes has been hampered by the heterogeneity of the disease. Compared to other complex diseases, such as inflammatory bowel disease (IBD, fewer susceptibility loci have been identified in AS. Furthermore, non-major histocompatibility-complex susceptibility loci discovered, such as ERAP1 and IL23R, are likely contributors to joint inflammation. Identification and confirmation of functional variants remains a significant challenge of investigations involving genome-wide association studies (GWAS. It remains unclear why none of the AS-susceptibility genes identified in GWAS appear to be directly involved in the ankylosing process. Numerous reviews have recently been published on the genetics of AS. Therefore, aside from a brief summary of what AS GWAS has successfully achieved thus far, this review will focus on directions that could address unanswered questions raised by GWAS. Keywords: ankylosing spondylitis, genome-wide association studies, risk loci, ankylosis, joint and gut inflammation, clinical subsets

  14. Genetic Polymorphisms of Stromal Interaction Molecule 1 Associated with the Erythrocyte Sedimentation Rate and C-Reactive Protein in HLA-B27 Positive Ankylosing Spondylitis Patients

    Wei, James Cheng-Chung; Hung, Kuo-Sheng; Hsu, Yu-Wen; Wong, Ruey-Hong; Huang, Chun-Huang; Jan, Ming-Shiou; Wu, Shyh-Jong; Juan, Yung-Shun; Chang, Wei-Chiao

    2012-01-01

    Ankylosing spondylitis (AS) is a chronic inflammation of the sacroiliac joints, spine and peripheral joints. The development of ankylosing spondylitis is still unclear. Genetics factors such as human leukocyte antigen HLA-B27 and ERAP1 have been widely reported to associate to AS susceptibility. In this study, we enrolled 361 AS patients and selected four tagging single nucleotides polymorphisms (tSNPs) at STIM1 gene. The correlation between STIM1 genetic polymorphisms and AS activity index (...

  15. Serum from patients with ankylosing spondylitis can increase PPARD, fra-1, MMP7, OPG and RANKL expression in MG63 cells

    Zaiying Hu; Dongfang Lin; Jun Qi; Minli Qiu; Qing Lv; Qiuxia Li; Zhiming Lin; Zetao Liao; Yunfeng Pan; Ou Jin; Yuqiong Wu; Jieruo Gu

    2015-01-01

    OBJECTIVES: To explore the effects of serum from patients with ankylosing spondylitis on the canonical Wnt/β-catenin pathway and to assess whether the serum has an osteogenic effect in MG63 cells. METHODS: MG63 cells were cultured with serum from 45 ankylosing spondylitis patients, 30 healthy controls, or 45 rheumatoid arthritis patients. The relative PPARD, fra-1, MMP7, OPG and RANKL mRNA levels were measured using quantitative real-time polymerase chain reaction. Associations between gene ...

  16. Two-dimensional gel analysis demonstrates no structural alteration of HLA-B27 polypeptides between patients with ankylosing spondylitis and healthy individuals.

    Trapani, J A; Walker, I D; McKenzie, I. F.

    1984-01-01

    After precipitation of the HLA-B27 antigen from the surface of peripheral blood lymphocytes (PBL) by means of an anti-HLA-B27 allospecific monoclonal antibody 2-dimensional gel electrophoresis was used to compare the structure of the B27 antigens derived from 5 patients with ankylosing spondylitis with that of healthy HLA-B27 positive counterparts. No significant difference in polypeptide structure was noted, which suggests that the pathogenesis of ankylosing spondylitis does not involve a st...

  17. Reproducibility of the Bath Ankylosing Spondylitis Indices of disease activity (BASDAI), functional status (BASFI) and overall well-being (BAS-G) in anti-tumour necrosis factor-treated spondyloarthropathy patients

    Madsen, Ole R; Rytter, Anne; Hansen, Lonnie B; Suetta, Charlotte; Egsmose, Charlotte

    2010-01-01

    The Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), the Bath Ankylosing Spondylitis Function Index (BASFI) and the Bath Ankylosing Spondylitis Global Score (BAS-G) (ranges 0-10) have gained widespread in use as self-reported measures of disease activity, functional impairment and...... overall well-being in patients with ankylosing spondylitis and other spondyloarthropathies (SpA). In Denmark, BASDAI, BASFI and BAS-G are systematically used to monitor treatment response in patients treated with tumour necrosis factor (TNF) inhibitors. The purpose of the present study was to examine the...

  18. Acute toxoplasmosis infection in a patient with ankylosing spondylitis treated with adalimumab: a case report

    M. de Almeida Santos Jr

    2011-06-01

    Full Text Available Ankylosing spondylitis (AS is a chronic inflammatory disease that affects the axial skeleton, often beginning in the sacroiliac joints, but accompanied also by other signs, including enthesitis, lung fibrosis and eye involvement. AS generally occurs in the second or third decade of life with inflammatory low back pain and has a strong relation with HLA-B27. The objective of the treatment until the end of the 90’s was to ameliorate pain and stiffness and preserve function (1. Nonselective nonsteroidal antiinflammatory drugs (NSAIDs, cyclooxygenase-2 selective inhibitors, and nonpharmalogic interventions, such as physiotherapy, exercise, education, and lifestyle modifications were the basis of the management. Therapy with agents like sulphasalazine was administered for peripheral arthritis (1, 2...

  19. The natural history of ankylosing spondylitis in the 21st century

    C. Campana

    2011-06-01

    Full Text Available Ankylosing spondylitis (AS is a chronic inflammatory disease that affects the axial skeleton and evolves in stiffnes followed by ankylosis and disability. However, it may be difficult to exactly establish the natural history of the disease and the influence of risk factors of progression, since most patients are treated with various pharmacologic or non-pharmacologic agents, which may potentially influence the natural progression of the disease. In this context, we report here a very interesting case of a 40 year old man, presented to our outpatient clinic, 28 years after the onset of AS. Previously for personal reasons, did not choose not to undergo any treatment. This case allows us to evaluate the natural radiological progression of the disease and the influence of predictive risk factors.

  20. Scoring inflammatory activity of the spine by magnetic resonance imaging in ankylosing spondylitis: a multireader experiment

    Lukas, Cédric; Braun, Jürgen; van der Heijde, Désirée;

    2007-01-01

    OBJECTIVE: Magnetic resonance imaging (MRI) of the spine is increasingly important in the assessment of inflammatory activity in clinical trials with patients with ankylosing spondylitis (AS). We investigated feasibility, inter-reader reliability, sensitivity to change, and discriminatory ability...... of 3 different scoring methods for MRI activity and change in activity of the spine in patients with AS. METHODS: Thirty sets of spinal MRI at baseline and after 24 weeks of followup, derived from a randomized clinical trial comparing a tumor necrosis factor (TNF)-blocking drug (n = 20) with placebo...... (n = 10) and selected to cover a wide range of activity at baseline and change in activity, were presented electronically in a partial latin-square design to 9 experienced readers from different countries (Europe, Canada). Readers scored each set of MRI 3 times, using 3 different methods including...

  1. Airway management in cervical spine ankylosing spondylitis: Between a rock and a hard place

    Naveen Eipe

    2013-01-01

    Full Text Available We report the perioperative course of a patient with long standing ankylosing spondylitis with severe dysphagia due to large anterior cervical syndesmophytes at the level of the epiglottis. He was scheduled to undergo anterior cervical decompression and the surgical approach possibly precluded an elective pre-operative tracheostomy. We performed a modified awake fibreoptic nasal intubation through a split nasopharyngeal airway while adequate oxygenation was ensured through a modified nasal trumpet inserted in the other nares. We discuss the role of nasal intubations and the use of both the modified nasopharyngeal airways we used to facilitate tracheal intubation. This modified nasal fibreoptic intubation technique could find the application in other patients with cervical spine abnormalities and in other anticipated difficult airways.

  2. Espondilite anquilosante e uveíte: revisão Ankylosing spondylitis and uveitis: overview

    Enéias Bezerra Gouveia

    2012-10-01

    Full Text Available O presente trabalho propõe uma revisão de epidemiologia, patogênese, quadro clínico, diagnóstico e tratamento da espondilite anquilosante e sua associação com alteração ocular com a devida condução da doença e suas manifestações. Os autores utilizaram em sua pesquisa os bancos de dados PubMed (MEDLINE, LILACS e Biblioteca do Centro de Estudos de Oftalmologia. A espondilite anquilosante é uma doença inflamatória crônica que acomete preferencialmente o esqueleto axial, podendo evoluir com rigidez e limitação funcional progressiva. Seu início costuma ocorrer por volta da segunda à terceira década de vida, preferencialmente em indivíduos do gênero masculino, caucasianos e HLA-B27-positivos. Sua etiologia e patogênese não são completamente elucidadas, e seu diagnóstico costuma ser tardio. O controle clínico e o tratamento são frequentemente satisfatórios.A uveíte anterior aguda é a manifestação extra-articular mais comum, ocorrendo em cerca de 20%-30% dos pacientes com espondilite anquilosante. Aproximadamente metade dos casos de uveíte anterior aguda está associada à presença do antígeno HLA-B27, podendo ser a primeira manifestação de uma doença reumatológica não diagnosticada, geralmente com boa resposta terapêutica e bom prognóstico. Concluímos que, para melhor avaliação e tratamento dos pacientes com uveíte, é importante maior integração entre oftalmologistas e reumatologistas.The present article reviews the epidemiology, pathogenesis, clinical features, diagnosis, and treatment of ankylosing spondylitis and its association with ocular changes. The authors used the PubMed (MEDLINE, LILACS, and Ophthalmology Library databases. Ankylosing spondylitis is a chronic inflammatory disease that usually affects the axial skeleton and can progress to stiffness and progressive functional limitation. Ankylosing spondylitis usually begins around the second to third decade of life, preferentially in HLA

  3. Safety of Etoricoxib, Celecoxib, and Nonselective Nonsteroidal Antiinflammatory Drugs in Ankylosing Spondylitis and Other Spondyloarthritis Patients

    Kristensen, L E; Jakobsen, A K; Askling, J; Nilsson, F; Jacobsson, L T H

    2015-01-01

    OBJECTIVE: Safety data regarding the use of etoricoxib and other nonsteroidal antiinflammatory drugs (NSAIDs) in ankylosing spondylitis (AS) and other spondyloarthritis (SpA) patients are rather limited. Our objective was to estimate and compare rates of gastrointestinal, renovascular, and...... cardiovascular adverse events in patients exposed to etoricoxib, celecoxib, or nonselective NSAIDs or totally unexposed to NSAIDs. METHODS: We performed a national register-based cohort study on patients with AS or SpA (n = 21,872) identified in the Swedish national patient register from 1987-2009. Treatment...... exposure was assessed time dependently based on the prescription drug register from 2006-2009, adjusting for sociodemographics and comorbidities derived from national population-based registers. RESULTS: Exposure to etoricoxib, celecoxib, and nonselective NSAIDs was 7.6%, 3.9%, and 71.2%, respectively. No...

  4. Association Study of Polymorphisms rs4552569 and rs17095830 and the Risk of Ankylosing Spondylitis in a Taiwanese Population

    Wei, James Cheng-Chung; Hsu, Yu-Wen; Hung, Kuo-Sheng; Wong, Ruey-Hong; Huang, Chun-Huang; Liu, Yi-Tzu; Guo, Yuh-Cherng; Ikegawa, Shiro; Chang, Wei-Chiao

    2013-01-01

    Ankylosing spondylitis (AS) is a chronic inflammation of the sacroiliac joints, spine and peripheral joints. However, the development of anklosing spondylitis is unclear. Human leukocyte antigens HLA-B27 and ERAP1 have been widely reported to be associated with AS susceptibility. A recent genome-wide association study (GWAS) showed that two new susceptibility loci between EDIL3 and HAPLN1 at 5q14.3 (rs4552569) and within ANO6 at 12q12 (rs17095830) contribute to the risk of AS in Han Chinese. ...

  5. Detection of active sacroiliitis with ankylosing spondylitis through intravoxel incoherent motion diffusion-weighted MR imaging

    Zhao, Ying-hua [Third Affiliated Hospital of Southern Medical University, Academy of Orthopedics, Department of Radiology, Guangzhou (China); Guangdong Academy of Medical Sciences, Department of Radiology, Guangdong General Hospital, Guangzhou (China); Li, Shao-lin; Zhao, Xiang-cheng; Hu, Shao-yong; Liu, Zhen-hua [Third Affiliated Hospital of Southern Medical University, Academy of Orthopedics, Department of Radiology, Guangzhou (China); Liu, Zai-yi; Chen, Xin; Liang, Chang-hong [Guangdong Academy of Medical Sciences, Department of Radiology, Guangdong General Hospital, Guangzhou (China); Mei Ms, Ying-jie [Philips Healthcare, Guangzhou (China); Chan, Queenie [Philips Electronics Hong Kong Ltd, Hong Kong (China)

    2015-09-15

    To confirm feasibility and assess intravoxel incoherent motion (IVIM) to differentiate active sacroiliitis and ankylosing spondylitis. Forty-one patients were divided into two groups, an active group (n = 20) and a chronic group (n = 21), according to the Bath Ankylosing Spondylitis (AS) Disease Activity Index (BASDAI) and laboratory parameters. In addition, 21 healthy volunteers were chosen as the control group. Tissue diffusivity (D{sub slow}), perfusion fraction (f), and pseudo-diffusion coefficient (D{sub fast}) values were obtained for all three groups. One-way analysis of variance and receiver operating characteristic analysis were performed for all parameters. There was good interobserver agreement on the measurements between the two observers. The optimal cut-off values (with respective AUC, sensitivity, specificity, positive likelihood ratio, and negative likelihood ratio) between active and chronic groups were D{sub slow} = 0.53 x 10{sup -3} mm{sup 2}/s (0.976, 90 %, 95.2 %, 18.9, 0.10) and f = 0.09 (0.545, 20 %, 95.5 %, 4.2, 0.84), and between chronic and control groups were D{sub slow} = 0.22 x 10{sup -3} mm{sup 2}/s (0.517, 9.52 %, 100 %, no number, 0.9) and f = 0.09 (0.935, 95.24 %, 80.95 %, 5, 0.059). D{sub slow} and f of IVIM diffusion-weighted (DW)-MRI in AS show a significant difference in the values of diffusion of water molecules and fractional perfusion-related volume among the three groups. (orig.)

  6. Bone morphogenetic protein 6 polymorphisms are associated with radiographic progression in ankylosing spondylitis.

    Young Bin Joo

    Full Text Available Nearly 25 genetic loci associated with susceptibility to ankylosing spondylitis (AS have been identified by several large studies. However, there have been limited studies to identify the genes associated with radiographic severity of the disease. Thus we investigated which genes involved in bone formation pathways might be associated with radiographic severity in AS.A total of 417 Korean AS patients were classified into two groups based on the radiographic severity as defined by the modified Stoke' Ankylosing Spondylitis Spinal Score (mSASSS system. Severe AS was defined by the presence of syndesmophytes and/or fusion in the lumbar or cervical spine (n = 195. Mild AS was defined by the absence of any syndesmophyte or fusion (n = 170. A total of 251 single nucleotide polymorphisms (SNPs within 52 genes related to bone formation were selected and genotyped. Odds ratios (OR and 95% confidence interval (95% CI were analysed by multivariate logistic regression controlling for age at onset of symptoms, sex, disease duration, and smoking status as covariates.We identified new loci of bone morphogenetic protein 6 (BMP6 associated with radiographic severity in patients with AS that passed false discovery rate threshold. Two SNPs in BMP6 were significantly associated with radiologic severity [rs270378 (OR 1.97, p = 6.74 × 10(-4 and rs1235192 [OR 1.92, p = 1.17 × 10(-3] adjusted by covariates.This is the first study to demonstrate that BMP6 is associated with radiographic severity in AS, supporting the role wingless-type like/BMP pathway on radiographic progression in AS.

  7. Expression of uncarboxylated matrix Gla protein in ankylosing spondylitis and its significance

    Han-qing HUANG

    2013-07-01

    Full Text Available Objective To investigate the serum level of uncarboxylated matrix Gla protein (ucMGP in ankylosing spondylitis (AS patients, and to evaluate its diagnostic value and the relation of ucMGP to inflammation and ossification process in AS. Methods Eight-two AS patients and 76 healthy controls were enrolled in this randomized controlled study. The clinical indices (age, gender, course of disease, disease activity, changes in radiographic studies, and indices of bone metabolism or inflammation, including erythrocyte sedimentation rate (ESR, C-reactive protein (CRP, osteocalcin (OC, and bone-specific alkaline phosphatase (BALP were evaluated or measured. The disease activity was assessed by Bath Ankylosing Spondylitis Disease Activity Index (BASDAI, and changes in radiographic pictures were evaluated according to the modified Stoke AS Spine Score (mSASSS, and serum level of ucMGP was measured by a competitive ELISA. The relationship between ucMGP and clinical indexes, radiographic scoring, indices in bone metabolism or inflammation was estimated by SPSS software, and the diagnostic value of ucMGP was analyzed by receiver operator characteristic (ROC curve. Results The levels of ESR and CRP in AS patients were higher than those in healthy controls, but the serum ucMGP was lower (2958±654nmol/L compared with healthy controls (4551±1036nmol/L, P0, r=-0.715, P1, r=-0.741, P10, r=-0.776, P<0.01; mSASSS <10, r=-0.297, P=0.028. Conclusion Serum ucMGP may serve as a diagnostic biomarker of AS and progression index of ossification, especially in late stage of AS.

  8. Determination of HLA-B27 Subtypes in Iranian Patients with Ankylosing Spondylitis

    Mohamad Hossein Nicknam

    2008-03-01

    Full Text Available The human leukocyte antigen-B27 is one of the class I molecules of the major histocompatibility complex which is strongly associated with ankylosing spondylitis (AS. The strength of the disease association with B27 varies markedly among racial and ethnic populations. It is an allele family, which constitutes about 31 subtypes, with a considerable geographic and ethnic difference in distribution. It is important to know whether certain subtypes show any preferential association with AS. Because there is no report regarding HLA-B27 subtypes in Iranian patients with AS, the factthe main there are rarelystudies (if any; purpose of the present study was to assess the frequency of subtypes of human leukocyte antigen (HLA-B27 in patients with ankylosing spondylitis in Iranian populationOne hundred and nineteen AS patients (82 HLA-B27 positive and 37 HLA-B27 negative were selected for this study. HLA-B27 positive patients were selected screened for B*27 subtyping were performed by polymerase chain reaction amplification with sequence-specific primers (PCR-SSP for B*27 subtyping.. The results of present study revealed that onlythat only two subtypes were detected in Iranian patients, including: B*2705 (52 patients, 63.4% and B*2702 (30 patients, 36.6%. Our results showed a restricted number of HLA-B27 subtypes associated with AS in Iran and an elevated frequency of the B*2705 allele in these patients similar to other Euro-Caucasoid (Aryan groups in the world.

  9. The genetic basis of ankylosing spondylitis: new insights into disease pathogenesis.

    Tsui, Florence Wl; Tsui, Hing Wo; Akram, Ali; Haroon, Nigil; Inman, Robert D

    2014-01-01

    Ankylosing spondylitis (AS) is a complex disease involving multiple risk factors, both genetic and environmental. AS patients are predominantly young men, and the disease is characterized by inflammation and ankylosis, mainly at the cartilage-bone interface and enthesis. HLA-B27 has been known to be the major AS-susceptibility gene for more than 40 years. Despite advances made in the past few years, progress in the search for non-human leukocyte antigen susceptibility genes has been hampered by the heterogeneity of the disease. Compared to other complex diseases, such as inflammatory bowel disease (IBD), fewer susceptibility loci have been identified in AS. Furthermore, non-major histocompatibility-complex susceptibility loci discovered, such as ERAP1 and IL23R, are likely contributors to joint inflammation. Identification and confirmation of functional variants remains a significant challenge of investigations involving genome-wide association studies (GWAS). It remains unclear why none of the AS-susceptibility genes identified in GWAS appear to be directly involved in the ankylosing process. Numerous reviews have recently been published on the genetics of AS. Therefore, aside from a brief summary of what AS GWAS has successfully achieved thus far, this review will focus on directions that could address unanswered questions raised by GWAS. PMID:24971029

  10. The 1957 MRC report on leukaemia and aplastic anaemia in patients irradiated for ankylosing spondylitis

    The estimation of the carcinogenic effects of exposure to low doses of ionizing radiation has depended primarily on extrapolation from effects seen in two populations exposed to relatively high doses-the survivors of the atomic bomb explosions in Japan and patients treated in the UK with x-rays for the arthritic condition ankylosing spondylitis. The study of the leukaemia risk in over 14000 irradiated spondylitis patients was completed in an astonishingly short period of time in the mid-1950s. The full report of the original study has been difficult to access because it was not published in a journal but only as a Special Report of the UK Medical Research Council. To mark 50 years since this publication this full report is reproduced in this issue of the Journal. This accompanying review describes the background to the study, the principal findings and the further follow-up of the population that documented the risks of cancers in addition to leukaemia associated with the x-ray treatment. The architects of the study were a radiobiologist, Michael Court-Brown, and an epidemiologist, Richard Doll. Their very productive study of the leukaemia risk among spondylitics spawned a lifelong collaboration including further seminal studies of the carcinogenic effects of radiation exposure, which are also summarised in the review. (review)

  11. Response to anti-TNF-α treatment for secondary renal amyloidosis in a patient with ankylosing spondylitis

    A. Gallo

    2011-09-01

    Full Text Available Renal amyloidosis is a complication of ankylosing spondylitis. A possible pathogenetic role is due to TNF-α, with a direct action on glomerular receptors TNFR2 and renal injury, secondary to deposition of amyloid fibrils. The most frequent clinical manifestation is proteinuria or nephrotic syndrome. Etanercept, a soluble receptor of TNF-α, binds this circulant cytokine with a progressive improvement of renal function and reduction of deposits of amyloid. Transient leukopenia, observed during ankylosing spondylitis, should not be considered a controindication to the use of Etanercept, but it requires a constant monitoring. The benefit observed in our patient can represent an indication to the use of Etanercept for the management of amyloidosis.

  12. Translation and validation of non-English versions of the Ankylosing Spondylitis Quality of Life (ASQOL) questionnaire

    Revicki Dennis; Twiss James; Meads David M; McKenna Stephen P; Doward Lynda C; Wong Robert L; Luo Michelle P

    2007-01-01

    Abstract Background The Ankylosing Spondylitis Quality of Life (ASQOL) questionnaire is a unidimensional, disease-specific measure developed in the UK and the Netherlands. This study describes its adaptation into other languages. Methods The UK English ASQOL was translated into US English; Canadian French and English; French; German; Italian; Spanish; and Swedish (dual-panel methods). Cognitive debriefing interviews were conducted with AS patients. Psychometric/scaling properties were assesse...

  13. Successful Etanercept Therapy for Refractory Sacroiliitis in a Patient with Ankylosing Spondylitis and Mixed Connective Tissue Disease

    Lee, Jee Young; Chang, Hyun Kyu; Kim, Seong-Kyu

    2008-01-01

    The concurrence of ankylosing spondylitis (AS) in a patient with mixed connective tissue disease (MCTD) is rarely described in the literature. Significant and sustained efficacy with tumor necrosis factor (TNF)-α blockers has been demonstrated in AS patients. However, evidence to date has revealed associated side effects, including antinuclear antibody induction and development of a lupus-like syndrome. Several authors have reported lupus-like manifestations in MCTD patients treated with TNF-...

  14. Robotic-Assisted Device in Posterior Spinal Fusion for a High Risk Thoraculombar Fracture in Ankylosing Spondylitis

    Suliman, Ali; Wollstein, Ronit; Bernfeld, Benjamin; Bruskin, Alexander

    2014-01-01

    Fractures in ankylosing spondylitis (AS) are often difficult to treat and surgical treatment may be fraught with complications. We describe the use of a robotic-assisted device in the surgical treatment of an unstable L1 fracture in an elderly patient with chronic lymphocytic leukemia and AS. The postoperative course was uneventful and the patient was discharged after 3 days. The use of a robotic-assisted device in spine surgery is particularly indicated in difficult high risk cases.

  15. Ossification of the posterior longitudinal ligament in three geographically and genetically different populations of ankylosing spondylitis and other spondyloarthropathies

    Ramos-Remus, C.; Russell, A.; Gomez-Vargas, A.; Hernandez-Chavez, A.; Maksymowych, W.; Gamez-Nava, J.; Gonzalez-Lopez, L.; Garcia-Hernandez, A.; Meono-Morales, E.; Burgos-Vargas, R; Suarez-Almazor, M.

    1998-01-01

    STUDY DESIGN—Cross sectional.
RESEARCH QUESTIONS—(a) Is any clinical variable of ankylosing spondylitis (AS) associated with the presence of ossification of the posterior longitudinal ligament (OPLL)? and (b) Is OPLL present in patients with AS from different geographical or genetic backgrounds?
METHODS—Three groups were assembled: (1) a prospective group of 103 consecutive AS patients from two community based rheumatology clinics from Guadalajara, who were evaluated using: a questionnaire wi...

  16. Unilateral sternocostoclavicular hyperostosis in a patient with ankylosing spondylitis: A case report with color Doppler ultrasonogram findings

    Sumantro Mondal; Debanjali Sinha; Arijit Nag; Alakendu Ghosh

    2013-01-01

    Sternocostoclavicular hyperostosis is a chronic inflammatory disorder affecting the sternoclavicular joint and upper ribs. There is a strong association with seronegative spondyloarthropathy in which bilateral involvement is common. Ultrasonography and Color Doppler findings of this entity have not been described previously, to the best of our knowledge. We describe the findings in a patient of ankylosing spondylitis who was referred for unilateral sternoclavicular joint swelling.

  17. Unilateral sternocostoclavicular hyperostosis in a patient with ankylosing spondylitis: A case report with color Doppler ultrasonogram findings

    Sumantro Mondal

    2013-01-01

    Full Text Available Sternocostoclavicular hyperostosis is a chronic inflammatory disorder affecting the sternoclavicular joint and upper ribs. There is a strong association with seronegative spondyloarthropathy in which bilateral involvement is common. Ultrasonography and Color Doppler findings of this entity have not been described previously, to the best of our knowledge. We describe the findings in a patient of ankylosing spondylitis who was referred for unilateral sternoclavicular joint swelling.

  18. Central venous catheter malposition in the azygos vein and difficult endotracheal intubation in severe ankylosing spondylitis: a case report

    Moon, Eunjin; Jeong, Hyungmo; Chung, Junyoung; Yi, Jaewoo

    2015-01-01

    Ankylosing spondylitis (AS) can be challenging for anesthesiologists because central venous access can be difficult, and the airway can be blocked due to the fixed flexion deformity of the spine. In this case, we attempted central access via the right subclavian vein, but the catheter was repeatedly inserted into the azygos vein, which was confirmed by radiology. After several attempts, the catheter position was corrected at the superior vena cava-atrial junction. Although several useful devi...

  19. How should clinicians manage osteoporosis in ankylosing spondylitis?

    Bessant, Rupa; Keat, Andrew

    2002-07-01

    Osteoporosis is a common complication of AS, with an incidence between 18.7% and 62%. The prevalence of osteoporosis is greater in males, and increases with increasing patient age and disease duration. Osteoporosis is also more common in patients with syndesmophytes, cervical fusion, and peripheral joint involvement. These variables are not all independent, as they may be indicators of disease duration. Osteoporosis in patients with AS is largely confined to the axial skeleton, in contrast to the pattern of osteoporosis seen in rheumatoid arthritis. BMD at the lumbar spine and femoral neck may be severely reduced, while most studies indicate that carpal and radial BMD remain within normal limits. The development of syndesmophytes in late AS can lead to difficulties in the use of DEXA scanning to determine lumbar BMD, as the extraspinal bone may obscure osteoporotic vertebrae. Under these circumstances more accurate assessment of lumbar BMD, and one that correlates better with femoral neck BMD, may be obtained by quantitative CT scanning or DEXA scanning of the lateral aspect of the L3 vertebra. Osteoporosis in AS significantly increases the risk of vertebral compression fractures within 5 years of the diagnosis of AS. The risk of a vertebral compression fracture occurring over a 30 year period following the diagnosis of AS is 14%, compared to 3.4% for population controls. In patients with vertebral osteoporosis relatively minor trauma, such as slipping, can lead to spinal fracture and dislocatior with subsequent damage to the spinal cord. There is a higher incidence of spinal cord injury following spinal fracture dislocations in patients with AS, and the resulting neurological deficit can range from mild sensory loss to complete paraplegia. Cytokines such as TNF-alpha and IL-6 may play an important part in the pathogenesis of osteoporosis in early AS, and IL-6 levels have been correlated with markers of disease activity and severity. In late AS, mechanical factors

  20. 32P-chromic phosphate colloidal synovectomy combined with routine medication treating the hip disease of ankylosing spondylitis

    Objective: To observe the therapeutic effect of 32P-chromic phosphate colloidal synovectomy combined with routine medication in the treatment of the hip disease of ankylosing spondylitis. Methods: Eight-two ankylosing spondylitis unilateral hip patients were divided into two groups. Forty-two were enrolled in the routine medication combined with 32P-chromic phosphate colloidal synovectomy group (treatment group) and 42 in conventional medicine group (control group). The efficacy and safety were observed. Results: The effective rate of treatment group and control group were 73.8% and 52.4% respectively in the following six months. The difference was significant (χ2=4.840, P2=0.047, P>0.05 ). There was progress on the X-ray phases of hip joint in three-year follow-up, for the difference between the treatment group and the control group was significant (χ2=5.516, P0.05 ). When followed up for 6 months,the differences in the visual analogue scale(VAS) for hip of the treatment group and the control group were statistically different between before and after treatment (t=2.389, P0.05). The side effects was ob served only in five cases which was transient pain increase in joints. Conclusion: 32P-chromic phosphate colloid synovectomy combined with routine medication had a short-term effect in treating the hip joint disease of ankylosing spondylitis. (authors)

  1. Responsiveness of the Ankylosing Spondylitis Disease Activity Score (ASDAS) and clinical and MRI measures of disease activity in a 1-year follow-up study of patients with axial spondyloarthritis treated with tumour necrosis factor alpha inhibitors

    Pedersen, Susanne Juhl; Sørensen, Inge Juul; Hermann, Kay-Geert A; Madsen, Ole Rintek; Tvede, Niels; Hansen, Michael Sejer; Thamsborg, Gorm; Andersen, Lis Smedegaard; Majgaard, Ole; Loft, Anne Gitte; Erlendsson, Jon; Asmussen, Karsten Heller; Johansen, Julia S; Jurik, Anne Grethe; Møller, Jakob Møllenbach; Hasselquist, Maria; Mikkelsen, Dorrit; Skjødt, Thomas; Hansen, Annette; Østergaard, Mikkel

    2010-01-01

    To investigate construct validity and responsiveness of the novel ankylosing spondylitis (AS) disease activity score (ASDAS) in patients with spondyloarthritis (SpA).......To investigate construct validity and responsiveness of the novel ankylosing spondylitis (AS) disease activity score (ASDAS) in patients with spondyloarthritis (SpA)....

  2. Cross-cultural adaptation and validation of the Portuguese version of "The assessment of knowledge in ankylosing spondylitis patients by a self-administered questionnaire".

    da Rocha Lopes, Sofia Manuela; Duarte, José Alberto; Mesquita, Cristina Teresa Torrão Carvalho

    2016-04-01

    Knowledge is an important factor in patients with ankylosing spondylitis regarding the adoption of appropriate behaviours and education. The aim of this study was to culturally adapt and validate "The assessment of knowledge in ankylosing spondylitis patients by a self-administered questionnaire" for the Portuguese population with ankylosing spondylitis. The Portuguese version of "The assessment of knowledge in ankylosing spondylitis patients by a self-administered questionnaire" was administered to a sample of 180 subjects, from which 63 individuals responded. The adaptation process involved translation, back-translation and submission to a committee of experts in the area, culminating with a Portuguese version of the instrument. Next, the scale reliability and validity were assessed. There was a statistically significant decrease from test to retest, although the intra-class correlation coefficient between test and retest was 0.76 (95 % CI 0.61-0.86), which was considered good. From 180 individuals, 63 (35.0 %) subjects were available for the present study. The proportion of individuals that correctly answered each item ranged from 19 to 92 %, corresponding to items 8 and 13, respectively. The mean number of correct answers was 8.5 [mean (SD) = 2.4] in 12 questions. The proposed Portuguese version of the ankylosing spondylitis knowledge scale showed good reliability, reproducibility and construct validity. PMID:26856726

  3. Are Indian patients with juvenile-onset ankylosing spondylitis taller than reference population ?

    Pulukool Sandhya

    2015-01-01

    Full Text Available Background & objectives: Paucity of growth retardation has been observed by us in patients with juvenile-onset ankylosing spondylitis (JAS in a tertiary care health centre in south India. We, therefore, undertook this pilot study to assess and compare anthropometry of patients with JAS who were 15 yr and older with that of adult onset ankylosing spondylitis (AAS and matching Indian reference population. Methods: Consecutive male patients (December 2009- October 2012 with JAS and AAS fulfilling Modified New York Criteria were selected after applying inclusion and exclusion criteria. Demography and anthropometry were noted. Height of both patient groups as well as their parents and siblings were compared with that of the reference population. Mid-parental height and delta height were derived. Those with delta height of >8.5 cm were compared with the remaining. Multivariate logistic regression was done for variables that were found to be significant by chi-square in bivariate analysis. Similar analysis was done for BMI also. Results: There was no significant difference in anthropometric variables between JAS and AAS groups. Twenty eight of the 30 (93.33% JAS patients were taller as compared to the reference population. Twenty six (86.67% AAS patients were taller than the reference population. The mean heights of JAS (170.67 ± 6.94 cm and AAS (168.2 ± 5.94 cm patients were significantly higher than the reference value of 163.11 cm; both p0 <0.001. Logistic regression revealed that tallness in JAS was associated positively with hypermobility (OR=23.46,95%CI 1.2-447.2, p0 =0.036. No significant association was detected for height in AAS and for BMI in both JAS and AAS groups. Interpretation & conclusions: No growth retardation was seen in patients with JAS in our study. Majority of patients with JAS and AAS were taller than reference population. The difference between mean height of JAS and AAS was not significant. Larger studies involving different

  4. Radiography of the spine and sacro-iliac joints in ankylosing spondylitis and psoriasis

    A grading system involving six stages of arthritis from grade O=normal joints to grade V=extensive bony ankylosis in the sacro-iliac joints and a scheme applicable for quantitative registration of the radiographic findings of the spine in ankylosing spondylitis (AS) are detailed. These radiographic grading systems were used in a study comprising 48 patients with psoriasis (group A), 19 patients with AS and psoriasis (group B), 103 patients with AS (group C) and 231 first-degree relatives of the patients belonging to groups B and C (group D). Radiographic abnormalities of the spine were found totally in 80 per cent of the patients belonging to groups B and C. In these groups sclerotic anterior borders of vertebrae (SABS) and/or straightened anterior surfaces of vertebrae were seen totally in 66 per cent. SABS were earlier findings than syndesmophyte formation which was found in 60 per cent of the patients belonging to groups B and C. Except for ankylosis of the apophyseal joints and ossified interspinous ligament most frequently found in the lower lumbar region in patients with duration of disease more than 20 years, all abnormalities of the spine were most frequent in the dorsolumbar junction. Grade V sacro-iliitis was associated with ankylosis of two or more segments of the spine. Such spinal changes were infrequently seen in patients with grade IV sacro-iliitis. This finding supports the previous notion that among patients fulfilling the criteria for AS, there is a group with a non-ankylosing disease. Thus two different subgroups of AS could be identified. Except for frequent unilateral sacro-iliitis and slight changes of the spine in group A no radiographic differences were found between the groups A, B and C. Sacro-iliitis was found in 22(9%) in group D, and 11 of those with sacro-iliitis had abnormalities of the spine compatible with AS. (orig.)

  5. Radiography of the spine and sacro-iliac joints in ankylosing spondylitis and psoriasis

    Dale, K.; Vinje, O.

    A grading system involving six stages of arthritis from grade O=normal joints to grade V=extensive bony ankylosis in the sacro-iliac joints and a scheme applicable for quantitative registration of the radiographic findings of the spine in ankylosing spondylitis (AS) are detailed. These radiographic grading systems were used in a study comprising 48 patients with psoriasis (group A), 19 patients with AS and psoriasis (group B), 103 patients with AS (group C) and 231 first-degree relatives of the patients belonging to groups B and C (group D). Radiographic abnormalities of the spine were found totally in 80 per cent of the patients belonging to groups B and C. In these groups sclerotic anterior borders of vertebrae (SABS) and/or straightened anterior surfaces of vertebrae were seen totally in 66 per cent. SABS were earlier findings than syndesmophyte formation which was found in 60 per cent of the patients belonging to groups B and C. Except for ankylosis of the apophyseal joints and ossified interspinous ligament most frequently found in the lower lumbar region in patients with duration of disease more than 20 years, all abnormalities of the spine were most frequent in the dorsolumbar junction. Grade V sacro-iliitis was associated with ankylosis of two or more segments of the spine. Such spinal changes were infrequently seen in patients with grade IV sacro-iliitis. This finding supports the previous notion that among patients fulfilling the criteria for AS, there is a group with a non-ankylosing disease. Thus two different subgroups of AS could be identified. Except for frequent unilateral sacro-iliitis and slight changes of the spine in group A no radiographic differences were found between the groups A, B and C. Sacro-iliitis was found in 22(9%) in group D, and 11 of those with sacro-iliitis had abnormalities of the spine compatible with AS. (orig.).

  6. Vertebral fractures in patients with ankylosing spondylitis. A retrospective analysis of 66 patients

    Purpose: Retrospective analysis of vertebral fractures in patients with ankylosing spondylitis (AS) for the evaluation of associations with mortality, concurrent neurological deficits, and other complications. Materials and Methods: Image analysis (conventional radiographs, CT, MRI) was applied to all patients with AS admitted between 1997 and 2007 due to vertebral fractures to determine fracture location and classification. Patient characteristics, trauma mechanism, neurological symptoms, and other complications were documented. Results: 66 patients (54 male, age 64 ± 11 years) were enrolled in the study. 74 % of patients suffered from minor trauma. 51 % and 56 % had cervicothoracic and thoracolumbar fractures, respectively, while 8 % had multi-level fractures. 63 % of patients suffered combined vertebrodiscal fractures. 70 % revealed neurological symptoms, significantly correlating with spinal stenosis (p 0.024; Odds ratio 4.265) and hyperlordosis (p = 0.014; OR 4.806). 68 % developed complications with non-combined fractures (p =.042; OR 4.954) and paravertebral hematomas (p =.009; OR 16.969) representing independent risk factors. The female gender (p = 0.005; OR 15.617) and conservative therapy (p = 0.040; OR.094) exerted significant influence on the mortality rate. Conclusion: Vertebral fractures frequently occur in patients with AS after minor trauma and often lead to neurological symptoms, which in turn are associated with spinal stenosis and hyperlordosis. Paravertebral hematomas and non-combined fractures are accompanied by higher incidences of other complications. The female gender entails a higher mortality rate. (orig.)

  7. Hip morphometry of femoroacetabular impingement pattern in patients with ankylosing spondylitis

    To analyze hip morphometry of femoroacetabular impingement (FAI) pattern in patients with ankylosing spondylitis (AS) and correlate them with sacroiliitis grades. 384 patients with AS were analyzed regarding demographics, radiologic signs of FAI for hip involvement, and sacroiliitis grades. FAI was classified into 3 types according to alpha angle, lateral center-edge angle and pistol grip deformity. Sacroiliitis was graded according to the New York criteria. Prevalence of FAI morphometry types was determined and evaluated for association with sacroiliitis grades. Statistical analysis regarding numerical variables, including age, sacroiliitis score using t-test, sacroiliitis score in three groups using Kruskal-Wallis test and Mann-Whitney U-test, corrected by Bonferroni methods for post hoc analysis was done. Among 384 patients, 141 (36.7%) had FAI morphometry. Male predominance was found in group with FAI pattern involvement (87.2%) (p = 0.000). Pincer type (20.6%) was the most common. Hip involvement group also showed greater sacroiliitis score (2.49 vs. 1.75, p = 0.000). Combined-type had greater sacroiliitis score compared with others (p = 0.002, 0.003). FAI morphometry was frequent in hips of AS patients (36.7%), especially pincer type, more frequent in male, and associated with significantly greater grade of sacroiliitis; combined type FAI pattern had greater sacroiliitis score

  8. Association between endoplasmic reticulum aminopeptidase-1 (ERAP-1 and susceptibility to ankylosing spondylitis in Iran.

    Mahdi Mahmoudi

    2012-12-01

    Full Text Available Ankylosing Spondylitis (AS is an inflammatory arthritis, which affects mainly spine and sacroiliac joints. According to recent studies, ERAP1 is the second most common candidate gene for  AS susceptibility after HLA-B27. The  aim of this study was to  determine the association of ERAP1 gene polymorphisms with AS in Iranian population.The study group comprised 387 Iranian AS patients and 316 healthy controls from Iran.Using Real Time PCR allelic discrimination method,  we genotyped four SNPs (rs30187, rs469876, rs13167972 and rs27434 of ERAP1.We found  that  rs30187 and rs27434 were significantly associated with AS in Iranian population (P=6×10-5, P=7×10-3,  respectively. The rs30187 T/T genotype was associated with AS compared  with C/C  genotype (P=1.5×10-5.  The  rs27434 G/G genotype was inversely associated with  AS (P=5×10-3.  Two  specific haplotypes  including:  rs30187/ rs469876/ rs13167972/ rs27434 TAAA and CAGG  were associated with increased and decreased risk of AS in Iranian population, respectively.These results indicated that ERAP1 SNPs and haplotypes were associated with AS in Iranian population.

  9. Level set based vertebra segmentation for the evaluation of Ankylosing Spondylitis

    Tan, Sovira; Yao, Jianhua; Ward, Michael M.; Yao, Lawrence; Summers, Ronald M.

    2006-03-01

    Ankylosing Spondylitis is a disease of the vertebra where abnormal bone structures (syndesmophytes) grow at intervertebral disk spaces. Because this growth is so slow as to be undetectable on plain radiographs taken over years, it is necessary to resort to computerized techniques to complement qualitative human judgment with precise quantitative measures on 3-D CT images. Very fine segmentation of the vertebral body is required to capture the small structures caused by the pathology. We propose a segmentation algorithm based on a cascade of three level set stages and requiring no training or prior knowledge. First, the noise inside the vertebral body that often blocks the proper evolution of level set surfaces is attenuated by a sigmoid function whose parameters are determined automatically. The 1st level set (geodesic active contour) is designed to roughly segment the interior of the vertebra despite often highly inhomogeneous and even discontinuous boundaries. The result is used as an initial contour for the 2nd level set (Laplacian level set) that closely captures the inner boundary of the cortical bone. The last level set (reversed Laplacian level set) segments the outer boundary of the cortical bone and also corrects small flaws of the previous stage. We carried out extensive tests on 30 vertebrae (5 from each of 6 patients). Two medical experts scored the results at intervertebral disk spaces focusing on end plates and syndesmophytes. Only two minor segmentation errors at vertebral end plates were reported and two syndesmophytes were considered slightly under-segmented.

  10. Sweet's syndrome in a patient with acute Crohn's colitis and longstanding ankylosing spondylitis.

    Petermann, A; Tebbe, B; Distler, A; Sieper, J; Braun, J

    1999-01-01

    Acute neutrophilic dermatosis, also referred to as Sweet's syndrome according to the first description in 1964, occurs not only as an isolated phenomenon but also in the context of neoplastic and inflammatory diseases, occasionally including arthritides. Recently Sweet's syndrome has been reported in a small number of patients with chronic inflammatory bowel disease, mostly in advanced stages of the disease. Here, we describe the sudden outbreak of acute neutrophilic dermatosis in coincidence with the onset of severe Crohn's disease (CD) in a patient with long-standing ankylosing spondylitis (AS). This condition has not been described before and therefore Sweet's syndrome should be added to the spectrum of skin manifestations the rheumatologist has to think about in the context of the spondylarthropathies (SpA). Furthermore, this case report is of interest because the skin lesions of Sweet's syndrome are somewhat similar to psoriasis, which is a rather frequent feature of the spondylarthropathies. This article intends to clarify the clinical and histological differentiation between Sweet's syndrome, psoriatic skin lesions and erythema nodosum for the rheumatologist and stresses that these conditions must each be treated in a completely different manner. PMID:10544847

  11. Protocol for a population-based Ankylosing Spondylitis (PAS cohort in Wales

    Atkinson Mark D

    2010-09-01

    Full Text Available Abstract Background To develop a population-based cohort of people with ankylosing spondylitis (AS in Wales using (1 secondary care clinical datasets, (2 patient-derived questionnaire data and (3 routinely-collected information in order to examine disease history and the health economic cost of AS. Methods This data model will include and link (1 secondary care clinician datasets (i.e. electronic patient notes from the rheumatologist (2 patient completed questionnaires (giving information on disease activity, medication, function, quality of life, work limitations and health service utilisation and (3 a broad range of routinely collected data (including; GP records, in-patient hospital admission data, emergency department data, laboratory/pathology data and social services databases. The protocol involves the use of a unique and powerful data linkage system which allows datasets to be interlinked and to complement each other. Discussion This cohort can integrate patient supplied, primary and secondary care data into a unified data model. This can be used to study a range of issues such as; the true economic costs to the health care system and the patient, factors associated with the development of severe disease, long term adverse events of new and existing medication and to understand the disease history of this condition. It will benefit patients, clinicians and health care managers. This study forms a pilot project for the use of routine data/patient data linked cohorts for other chronic conditions.

  12. ERAP1 structure, function and pathogenetic role in ankylosing spondylitis and other MHC-associated diseases.

    Alvarez-Navarro, Carlos; López de Castro, José A

    2014-01-01

    The endoplasmic reticulum aminopeptidase 1 (ERAP1) is a multifunctional enzyme involved in the final processing of Major Histocompatibility Complex class I (MHC-I) ligands and with a significant influence in the stability and immunological properties of MHC-I proteins. ERAP1 polymorphism is associated with ankylosing spondylitis among HLA-B27-positive individuals and the altered enzymatic activity of natural variants has significant effects on the HLA-B27 peptidome, suggesting a critical pathogenetic role of peptides in this disease. Likewise, the association of ERAP1 with other MHC-I associated disorders and its epistasis with their susceptibility MHC alleles point out to a general role of the MHC-I peptidome in these diseases. The functional interaction between ERAP1 and HLA-B27 or other MHC-I molecules may be related to the processing of specific epitopes, or to a more general peptide-dependent influence on other biological features of the MHC-I proteins. In addition, from a consideration of the reported functions of ERAP1, including its involvement in angiogenesis and macrophage activation, a more complex and multi-level influence in the inflammatory and immune pathways operating in these diseases cannot be ruled out. PMID:23916068

  13. The genetic associations of acute anterior uveitis and their overlap with the genetics of ankylosing spondylitis.

    Robinson, P C; Leo, P J; Pointon, J J; Harris, J; Cremin, K; Bradbury, L A; Stebbings, S; Harrison, A A; Evans, D M; Duncan, E L; Wordsworth, B P; Brown, M A

    2016-01-01

    Acute anterior uveitis (AAU) involves inflammation of the iris and ciliary body of the eye. It occurs both in isolation and as a complication of ankylosing spondylitis (AS). It is strongly associated with HLA-B*27, but previous studies have suggested that further genetic factors may confer additional risk. We sought to investigate this using the Illumina Exomechip microarray, to compare 1504 cases with AS and AAU, 1805 with AS but no AAU and 21 133 healthy controls. We also used a heterogeneity test to test the differences in effect size between AS with AAU and AS without AAU. In the analysis comparing AS+AAU+ cases versus controls, HLA-B*27 and HLA-A*02:01 were significantly associated with the presence of AAU (PERAP1 has a larger effect on AAU compared with that in AS alone. These findings also suggest that variants in ERAP1 have a differential impact on the risk of AAU when compared with AS, and hence the genetic risk for AAU differs from AS. PMID:26610302

  14. Immunogenetic Study in Chinese Population with Ankylosing Spondylitis: Are There Specific Genes Recently Disclosed?

    Jiayu Zhai

    2013-01-01

    Full Text Available Purpose. Ankylosing spondylitis (AS is a systemic, autoimmune disease resulting in the destruction of the affected joints. Over the past 5 years, several new genes or genetic regions associated with AS have been identified in the Chinese population. This paper aims to discuss the major findings and related potential mechanisms of these studies in our population. Recent Findings. In recent years, due to the rapid advances in computational genetics and technology, there has been an increasing list of well-validated genes or genetic regions associated with AS susceptibility. So far, several genes or genetic regions have now been reported in the Han ethnic Chinese population, containing the major histocompatibility complex (MHC, ERAP1, IL-23R, 12q12, 2p15, 5q14.3, and so on. Different hypotheses for disease mechanisms have been investigated on the basis of the functional studies of these genes or genetic regions. Summary. This paper tries to summarize the association of several candidate genes with risk for AS in the Han ethnic Chinese population and aims to identify the novel inflammatory pathways and provide potential strategies for better therapies.

  15. Functionally distinct ERAP1 allotype combinations distinguish individuals with Ankylosing Spondylitis.

    Reeves, Emma; Colebatch-Bourn, Alexandra; Elliott, Tim; Edwards, Christopher J; James, Edward

    2014-12-01

    For more than 40 y, expression of HLA-B27 has been strongly associated with the chronic inflammatory disease Ankylosing Spondylitis (AS); however, the mechanisms underlying this association are still unknown. Single nucleotide polymorphisms within the aminopeptidase endoplasmic reticulum aminopeptidase 1 (ERAP1), which is essential for trimming peptides before they are presented to T cells by major histocompatibility complex (MHC) class I molecules, have been linked with disease. We show that ERAP1 is a highly polymorphic molecule comprising allotypes of single nucleotide polymorphisms. The prevalence of specific ERAP1 allotypes is different between AS cases and controls. Both chromosomal copies of ERAP1 are codominantly expressed, and analysis of allotype pairs provided clear stratification of individuals with AS versus controls. Functional analyses demonstrated that ERAP1 allotype pairs seen in AS cases were poor at generating optimal peptide ligands for binding to murine H-2K(b) and -D(b) and the AS-associated HLA-B*2705. We therefore provide strong evidence that polymorphic ERAP1 alters protein function predisposing an individual to AS via its influence on the antigen processing pathway. PMID:25422414

  16. A polymorphism in ERAP1 is associated with susceptibility to ankylosing spondylitis in a Turkish population.

    Cinar, Muhammet; Akar, Hatice; Yilmaz, Sedat; Simsek, Ismail; Karkucak, Mutlu; Sagkan, Rahsan Ilıkci; Pekel, Aysel; Erdem, Hakan; Avci, Ismail Yasar; Acikel, Cengizhan; Musabak, Ugur; Tunca, Yusuf; Pay, Salih

    2013-11-01

    We assessed the role played by the ERAP1 gene in Turkish patients with ankylosing spondylitis (AS) in terms of disease susceptibility, clinical manifestations, and disease severity. We included 150 consecutive AS patients who met the modified New York classification criteria and 150 healthy controls. We documented the presence of 10 ERAP1 single-nucleotide polymorphisms (SNPs) and HLA-B27 in these patients. ERAP1 SNPs were genotyped using competitive allele-specific polymerase chain reaction. Differences between genotype and allele frequencies were compared using the Pearson's Chi-square test. The associations between ERAP1 SNPs, on the one hand, and with disease severity and clinical findings, on the other, were determined. One SNP, rs26653, was significantly associated with AS susceptibility (OR 1.609, 95% CI 1.163-2.226; p = 0.004). The population-attributable risk of possession of the rs26653 SNP allele was 23.4%. No relationship was noted between HLA-B27 positivity and the distribution of rs26653 genotype frequency. No associations were seen between disease severity measures and clinical manifestations of AS. In summary, an ERAP1 polymorphism was associated with AS in a Turkish population. The contributions of HLA-B27 and the rs26653 SNP to AS pathogenesis appear to be independent. PMID:23864143

  17. Major histocompatibility complex associations of ankylosing spondylitis are complex and involve further epistasis with ERAP1.

    Cortes, Adrian; Pulit, Sara L; Leo, Paul J; Pointon, Jenny J; Robinson, Philip C; Weisman, Michael H; Ward, Michael; Gensler, Lianne S; Zhou, Xiaodong; Garchon, Henri-Jean; Chiocchia, Gilles; Nossent, Johannes; Lie, Benedicte A; Førre, Øystein; Tuomilehto, Jaakko; Laiho, Kari; Bradbury, Linda A; Elewaut, Dirk; Burgos-Vargas, Ruben; Stebbings, Simon; Appleton, Louise; Farrah, Claire; Lau, Jonathan; Haroon, Nigil; Mulero, Juan; Blanco, Francisco J; Gonzalez-Gay, Miguel A; Lopez-Larrea, C; Bowness, Paul; Gaffney, Karl; Gaston, Hill; Gladman, Dafna D; Rahman, Proton; Maksymowych, Walter P; Crusius, J Bart A; van der Horst-Bruinsma, Irene E; Valle-Oñate, Raphael; Romero-Sánchez, Consuelo; Hansen, Inger Myrnes; Pimentel-Santos, Fernando M; Inman, Robert D; Martin, Javier; Breban, Maxime; Wordsworth, Bryan Paul; Reveille, John D; Evans, David M; de Bakker, Paul I W; Brown, Matthew A

    2015-01-01

    Ankylosing spondylitis (AS) is a common, highly heritable, inflammatory arthritis for which HLA-B*27 is the major genetic risk factor, although its role in the aetiology of AS remains elusive. To better understand the genetic basis of the MHC susceptibility loci, we genotyped 7,264 MHC SNPs in 22,647 AS cases and controls of European descent. We impute SNPs, classical HLA alleles and amino-acid residues within HLA proteins, and tested these for association to AS status. Here we show that in addition to effects due to HLA-B*27 alleles, several other HLA-B alleles also affect susceptibility. After controlling for the associated haplotypes in HLA-B, we observe independent associations with variants in the HLA-A, HLA-DPB1 and HLA-DRB1 loci. We also demonstrate that the ERAP1 SNP rs30187 association is not restricted only to carriers of HLA-B*27 but also found in HLA-B*40:01 carriers independently of HLA-B*27 genotype. PMID:25994336

  18. Effects of physical therapy for the management of patients with ankylosing spondylitis in the biological era.

    Giannotti, Erika; Trainito, Sabina; Arioli, Giovanni; Rucco, Vincenzo; Masiero, Stefano

    2014-09-01

    Exercise is considered a fundamental tool for the management of ankylosing spondylitis (AS), in combination with pharmacological therapy that with the advent of biological therapy has improved dramatically the control of signs and symptoms of this challenging disease. Current evidence shows that a specific exercise protocol has not been validated yet. The purpose of this review is to update the most recent evidence (July 2010-November 2013) about physiotherapy in AS, analyzing the possible role and synergistic interactions between exercise and biological drugs. From 117 studies initially considered, only 15 were included in the review. The results support a multimodal approach, including educational sessions, conducted in a group setting, supervised by a physiotherapist and followed by a maintaining home-based regimen. Spa exercise and McKenzie, Heckscher, and Pilates methods seem promising in AS rehabilitation, but their effectiveness should be further investigated in future randomized controlled trials (RCTs). When performed in accordance with the American College of Sports Medicine guidelines, cardiovascular training has been proven safe and effective and should be included in AS rehabilitation protocols. Exercise training plays an important role in the biological era, being now applicable to stabilized patients, leading ultimately to a better management of AS by physiatrists and rheumatologists throughout the world. On the basis of the current evidence, further research should aim to determine which exercise protocols should be recommended. PMID:24797772

  19. Common Mediterranean Fever (MEFV Gene Mutations Associated with Ankylosing Spondylitis in Turkish Population

    Serbulent Yigit

    2012-01-01

    Full Text Available Ankylosing spondylitis (AS is a common inflammatory rheumatic disease. Mediterranean fever (MEFV gene, which has already been identified as being responsible for familial Mediterranean fever (FMF, is also a suspicious gene for AS because of the clinical association of these two diseases. The aim of this study was to explore the frequency and clinical significance of MEFV gene mutations (M694V, M680I, V726A, E148Q and P369S in a cohort of Turkish patients with AS. Genomic DNAs of 103 AS patients and 120 controls were isolated and genotyped using polymerase chain reaction (PCR and restriction fragment length polymorphism (RFLP methods. There was a statistically significant difference of the MEFV gene mutation carrier rates between AS patients and healthy controls (p = 0.004, OR: 2.5, 95% CI: 1.32–4.76. This association was also observed in allele frequencies (p = 0.005, OR: 2.3, 95% CI: 1.27–4.2. A relatively higher frequency was observed for M694V mutation in AS patients than controls (10.7% versus 4.2% , p = 0.060. There were no significant differences between MEFV mutation carriers and non-carriers with respect to the clinical and demographic characteristics. The results of this study suggest that MEFV gene mutations are positively associated with a predisposition to develop AS.

  20. Major histocompatibility complex associations of ankylosing spondylitis are complex and involve further epistasis with ERAP1

    Cortes, Adrian; Pulit, Sara L.; Leo, Paul J.; Pointon, Jenny J.; Robinson, Philip C.; Weisman, Michael H.; Ward, Michael; Gensler, Lianne S.; Zhou, Xiaodong; Garchon, Henri-Jean; Chiocchia, Gilles; Nossent, Johannes; Lie, Benedicte A.; Førre, Øystein; Tuomilehto, Jaakko; Laiho, Kari; Bradbury, Linda A.; Elewaut, Dirk; Burgos-Vargas, Ruben; Stebbings, Simon; Appleton, Louise; Farrah, Claire; Lau, Jonathan; Haroon, Nigil; Mulero, Juan; Blanco, Francisco J.; Gonzalez-Gay, Miguel A.; Lopez-Larrea, C; Bowness, Paul; Gaffney, Karl; Gaston, Hill; Gladman, Dafna D.; Rahman, Proton; Maksymowych, Walter P.; Crusius, J. Bart A.; van der Horst-Bruinsma, Irene E.; Valle-Oñate, Raphael; Romero-Sánchez, Consuelo; Hansen, Inger Myrnes; Pimentel-Santos, Fernando M.; Inman, Robert D.; Martin, Javier; Breban, Maxime; Wordsworth, Bryan Paul; Reveille, John D.; Evans, David M.; de Bakker, Paul I.W.; Brown, Matthew A.

    2015-01-01

    Ankylosing spondylitis (AS) is a common, highly heritable, inflammatory arthritis for which HLA-B*27 is the major genetic risk factor, although its role in the aetiology of AS remains elusive. To better understand the genetic basis of the MHC susceptibility loci, we genotyped 7,264 MHC SNPs in 22,647 AS cases and controls of European descent. We impute SNPs, classical HLA alleles and amino-acid residues within HLA proteins, and tested these for association to AS status. Here we show that in addition to effects due to HLA-B*27 alleles, several other HLA-B alleles also affect susceptibility. After controlling for the associated haplotypes in HLA-B, we observe independent associations with variants in the HLA-A, HLA-DPB1 and HLA-DRB1 loci. We also demonstrate that the ERAP1 SNP rs30187 association is not restricted only to carriers of HLA-B*27 but also found in HLA-B*40:01 carriers independently of HLA-B*27 genotype. PMID:25994336

  1. A Sub-Pathway Based Method to Identify Candidate Agents for Ankylosing Spondylitis

    Ming Li

    2012-10-01

    Full Text Available The need for new therapeutics for Ankylosing Spondylitis (AS is highlighted by the general lack of efficacy for most agents currently available for this disease. Many recent studies have detailed molecular pathways in AS, and several molecule-targeting agents are undergoing evaluation. We aimed to explore the mechanism of AS and identify biologically active small molecules capable of targeting the sub-pathways which were disregulated in the development of AS. By using the GSE25101 microarray data accessible from the Gene Expression Omnibus database, we first identified the differentially expressed genes (DEGs between AS samples and healthy controls, followed by the sub-pathway enrichment analysis of the DEGs. In addition, we propose the use of an approach based on targeting sub-pathways to identify potential agents for AS. A total of 3,280 genes were identified as being significantly different between patients and controls with p-values < 0.1. Our study showed that neurotrophic signaling pathway and some immune-associated pathways may be involved in the development of AS. Besides, our bioinformatics analysis revealed a total of 15 small molecules which may play a role in perturbing the development of AS. Our study proposes the use of an approach based on targeting sub-pathways to identify potential agents for AS. Candidate agents identified by our approach may provide the groundwork for a combination therapy approach for AS.

  2. Hip morphometry of femoroacetabular impingement pattern in patients with ankylosing spondylitis

    Lee, Jong Yoon; Lee, Eu Gene; Choi, Jung Ah [Dept. of Radiology, Seoul National University Bundang Hospital, Seongnam (Korea, Republic of)

    2015-06-15

    To analyze hip morphometry of femoroacetabular impingement (FAI) pattern in patients with ankylosing spondylitis (AS) and correlate them with sacroiliitis grades. 384 patients with AS were analyzed regarding demographics, radiologic signs of FAI for hip involvement, and sacroiliitis grades. FAI was classified into 3 types according to alpha angle, lateral center-edge angle and pistol grip deformity. Sacroiliitis was graded according to the New York criteria. Prevalence of FAI morphometry types was determined and evaluated for association with sacroiliitis grades. Statistical analysis regarding numerical variables, including age, sacroiliitis score using t-test, sacroiliitis score in three groups using Kruskal-Wallis test and Mann-Whitney U-test, corrected by Bonferroni methods for post hoc analysis was done. Among 384 patients, 141 (36.7%) had FAI morphometry. Male predominance was found in group with FAI pattern involvement (87.2%) (p = 0.000). Pincer type (20.6%) was the most common. Hip involvement group also showed greater sacroiliitis score (2.49 vs. 1.75, p = 0.000). Combined-type had greater sacroiliitis score compared with others (p = 0.002, 0.003). FAI morphometry was frequent in hips of AS patients (36.7%), especially pincer type, more frequent in male, and associated with significantly greater grade of sacroiliitis; combined type FAI pattern had greater sacroiliitis score.

  3. Application value of curved planar reconstruction in sacroiliac joint of ankylosing spondylitis

    Objective: To determine the application value of curved planar reconstruction (CPR) of multislice spiral computed tomography(MSCT) in changes of sacroiliac joint of ankylosing spondylitis(AS). Methods: 33 patients with AS diagnosed clinically were chosen to take MSCT scanning of bilateral sacroiliac joints with the slice thick of 5mm and the slice interval of 5 mm. The primary images were transported to General Electric AW4.0 workstation, and the multiplanar reformatted sagittal images of sacrum were obtained by the reformat software, and further the coronary images of bilateral sacroiliac joints by CPR with the construction curves coincident with sacrums. Results: All coronary images of bilateral sacroiliac joints by CPR were excellent in density and space resolution, and showed complete sacroiliac joints and their changes clearly and directly. Of all 33 cases, 2 were graded as grade 0, 5 grade I, 11 grade II, 10 grade III, 5 glade IV, according to grading standard. Conclusion: The coronary images of sacroiliac joint by CPR are enough clear and eligible for clinical diagnosis, and, in combination with transversal images, are helpful to complete assessment about the grade and scope of changes of sacroiliac joint in AS patients. (authors)

  4. Mortality among patients with ankylosing spondylitis after a single treatment course with x-rays

    Mortality was studied in 14,111 patients with ankylosing spondylitis given a single course of x-ray treatment during 1935-54. Mortality from all causes was 66% greater than that of the general population of England and Wales. The substantial excesses of deaths from non-neoplastic conditions appeared to be associated with the disease itself rather than its treatment. A nearly fivefold excess of deaths from leukaemia and a 62% excess of deaths from cancers of sites that would have been in the radiation fields (''heavily irradiated sites'') were likely to have been a direct consequence of radiation treatment. Excess death rate from leukaemia was greatest three to five years after treatment and close to zero after 18 years. Excess of cancers of heavily irradiated sites did not become apparent until nine or more years after irradiation continuing for a further 11 years. More than 20 years after irradiation the excess risk declined but the fall was not statistically significant. The number of cancers of sites not considered to be in the radiation beams was 20% greater than expected. This excess, although not statistically significant, may have been due to scattered radiation. The risk of a radiation-induced leukaemia or other cancer was related to age at treatment time. (author)

  5. Allicin Attenuates Inflammation and Suppresses HLA-B27 Protein Expression in Ankylosing Spondylitis Mice

    Xin Gu

    2013-01-01

    Full Text Available Here we aimed to determine the therapeutic effect of allicin on ankylosing spondylitis (AS and explore the mechanism(s of action. AS mouse model was constructed by transferring the HLA-B2704 gene into Kunming mice and verified by RT-PCR and CT imaging. Verified AS mice were randomly divided into model group ( and allicin-treated groups (50, 100, and 200 mg/kg, resp., , p.o., for 2 months. Wild type mice were used as control (. The levels of AS-related inflammatory factors were measured by ELISA. mRNA and protein expressions of HLA-B27 were checked by RT-PCR and western blotting. As the results, the mouse model of AS was successfully established, and high-dose allicin could markedly alleviate spine inflammatory injury possibly via reducing the secretion of the inflammatory factors (IL-6, IL-8, and TNF-α sharply in AS mice. Moreover, allicin significantly inhibited HLA-B27 protein translation but failed to suppress HLA-B27 gene transcription in AS mice, indicating a posttranscriptional mechanism of this modulation. In conclusion, allicin has potential to be used for AS treatment as an anti-inflammatory nutraceutical.

  6. Intravitreal Triamcinolone Acetonide for Macular Edema in HLA-B27 Negative Ankylosing Spondylitis

    M.M. Moschos

    2010-12-01

    Full Text Available We report a case of a human leukocyte antigen B27 (HLA-B27-negative patient with cystoid macular edema (CME and ankylosing spondylitis (AS after treatment with triamcinolone acetonide. The patient complained of deterioration of visual acuity of the right eye during the last 10 days. At presentation visual acuity of the right eye was 0.2, and the ophthalmic examination did not reveal any sign of active uveitis. Fluorescein angiography (FA and ocular coherent tomography (OCT showed CME. The left eye was normal with a visual acuity of 0.9. Eight weeks after intravitreal injection of triamcinolone acetonide, visual acuity improved to 0.8 and OCT revealed regression of macular edema. Six months later no recurrence was observed. Our case report indicates for the first time that CME may occur in AS independently of the presence of HLA-B27 and intraocular inflammation. Intravitreal use of triamcinolone acetonide can reduce macular edema and restore visual acuity.

  7. Indications and results of a radium-224 (thorium x) therapy of ankylosing spondylitis (Sp.a.)

    224Ra treatment of ankylosing spondylitis with 1 i.v. injection of 28 μCi 224Ra per week and a total of 10 injections is indicated only for stages II and III of the disease if the inflammation of the small vertebral joints and iliosacral grooves are resistant to therapy and if the progressive ankylosis of the vertebral column can be proved by radiography and scintiscanning. It should not be applied, in general, during stage I, where only ilisacral arthritis can be diagnosed in the iliosacral grooves, and in stage IV, full-scale osseous ankylosis of the vertebral column with or without involvement of the extremity joints. Due to the antiosteoblastic action of the α radiation of 224Ra and the antiphlogistic action of the β and γ radiation released during the radioactive decay of 224Ra daughter products, the pain during stages II and III of a.sp. is greatly alleviated, and intensive gymnastic and balneological treatment during the 10 weeks' stay in hospital is made possible. Malignant bone tumours have never been observed so far, although the period of observation has been as long as 29 years in some cases. Even in those patients who died of tumours of the soft tissue, the rate was only 14% compared to the 20% rate in the normal population. (orig./MG)

  8. Anesthesia Strategies and Perioperative Optimization for Patients with Ankylosing Spondylitis Undergoing Total Hip Replacement Surgery.

    2016-06-10

    Objective To identify the characteristics of anesthesia and perioperative management for ankylosing spondylitis (AS) patients undergoing total hip arthroplasty (THA). Methods Totally 63 patients scheduled for single THA in PUMC Hospital from January 1st 2013 to June 1st 2015 were included in this retrospective analysis,among whom 21 patients were diagnosed of AS. The perioperative clinical data included:demographic data,American Society of Anesthesiologists (ASA) classification,medical history,airway assessment,preoperative laboratory examinations,electrocardiogram,pulmonary function tests,intubation information,operation time,intraoperative intake and output volume,postoperative hospital stay,and postoperative complications. Results Significantly fewer AS patients undergoing THA were evaluated as ASA classification I than non-AS patients (9.5% vs. 33.3%,P=0.041). AS patients had significantly higher level of preoperative high-sensitivity C-reactive protein [(17.0±14.8)mg/L vs.(4.3±7.1)mg/L,P0.05). Conclusions AS patients undergoing THA have elevated preoperative inflammatory markers,with high incidence of pulmonary function abnormality and difficult airway. In consideration of high risk of surgery and anesthesia,adequate airway evaluation and optimization of perioperative management are needed to ensure the patients' safety. PMID:27469916

  9. Adipokines, Biomarkers of Endothelial Activation, and Metabolic Syndrome in Patients with Ankylosing Spondylitis

    Fernanda Genre

    2014-01-01

    Full Text Available Ankylosing spondylitis (AS is a chronic inflammatory rheumatic disease associated with accelerated atherosclerosis and increased risk of cardiovascular (CV disease. AS patients also display a high prevalence of features clustered under the name of metabolic syndrome (MeS. Anti-TNF-α therapy was found to be effective to treat AS patients by suppressing inflammation and also improving endothelial function. Previously, it was demonstrated that a short infusion of anti-TNF-α monoclonal antibodyinfliximab induced a rapid and dramatic reduction in serum insulin levels and insulin resistance along with a rapid improvement of insulin sensitivity in nondiabetic AS patients. The role of adipokines, MeS-related biomarkers and biomarkers of endothelial cell activation and inflammation seem to be relevant in different chronic inflammatory diseases. However, its implication in AS has not been fully established. Therefore, in this review we summarize the recent advances in the study of the involvement of these molecules in CV disease or MeS in AS. The assessment of adipokines and biomarkers of endothelial cell activation and MeS may be of potential relevance in the stratification of the CV risk of patients with AS.

  10. Interaction between ERAP1 and HLA-B27 in ankylosing spondylitis implicates peptide handling in the mechanism for HLA-B27 in disease susceptibility

    Evans, David M; Spencer, Chris C.A.; Pointon, Jennifer J.; Su, Zhan; Harvey, David; Kochan, Grazyna; Oppermann, Udo; Dilthey, Alexander; Pirinen, Matti; Stone, Millicent A.; Appleton, Louise; Moutsianas, Loukas; Leslie, Stephen; Wordsworth, Tom; Kenna, Tony J.

    2011-01-01

    Ankylosing spondylitis is a common form of inflammatory arthritis predominantly affecting the spine and pelvis that occurs in approximately 5 out of 1,000 adults of European descent. Here we report the identification of three variants in the RUNX3, LTBRTNFRSF1A and IL12B regions convincingly associated with ankylosing spondylitis (P < 5 × 10−8 in the combined discovery and replication datasets) and a further four loci at PTGER4, TBKBP1, ANTXR2 and CARD9 that show strong association across all...

  11. Long term investigation of late effects in ankylosing spondylitis patients treated with radium-224

    Wick, R.R. [GSF - National Research Center for Environment and Health, Inst. of Radiobiology, Neuherberg (Germany); Nekolla, E.A. [Federal Office for Radiation Protection (BfS), Neuherberg (Germany)

    2005-07-01

    An epidemiological study has been carried out on 1462 ankylosing spondylitis (AS) patients followed since 1971 at the GSF - National Research Center for Environment and Health. The aim of the study was to ascertain the late health effects occurring in these patients who had received repeated intravenous injections of the short lived {alpha}-emitter {sup 224}radium between 1948 and 1975 (excluding patients treated additionally with X-rays). The then usual therapeutic protocol consisted of a total of 10 to 12 injections of 1.036 MBq (28 {mu}Ci) of {sup 224}Ra each, given at weekly intervals. This resulted in a cumulative {alpha}-dose of 0.56 to 0.67 Gy to the marrow-free skeleton (bone surface dose: {proportional_to} 5.5 Gy) of a 70-kg-man (standard man). These patients have been followed together with a control group of 1324 ankylosing spondylitis patients not treated with radioactive drugs and/or X-rays. Up to August 2004, causes of death have been ascertained for 913 exposed patients and 971 controls (mean follow-up time {proportional_to} 26 yr in the exposed group or {proportional_to} 24 yr in the control group). In the exposed group there has been a total of 251 malignant diseases (vs. 277.0 expected cases) and 233 cases (vs. 302.4 exp.) among the controls. In the exposure group 16 cases of kidney cancer (vs. 8.7 cases expected, p = 0.02), 6 cases of liver cancer (vs. 3.3 exp., p = 0.12), and 4 cases of thyroid cancer (vs. 1.1 exp., p = 0.03) were observed. The most striking observation, however, were the 16 cases of leukaemia in the exposure group (vs. 6.5 cases expected, p = 0.001) compared to only 10 cases of leukaemia in the control group (vs. 7.1 cases expected, p = 0.2). Further subclassification of the leukaemias demonstrated a high increase of myeloid leukaemia in the exposure group (10 cases obs. vs. 2.8 cases exp., p <0.001), and particularly, of myeloid leukaemia (7 cases observed vs. 1.7 expected, p = 0.002), whereas in the control group the number

  12. ERAP1 genetic variations associated with HLA-B27 interaction and disease severity of syndesmophytes formation in Taiwanese ankylosing spondylitis

    Wang, Chin-Man; Ho, Huei-Huang; Chang, Su-Wei; Wu, Yeong-Jian Jan; Lin, Jing-Chi; Chang, Pi-Yueh; Wu, Jianming; Chen, Ji-Yih

    2012-01-01

    Introduction Ankylosing spondylitis (AS) is a familial, heritable disease specified by syndesmophyte formation leading to an ankylosed spine. Endoplasmic reticulum aminopeptidase 1 (ERAP1) genetic variations have been widely proved to be associated with AS in several ethnic populations. The aim of this study was to investigate whether ERAP1 single nucleotide polymorphisms (SNPs) are associated with AS susceptibility and disease severity in Taiwanese. Methods Four ERAP1 SNPs (rs27037, rs27980,...

  13. Comparison of the antibody responses to the 77 Klebsiella capsular types in ankylosing spondylitis and various rheumatic diseases.

    Sahly, H; Kekow, J; Podschun, R.; Schaff, M; Gross, W. L.; Ullmann, U

    1994-01-01

    The production of antibodies to Klebsiella capsular polysaccharides was measured in sera from either HLA-B27-positive (HLA-B27+) or HLA-B27-negative (HLA-B27-) patients with classical ankylosing spondylitis (n = 54). These sera were compared with sera from patients with various rheumatic diseases (n = 82) and HLA-B27+ or HLA-B27- healthy individuals (n = 85). All sera were analyzed by means of an enzyme-linked immunosorbent assay specific to each of the 77 Klebsiella serotypes. The sera from ...

  14. Functional Interaction of the Ankylosing Spondylitis-associated Endoplasmic Reticulum Aminopeptidase 1 Polymorphism and HLA-B27 in Vivo*

    García-Medel, Noel; Sanz-Bravo, Alejandro; Nguyen, Dung; Galocha, Begoña; Gómez-Molina, Patricia; Martín-Esteban, Adrián; Alvarez-Navarro, Carlos; de Castro, José A. López

    2012-01-01

    The association of ERAP1 with ankylosing spondylitis (AS)1 among HLA-B27-positive individuals suggests that ERAP1 polymorphism may affect pathogenesis by altering peptide-dependent features of the HLA-B27 molecule. Comparisons of HLA-B*27:04-bound peptidomes from cells expressing different natural variants of ERAP1 revealed significant differences in the size, length, and amount of many ligands, as well as in HLA-B27 stability. Peptide analyses suggested that the mechanism of ERAP1/HLA-B27 in...

  15. Taylor′s approach in an ankylosing spondylitis patient posted for percutaneous nephrolithotomy: A challenge for anesthesiologists

    Jindal Parul

    2009-01-01

    Full Text Available We describe a patient with long-standing ankylosing spondylitis who underwent percutaneous nephrolithotomy under spinal anesthesia. At preoperative assessment, it was considered that intubation of the trachea was likely to be difficult. Fiberoptic bronchoscopy was attempted, but without success. As the standard technique for spinal anesthesia failed, a variation of the paramedian approach in the lumbosacral approach, also known as Taylor′s approach was successfully attempted. This resulted in adequate sensory and motor blockade for the surgical procedure. The patient did not require airway interventions, but equipment and aids to secure airway were available.

  16. The application of MR imaging in the detection of hip involvement in patients with ankylosing spondylitis

    Objective: To investigate the changes in hip MR imaging, evaluate the frequency of hip involvement and compare the value of clinical symptoms, radiographs, and MR imaging in the detection of hip involvement in patients with ankylosing spondylitis (AS). Methods: Anteroposterior radiographs of the pelvis, MR imaging of the hip and clinical evaluation were undertaken in 58 patients with definite AS. All patients were followed up 3 years. Annual radiographs and clinical evaluation were carried out. The imaging data were independently assessed by two experienced radiologists who were blinded to patient identity and clinical characteristics. Based on the Bath Ankylosing Spondylitis Radiology Hip Index (BASRI-hip) scoring system, BASRI-hip scores ≥2 were defined as radiological hip involvement. On MR imaging, both acute and chronic inflammatory changes were considered positive signs for hip involvement. Symptomatic hip involvement was defined as current or past pain or limitation of the hip movement. The statistical analysis was performed using the χ2 test for comparison of sensitivity among clinical symptoms, radiographs, and MR imaging in the detection of hip involvement and the Student's t-test for comparison of disease duration between with and without hip involvement. A P value <0.05 was considered to be statistically significant. For interpreting MRI and radiographs, the percentage of agreement between the two assessors and the kappa coefficients were calculated. Results: On MR imaging, positive changes were detected in 86 (74.1%) hips among 116 hips in all 58 patients. Joint effusion was observed in 73 (62.9%) hips; 23 out of 27 patients who underwent fat-saturated contrast-enhanced T1-weighted sequences had abnormal synovial enhancement in bilateral hips. The other abnormal MR findings included subchondral bone marrow edema in 35 (30.2%) hips, enthesitis in 22 (19.0%) hips, fatty accumulation of the bone marrow in 28 (24.1%) hips, bone erosive destruction

  17. Golimumab administered subcutaneously every 4 weeks in ankylosing spondylitis: 5-year results of the GO-RAISE study

    Deodhar, Atul; Braun, Jürgen; Inman, Robert D; Zhou, Yiying; Xu, Stephen; Han, Chenglong; Hsu, Benjamin

    2015-01-01

    Objective Assess golimumab efficacy/safety through 5 years in patients with active ankylosing spondylitis (AS). Methods 356 patients with AS were randomly assigned to placebo, golimumab 50 mg or 100 mg every 4 weeks. At week 16, patients with inadequate response early escaped with blinded dose adjustments (placebo to 50 mg, 50 mg to 100 mg). At week 24, all patients receiving placebo crossed over to 50 mg. Blinded active therapy continued through week 104; from week 104 to week 252, the golimumab dose could be adjusted. Intent-to-treat and observed efficacy data were assessed by randomised treatment groups. Results At week 256, and with >4.5 years of golimumab, overall intent-to-treat Assessment in SpondyloArthritis international Society criteria for 20% improvement (ASAS20) and ASAS40 response rates were 66.0% (235/356) and 57.0% (203/356), respectively; Bath AS Disease Activity Index 50% improvement response was 55.9% (199/356). Observed response rates among the 255 (72%) patients who continued golimumab through week 252 were consistent, albeit somewhat higher. Among patients who increased golimumab from 50 to 100 mg, 60.6% (20/33) and 44.7% (17/38) achieved ASAS20/ASAS40 responses, respectively, following ≥2 consecutive doses of golimumab 100 mg. Golimumab safety through week 268 was similar to that through week 24 regardless of dose. Conclusions Clinical improvements observed in patients treated with golimumab through week 24 were sustained through week 256 (5 years). Long-term golimumab safety is consistent with that of other established tumour-necrosis-factor-antagonists. Trial registration number ClinicalTrials.gov: NCT00265083. PMID:25387477

  18. Fecal calprotectin is associated with disease activity in patients with ankylosing spondylitis.

    Duran, Arzu; Kobak, Senol; Sen, Nazime; Aktakka, Seniha; Atabay, Tennur; Orman, Mehmet

    2016-01-01

    Calprotectin is one of the major antimicrobial S100 leucocyte proteins. Serum calprotectin levels are associated with certain inflammatory diseases such as rheumatoid arthritis, systemic lupus erythematosus and inflammatory bowel disease. The aim of this study was to investigate serum and fecal calprotectin levels in patients with ankylosing spondylitis (AS) and show their potential relations to the clinical findings of the disease. Fifty-one patients fulfilling the New York criteria of AS and 43 healthy age- and gender-matched volunteers were included in the study. Physical and locomotor system examinations were performed and history data were obtained for all patients. Disease activity parameters were assessed together with anthropometric parameters. Routine laboratory examinations and genetic testing (HLA-B27) were performed. Serum calprotectin levels and fecal calprotectin levels were measured by an enzyme-linked immunosorbent assay. The mean age of the patients was 41.5 years, the mean duration of the disease was 8.6 years, and the delay in diagnosis was 4.2 years. Serum calprotectin levels were similar in both AS patients and in the control group (p=0.233). Serum calprotectin level was correlated with Bath AS disease activity index (BASDAI) and Bath AS functional index (BASFI) (p=0.001, p=0.002, respectively). A higher level of fecal calprotectin was detected in AS patients when compared with the control group. A statistically significant correlation between fecal calprotectin level and BASDAI, BASFI, C-reactive protein and Erythrocyte sedimentation rate were detected (p=0.002, p=0.005, p=0.001, p=0.002, respectively). The results indicated that fecal calprotectin levels were associated with AS disease findings and activity parameters. Calprotectin is a vital disease activity biomarker for AS and may have an important role in the pathogenesis of the disease. Multi-centered prospective studies are needed in order to provide further insight. PMID:26773186

  19. Fecal calprotectin is associated with disease activity in patients with ankylosing spondylitis

    Arzu Duran

    2016-01-01

    Full Text Available Calprotectin is one of the major antimicrobial S100 leucocyte proteins. Serum calprotectin levels are associated with certain inflammatory diseases such as rheumatoid arthritis, systemic lupus erythematosus and inflammatory bowel disease. The aim of this study was to investigate serum and fecal calprotectin levels in patients with ankylosing spondylitis (AS and show their potential relations to the clinical findings of the disease. Fifty-one patients fulfilling the New York criteria of AS and 43 healthy age- and gender-matched volunteers were included in the study. Physical and locomotor system examinations were performed and history data were obtained for all patients. Disease activity parameters were assessed together with anthropometric parameters. Routine laboratory examinations and genetic testing (HLA-B27 were performed. Serum calprotectin levels and fecal calprotectin levels were measured by an enzyme-linked immunosorbent assay. The mean age of the patients was 41.5 years, the mean duration of the disease was 8.6 years, and the delay in diagnosis was 4.2 years. Serum calprotectin levels were similar in both AS patients and in the control group (p=0.233. Serum calprotectin level was correlated with Bath AS disease activity index (BASDAI and Bath AS functional index (BASFI (p=0.001, p=0.002, respectively. A higher level of fecal calprotectin was detected in AS patients when compared with the control group. A statistically significant correlation between fecal calprotectin level and BASDAI, BASFI, C-reactive protein and Erythrocyte sedimentation rate were detected (p=0.002, p=0.005, p=0.001, p=0.002, respectively. The results indicated that fecal calprotectin levels were associated with AS disease findings and activity parameters. Calprotectin is a vital disease activity biomarker for AS and may have an important role in the pathogenesis of the disease. Multi-centered prospective studies are needed in order to provide further insight.

  20. Serum adipokines and adipose tissue distribution in rheumatoid arthritis and ankylosing spondylitis. A comparative study.

    ERIC eTOUSSIROT

    2013-12-01

    Full Text Available Rheumatoid arthritis (RA and ankylosing spondylitis (AS are inflammatory rheumatic diseases that may modify body composition. Adipose tissue has the ability to release a wide range of products involved in physiologic functions, but also in various pathological processes, including the inflammatory/immune response. RA and AS are both associated with the development of cardiovascular complications. It is has been established that central/abdominal and particularly intra-abdominal or visceral adiposity is closely linked to cardiovascular events. Thus, in this study, we aimed to evaluate the body composition of patients with RA or AS compared to healthy controls (HC with a special emphasis on the visceral region. In parallel, we measured adipose products or adipokines, namely leptin, adiponectin and its high molecular weight (HMW isoform, resistin, and ghrelin, a gastric peptide that plays a role in energetic balance. The homeostasis model assessment for insulin resistance (HOMA-IR and atherogenic index were used to evaluate cardiovascular risk. One hundred and twelve subjects were enrolled (30 patients with RA, 31 with AS and 51 HC. Body composition was measured using dual-energy X-ray absorptiometry (DXA to determine total fat mass and lean mass, adiposity, fat in the android and gynoid regions, and visceral fat. Patients and HC did not differ in terms of body mass index. On the contrary, adiposity was increased in RA (p= 0.01 while visceral fat was also increased, but only in women (p=0.01. Patients with AS tended to have lower total fat mass (p=0.07 and higher lean mass compared to HC (p = 0.07. Leptin and leptin/fat mass were decreased in male patients with AS (p

  1. TREATMENT IN PATIENTS WITH ANKYLOSING SPONDYLITIS IN THE REAL CLINICAL PRACTICE OF A RHEUMATOLOGIST IN RUSSIA

    Sh F Erdes

    2013-01-01

    Full Text Available Objective: to analyze the treatment of ankylosing spondylitis (AS in the real practice of a rheumatologist in Russia. Subjects and methods. The cross-sectional study included 330 AS patients who had been actively seeking medical advice from rheumatologists during 4 months in 24 cities and towns of the Russian Federation. The therapy performed was studied using the medical history data recorded by physicians in the specially designed clinical chart. Drug intake, its regularity, reasons for discontinuation of medications, and their clinical effect were elucidated in all the patients. The need to intensify the therapy and to use genetically engineered biological agents was determined by disease activity at the time of examination. Results. The medical histories indicated that 62% of the patients received nonsteroidal anti-inflammatory drugs (NSAIDs regularly, 34% had them periodically, and 4% were not treated; two thirds of the patients took diclofenac, nimesulide, or meloxicam. 33, 14, and 9% of the patients used sulfasalazine, methotrexate, and oral glucocorticosteroids, respectively. Sixty (18% patients received tumor necrosis factor-α (TNF-α inhibitors. Different physiotherapeutic methods were used in 30% of cases; only 46% did exercises regularly; as high as 4% of the patients had sanatorium-and-spa treatment. In the physicians' opinion, 81% of the patients needed intensified therapy and 62% did therapy with TNF-α inhibitors. At the same time TNF-α inhibitors were indicated in 38% of the patients according to the ASAS recommendations. Conclusion. In real clinical practice, AS treatment does not always meet the current recommendations: only 62% of the patients received continuous NSAID therapy; disease-modifying antirheumatic drugs were frequently used without any indications. 18% of the patients took TNF-α inhibitors and 38% really needed them.

  2. Tc-99m HIG Scintigraphy in Detection of Active Inflammation in Ankylosing Spondylitis

    Özhan Özdoğan

    2011-08-01

    Full Text Available Objective: The diagnosis of active inflammation in ankylosing spondylitis (AS is crucial for treatment to delay possible persistent deformities. There are no specific laboratory tests and imaging methods to clarify the active disease. We evaluated the value of Tc-99m human immunoglobulin (HIG scintigraphy in detection of active inflammation. Material and Methods: Twenty-nine patients were included. Tc-99m methylenediphosphonate bone (MDP and HIG scintigraphies were performed within 2-5 day intervals. Two control groups were constituted both for MDP and HIG scintigraphies. Active inflammation was determined clinically and by serologic tests. Both scintigraphies were evaluated visually. Sacroiliac joint index values (SII were calculated. Results: Active inflammation was considered in five (sacroiliitis in 2, sacroiliitis-spinal inflammation in 1, achilles tendinitis in 1, arthritis of coxafemoral joints in 1 patients. HIG scintigraphy demonstrated active disease in all 3 patients with active sacroiliitis. But, it was negative in the rest. The other 2 active cases were HIG negative. Right and left SII obtained from HIG scintigraphy was higher (p<0.05 in clinically active patients than inactive patients. There was not any significant difference between patients with inactive sacroiliitis and normal controls. Right and left SII obtained from bone scintigraphy was higher (p<0.05 in patient group than in control group. Conclusion: Clinically inactive AS patients, behave no differently than normal controls with quantitative sacroiliac joint evaluation on HIG scintigraphy. HIG scintigraphy may be valuable for evaluation of sacroiliac joints in patients with uncertain laboratory and clinical findings. (MIRT 2011;20:52-58

  3. Muscle activation patterns and gait biomechanics in patients with ankylosing spondylitis

    A. Caliri

    2011-09-01

    Full Text Available Patients with ankylosing spondylitis (AS may experience a progressive spinal kyphosis, which induces a forward and downward displacement of the centre of mass (COM of the trunk with consequent use of mechanisms to compensate for the displacement of the trunk. The analysis of patterns of movement gives an important opportunity for follow-up of patients and is an useful tool to plan a therapeutic and rehabilitative program. Objective: The aim of our study was to contribute to the description of abnormalities of gait biomechanics in patients with AS and to individualize, if existing, a typical pattern of these patients. Methods: Five patients with AS (3 men, 2 women were evaluated by gait analysis. Each patient was assessed with dynamic electromyography, with survey of phases of gait cycle and 3D video-analysis of gait related to data of platform (Digivec ® which allows to display real time the force vector of reaction foot-ground overlapping the screen image of patient. Results: The dynamometric platform located the following problems: increasing of the medium-lateral component of the reaction force on the ground in the mild and terminal stance. The anterior-posterior reaction force is diminished in both the initial and the terminal component. The timing of activation of the tibialis anterior results prolonged while the timing of activation of the gastrocnemius medialis results delayed. Conclusion: The patients with AS prefer therefore an eccentric contraction of the tibial anterior in comparison to a concentric contraction of the gastrocnemius medialis, “opting” for a gait strategy that confers greater stability but limited power.

  4. Association Study of IL-12B Polymorphisms Susceptibility with Ankylosing Spondylitis in Mainland Han Population.

    Li Zhang

    Full Text Available This study aims to determine whether the genetic polymorphisms of IL-12B gene is a susceptibility factor to Ankylosing spondylitis (AS in mainland Han Chinese population.Eight single-nucleotide polymorphisms (SNPs (rs10045431, rs11167764, rs3212227, rs6556412, rs6556416, rs6871626, rs6887695 and rs7709212 in the IL-12B gene were genotyped by iMLDR Assay technology in 400 patients [96% (384/400 HLA-B27(+] and 395 geographically and ethnically matched healthy controls in mainland Han Chinese population. The correlation between IL-12B genetic polymorphisms and AS activity index (BASDAI, BASFI were tested.The significant difference was found in genotype distribution between AS and healthy controls (χ2 = 6.942, P-value = 0.031 of the SNP rs6871626. Furthermore, significant evidence was also detected under the recessive model for minor allele A. The AA genotype carrier had 1.830 fold risk compared with C allele carrier (with CC and AC genotypes [OR (95% CI = 1.830 (1.131-2.961, P-value = 0.014]. Nevertheless, the difference was no longer significant after Bonferroni correction. Subset analysis on cases with HLA-B27(+ did find the same results. Three genotypic groups (AA, CC and CA in rs6871626 site was highly associated with the BASDAI and BASFI (P-value = 0.012 and P-value = 0.023, respectively, after adjustment for effect of age, sex, and disease duration, the P-value was 0.031 and 0.041, respectively. The AA genotype of rs6871626 was also significantly correlated with an increased BASDAI and BASFI compared to the AC and CC genotypes in AS patients.Our findings suggest that rs6871626 may be associated AS susceptibility and with disease activity (BASDAI, BASFI in mainland Han Chinese population.

  5. Proposal for levels of evidence schema for validation of a soluble biomarker reflecting damage endpoints in rheumatoid arthritis, psoriatic arthritis, and ankylosing spondylitis, and recommendations for study design

    Maksymowych, W.P.; Fitzgerald, O.; Wells, G.A.; Gladman, D.D.; Landewe, R.; Østergaard, Mikkel; Taylor, W.J.; Christensen, R.; Tak, P.P.; Boers, M.; Syversen, S.W.; Bathon, J.M.; Ritchlin, C.J.; Mease, P.J.; Bykerk, V.P.; Garnero, P.; Geusens, P.; El-Gabalawy, H.; Aletaha, D.; Inman, R.D.; Kraus, V.B.; Kvien, T.K.; der, Heijde D. van

    2009-01-01

    arthritis (RA), psoriatic arthritis (PsA), and ankylosing spondylitis (AS). We also aimed to generate consensus on minimum standards for the design of longitudinal studies aimed at validating biomarkers. METHODS: Before the meeting, the Soluble Biomarker Working Group prepared a preliminary framework and...

  6. Can erosions on MRI of the sacroiliac joints be reliably detected in patients with ankylosing spondylitis? - A cross-sectional study

    Weber, Ulrich; Pedersen, Susanne J; Østergaard, Mikkel; Rufibach, Kaspar; Lambert, Robert Gw; Maksymowych, Walter P

    2012-01-01

    Erosions of the sacroiliac joints (SIJ) on pelvic radiographs of patients with ankylosing spondylitis (AS) are an important feature of the modified New York classification criteria. However, radiographic SIJ erosions are often difficult to identify. Recent studies have shown that erosions can be...

  7. Inflammatory lesions of the spine on magnetic resonance imaging predict the development of new syndesmophytes in ankylosing spondylitis: evidence of a relationship between inflammation and new bone formation

    Maksymowych, Walter P; Chiowchanwisawakit, Praveena; Clare, Tracey; Pedersen, Susanne J; Østergaard, Mikkel; Lambert, Robert G W

    2009-01-01

    OBJECTIVE: To determine whether a vertebral corner that demonstrates an active corner inflammatory lesion (CIL) on magnetic resonance imaging (MRI) in patients with ankylosing spondylitis (AS) is more likely to evolve into a de novo syndesmophyte visible on plain radiography than is a vertebral...

  8. Serum from patients with ankylosing spondylitis can increase PPARD, fra-1, MMP7, OPG and RANKL expression in MG63 cells

    Hu, Zaiying; Lin, Dongfang; Qi, Jun; Qiu, Minli; Lv, Qing; Li, Qiuxia; Lin, Zhiming; Liao, Zetao; Pan, Yunfeng; Jin, Ou; Wu, Yuqiong; Gu, Jieruo

    2015-01-01

    OBJECTIVES: To explore the effects of serum from patients with ankylosing spondylitis on the canonical Wnt/β-catenin pathway and to assess whether the serum has an osteogenic effect in MG63 cells. METHODS: MG63 cells were cultured with serum from 45 ankylosing spondylitis patients, 30 healthy controls, or 45 rheumatoid arthritis patients. The relative PPARD, fra-1, MMP7, OPG and RANKL mRNA levels were measured using quantitative real-time polymerase chain reaction. Associations between gene expression and patient demographics and clinical assessments were then analyzed. RESULTS: MG63 cells treated with serum from ankylosing spondylitis patients had higher PPARD, fra-1, MMP7 and OPG gene expression than did cells treated with serum from controls or rheumatoid arthritis patients (all p0.05). CONCLUSIONS : Serum from ankylosing spondylitis patients increases PPARD, fra-1, MMP7, OPG and RANKL expression and the OPG/RANKL ratio in MG63 cells; these effects may be due to the stimulatory effect of the serum on the Wnt pathway. PMID:26602520

  9. Serum from patients with ankylosing spondylitis can increase PPARD, fra-1, MMP7, OPG and RANKL expression in MG63 cells

    Zaiying Hu

    2015-11-01

    Full Text Available OBJECTIVES: To explore the effects of serum from patients with ankylosing spondylitis on the canonical Wnt/β-catenin pathway and to assess whether the serum has an osteogenic effect in MG63 cells. METHODS: MG63 cells were cultured with serum from 45 ankylosing spondylitis patients, 30 healthy controls, or 45 rheumatoid arthritis patients. The relative PPARD, fra-1, MMP7, OPG and RANKL mRNA levels were measured using quantitative real-time polymerase chain reaction. Associations between gene expression and patient demographics and clinical assessments were then analyzed. RESULTS: MG63 cells treated with serum from ankylosing spondylitis patients had higher PPARD, fra-1, MMP7 and OPG gene expression than did cells treated with serum from controls or rheumatoid arthritis patients (all p0.05. CONCLUSIONS : Serum from ankylosing spondylitis patients increases PPARD, fra-1, MMP7, OPG and RANKL expression and the OPG/RANKL ratio in MG63 cells; these effects may be due to the stimulatory effect of the serum on the Wnt pathway.

  10. Genetic research progress of ankylosing spondylitis%强直性脊柱炎遗传学研究进展

    王立新

    2011-01-01

    Ankylosing spondylitis is a highly genetic predisposition seronegative spondyloarthropathies. Previous studies mainly reported the strong association between HLA - B27 gene and AS, but in recent years a large number of studies suggest that besides HLA - B27 gene, there may be other MHC and non - MHC genes associated with AS. This article reviews the genetic progress of ankylosing spondylitis in order to provide new ideas to its diagnosis, prevention and treatment.%强直性脊柱炎是一种具有高度遗传倾向的血清阴性脊柱关节病.既往的研究主要报道HLA- B27基因与AS的强相关性,但近年来大量的研究提示除HLA - B27基因外,可能还存在其他的MHC类和非MHC类基因与AS相关.本文综述了强直性脊柱炎的遗传学因素的研究进展,为其诊断、预防和治疗提供新的思路.

  11. Sulfasalazine Treatment Suppresses the Formation of HLA-B27 Heavy Chain Homodimer in Patients with Ankylosing Spondylitis

    Hui-Chun Yu

    2015-12-01

    Full Text Available Human leukocytic antigen-B27 heavy chain (HLA-B27 HC has the tendency to fold slowly, in turn gradually forming a homodimer, (B27-HC2 via a disulfide linkage to activate killer cells and T-helper 17 cells and inducing endoplasmic reticulum (ER stress to trigger the IL-23/IL-17 axis for pro-inflammatory reactions. All these consequences lead to the pathogenesis of ankylosing spondylitis (AS. Sulfasalazine (SSA is a common medication used for treatment of patients with AS. However, the effects of SSA treatment on (B27-HC2 formation and on suppression of IL-23/IL-17 axis of AS patients remain to be determined. In the current study, we examine the (B27-HC2 of peripheral blood mononuclear cells (PBMC, the mean grade of sarcoiliitis and lumbar spine Bath Ankylosing Spondylitis Radiology Index (BASRI scores of 23 AS patients. The results indicated that AS patients without (B27-HC2 on PBMC showed the lower levels of mean grade of sarcoiliitis and the lumbar spine BASRI scores. In addition, after treatment with SSA for four months, the levels of (B27-HC2 on PBMCs were significantly reduced. Cytokines mRNA levels, including TNFα, IL-17A, IL-17F and IFNγ, were also significantly down-regulated in PBMCs. However, SSA treatment did not affect the levels of IL-23 and IL-23R mRNAs.

  12. Sulfasalazine Treatment Suppresses the Formation of HLA-B27 Heavy Chain Homodimer in Patients with Ankylosing Spondylitis.

    Yu, Hui-Chun; Lu, Ming-Chi; Huang, Kuang-Yung; Huang, Hsien-Lu; Liu, Su-Qin; Huang, Hsien-Bin; Lai, Ning-Sheng

    2016-01-01

    Human leukocytic antigen-B27 heavy chain (HLA-B27 HC) has the tendency to fold slowly, in turn gradually forming a homodimer, (B27-HC)₂ via a disulfide linkage to activate killer cells and T-helper 17 cells and inducing endoplasmic reticulum (ER) stress to trigger the IL-23/IL-17 axis for pro-inflammatory reactions. All these consequences lead to the pathogenesis of ankylosing spondylitis (AS). Sulfasalazine (SSA) is a common medication used for treatment of patients with AS. However, the effects of SSA treatment on (B27-HC)₂ formation and on suppression of IL-23/IL-17 axis of AS patients remain to be determined. In the current study, we examine the (B27-HC)₂ of peripheral blood mononuclear cells (PBMC), the mean grade of sarcoiliitis and lumbar spine Bath Ankylosing Spondylitis Radiology Index (BASRI) scores of 23 AS patients. The results indicated that AS patients without (B27-HC)₂ on PBMC showed the lower levels of mean grade of sarcoiliitis and the lumbar spine BASRI scores. In addition, after treatment with SSA for four months, the levels of (B27-HC)₂ on PBMCs were significantly reduced. Cytokines mRNA levels, including TNFα, IL-17A, IL-17F and IFNγ, were also significantly down-regulated in PBMCs. However, SSA treatment did not affect the levels of IL-23 and IL-23R mRNAs. PMID:26729099

  13. Analysis of sagittal balance using spinopelvic parameters in ankylosing spondylitis patients treated with vertebral column decancellation surgery.

    Lin, Bin; Zhang, Wen-Bin; Cai, Tao-yi; Lu, Cheng-Wu; Zhou, Qin; Huang, Zhuanzhi; Yu, Hui

    2015-09-01

    This study was designed to explore the change of spinopelvic parameters after vertebral column decancellation (VCD) for the management of thoracolumbar kyphosis secondary to ankylosing spondylitis (AS). Forty-two AS patients including thirty-six males and six females with thoracolumbar kyphosis, who underwent VCD from April 2005 to June 2012 in our hospital, were retrospectively reviewed. A series of spinopelvic parameters including thoracic kyphosis (TK), lumbar lordosis (LL), sacral slope (SS), pelvic incidence (PI), pelvic tilt (PT) and sagittal vertical axis (SVA) measured on preoperative and postoperative free-standing radiographs were obtained and analyzed. Also clinical assessments were performed with the Oswestry disability index (ODI) and the Bath Ankylosing Spondylitis Activity and Function Index (BASDAI and BASFI) so as to seek correlations between radiological parameters and symptoms. Except for pelvic incidence (PI), significant difference was found in all radiological spinopelvic parameters between the preoperative and follow-up values. Furthermore, there was significant improvement in the clinical assessment parameters ODI, BASDAI and BASFI, which all correlated significantly with the postoperative pelvic tilt (PT). The results of this study show that posterior VCD is an effective option to manage sagittal imbalance in AS. In the current series, patients improving LL and PT were found to achieve good clinical outcomes. Overall, our findings show that it is important to quantify sagittal spinopelvic parameters and promote sagittal balance in the surgery for AS. PMID:26435251

  14. Midlife Ankylosing Spondylitis Increases the Risk of Cardiovascular Diseases in Males 5 Years Later

    Hung, Yao-Min; Chang, Wei-Pin; Wei, James Cheng-Chung; Chou, Pesus; Wang, Paul Yung-Pou

    2016-01-01

    Abstract There are limited studies describing the association between ankylosing spondylitis (AS) and cardiovascular disease (CVD) in patients over 40 years old. We aimed to focus on the incident AS patients in those aged 40 years or older and to investigate whether events of CVD occurred more than the general population. We conducted a nationwide cohort study between 2000 and 2005 using the Taiwan National Health Insurance Research Database. The risk of newly diagnosed CVD was compared between incident AS patients and matched age- and sex-matched subjects without AS. Events of CVDs were classified into 1 of 5 subcategories: hypertensive heart disease, coronary heart disease, congestive heart failure, cerebrovascular disease, or “other” CVD according to the ICD-9-CM codes. Cumulative incidences and hazard ratios (HRs) were calculated after adjusting for demographic and comorbid medical disorders. Multivariate analyses were performed using Cox proportional hazards model. We compared 537 AS and 2685 non-AS patients and found that the cumulative incidence rate of CVD during follow-up period was higher in the AS cohort than the non-AS cohort. The crude HR of CVD for the AS group was 1.24 [95% confidence interval (95% CI), 1.05–1.46; P = 0.01] and the adjusted HR was 1.20 with 95% CI 1.02 to 1.42 (P = 0.03). When stratified by age, AS cohort at age 60 to 69 years exhibited a significantly higher HR for all CVD than the general population cohort (adjusted HR 1.48, 95% CI 1.06–2.08, P the general population cohort with the adjusted HR 1.28 (95% CI 1.01–1.63, P < 0.05). There was no statistically significant difference for females. Patients with AS, especially age 60 to 69 years male patients, had a higher risk of CVDs than non-AS controls. PMID:27149491

  15. [German patient version of the ASAS/EULAR recommendations for the management of ankylosing spondylitis].

    Kiltz, U; Feldtkeller, E; Braun, J

    2010-03-01

    The evidence-based recommendations on the management of ankylosing spondylitis (AS) have enjoyed a high level of acceptance and circulation in Germany, as well as in other European countries. To make patient participation in the decision-making process regarding their disease easier, as well as to strengthen the physician-patient relationship, the ASAS and EULAR have set up an initiative to formulate a patient-friendly version of the recommendations, initially in English. In order that this lay version can also be used in German-speaking countries, a group predominantly comprising patients was formed to ensure that the German translation of this version has the broadest possible basis. In cooperation with the German (DVMB), Austrian (OVMB) and Swiss Morbus Bechterew Associations (SVMB), as well as the German Rheumatology League, patients from Germany, Austria and Switzerland with appropriate English skills were invited to a meeting in 2008. The aim of the translation was to leave the content unchanged while finding a level of speech easily understandable to the lay person. The translated text was considered as accepted when a minimum of 12 patients (>80%) gave their approval on the wording of the translation of individual recommendations in an open vote. The rheumatologist given the function of moderator was not entitled to vote. The level of approval for each recommendation was determined (0: no approval to 10: full approval). The 14 patients were able to translate the English patient version into German. Choice of words and style of speech were discussed intensively. Acceptance of the translation of the 10 recommendations was generally high. The content was clearly accepted with an approval rate of 8.4+/-1.6. This was the first time that patients, in cooperation with rheumatologists, have translated an international patient version on AS management into German under controlled conditions. The translation text was approved by the majority in terms of both form and

  16. Clinical features of Crohn disease concomitant with ankylosing spondylitis: A preliminary single-center study.

    Liu, Song; Ding, Jie; Wang, Meng; Zhou, Wanqing; Feng, Min; Guan, Wenxian

    2016-07-01

    Extraintestinal manifestations (EIMs) cause increased morbidity and decreased quality of life in Crohn disease (CD). Ankylosing spondylitis (AS) belongs to EIMs. Very little is known on the clinical features of CD concomitant with AS. This study is to investigate the clinical features of CD patients with AS.We retrospectively collected all CD patients with AS in our hospital, and established a comparison group (CD without AS) with age, sex, and duration of Crohn disease matched. Clinical information was retrieved for comparison.Eight CD + AS patients were identified from 195 CD patients. Sixteen CD patients were randomly selected into comparison group. All CD + AS patients were male, HLA-B27 (+), and rheumatoid factor (-) with an average age of 40.8 ± 4.52 years. Significant correlation between disease activity of CD and AS was revealed (r = 0.857, P = 0.011). Significant correlation between disease activity of CD and functional limitation associated with AS was identified (r = 0.881, P < 0.01). C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), and globulin were positively correlated to Crohn disease activity index (CDAI), Bath AS disease activity index, and Bath AS functional index(BASFI) scores (r = 0.73-0.93, P < 0.05). Albumin was negatively associated with CDAI and BASFI (r = -0.73 to -0.91, P < 0.05). The ratio of albumin to globulin (Alb/Glo) was significantly related to all 3 scores (r = -0.81 to -0.91, P < 0.05).Male predominance with a 4.12% concomitant incidence of AS is observed in CD patients. Disease activity of CD correlates with disease activity of AS and functional limitation caused by AS. CRP, ESR, and Alb/Glo may serve as biomarkers for disease activity and functional limitation in CD patients concomitant with AS, although future studies are expected. PMID:27428240

  17. Association of IL1R polymorphism with HLA-B27 positive in Iranian patients with ankylosing spondylitis.

    Mahmoudi, M; Amirzargar, A A; Jamshidi, A R; Farhadi, E; Noori, S; Avraee, M; Nazari, B; Nicknam, M H

    2011-12-01

    Ankylosing spondylitis (AS) is one of the most common causes of inflammatory arthritis, with an estimated prevalence of 0.1-0.9%. Genetic factors have been strongly implicated in its aetiology, and heritability as assessed by twin studies has been estimated to be >90%. HLA- B27 is almost essential for inheritance of AS; it is not merely sufficient for explaining the pattern of familial recurrence of the disease. This study's purpose is to investigate the association of ankylosing spondylitis with single-nucleotide polymorphisms (SNPs) in the IL-1 family: IL-1a (-889C/T) rs1800587, IL-1b (-511C/T) rs16944, IL-1b (+3962C/T) rs1143634, IL-1R (Pst-1 1970C/T) rs2234650 and IL-1RA (Mspa-1 11100C/T) rs315952. 99 unrelated Iranian AS patients and 217 healthy control subjects were selected. Cytokine typing was performed by the polymerase chain reaction with sequence-specific primers assay. The allele and genotype frequencies of the polymorphisms were determined: The IL1α rs1800587, IL1β rs16944 and IL1β rs1143634 were not significantly associated with AS. Genotype frequencies at IL1R rs2234650 differed between cases and controls (χ(2)=8.85; p=0.01); the IL1R rs2234650 C/T and T/T genotypes were less common in AS patients than controls. The IL1R rs2234650 C/T genotype was inversely associated with AS comparing with the IL1R rs2234650 C/C genotype (OR=0.48; p=0.005). IL1R rs2234650 C/T genotype was less common in patients than controls (OR=0.37; p=0.02).Furthermore IL1R rs2234650 T allele was strongly associated with HLA-B2702 patients rather than HLA-B2705 but was not associated with HLA-B27 negative patients (OR=0.33; p=0.01). Polymorphisms of IL1α rs1800587, IL1β rs16944 and IL1β rs1143634 were not significantly associated with ankylosing spondylitis but inversely in this study IL1R rs2234650 was significantly associated and carriage of T allele in IL1R rs2234650 seems to be protective, while carriage of C allele result in two fold higher risk of developing AS. PMID

  18. Espondilite anquilosante e anestesia Espondilitis anquilosante y anestesia Ankylosing spondylitis and anesthesia

    Carlos Rogério Degrandi Oliveira

    2007-04-01

    40 años; es rara después de los 50 años. Las mujeres corresponden solamente a la minoría de pacientes. Existe poca información sobre la EA en la literatura anestésica. El objetivo de este artículo fue revisar aspectos de la EA de interés para el anestesiólogo, permitiendo un adecuado manoseo perioperatorio. CONTENIDO: Están definidas las características de la espondilitis anquilosante en cuanto a la clínica y la conducta anestésica. CONCLUSIONES: Los pacientes con enfermedades crónicas de la columna vertebral presentan desafíos específicos para el anestesiólogo. El manoseo de la vía aérea y el acceso al neuro-eje podrán ser difíciles. La preferencia ha sido dada a la anestesia general, incluso con la vía aérea de difícil acceso, evitando la anestesia en el neuro-eje. El grado de involucración de la columna cervical determinará cuanto podrá ser difícil la intubación traqueal. Un cuidado especial debe tenerse para evitar la manipulación excesiva de la columna cervical, lo que podría conllevar al trauma de la médula espinal.BACKGROUND AND OBJECTIVES: Ankylosing spondylitis (AS is a chronic inflammatory disease of the joints, included in the group of seronegative spondyloarthropathies. Its main characteristic is the fusion of the bones in the spine, which causes loss of flexibility of the back and neck. Other large articulations and connective tissues can be affected by the inflammatory process. It affects mainly men between the ages of 20 and 40; it is rare after the age of 50. Women represent a minority of patients. There is little information about AS in the anesthetic literature. The objective of this article was to review the characteristics of AS pertaining anesthesiology for an adequate perioperative handling. CONTENTS: The clinical characteristics of ankylosing spondylitis pertaining to the anesthetic conduct are reviewed. CONCLUSIONS: Patients with chronic diseases of the spine represent specific challenges to the anesthesiologist

  19. Duration of remission after halving of the etanercept dose in patients with ankylosing spondylitis: a randomized, prospective, long-term, follow-up study

    Nannini C

    2013-01-01

    Full Text Available Fabrizio Cantini, Laura Niccoli, Emanuele Cassarà, Olga Kaloudi, Carlotta NanniniDivision of Rheumatology, Misericordia e Dolce Hospital, Prato, ItalyBackground: The aim of this study was to evaluate the proportion of patients with ankylosing spondylitis maintaining clinical remission after reduction of their subcutaneous etanercept dose to 50 mg every other week compared with that in patients receiving etanercept 50 mg weekly.Methods: In the first phase of this randomized, prospective, follow-up study, all biologic-naïve patients identified between January 2005 and December 2009 as satisfying the modified New York clinical criteria for ankylosing spondylitis treated with etanercept 50 mg weekly were evaluated for disease remission in January 2010. In the second phase, patients meeting the criteria for remission were randomized to receive subcutaneous etanercept as either 50 mg weekly or 50 mg every other week. The randomization allocation was 1:1. Remission was defined as Bath Ankylosing Spondylitis Disease Activity Index < 4, no extra-axial manifestations of peripheral arthritis, dactylitis, tenosynovitis, or iridocyclitis, and normal acute-phase reactants. The patients were assessed at baseline, at weeks 4 and 12, and every 12 weeks thereafter. The last visit constituted the end of the follow-up.Results: During the first phase, 78 patients with ankylosing spondylitis (57 males and 21 females, median age 38 years, median disease duration 12 years were recruited. In January 2010, after a mean follow-up of 25 ± 11 months, 43 (55.1% patients achieving clinical remission were randomized to one of the two treatment arms. Twenty-two patients received etanercept 50 mg every other week (group 1 and 21 received etanercept 50 mg weekly (group 2. At the end of follow-up, 19 of 22 (86.3% subjects in group 1 and 19 of 21 (90.4% in group 2 were still in remission, with no significant difference between the two groups. The mean follow-up duration in group

  20. Fat metaplasia and backfill are key intermediaries in the development of sacroiliac joint ankylosis in patients with ankylosing spondylitis

    Maksymowych, Walter P; Wichuk, Stephanie; Chiowchanwisawakit, Praveena;

    2014-01-01

    OBJECTIVE: Fat metaplasia in bone marrow on T1-weighted magnetic resonance imaging (MRI) scans may develop after resolution of inflammation in patients with ankylosing spondylitis (AS) and may predict new bone formation in the spine. Similar tissue, termed backfill, may also fill areas of excavated...... bone in the sacroiliac (SI) joints and may reflect resolution of inflammation and tissue repair at sites of erosions. The purpose of this study was to test our hypothesis that SI joint ankylosis develops following repair of erosions and that tissue characterized by fat metaplasia is a key intermediary...... step in this pathway. METHODS: We used the Spondyloarthritis Research Consortium of Canada (SPARCC) SI structural lesion score (SSS) method to assess fat metaplasia, erosions, backfill, and ankylosis on MRIs of the SI joints in 147 patients with AS monitored for 2 years. Univariate and multivariate...

  1. Treatment of Ankylosing Spondylitis with Medicated Moxibustion plus Salicylazosulfapyridine and Methotrexate--A Report of 30 Cases

    2006-01-01

    Objective: To evaluate the therapeutic effect of medicated moxibustion plus administration of salicylazosulfapyridine (SASP) and methotrexate (MTX) for treatment of active ankylosing spondylitis (AS).Method: Ninety cases of active AS were randomly assigned to Group A, B and C (N=30 in each group),and treated respectively with SASP and MTX, acupuncture plus SASP and MTX, and composite sulfur (tablet) moxibustion plus SASP and MTX for 3 successive courses (2 months each course with an interval of 5 days). Results: Improvement in sacroiliitis index, Schober test, occipital wall test, finger-ground distance, as well as the erythrocyte sedimentation rate (ESR) and the content of C-reactive protein (CRP) in Group B and C was far superior to that of Group A (P<0.01). Conclusion: Combined use of western medicine with acupuncture or with medicated moxibustion produces a better therapeutic effect than western medicine given alone.

  2. Roles of Sagittal Anatomical Parameters of the Pelvis in Primary Total Hip Replacement for Patients with Ankylosing Spondylitis.

    Gu, Minghui; Zhang, Zhiqi; Kang, Yan; Sheng, Puyi; Yang, Zibo; Zhang, Ziji; Liao, Weiming

    2015-12-01

    We examined the correlation between acetabular prostheses and sagittal anatomical parameters of the pelvis for the preoperative evaluation of total hip arthroplasty in 29 patients with ankylosing spondylitis between April 2004 and November 2011. No implant dislocation or subsidence was observed at 4.18 years. The relationship between sagittal parameters conformed to the equation Pelvic incidence (PI)=Pelvic tilt (PT)+Sacral slope (SS). Better outcomes were achieved in the SS>PT group, postoperative function was positively correlated with SS/PI. Functional abduction and anteversion were positively correlated with PT but negatively correlated with SS. Due to the compensatory changes in the pelvis and spine of patients with AS, the preoperative assessment of sagittal parameters plays pivotal roles in placing acetabular prostheses in optimal positions and preventing postoperative impingement and dislocation. PMID:26164560

  3. Coexistence of Behçet’s disease with ankylosing spondylitis and familial Mediterranean fever: a rare occurrence

    Makram Frigui

    2011-05-01

    Full Text Available Behçet's disease (BD and familial Mediterranean fever (FMF, which are two separate diseases sharing some clinical features, may also coexist in the same patient. Further investigations are needed to understand whether this coexistence is due to either chance or geographical distribution patterns of these diseases or to common etiopathogenetic characteristics. Spondylarthritis as part of the clinical picture in these two diseases has been questioned and probably it is not a prominent characteristic of any of them. We report a 35- year-old Tunisian man who had an association of BD, FMF and Human Leukocyte Antigen (HLA B27 positive ankylosing spondylitis. Although that spondylarthritis is an infrequent joint involvement of FMF and BD, it must be looked for in case of association of these diseases.

  4. [Patient evaluation of the German version of the ASAS/EULAR recommendations for the management of ankylosing spondylitis].

    Kiltz, U; Feldtkeller, E; Braun, J

    2008-12-01

    On the initiative of the ASAS (Assessment of SpondyloArthritis International Society) and EULAR (European League against Rheumatism), evidence-based recommendations for the management of ankylosing spondylitis (AS) were drawn up, with healthcare professionals as the target group for these recommendations. To facilitate patient participation in the decision-making process with regard to their disease, and to further improve the doctor-patient relationship, the ASAS and EULAR are working on a patient-friendly version of the recommendations.In order to establish to what extent the ASAS/EULAR recommendations, as translated by German experts, can be understood by patients, the recommendations for health care professionals, together with an evaluation form, was distributed to 105 delegates of the German society for ankylosing spondylitis (Deutschen Vereinigung Morbus Bechterew, DVMB). Responders were questioned on text comprehension and their level of agreement (0: not agree at all to 10: fully agree). Space was also provided for additional comments.In total, 59 delegates filled out the questionnaire (rate of return: 56.2%). For recommendation Nos. 1, 2, 5, 6 and 7, text comprehension was moderate. On average, the recommendations were positively assessed with 8.38+/-1.9. Recommendation No. 4 (non-pharmacological therapy) was given the highest agreement (9.54+/-1.02), while recommendation No. 7 (corticosteroids, 6.54+/-2.55) received the lowest agreement. The acceptance of the recommendation was high with 87.9% questions answered.For the first time, the German expert translation of recommendations for the management of AS patients was evaluated by patients. The present translation met with broad approval. To minimize text comprehension problems, patients should be involved in compiling a future patient version. PMID:19011877

  5. Analysis of Killer Cell Immunoglobulin-like Receptor Genes and Their HLA Ligands in Iranian Patients with Ankylosing Spondylitis.

    Mahmoudi, Mehdi; Jamshidi, Ahmad Reza; Karami, Jafar; Mohseni, Alireza; Amirzargar, Ali Akbar; Farhadi, Elham; Ahmadzadeh, Nooshin; Nicknam, Mohammad Hossein

    2016-02-01

    Ankylosing Spondylitis (AS) is a chronic rheumatic disease which mainly involves the axial skeleton. It seems that non-HLA genes, as well as HLA-B27 gene, are linked to the etiology of the disease. Recently, it has been documented that KIRs and their HLA ligands are contributed to the Ankylosing Spondylitis. The aim of this study was to evaluate the KIR genes and their HLA ligands in Iranian AS patients and healthy individuals. The present study includes 200 AS patient samples and 200 healthy control samples. KIR genotyping was performed using the polymerase chain reaction sequence-specific primer (PCR-SSP) method to type the presence or absence of the 16 KIR genes, 6 known specific HLA class I ligands and also, two pseudogenes. Two KIR genes (KIR-2DL3 and KIR2DL5), and among the HLA ligands, two HLA ligands (HLA-C2Lys80 and HLA-B27) genes were significantly different between case and control groups. In addition, we found some interesting KIR/HLA compound genotypes, which were associated with AS susceptibility. Our results suggest that the AS patients present more activating and less inhibitory KIR genes with combination of their HLA ligands than healthy controls. Once the balance of signal transduction between activating and inhibitory receptors is disturbed, the ability of NK cells to identify and lyse the targets in immune responses will be compromised. Accordingly, imbalance of activating and inhibitory KIR genes by up-regulating the activation and losing the inhibition of KIRs signaling or combination of both might be one of the important factors which underlying the pathogenesis of AS. PMID:26996109

  6. Comparative study of radiography, CT and MRI in the identification of hip involvement in patients with ankylosing spondylitis

    Objective: To study the imaging findings of hip involvement and to compare the sensitivity of radiography, CT, and MRI in the identification of hip involvement in patients with ankylosing spondylitis (AS). Methods: Anteroposterior radiography of the pelvis and MRI of hip were performed in 55 patients with AS. CT scan of hip was performed in 29 of 55 patients. T1-weighted, T2-weighted, short tau inversion recovery (STIR) and three dimensional balanced turbo field echo with water selective excitation (3D-BTFE-WATS) coronal sequences of hips were obtained in all patients, of which fat-saturated contrast-enhanced T1-weighted sequence was performed in 24 patients. The imaging data of 55 patients were analyzed. The chi-square test was used to analyze the sensitivity in the identification of hip involvement among radiography, CT, and MRI. Results: Among 110 hips in all 55 patients, abnormal changes were detected in 13 hips by radiography, 85 hips by MRI. The findings of radiography included bone erosions in 13 hips, joint space narrowing in 4 hips,syndesmophytes in 5 hips. MRI revealed bone erosive destruction in 31 hips, joint space narrowing in 4 hips, joint effusion in 80 hips, subchondral bone marrow edema in 32 hips, fat accumulation of bone marrow in 28 hips, enthesitis in 21 hips. Bilateral synovial enhancement was showed in 19 of 24 patients who underwent fat-saturated contrast-enhanced T1-weighted sequence. Of the 58 hip joints in 29 patients who underwent CT examination, not only did CT show all bone erosions detected by radiography and MRI, but CT revealed bone erosive destruction that were not identified by radiography in 10 hips and by MRI in 1 hip as well. Abnormal changes were detected in 10.3% (6/58)by radiography, 27.6% (16/58) by CT, and 77.6% (45/58) by MRI. The sensitivity of MRI in the identification of hip involvement is higher than that of radiography and CT (χ2=53.22 and 29.08, P<0.05). In addition to chronic bone structural changes, MRI depicted

  7. Association study of polymorphisms rs4552569 and rs17095830 and the risk of ankylosing spondylitis in a Taiwanese population.

    James Cheng-Chung Wei

    Full Text Available Ankylosing spondylitis (AS is a chronic inflammation of the sacroiliac joints, spine and peripheral joints. However, the development of anklosing spondylitis is unclear. Human leukocyte antigens HLA-B27 and ERAP1 have been widely reported to be associated with AS susceptibility. A recent genome-wide association study (GWAS showed that two new susceptibility loci between EDIL3 and HAPLN1 at 5q14.3 (rs4552569 and within ANO6 at 12q12 (rs17095830 contribute to the risk of AS in Han Chinese. In this study, we enrolled 475 AS patients and 475 healthy subjects to assess whether these genetic variations contribute to the susceptibility and the severity of AS in the Taiwanese population. The correlation between genetic polymorphisms, AS activity indexes, (namely, BASDAI, BASFI and BAS-G and AS complications (uveitis and inflammatory bowel disease were tested using the markers, rs4552569 and rs17095830. Although no association between rs4552569/rs17095830 genetic polymorphisms and AS susceptibility/severity was found, a significant association between rs17095830 and inflammatory bowel disease was observed in a Taiwanese population.

  8. Problems of rheumatoid arthritis and ankylosing spondylitis patients in their labor and life environments.

    Urbánek, T; Sitajová, H; Hudáková, G

    1984-01-01

    The results of a sociomedical study performed in a representative group 715 patients of productive age comparising 545 cases of rheumatoid arthritis (RA) and 170 cases of ankylosing spondylitis (AS), are presented in this paper. The set was constituted by means of a stratified selection from 6 districts in Slovakia. Data about the patients were obtained by medical examination accompanied by a sociological survey carried out in the form of a semi-standardized interview. Among the 545 RA patients women prevailed (80.4%), while in the AS group it was men (83.5%). In so far as the age was concerned, most of the RA patients were in their 5th and 6th decades while the AS patients were 10 years younger. 2/3 of the patients with RA had but a primary grade education, a significantly higher level of education could be found among the AS patients. When taking into account the degree of advancement of the disease there was a marked preponderance of medium grade stages among the RA cases (71.3% of the cases were of grades II and III), while among the AS 2/3 of the cases were of grades IV and V. Notwithstanding the more advanced stages of the disease the AS patients were more efficient functionally: 61.2% of them remained in their original employment (while the RA patients only in 45.5% of the cases) and 2.9% of them were entirely dependent upon help of others in self-care (among the RA patients it was in 9.5%). 36.4% of the RA patients and 51.1% of the AS patients whose disease was active were exposed to the effect of the weather in their work. A full invalid rent had to be given to 46.8% of the productive age RA patients and only to 28.8% of those suffering from AS. There was a direct relationship between the patients' labour activity and their eventual relegation to an invalid rent reception state and the degree of their education. In environmental conditions of life the narrow space of the apartment influenced negatively the activity of the rheumatoid process. Understanding

  9. Rheumatic patients at work : a study of labour force participations and its determinants in rheumatoid arthritis, ankylosing spondylitis, and juvenile chronic arthritis

    Chorus, A.M.J.

    2004-01-01

    This thesis at the University of Maastricht, defended at May 7, 2004, yields several important and new findings with regard to work related quality of life, participation in the labour force and its determinants of patients with rheumatoid arthritis (RA), ankylosing spondylitis (AS) and juvenile chronic arthritis (JCA) in the Netherlands. The four research questions were: 1. What is the importance of paid work for the quality of life of patients with rheumatic diseases; 2. To what extent do p...

  10. Peptide Handling by HLA-B27 Subtypes Influences Their Biological Behavior, Association with Ankylosing Spondylitis and Susceptibility to Endoplasmic Reticulum Aminopeptidase 1 (ERAP1)*

    García-Medel, Noel; Sanz-Bravo, Alejandro; Alvarez-Navarro, Carlos; Gómez-Molina, Patricia; Barnea, Eilon; Marcilla, Miguel; Admon, Arie; de Castro, José A. López

    2014-01-01

    HLA-B27 is strongly associated with ankylosing spondylitis (AS). We analyzed the relationship between structure, peptide specificity, folding, and stability of the seven major HLA-B27 subtypes to determine the role of their constitutive peptidomes in the pathogenicity of this molecule. Identification of large numbers of ligands allowed us to define the differences among subtype-bound peptidomes and to elucidate the peptide features associated with AS and molecular stability. The peptides iden...

  11. Cartilage in facet joints of patients with ankylosing spondylitis (AS) shows signs of cartilage degeneration rather than chondrocyte hypertrophy: implications for joint remodeling in AS

    Bleil, Janine; Sieper, Joachim; Maier, Rene; Schlichting, Uwe; Hempfing, Axel; Syrbe, Uta; Appel, Heiner

    2015-01-01

    Introduction In ankylosing spondylitis (AS), joint remodeling leading to joint ankylosis involves cartilage fusion. Here, we analyzed whether chondrocyte hypertrophy is involved in cartilage fusion and subsequent joint remodeling in AS. Methods We assessed the expression of chondrocyte hypertrophy markers runt-related transcription factor 2 (Runx2), type X collagen (COL10), matrix metalloproteinase 13 (MMP13), osteocalcin and beta-catenin and the expression of positive bone morphogenic protei...

  12. Increased body mass index in ankylosing spondylitis is associated with greater burden of symptoms and poor perceptions of the benefits of exercise

    Wilson, Fiona

    2014-01-01

    PUBLISHED OBJECTIVE: Increased body mass index (BMI) in patients with ankylosing spondylitis (AS) is associated with a greater burden of symptoms and poor perceptions of the benefits of exercise. In AS, the effect of obesity on disease characteristics and exercise perceptions is unknown. We evaluated the prevalence of obesity in AS, to assess the attitudes of patients toward exercise and to evaluate the effect of obesity on symptoms and disease activity. METHODS: Demographic dat...

  13. The value of combination of magnetic resonance imaging and HLA-B27 in early diagnosis of ankylosing spondylitis%磁共振联合HLA-B27诊断早期强直性脊柱炎的应用价值

    孔庆聪; 邵硕; 刘卫敏; 王晓红; 林云崖; 单鸿

    2012-01-01

    目的 探讨MRI联合HLA-B27抗原检测骶髂关节强直性脊柱炎(AS)早期诊断的临床价值.方法 回顾性分析经临床确诊的35例早期AS患者,均行骶髂关节X线、MRI检查及HLA-B27抗原检测,并分别比较骶髂关节MRI、HLA-B27、骶髂关节MRI联合HLA-B27的阳性率.结果 35例早期强直性脊柱炎患者中,通过MRI检查诊断早期强直性脊柱炎的阳性率为74.3%(26/35例),HLA-B27阳性率为88.6%(31/35例),骶髂关节MRI联合HLA-B27的阳性率为97.1%(34/35例),其中MRI联合HLA-B27的阳性检出率高于MRI有统计学意义(P=0.013),MRI与HLA-B27、MRI联合HLA-B27与HLA-B27的阳性检出率比较无统计学意义(P>0.05).结论 骶髂关节MRI联合HLA-B27检查能提高早期强直性脊柱炎的阳性检出率,有利于临床早期诊断、早期治疗.%Objective To explore the clinical value of combination of Magnetic Resonance Imaging! MRI) and HLA-B27 in early diagnosis of ankylosing spondylitis (AS). Methods 35 patients with early AS proven by clinical examination were included in this study. All patients underwent X-ray,MRI and HLA-B27 examination before treatment. The positive rates in detecting AS were compared between MRI and combination MR imaging and HLA-B27. Results Among the 35 patients of early AS, only 26 (74. 3%) were diagnosed to be early AS by MRI,the positive rate of HAL-B27 was 88. 6% ,the positive rate of MRI combined with HLA-B27 was 97. 1% . The positive rate of MRI combined with HLA-B27 was significantly higher than that of MRI (P = 0. 013 ) . While thepositive rates were not statistically significant between MRI and HLA-B27,and between MRI combined with HLA-B27and HLA-B27 alone (P>0. 05). Conclusion Combination of MRI examination and HLA-B27 can improve the detecting rate early of AS.

  14. Ankylosing spondylitis or diffuse idiopathic skeletal hyperostosis in royal Egyptian mummies of 18th -20th Dynasties? CT and archaeology studies.

    Saleem, Sahar N; Hawass, Zahi

    2014-12-01

    Objective. To study the computed tomography(CT) images of royal Ancient Egyptian mummies dated to the 18th to early 20th Dynasties for the claimed diagnoses of ankylosing spondylitis (AS) and diffuse idiopathic skeletal hyperostosis (DISH) and to correlate the findings with the archaeology literature.Methods. We studied the CT images of 13 royal Ancient Egyptian mummies (1492–1153 BC) for evidence of AS and DISH and correlated our findings with the archaeology literature.Results. The findings of the CT scans excluded the diagnosis of AS, based on the absence of sacroiliac joint erosions or fusion of the facet joints. Four mummies fulfilled the diagnostic criteria for DISH:Amenhotep III (18th Dynasty), Ramesses II, his son Merenptah, and Ramesses III (19th to early 20th Dynasties).The diagnosis of DISH, a commonly a symptomatic disease of old age, in the 4 pharaohs is in concordance with their longevity and active lifestyles.Conclusion. CT findings excluded the diagnosis of AS in the studied royal Ancient Egyptian mummies and brought into question the antiquity of the disease. The CT features of DISH during this ancient period were similar to those commonly seen in modern populations,and it is likely that they will also be similar in the future.The affection of Ramesses II and his son Merenptah supports familial clustering of DISH. The process of mummification may induce changes in the spine that should be considered during investigations of disease in ancient mummies. PMID:25329920

  15. Vertebral fractures in patients with ankylosing spondylitis. A retrospective analysis of 66 patients; Wirbelfrakturen bei Patienten mit Spondylitis ankylosans. Eine retrospektive Analyse von 66 Patienten

    Altenbernd, J.; Bitu, S.; Lemburg, S.; Peters, S.; Nicolas, V.; Heyer, C.M. [Berufsgenossenschaftliches Klinikum Bergmannsheil, Bochum (Germany). Inst. fuer Diagnostische Radiologie, Interventionelle Radiologie und Nuklearmedizin; Seybold, D. [Berufsgenossenschaftliches Klinikum Bergmannsheil, Bochum (Germany). Chirurgische Klinik und Poliklinik; Meindl, R. [Berufsgenossenschaftliches Klinikum Bergmannsheil, Bochum (Germany). Abt. Neurotraumatologie und Rueckenmarksverletzte

    2009-01-15

    Purpose: Retrospective analysis of vertebral fractures in patients with ankylosing spondylitis (AS) for the evaluation of associations with mortality, concurrent neurological deficits, and other complications. Materials and Methods: Image analysis (conventional radiographs, CT, MRI) was applied to all patients with AS admitted between 1997 and 2007 due to vertebral fractures to determine fracture location and classification. Patient characteristics, trauma mechanism, neurological symptoms, and other complications were documented. Results: 66 patients (54 male, age 64 {+-} 11 years) were enrolled in the study. 74 % of patients suffered from minor trauma. 51 % and 56 % had cervicothoracic and thoracolumbar fractures, respectively, while 8 % had multi-level fractures. 63 % of patients suffered combined vertebrodiscal fractures. 70 % revealed neurological symptoms, significantly correlating with spinal stenosis (p = 0.024; Odds ratio 4.265) and hyperlordosis (p = 0.014; OR 4.806). 68 % developed complications with non-combined fractures (p =.042; OR 4.954) and paravertebral hematomas (p =.009; OR 16.969) representing independent risk factors. The female gender (p = 0.005; OR 15.617) and conservative therapy (p = 0.040; OR.094) exerted significant influence on the mortality rate. Conclusion: Vertebral fractures frequently occur in patients with AS after minor trauma and often lead to neurological symptoms, which in turn are associated with spinal stenosis and hyperlordosis. Paravertebral hematomas and non-combined fractures are accompanied by higher incidences of other complications. The female gender entails a higher mortality rate. (orig.)

  16. Restless legs syndrome is associated with poor sleep quality and quality of life in patients with ankylosing spondylitis: a questionnaire-based study.

    Demirci, Seden; Demirci, Kadir; Doğru, Atalay; İnal, Esra Erkol; Koyuncuoğlu, Hasan Rifat; Şahin, Mehmet

    2016-09-01

    We aimed to investigate the frequency of restless legs syndrome (RLS) and the associations between RLS and quality of sleep and life in patients with ankylosing spondylitis (AS). One hundred and eight AS patients and 64 controls were included in this study. Demographics, clinical, and laboratory data were recorded. The presence of RLS was determined with face-to-face interview by an experienced neurologist based on the International RLS Study Group criteria. RLS severity was evaluated using International RLS Study Group rating scale. Sleep quality and insomnia severity were assessed by Pittsburgh sleep quality index (PSQI) and insomnia severity index (ISI), respectively. Disease-related quality of life was evaluated by AS quality of life questionnaire (ASQoL). The frequency of RLS was significantly higher in AS patients than in controls (36.4 vs. 14.0 %, p = 0.004). RLS severity score for AS patients was significantly higher than that for controls (p = 0.03). The AS patients had higher scores in the subjective sleep quality, sleep latency, sleep duration, habitual sleep efficiency, sleep disturbances, use of sleep medication domains of PSQI, and also total PSQI and ISI than controls (p sleep and quality of life in AS patients, clinicians should be aware of RLS for early diagnosis and management in AS patients. PMID:26563408

  17. Clinical, para-clinical and subjective quality of life modifications after[224Ra] radium-chloride-therapy (224 SpondylAT) in ankylosing spondylitis (Bechterew's disease)

    Aim: The ankylosing spondylitis is a painful, chronically inflammatory illness which mainly manifests itself at the spine, and in addition at the peripheral joints with a pronounced inclination to reinforcement. Over the last years we again have been having the possibility to help the patients with a [224Ra]radium treatment to reduce the pain and probably stop the progress of the disease. The purpose was to examine the analgetic effect in connection with the para-clinical inflammation parameters and subjective modifications of the quality of life. Material and Methods: In our clinic, 5 patients (1 woman, 4 men) (age median 43,4 years) were treated over a period of 10 weeks with one weekly injection of 1 MBq [224Ra]radium chloride (224 SpondylAT). Before the therapy, at the last day of treatment, and 3 and 6 month after the therapy we documented the pain score (scale 1 to 10) of patients and the laboratory-chemical data (hemoglobin, leukocytes, neutrophile leukocytes, thrombocytes, CRP, blood sedimentation). Physical operability, psychological fortunes and the social role behavior was measured with the clinical test profile of quality of life chronically patients. The patients were asked retrospectively (approx. 5 to 15 months) to estimate their pre- and post-therapeutic situation. Results: Before the therapy, the inflammation parameters CRP (average 24.5) and BSR (average 47) of all patients were clearly increased. After 3 months, the CRP value showed a descending tendency, after 6 months however the starting value was almost reached again. The blood sedimentation rate was lowest 3 months after therapy; at a check after 6 months it was somewhat more higher, however still under the outgoing value. After 3 months, the pain score indicated by the patients was reduced from the first value of 7 significantly to 5,3, and after 6 months to 3,7. A significant modification of the blood cell parameters did not occur during the investigation period. 4 of 5 patients showed an

  18. Modern approaches to early diagnosis of ankylosing spondylitis

    A G Bochkova

    2009-10-01

    Full Text Available Анкилозирующий спондилит (АС поражает молодых людей в наиболее продуктивном возрасте (на 3-ей декаде жизни и с первых лет болезни оказывает негативное влияние на работоспособность, получение образования, создание семьи. Длительное время существовало ошибочное мнение, что эффективной терапии АС не существует, а большинство пациентов АС имеют хороший прогноз для жизни, поэтому своевременному диагнозу не придавалось должного значения. Около 70% пациентов АС через 10-15 лет теряют трудоспособность и имеют значительное снижение качества жизни [1]. Летальность у больных АС выше в 1,5-4 раза, а выживаемость пациентов после 40 лет течения АС на 12% меньше по сравнению с общей популяцией [2]. Среди всех хронических ревматических заболеваний самый длительный период времени от появления первых симптомом до установления достоверного диагноза АС отмечается у пациентов АС и составляет около 7 лет [3]. Несмотря на то, что заболевание описано более 100 лет назад, диагноз в течение первых 7-10 лет болезни (до формирования классической рентгенологической картины в позвоночнике вызывает затруднения не только у врачей общей практики, но и у ревматологов. Это является одной из причин того, что распространенность АС, наиболее изученного заболевания из группы спондилоартритов, значительно различается в отдельных странах и колеблется от 0,2% до 1,9% в разных популяциях [4]. По данным недавнего эпидемиологического исследования распространенность АС и спондилоартритов в России ниже, чем в большинстве европейских стран (менее 0,1% [5], что доказывает, что большая часть пациентов АС, по-видимому, наблюдаются с другими диагнозами.

  19. Long-term efficiency of infliximab in patients with ankylosing spondylitis: real life data confirm the potential for dose reduction

    Heldmann, F; van den Bosch, F; Burmester, G; Gaston, H; van der Horst-Bruinsma, I E; Krause, A; Schmidt, R; Schneider, M; Sieper, J; Andermann, B; van Tubergen, A; Witt, M; Braun, J

    2016-01-01

    Objective To analyse the treatment outcome of patients with ankylosing spondylitis (AS) in the European AS infliximab cohort (EASIC) study after a total period of 8 years with specific focus on dosage and the duration of intervals between infliximab infusions. Methods EASIC included patients with AS who had received infliximab for 2 years as part of the ASSERT trial. After that period, rheumatologists were free to change the dose or the intervals of infliximab. Clinical data were status at baseline, end of ASSERT and for a total of 8 years of follow-up. Results Of the initially 71 patients with AS from EASIC, 55 patients (77.5%) had completed the 8th year of anti-tumour necrosis factor (TNF) treatment. Of those, 48 patients (87.3%) still continued on infliximab. The mean infusion interval increased slightly from 6 to 7.1±1.5 weeks, while 45.8% patients had increased the intervals up to a maximum of 12 weeks. The mean infliximab dose remained stable over time, with a minimum of 3.1 mg/kg and a maximum of 6.4 mg/kg. In patients receiving 85% patients still remained on the same treatment, without any major safety events. Furthermore, both the infusion intervals and also the mean infliximab dose were modestly reduced in ≥70% of the patients without the loss of clinical efficiency. PMID:27493791

  20. Novel non-HLA-susceptible regions determined by meta-analysis of four genomewide scans for ankylosing spondylitis

    Jinxian Huang; Chao Li; Haixia Xu; Jieruo Gu

    2008-04-01

    We identified novel non-HLA-susceptible regions for ankylosing spondylitis (AS) by applying the genome-search-meta-analysis (GSMA) method to combine the previous four AS genomewide scan studies including 479 families with 1175 affected individuals. Three original genomescans were mainly analysed for Caucasian families and one analysed for Han Mongolian families. Ten bins had both Psumrnk and Pord < 0.05, suggesting these bins most likely contain AS-linked loci. The 10 bins are 6.2, 16.3, 6.1, 3.3, 6.3, 16.4, 10.5, 17.1, 2.5 and 2.9. The most significant result of linkage was on chromosome 6p22.3–p21.1 (bin 6.2, Psumrnk < 0.000417), where HLA loci are located. By addition of a genome scan of Chinese origin, our GSMA result further confirmed the HLA loci as the greatest susceptible region to AS and suggested that non-HLA loci chromosome 16q, 3p, 10q, 2p, 2q and 17p, may also contain AS-linked loci. The novel loci identified in our result give hints to further studies.

  1. Non-­‐pharmacological treatment of ankylosing spondylitis: Barriers to effective implementation of recommendations in Morocco

    Abderrazak Hajjioui

    2014-05-01

    Full Text Available This cross-sectional study aimed to describe non--‐pharmacological treatment modalities in Moroccan patients with ankylosing spondylitis (AS, and to approach physical therapy implementation barriers. 61 patients with AS according to New York classification criteria were included in the study. Socio-demographic data and clinical characteristics were collected and different therapeutic modalities, including physical therapy were investigated. The mean age of the patients was 38.20 (SD 12.36 years with a male/female ratio of 1.5. 55 (90% patients received pharmacological therapy, 37 (60.7% received physical therapy, 5(8.2% underwent surgery and 36 (59% tried at least one type of complementary medicine (medicine plants, sand baths, acupuncture, fire needles, and cupping. Patients’ major expectations from physical therapy were improving their functional status (86.5%, and reducing their pain (59.5%. Most patients (86.49% were satisfied of their physical therapy and 56.8% practiced home exercises. Reasons for nonattendance to physical therapy for the remaining 24 patients were nonprescription (58.3%, lack of financial resources (20.8%, geographical remoteness from rehabilitation centers (4% and lack of motivation (17%. Non-pharmacological treatment, especially based on exercise and education, is an integral part of the comprehensive management of AS. However, it is not efficiently implemented in Morocco and more effort should be made to develop this both efficient and relatively inexpensive component of AS treatment.

  2. IGF-1 and ADMA Levels Are Inversely Correlated in Nondiabetic Ankylosing Spondylitis Patients Undergoing Anti-TNF-Alpha Therapy

    Fernanda Genre

    2014-01-01

    Full Text Available Like rheumatoid arthritis, ankylosing spondylitis (AS is also an inflammatory disease associated with accelerated atherosclerosis and the presence of metabolic syndrome (MeS features. AS patients often display osteoporosis as well as new bone formation. Insulin-like growth factor 1 (IGF-1 is a protein involved in both inflammation and bone metabolism. In the present study we assessed whether disease activity, systemic inflammation, MeS features, adipokines, and biomarkers of endothelial activation were associated with IGF-1 and insulin-like growth factor binding protein-3 (IGFBP-3 levels in a series of 30 nondiabetic AS patients without CV disease undergoing TNF-α antagonist-infliximab therapy. All determinations were made in the fasting state, immediately before an infliximab infusion. Although no association of IGF-1 and IGFBP-3 levels with angiopoietin-2 or osteopontin was found, an inverse correlation between IGF-1 levels and asymmetric dimethylarginine (ADMA, an endogenous endothelial nitric oxide synthase inhibitor that impairs nitric oxide production and secretion promoting endothelial dysfunction, was found (r=-0.397; P=0.04. However, no significant association was found between IGF-1 and IGFBP-3 levels and disease activity, systemic inflammation, metabolic syndrome features, or adipokines. In conclusion, in nondiabetic patients with AS undergoing periodic anti-TNF-α therapy, IGF-1 and ADMA are inversely correlated.

  3. Serum DKK-1 level in the development of ankylosing spondylitis and rheumatic arthritis: a meta-analysis

    Zhang, Li; Ouyang, Hui; Xie, Zhen; Liang, Zhi-Hui; Wu, Xiong-Wen

    2016-01-01

    To explore the association of serum Dickkopf-1 (DKK-1) levels with the development of ankylosing spondylitis (AS) and rheumatic arthritis (RA) in humans, databases including PubMed, EBSCO, Springerlink, Ovid, WANFANG and China National Knowledge Infrastructure (CNKI) were searched to identify relevant studies. On the basis of rigorous inclusion and exclusion criteria, case–control studies of the relationships between serum DKK-1 levels and AS and RA published before December 2014 were enrolled. Statistical analyses were performed using Comprehensive Meta-analysis 2.0 (CMA 2.0). Seven case–control trials with a total of 300 AS patients, 136 RA patients and 232 healthy controls were included in this study. Meta-analysis results revealed that DKK-1 serum levels were significantly higher in AS patients than in normal controls (standard mean differences (s.m.d.)=0.301, 95% confidence interval (CI)=0.094–0.507, P=0.004), whereas no significant difference in DKK-1 serum levels was observed between RA patients and healthy controls (s.m.d.=0.798, 95% CI=−2.166–3.763, P=0.598). Serum DKK-1 level may be closely related to the development of AS but not of RA. PMID:27103566

  4. Long-term investigation of the risk of malignant diseases following intravenous radium-224 treatment for ankylosing spondylitis

    Background and purpose: in German-speaking countries, the intravenous treatment of ankylosing spondylitis (AS) with radium-224 (224Ra) was common between the late 1940s and 2005. In this long-term investigation, the risk of malignant diseases following intravenous 224Ra treatment for AS was assessed. Patients and methods: in a prospective long-term study, 1,471 patients with AS who were treated with 224Ra between 1948 and 1975 have been followed together with a control group of 1,324 AS patients treated neither with radioactive drugs nor with X-rays. Standardized questionnaires to evaluate the patients' health status were used. Observed numbers of malignant diseases were compared with those of the control group as well as with expected numbers for a normal population. Results: After 26 years of follow-up, causes of death have been certified for 1,006 patients of the exposure group (control group: 1,072 patients). Significantly increased rates of myeloid leukemia (12 cases observed vs. 2.9 expected; p 224Ra led to increased incidences of myeloid leukemia and malignancies of kidneys, thyroid and female genital organs. Although this kind of therapy is now abandoned, there is a need for close follow-up of patients who received it. (orig.)

  5. Distinct immune signatures in the colon of Crohn's disease and ankylosing spondylitis patients in the absence of inflammation.

    Dunn, Elliott T J; Taylor, Edward S; Stebbings, Simon; Schultz, Michael; Butt, A Grant; Kemp, Roslyn A

    2016-05-01

    Crohn's disease (CD) is an inflammatory bowel disease characterized by patchy inflammation of the gastrointestinal tract. Ankylosing spondylitis (AS) is primarily characterized by inflammation of the lower vertebral column, and many patients with AS present with inflammatory gut symptoms. Genome-wide association studies have highlighted significant overlap in short nucleotide polymorphisms for both diseases. We hypothesized that patients with CD and AS have a common intestinal immune signature, characterized by inflammatory T cells, compared with healthy people. We designed a pilot study to determine both the feasibility of defining complex immune signatures from primary tissue, and differences in the local immune signature of people with inflammatory diseases compared with healthy people. Intestinal biopsies were obtained by colonoscopy from healthy patients, non-inflamed regions of CD patients and AS patients with inflammatory gut symptoms. A flow cytometry platform was developed measuring polyfunctional T-cell populations based on cytokines, surface molecules and transcription factors. There was overlap in the immune signature of people with CD or AS, characterized by changes in the frequency of regulatory T cells, compared with healthy people. There were significant differences in frequencies of other polyfunctional T-cell populations-CD patients had an increased frequency of T cells producing interleukin-22 (IL-22) and interferon-γ, whereas AS patients had an increased frequency of T cells producing IL-2; compared with healthy people. These data indicate that the local immune signature could be described in these patients and that distinct immune mechanisms may underlie disease progression. PMID:26647966

  6. Serum DKK-1 level in the development of ankylosing spondylitis and rheumatic arthritis: a meta-analysis.

    Zhang, Li; Ouyang, Hui; Xie, Zhen; Liang, Zhi-Hui; Wu, Xiong-Wen

    2016-01-01

    To explore the association of serum Dickkopf-1 (DKK-1) levels with the development of ankylosing spondylitis (AS) and rheumatic arthritis (RA) in humans, databases including PubMed, EBSCO, Springerlink, Ovid, WANFANG and China National Knowledge Infrastructure (CNKI) were searched to identify relevant studies. On the basis of rigorous inclusion and exclusion criteria, case-control studies of the relationships between serum DKK-1 levels and AS and RA published before December 2014 were enrolled. Statistical analyses were performed using Comprehensive Meta-analysis 2.0 (CMA 2.0). Seven case-control trials with a total of 300 AS patients, 136 RA patients and 232 healthy controls were included in this study. Meta-analysis results revealed that DKK-1 serum levels were significantly higher in AS patients than in normal controls (standard mean differences (s.m.d.)=0.301, 95% confidence interval (CI)=0.094-0.507, P=0.004), whereas no significant difference in DKK-1 serum levels was observed between RA patients and healthy controls (s.m.d.=0.798, 95% CI=-2.166-3.763, P=0.598). Serum DKK-1 level may be closely related to the development of AS but not of RA. PMID:27103566

  7. Treatment of Ankylosing Spondylitis With a Bushen-Qiangdu-Zhilv Decoction: A Case Report With a 3-year Follow-up.

    Zhou, Ying-Yan; Lin, Jie-Hua; Huang, Run-Yue; He, Yi-Ting

    2016-04-01

    Context • Ankylosing spondylitis (AS) is a refractory rheumatic disease, characterized by sacroiliitis and structural damage, and over decades, it can lead to joint fusion, frequently followed by significant spinal deformity and disability. However, to date, no method has been found to be effective in relieving or blocking structural damage to joints. Objective • The study intended to show that a decoction of Bushen-Qiangdu-Zhilv (BQZ), a therapy used in traditional Chinese medicine (TCM), can provide an alternative treatment for AS patients. Design • The research team performed a case study. Setting • The study was conducted at Guangdong Provincial Hospital of TCM in Guangzhou, China. Participant • The case study involved a 33-y-old male patient with active AS who visited the research team's clinic. Intervention • The patient took the BQZ orally 2 ×/d at 30 min after breakfast and 30 min after dinner. The patient returned to the clinic for consultation monthly. The patient took 2 servings/d for 10 mo and then received continuous BQZ treatment of the maintenance dosage for a period of approximately 3 y until December 2013. The maintenance dosage of BQZ was 3 or 4 decoctions per wk. Outcome Measures • The study used a number of measurements to evaluate the outcomes of treatment: (1) disease activity-the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI); (2) functional condition-the Bath Ankylosing Spondylitis Functional Index (BASFI); (3) inflammation-ratings of morning stiffness and night pain, serum C-reactive protein (CRP) concentration measured by means of particle-enhanced immunonephelometry, and erythrocyte sedimentation rate (ESR) value as detected using the Westergren method; (4) spinal mobility-the Bath Ankylosing Spondylitis Metrology Index (BASMI); and (5) global assessments by patient and physician. Results • The participant showed improvements in inflammatory symptoms and recovery from structural damage after receiving the

  8. Focal sialadenitis in patients with ankylosing spondylitis and spondyloarthropathy: a comparison with patients with rheumatoid arthritis or mixed connective tissue disease

    Helenius, L; J. Hietanen; Helenius, I.; Kautiainen, H.; Piirainen, H; Paimela, L; Lappalainen, M.; Suuronen, R; Lindqvist, C; Leirisalo-Repo, M

    2001-01-01

    OBJECTIVES—To investigate the occurrence of and risk factors for focal sialadenitis in patients with rheumatoid arthritis (RA), mixed connective tissue disease (MCTD), ankylosing spondylitis (AS), and spondyloarthropathy (SpA).
METHODS—A total of 85 patients (25 with RA, 19 with MCTD, 19 with AS, 22 with SpA) participated in the study. Each patient filled out a questionnaire for eye and oral symptoms and for the use of medication, and was interviewed; other tests included Schirmer's test, lab...

  9. Endoplasmic reticulum aminopeptidase-1 alleles associated with increased risk of Ankylosing Spondylitis reduce HLA-B27 mediated presentation of multiple antigens

    Seregin, Sergey S.; Rastall, David P. W.; Evnouchidou, Irini; Charles F Aylsworth; Quiroga, Dionisia; Kamal, Ram P.; Godbehere-Roosa, Sarah; Blum, Christopher F.; Ian A York; Stratikos, Efstratios; Amalfitano, Andrea

    2013-01-01

    Ankylosing spondylitis (AS) is a chronic systemic arthritic disease that leads to significant disability and loss of quality of life in the ~0.5% of the worldwide human population it affects. There is currently no cure for AS and mechanisms underlying its pathogenesis remain unclear. AS is highly genetic, with over 70% of the genetic risk being associated with the presence of HLA-B27 and endoplasmic reticulum aminopeptidase-1 (ERAP1) alleles. Furthermore, gene-gene interactions between HLA-B2...

  10. Silencing or inhibition of endoplasmic reticulum aminopeptidase 1 (ERAP1) suppresses free heavy chain expression and Th17 responses in ankylosing spondylitis

    Chen, Liye; Ridley, Anna; Hammitzsch, Ariane; Al-Mossawi, Mohammad Hussein; Bunting, Helen; Georgiadis, Dimitris; Chan, Antoni; Kollnberger, Simon; Bowness, Paul

    2015-01-01

    Objective Human leucocyte antigen (HLA)-B27 and endoplasmic reticulum aminopeptidase 1 (ERAP1) are strongly associated with ankylosing spondylitis (AS). ERAP1 is a key aminopeptidase in HLA class I presentation and can potentially alter surface expression of HLA-B27 free heavy chains (FHCs). We studied the effects of ERAP1 silencing/inhibition/variations on HLA-B27 FHC expression and Th17 responses in AS. Methods Flow cytometry was used to measure surface expression of HLA class I in peripher...

  11. Proposal for levels of evidence schema for validation of a soluble biomarker reflecting damage endpoints in rheumatoid arthritis, psoriatic arthritis, and ankylosing spondylitis, and recommendations for study design

    Maksymowych, Walter P; Fitzgerald, Oliver; Wells, George A;

    2009-01-01

    arthritis (RA), psoriatic arthritis (PsA), and ankylosing spondylitis (AS). We also aimed to generate consensus on minimum standards for the design of longitudinal studies aimed at validating biomarkers. METHODS: Before the meeting, the Soluble Biomarker Working Group prepared a preliminary framework and...... discussed various models for association and prediction related to the statistical strength domain. In addition, 3 Delphi exercises addressing longitudinal study design for RA, PsA, and AS were conducted within the working group and members of the Assessments in SpondyloArthritis International Society (ASAS...

  12. Low T cell production of TNFα and IFNγ in ankylosing spondylitis: its relation to HLA-B27 and influence of the TNF-308 gene polymorphism

    Rudwaleit, M; Siegert, S.; Yin, Z; Eick, J; Thiel, A.; Radbruch, A; Sieper, J; Braun, J.

    2001-01-01

    OBJECTIVE—To test the hypothesis that ankylosing spondylitis (AS) is a T helper cell type 2 polarised disease by quantifying the T cell cytokines interferon γ (IFNγ), interleukin 4 (IL4), tumour necrosis factor α (TNFα), and IL10 at the single cell level in patients with AS in comparison with healthy HLA-B27 negative and HLA-B27 positive controls.
METHODS—Peripheral blood mononuclear cells from 65 subjects (25 HLA-B27 positive patients with active AS, 18 healthy HLA-B27 positive controls, and...

  13. Position 97 of HLA-B, a residue implicated in ankylosing spondylitis pathogenesis, plays a key role in cell surface free heavy chain expression

    Chen, L.; Shi, H; Yuan, J; Bowness, P.

    2016-01-01

    Objective: Association of position 97 (P97) residue polymorphisms in human leukocyte antigen (HLA)-B, including HLA-B*27, with Ankylosing Spondylitis (AS) has recently been reported. We studied the effect of P97 variations on cell surface expression of the AS-associated HLA-B*27 and HLA-B*51, and the AS-protective HLA-B*7. Methods: Flow cytometry was used to measure surface expression of HLA-B*27 in C1R/HeLa cells expressing HLA-B*27 (N97) and six mutants at P97 (N97T, N9...

  14. An HLA-C amino-acid variant in addition to HLA-B*27 confers risk for ankylosing spondylitis in the Korean population

    Kim, Kwangwoo; Bang, So-Young; Lee, Seunghun; Lee, Hye-Soon; Shim, Seung-Cheol; Kang, Young Mo; Suh, Chang-Hee; Sun, Celi; Nath, Swapan K; Bae, Sang-Cheol; Kim, Tae-Hwan

    2015-01-01

    Introduction The presence of the HLA-B*27 allele is a major risk factor for the development of ankylosing spondylitis (AS), which causes chronic inflammation of the spine and other sites. We investigated residual effects outside HLA-B within the major histocompatibility complex (MHC) region in the Korean population. Methods Using the Korean HLA reference panel, we inferred the classic HLA alleles and amino-acid residues of the six HLA genes (HLA-A, -B, -C, -DPB1, -DQB1, and -DRB1) and MHC sin...

  15. Antinuclear, anti-dsDNA and anti-ENA antibodies in patients affected with rheumatoid arthritis or ankylosing spondylitis during treatement with infliximab

    L. Punzi; Fiocco, U; C. Botsios; M. Podswiadek; P. Grypiotis; A. Ruffatti; A. Hoxha; Todesco, S

    2011-01-01

    Objective: We evaluated the induction and clinical significance of ANA, anti-dsDNA and anti-ENA during infliximab therapy in patients with Rheumatoid Arthritis (RA) or Ankylosing Spondylitis (AS). Methods: We tested sera from 30 RA and 30 AS patients before and during treatment with infliximab. ANA and antidsDNA were determined by indirect immunofluorescence and anti-ENA by an “in house” counterimmunoelectrophoresis. Statistical analysis was performed by X2 and McNemar’s tests and U-test of M...

  16. Translation and validation of non-English versions of the Ankylosing Spondylitis Quality of Life (ASQOL) questionnaire

    Doward, Lynda C; McKenna, Stephen P; Meads, David M; Twiss, James; Revicki, Dennis; Wong, Robert L; Luo, Michelle P

    2007-01-01

    Background The Ankylosing Spondylitis Quality of Life (ASQOL) questionnaire is a unidimensional, disease-specific measure developed in the UK and the Netherlands. This study describes its adaptation into other languages. Methods The UK English ASQOL was translated into US English; Canadian French and English; French; German; Italian; Spanish; and Swedish (dual-panel methods). Cognitive debriefing interviews were conducted with AS patients. Psychometric/scaling properties were assessed using data from two Phase III studies of adalimumab. Baseline and Week-2 data were used to assess test-retest reliability. Validity was determined by correlation of ASQOL with SF-36 and BASFI and by discriminative ability of ASQOL based on disease severity. Item response theory (Rasch model) was used to test ASQOL's scaling properties. Results Cognitive debriefing showed the new ASQOL versions to be clear, relevant and comprehensive. Sample sizes varied, but were sufficient for: psychometric/scaling assessment for US English and Canadian English; psychometric but not scaling analyses for German; and preliminary evidence of these properties for the remaining languages. Test-retest reliability and Cronbach's alpha coefficients were high: US English (0.85, 0.85), Canadian English (0.87, 0.86), and German (0.77, 0.79). Correlations of ASQOL with SF-36 and BASFI for US English, Canadian English, and German measures were moderate, but ASQOL discriminated between patients based on perceived disease severities (p < 0.01). Results were comparable for the other languages. US English and Canadian English exhibited fit to the Rasch model (non-significant p-values: 0.54, 0.68), confirming unidimensionality. Conclusion The ASQOL was successfully translated into all eight languages. Psychometric properties were excellent for US English, Canadian English, and German, and extremely promising for the other languages. PMID:17274818

  17. Translation and validation of non-English versions of the Ankylosing Spondylitis Quality of Life (ASQOL questionnaire

    Revicki Dennis

    2007-02-01

    Full Text Available Abstract Background The Ankylosing Spondylitis Quality of Life (ASQOL questionnaire is a unidimensional, disease-specific measure developed in the UK and the Netherlands. This study describes its adaptation into other languages. Methods The UK English ASQOL was translated into US English; Canadian French and English; French; German; Italian; Spanish; and Swedish (dual-panel methods. Cognitive debriefing interviews were conducted with AS patients. Psychometric/scaling properties were assessed using data from two Phase III studies of adalimumab. Baseline and Week-2 data were used to assess test-retest reliability. Validity was determined by correlation of ASQOL with SF-36 and BASFI and by discriminative ability of ASQOL based on disease severity. Item response theory (Rasch model was used to test ASQOL's scaling properties. Results Cognitive debriefing showed the new ASQOL versions to be clear, relevant and comprehensive. Sample sizes varied, but were sufficient for: psychometric/scaling assessment for US English and Canadian English; psychometric but not scaling analyses for German; and preliminary evidence of these properties for the remaining languages. Test-retest reliability and Cronbach's alpha coefficients were high: US English (0.85, 0.85, Canadian English (0.87, 0.86, and German (0.77, 0.79. Correlations of ASQOL with SF-36 and BASFI for US English, Canadian English, and German measures were moderate, but ASQOL discriminated between patients based on perceived disease severities (p Conclusion The ASQOL was successfully translated into all eight languages. Psychometric properties were excellent for US English, Canadian English, and German, and extremely promising for the other languages.

  18. Health-related Quality of Life Assessment on 100 Tunisian Patients with Ankylosing Spondylitis using the SF-36 Survey

    Wafa Hamdi

    2012-11-01

    Full Text Available Objectives: The main objective of the study was to examine the self reported health status in patients with ankylosing spondylitis (AS compared with the general population and the secondary objective (in the AS group was to study the association between health status, demographic parameters, and specific disease instruments in AS.Methods: A cross sectional study of 100 AS patients recruited between 2006 and 2009 at the Department of Rheumatology. Health status was assessed by using the SF-36 health questionnaire in patients with AS. Demographic characteristics and disease specific instruments were also examined by the questionnaire. A sample of 112 healthy individuals was also surveyed using the SF-36 health questionnaire.Results: This study showed a great impairment in the quality of life of patients with AS involving all scales. All male patients with AS reported significantly impaired health-related quality of life on all items of the SF-36 compared with the general population whereas female patients reported poorer health on three items only, namely physical functioning, general health and bodily pain. Mental health was mostly affected than physical role. The physical role was significantly higher in patients with high education level than in patients with low education level (p=0.01. Physical functioning was better in employed patients. All scales of SF-36 were correlated with BASFI, BASDAI and BAS-G. Only physical functioning and general health were correlated with BASMI.Conclusion: Impairment in the quality of life can be significantwhen suffering from AS, affecting mental health more than physicalhealth. Among disease parameters, functional impairment,disease activity, mobility limitation, and spinal pain were the most associated factors resulting to the deterioration of quality of life.

  19. Impact of gender, work, and clinical presentation on diagnostic delay in Italian patients with primary ankylosing spondylitis.

    Bandinelli, F; Salvadorini, G; Sedie, A Delle; Riente, L; Bombardieri, S; Matucci-Cerinic, M

    2016-02-01

    The variability of demographic, social, genetic, and clinical factors might influence the time between the onset of symptoms and the diagnosis [diagnostic delay (DD)] of ankylosing spondylitis (AS) in different geographic areas. Different clinical manifestations in men and women affected by AS might indicate a possible role of gender in DD. The aim of the present study was to investigate the influence of demographic, social, genetic, and clinical factors on DD and the differences of DD between men and women related to the presence of different demographic, social, clinical, and genetic parameters in an Italian cohort of primary AS patients. A total of 135 Italian primary AS patients (45 female and 90 male, 27.9 ± 0.89 years old at onset) were studied. The DD, gender, education and work (manual or non-manual) levels, and type of first clinical presentation (inflammatory back pain, arthritis, enthesitis) at onset, family history of AS, and HLA B27 presence were analyzed. The DD (8.744 mean ±0.6869) was significantly higher in men (p = 0.0023), in axial presentation (p = 0.0021), and in manual work (even if with low significance, p = 0.047). The lower DD in women in comparison to that in men was likely related to higher education (p = 0.0045) and work (p = 0.0186) levels, peripheral involvement (p = 0.0009), and HLA B27 positivity (p = 0.0231). DD was higher in AS patients: male, employed in manual jobs, and with axial symptoms at onset. In men, DD seemed to be negatively influenced by lower level of education and work, axial clinical presentation, and HLA B27. PMID:26238665

  20. Association of HLA-B27 and ERAP1 with ankylosing spondylitis susceptibility in Beijing Han Chinese.

    Zhang, Z; Dai, D; Yu, K; Yuan, F; Jin, J; Ding, L; Hao, Y; Liang, F; Liu, N; Zhao, X; Long, J; Xi, Y; Sun, Y-Y

    2014-05-01

    This study investigated the genetic polymorphisms of HLA-B27, together with polymorphisms on endoplasmic reticulum aminopeptidase 1 (ERAP1), and susceptibility for ankylosing spondylitis (AS) in the Beijing Han population. A case-control study was carried out for 602 AS patient samples and 619 matched controls of Han Chinese. HLA-B27 genotyping was performed by polymerase chain reaction-sequence specific primers (PCR-SSP), and four ERAP1 SNPs (rs27037, rs27980, rs27582, and rs27434) were selected and genotyped on the Sequenom iPlex platform (Sequenom, San Diego, CA). Association analysis was performed using the likelihood ratio χ(2) test. This study identified four HLA-B27 alleles in Beijing Han AS patients, B*27:02, B*27:04, B*27:05, and B*27:07, of which B*27:05 was the most significant geographical different subtype among AS patients in Chinese. Our results confirmed that HLA-B27 was strongly associated with AS (P=1.9 × 10(-150) ), and the most strongly associated alleles were B*27:04, B*27:05, and B*27:02. Our study also confirmed a weak association between ERAP1 (rs27434) and AS. We also observed that for HLA-B*27:02 and HLA-B*27:04 positive AS patients, rs27434 and rs27582 were associated with AS. In contrast, for HLA-B27-negative and HLA-B*27:05-positive AS patients, this association was not observed. This is the first study to show that both B27 and ERAP1 are AS genetic susceptibility genes in Beijing Han. Interactions between ERAP1 and HLA-B*27:02 and B*27:04 may play an important role in the AS pathogenesis. PMID:24666027

  1. Effect of HLA-B*27 and its subtypes on clinical manifestations and severity of ankylosing spondylitis in Iranian patients.

    Sasan Fallahi

    2013-12-01

    Full Text Available The aim of this study was to assess the role of HLA-B*27 and it's subtypes in determining severity and clinical manifestations of ankylosing spondylitis (AS.A total of 163 AS patients were assessed for clinical manifestations and severity using structured questionnaires. HLA-B*27 screening and B*27 sub-typing were performed by PCR.One hundred twenty two patients (74.8% were B*27 positive. The male to female ratio, peripheral arthritis, steroid use, intense dorsal kyphosis and decrease of cervical slope had a significantly higher frequency in B*27 positive patients compared to B*27 negative ones (p=0.01, 0.001, 0.01, 0.04 and 0.04, respectively. However, the age of diagnosis was significantly lower in B*27 positive patients (p=0.005. Trend in uveitis and some severity markers including: BASMI and ASQoL were toward higher values in B*27 positive group with no significant difference. After controlling confounding variables, significant relationship was found only between B*27 and BASMI (p=0.01. B*27 subtypes in patients were included B*2705: 48.4%, B*2702: 42.6%, B*2704: 5.7% and B*2707: 3.3%. No significant differences were seen for severity markers and clinical manifestations between subtypes; although trend toward lower values of severity markers, less intense dorsal kyphosis and less decrease of cervical slope were observed in B*2704 and B*2707 versus other polymorphisms.Clinical features and severity of AS is influenced by HLA-B*27. Trend toward higher severity markers in B*2705 and B*2702 versus other polymorphisms might be subject of interest for evaluation in other ethnicities with concentration to other novel susceptibility genes co-inherited in each B*27 subtype.

  2. Influence of sinomenine on protein profiles of peripheral blood mononuclear cells from ankylosing spondylitis patients: a pharmacoproteomics study

    HUANG Zhi-xiang; TAN Jin-hui; LI Tian-wang; DENG Wei-ming; QIU Ke-wei; LIAO Ze-tao; ZENG Zhao-qiu

    2013-01-01

    Background Ankylosing spondylitis (AS) is a common inflammatory rheumatic disease which lacks satisfactory treatment so far.Sinomenine (SIN) is an alkaloid and has recently been utilized in treating multiple rheumatic diseases including AS in China,but its exact mechanism remains to be explored.This study investigated the alteration of proteome in peripheral blood mononuclear cells (PBMCs) from AS patients.Methods Thirty AS patients were enrolled in this study.PBMCs from each AS patient were cultured in medium with or without SIN respectively.Then PBMCs proteins from both groups were separated by two-dimensional electrophoresis (2-DE) and analyzed by mass spectrometry (MS).Two differentially expressed proteins were then chosen to be verified using Western blotting.Results Seven proteins,including α-synuclein (SNCA),calmodulin (CALM),acidic leucine-rich nuclear phosphoprotein 32 family member A (ANP32A),chloride intracellular channel protein 1 (CLIC1),guanine nucleotide-binding protein G(I)/G(S)/ G(T) subunit beta-1 (GNB1),gelsolin (GSN) and histone H2B type 1-M (HISTH2BM)were over-expressed,while coronin1A (CORO1A) was under-expressed in the SIN-treated PBMCs.Further bioinformatics search indicated that the changes of SNCA,ANP32A and CLIC1 pertained to apoptosis,while changes of GSN and CORO1A were associated with both apoptosis and inhibition of immunological function.Subsequently GSN and CORO1A were selected to validate by Western blotting and the results were consistent with those of 2-DE.Conclusion There were 8 differentially expressed proteins in the SIN-treated PBMCs,which might shed some light on the mechanism of SIN in the treatment of AS.

  3. Comparison of rates of referral and diagnosis of axial spondyloarthritis before and after an ankylosing spondylitis public awareness campaign.

    Harrison, Andrew A; Badenhorst, Christoffel; Kirby, Sandra; White, Douglas; Athens, Josie; Stebbings, Simon

    2014-07-01

    The objective of this research is to measure the effect of a national ankylosing spondylitis (AS) public awareness campaign on numbers of referrals for suspected AS and numbers of cases diagnosed with axial spondyloarthritis (SpA). A television advertising campaign was conducted by Arthritis New Zealand in 2011 to raise public awareness of AS. A retrospective analysis was made of referrals received by the three rheumatology services 3 months before the campaign started and 3 months after the campaign ended. The age, gender, number of referrals for suspected AS and number of referrals resulting in a diagnosis of axial SpA were recorded. Independent analysis showed that the awareness campaign reached 82 % of the primary target audience. In the 3 months after the awareness campaign, there was a significant increase in referrals for suspected AS compared with the 3 months before the campaign (54 vs. 88, 63 %, p = 0.0056). Referrals for other conditions did not change. The number of referrals resulting in a diagnosis of axial SpA also increased (27 vs. 44, 63 %, p = 0.0576). The mean ages of the patients referred and of those diagnosed with axial SpA did not change. The male/female ratio was 1:1 among the referrals for suspected AS and 2:1 in referrals diagnosed with axial SpA, before and after the campaign. The Arthritis New Zealand AS public awareness campaign was associated with a significant increase in referrals to rheumatology services for suspected AS and an increase in the diagnosis of axial SpA in clinics. PMID:24609715

  4. IL23R gene confers susceptibility to ankylosing spondylitis concomitant with uveitis in a Han Chinese population.

    Hongtao Dong

    Full Text Available PURPOSE: The interleukin-23 receptor (IL-23R has been shown to be associated with ankylosing spondylitis (AS in many different populations. This study examined whether IL-23R polymorphisms were associated with susceptibility to this disease in a Chinese Han population. METHODS: Three single-nucleotide polymorphisms (SNP, rs7517847, rs11209032, and rs17375018, were genotyped in 291 AS patients and 312 age-, sex-, and ethnically matched healthy controls using a polymerase chain reaction (PCR restriction fragment length polymorphism (RFLP assay. RESULTS: The genotype and allele frequencies of rs17375018, rs7517847, and rs11209032 were not different between the patients with AS and the healthy controls. On the one hand, stratification analysis indicated that the rs17375018 GG genotype and the G allele were increased in AS patients who were HLA-B27 positive (corrected p = 0.024, odds ratio [OR] 2.35, 95% CI 1.30-4.24; p c = 0.006, OR 1.98, 95% CI 1.28-3.07, respectively. On the other hand, the analysis according to clinical characteristics showed a significantly increased prevalence of the homozygous rs17375018 GG genotype and the G allele in patients with AS and uveitis compared with the controls (p c = 0.024 and p c = 0.024, respectively. In addition, haplotype analysis performed with the SHEsis platform revealed no significant difference concerning the haplotypes between AS patients and healthy controls. CONCLUSIONS: In this study, the results suggested that the rs17375018 of IL23R was positively associated with HLA-B27-positive AS and that the rs17375018 GG of IL-23R was associated with AS concomitant with uveitis. We found no evidence for an association between the other two SNPs of IL-23R and AS.

  5. Predictors of treatment response and drug continuation in 842 patients with ankylosing spondylitis treated with anti-tumour necrosis factor: results from 8 years' surveillance in the Danish nationwide DANBIO registry

    Glintborg, Bente; Østergaard, Mikkel; Krogh, Niels Steen; Dreyer, Lene; Kristensen, Hanne Lene; Hetland, Merete Lund

    2010-01-01

    To use prospectively registered data from the Danish nationwide rheumatological database (DANBIO) to describe disease activity, clinical response, treatment duration and predictors of drug survival (ie, number of days individual patients maintained treatment) and clinical response among patients ...... with ankylosing spondylitis (AS) receiving their first treatment series with a tumour necrosis factor α (TNFα) inhibitor....

  6. Predictors of treatment response and drug continuation in 842 patients with ankylosing spondylitis treated with anti-tumour necrosis factor: results from 8 years' surveillance in the Danish nationwide DANBIO registry

    Glintborg, Bente; Østergaard, Mikkel; Krogh, Niels Steen; Kristensen, Hanne Lene; Hetland, Merete Lund; Dreyer, Lene

    2010-01-01

    To use prospectively registered data from the Danish nationwide rheumatological database (DANBIO) to describe disease activity, clinical response, treatment duration and predictors of drug survival (ie, number of days individual patients maintained treatment) and clinical response among patients ...... with ankylosing spondylitis (AS) receiving their first treatment series with a tumour necrosis factor a (TNFa) inhibitor....

  7. Comparison of non-radiographic axial spondyloarthritis and ankylosing spondylitis patients - baseline characteristics, treatment adherence, and development of clinical variables during three years of anti-TNF therapy in clinical practice

    Wallman, Johan K; Kapetanovic, Meliha C; Petersson, Ingemar F;

    2015-01-01

    BACKGROUND: The relationship between non-radiographic axial spondyloarthritis (nr-axSpA) and ankylosing spondylitis (AS) is currently debated. Using observational data from the South Swedish Arthritis Treatment Group register, we thus aimed to compare clinical development and treatment adherence ...

  8. Combined effects of ankylosing spondylitis-associated ERAP1 polymorphisms outside the catalytic and peptide-binding sites on the processing of natural HLA-B27 ligands.

    Martín-Esteban, Adrian; Gómez-Molina, Patricia; Sanz-Bravo, Alejandro; López de Castro, José A

    2014-02-14

    ERAP1 polymorphism involving residues 528 and 575/725 is associated with ankylosing spondylitis among HLA-B27-positive individuals. We used four recombinant variants to address the combined effects of the K528R and D575N polymorphism on the processing of HLA-B27 ligands. The hydrolysis of a fluorogenic substrate, Arg-528/Asp-575 ERAP1 was a major determinant of the abundance of these peptides in vivo. The hydrolysis of fluorogenic and peptide substrates by an HLA-B27 ligand or a shorter peptide, respectively, was increasingly inhibited as a function of ERAP1 activity, indicating that residues 528 and 575 affect substrate inhibition of ERAP1 trimming. The significant and complex effects of co-occurring ERAP1 polymorphisms on multiple HLA-B27 ligands, and their potential to alter the immunological and pathogenetic features of HLA-B27 as a function of the ERAP1 context, explain the epistatic association of both molecules in ankylosing spondylitis. PMID:24352655

  9. Genetic polymorphisms of stromal interaction molecule 1 associated with the erythrocyte sedimentation rate and C-reactive protein in HLA-B27 positive ankylosing spondylitis patients.

    James Cheng-Chung Wei

    Full Text Available Ankylosing spondylitis (AS is a chronic inflammation of the sacroiliac joints, spine and peripheral joints. The development of ankylosing spondylitis is still unclear. Genetics factors such as human leukocyte antigen HLA-B27 and ERAP1 have been widely reported to associate to AS susceptibility. In this study, we enrolled 361 AS patients and selected four tagging single nucleotides polymorphisms (tSNPs at STIM1 gene. The correlation between STIM1 genetic polymorphisms and AS activity index (BASDAI, BASFI, BAS-G as well as laboratory parameters of inflammation (erythrocyte sedimentation rate (ESR and C-reactive protein (CRP were tested. Our results indicated that HLA-B27 positive AS patients who are carrying the minor allele homozygous G/G genotype of SNP rs3750996 significantly associated with a higher level of ESR in serum. Furthermore, rs3750996/rs3750994 pairwise allele analysis indicated that G-C haplotypes also significantly correlated with higher level of ESR as well as CRP. These findings provide a better understanding of STIM1 genetic contribution to the pathogenesis of AS.

  10. Risk of leukaemia following intravenous treatment with 224Ra - results of a long term follow-up study of ankylosing spondylitis patients

    In an epidemiological study of the somatic late effects risk following incorporation of a short lived α-emitter, 1473 ankylosing spondylitis patients treated with repeated intravenous injections of 224Ra in the years 1948 - 75, have been observed in the GSF. The usual therapeutic plan consisted of a total of 10 - 12 injections of 1.036 MBq (28 μCi) of 224Ra each, given at weekly intervals; this would result in an cumulative α-dose of 0.56 - 0.67 Gy to the marrow-free skeleton of a 70-kg-man (standard man). These patients have been followed together with a control group of ankylosing spondylitis patients not treated with radioactive drugs and/or X-rays. Until May 1993 (mean follow-up time 19.9 yr), 595 patients of the exposure group and 722 patients of the control group have died, causes of death have been ascertained for 578, resp. 668 patients. Among others we observed in the exposure group 10 cases of leukaemia (vs. 2.7 - 2.8 cases expected, p 239Pu, an α-emitter which like 224Ra deposits preferentially on the bone surface. (orig.)

  11. IMPACT OF THE SPECIFIC FEATURES OF DISEASE COURSE AND THERAPY ON QUALITY OF LIFE IN PATIENTS WITH ANKYLOSING SPONDYLITIS

    N. A. Kuznetsova

    2015-03-01

    Full Text Available Objective: to investigate the impact of specific features of the course of ankylosing spondylitis (AS, sociodemographic factors, and therapy on quality of life (QL in patients with this disease. Subjects and methods. The results of studying QL (with the SF-36 questionnaire in 90 adult patients with AS versus 45 healthy individuals (a control group were presented. Within 6 months before study inclusion, 30 patients with AS received only nonsteroidal anti-inflammatory drugs (NSAIDs; 27 – NSAIDs + sulfasalazine (SULF, 15 – NSAIDs + infliximab (INF; 18 (20% patients were not systematically treated and were excluded from the study. A control group comprised 45 apparently healthy volunteers (32 men and 13 women; both groups were matched for gender and age. Results and discussion. The patients with AS were found to have lower physical and psychological QL scores than the controls (p < 0.001. In those with AS, QL worsened as the inflammatory disease activity, functional limitations, articular manifestations and enthesitis increased. Coxitis detected in 76.7% of the patients had a negative effect on rolephysical functioning. The sociodemographic factors were not found to have a statistically significant influence on QL in the patients with AS. The QL scores were higher in the patients taking INF in combination with NSAIDs. Evaluation of the impact of performed drug therapy on QL in the patients receiving SULF versus the controls revealed statistically significant worse scores in all the scales of the SF-36 questionnaire (p < 0.001. In the patients who had NSAIDs only, the QL scores were also worse than those in the control group (p < 0.001. According to the data of the SF-36 questionnaire, a number of QL scores in the patients receiving INF + NSAIDs proved to be similar in the apparently healthy individuals. Thus, the patients with AS have considerably lower physical and psychological QL scores than the healthy people. QL worsens as the inflammatory

  12. Disease-associated polymorphisms in ERAP1 do not alter endoplasmic reticulum stress in patients with ankylosing spondylitis.

    Kenna, T J; Lau, M C; Keith, P; Ciccia, F; Costello, M-E; Bradbury, L; Low, P-L; Agrawal, N; Triolo, G; Alessandro, R; Robinson, P C; Thomas, G P; Brown, M A

    2015-01-01

    The mechanism by which human leukocyte antigen B27 (HLA-B27) contributes to ankylosing spondylitis (AS) remains unclear. Genetic studies demonstrate that association with and interaction between polymorphisms of endoplasmic reticulum aminopeptidase 1 (ERAP1) and HLA-B27 influence the risk of AS. It has been hypothesised that ERAP1-mediated HLA-B27 misfolding increases endoplasmic reticulum (ER) stress, driving an interleukin (IL) 23-dependent, pro-inflammatory immune response. We tested the hypothesis that AS-risk ERAP1 variants increase ER-stress and concomitant pro-inflammatory cytokine production in HLA-B27(+) but not HLA-B27(-) AS patients or controls. Forty-nine AS cases and 22 healthy controls were grouped according to HLA-B27 status and AS-associated ERAP1 rs30187 genotypes: HLA-B27(+)ERAP1(risk), HLA-B27(+)ERAP1(protective), HLA-B27(-)ERAP1(risk) and HLA-B27(-)ERAP1(protective). Expression levels of ER-stress markers GRP78 (8 kDa glucose-regulated protein), CHOP (C/EBP-homologous protein) and inflammatory cytokines were determined in peripheral blood mononuclear cell and ileal biopsies. We found no differences in ER-stress gene expression between HLA-B27(+) and HLA-B27(-) cases or healthy controls, or between cases or controls stratified by carriage of ERAP1 risk or protective alleles in the presence or absence of HLA-B27. No differences were observed between expression of IL17A or TNF (tumour necrosis factor) in HLA-B27(+)ERAP1(risk), HLA-B27(+)ERAP1(protective) and HLA-B27(-)ERAP1(protective) cases. These data demonstrate that aberrant ERAP1 activity and HLA-B27 carriage does not alter ER-stress levels in AS, suggesting that ERAP1 and HLA-B27 may influence disease susceptibility through other mechanisms. PMID:25354578

  13. Decreased frequencies of circulating follicular helper T cell counterparts and plasmablasts in ankylosing spondylitis patients Naive for TNF blockers.

    María-Belén Bautista-Caro

    Full Text Available Follicular helper T cells (Tfh, localized in lymphoid organs, promote B cell differentiation and function. Circulating CD4 T cells expressing CXCR5, ICOS and/or PD-1 are counterparts of Tfh. Three subpopulations of circulating CD4+CXCR5+ cells have been described: CXCR3+CCR6- (Tfh-Th1, CXCR3-CCR6+ (Tfh-Th17, and CXCR3-CCR6- (Tfh-Th2. Only Tfh-Th17 and Tfh-Th2 function as B cell helpers. Our objective was to study the frequencies of circulating Tfh (cTfh, cTfh subsets and plasmablasts (CD19+CD20-CD27+CD38high cells, and the function of cTfh cells, in patients with Ankylosing Spondylitis (AS. To this end, peripheral blood was drawn from healthy controls (HC (n = 50, AS patients naïve for TNF blockers (AS/nb (n = 25 and AS patients treated with TNF blockers (AS/b (n = 25. The frequencies of cTfh and plasmablasts were determined by flow cytometry. Cocultures of magnetically sorted CD4+CXCR5+ T cells with autologous CD19+CD27- naïve B cells were established from 3 AS/nb patients and 3 HC, and concentrations of IgG, A and M were measured in supernatants. We obseved that AS/nb but not AS/b patients, demonstrated decreased frequencies of circulating CD4+CXCR5+ICOS+PD-1+ cells and plasmablasts, together with a decreased (Tfh-Th17+Tfh-Th2/Tfh-Th1 ratio. The amounts of IgG and IgA produced in cocultures of CD4+CXCR5+ T cells with CD19+CD27- B cells of AS/nb patients were significantly lower than observed in cocultures established from HC. In summary, AS/nb but not AS/b patients, demonstrate a decreased frequency of cTfh and plasmablasts, and an underrepresentation of cTfh subsets bearing a B helper phenotype. In addition, peripheral blood CD4+CXCR5+ T cells of AS/nb patients showed a decreased capacity to help B cells ex vivo.

  14. 强直性脊柱炎骶髂关节病变的低场MRI诊断价值分析%Diagnostic Values of Low Field MRI for Sacroiliac Joints Lesions in Ankylosing Spondylitis

    查广盛

    2011-01-01

    目的 探讨强直性脊柱炎(AS)骶髂关节(SIJ)病变的低场MRI的诊断价值.方法 回顾性分析临床确诊的37例ASSIJ病变患者的MRI表现,并与X线、CT表现进行比较.结果 37例AS患者中,34例MRI显示SIJ软骨异常、19例显示关节下骨髓水肿、21例显示脂肪沉积、29例显示骨质破坏、11例合并髋关节病变.X线平片检出SIJ病变0~Ⅰ级14例、Ⅱ级4例、Ⅲ级14例、Ⅳ级5例;CT检出SIJ病变0级4例、I级3例、Ⅱ级12例、Ⅲ级13例、IV级5例;MRI检出SIJ病变Ⅰ级7例、Ⅱ级14例、Ⅲ级11例、Ⅳ级5例.结论 低场MRI可清晰地显示SIJ软骨异常、骨髓水肿、脂肪沉积及早期骨侵蚀改变,是ASSIJ病变早期首选影像学诊断方法.%Objective To explore the diagnostic values of low field MRI for sacroiliac joints lesions in ankylosing spon-dylitis. Methods MRI features of 37 cases with sacroiliac joints lesions from ankylosing spondylitis were retrospectively analyzed and compared with X - ray and CT manifestations. Results As for the MR images of the 37 ankylosing spondy - litis cases, cartilage changes of sacroiliac joints was found in 34 cases, subchondral bone marrow edema was noted in 19 cases, fatty deposition was found in 21 cases, bone erosion was seen in 29 cases, and hip -joint lesions were noted in 11 cases. X - ray plain films showed that 14 cases were of level 0-1,4 cases were of level II , 14 cases were of level IH , 5 cases were of level IV ; CT scan showed that 4 cases were of level 0, 3 cases were of level I , 12 cases were of level II , 13 cases were of level IH , 5 cases were of level IV ; MRI scan showed that 7 cases were of 1, 14 cases were of level II , 11 cases were of level IH , 5 cases were of level IV. Conclusion Low field MRI clearly shows the cartilage abnormalities, bone marrow edema, fatty deposition and early bone erosion of sacroiliac joints. MRI is an ideal imaging method for early diagnosis of ankylosing spondylitis.

  15. Danske anbefalinger for behandling af ankyloserende spondylitis og spondylartritis udarbejdet i et internationalt projektsamarbejde

    Pedersen, Susanne Juhl; Madsen, Ole Rintek; Erlendsson, Jon; Schiøttz-Christensen, Berit; Sørensen, Inge Juul; Andersen, Lis Smedegaard; Ostergaard, Mikkel

    2008-01-01

    INTRODUCTION: The multinational initiative "3e Initiative in Rheumatology - Multi-national Recommendations for the Management of Ankylosing Spondylitis 2006-7" served the primary purpose of providing specific recommendations for the management of ankylosing spondylitis and spondyloarthritis...

  16. Complete Remission of Nephrotic Syndrome Without Resolution of Amyloid Deposit After Anti-Tumor Necrosis Factor α Therapy in a Patient With Ankylosing Spondylitis.

    Lee, Yu Ho; Kim, Eun Young; Jeong, Da Wun; Kim, Yang-Gyun; Lee, Sang-Ho; Song, Ran; Yang, Hyung In; Lim, Sung Jig; Moon, Ju-Young; Lee, Sang-Hoon

    2016-03-01

    In secondary amyloid A amyloidosis resulting from rheumatologic diseases, tumor necrosis factor α blockers have been reported to be effective in the treatment of both arthritis and amyloidosis. However, there have been few reports concerning the alterations of renal tissue histology before and after long-term tumor necrosis factor α blockers therapy in secondary renal amyloidosis. We report the histological change after tumor necrosis factor α blocker therapy in patient with amyloid A amyloidosis and nephrotic syndrome secondary to underlying ankylosing spondylitis. The patient achieved complete remission of nephrotic syndrome after 17 months of etanercept treatment. We performed the second kidney biopsy after 40 months, and there was little change in the degree of amyloid deposition in the mesangial area and capillary loops compared with the first biopsy. The interstitial inflammation and foot process effacement, however, were fully recovered. PMID:26906302

  17. Bioboosters in the treatment of rheumatic diseases: a comprehensive review of currently available biologics in patients with rheumatoid arthritis, ankylosing spondylitis and psoriatic arthritis

    Fabrizio Cantini

    2009-12-01

    Full Text Available Fabrizio Cantini, Carlotta Nannini, Laura NiccoliSecond Division of Medicine, Rheumatology Unit, Hospital of Prato, ItalyAbstract: Immunologic research has clarified many aspects of the pathogenesis of inflammatory rheumatic disorders. Biologic drugs acting on different steps of the immune response, including cytokines, B- and T-cell lymphocytes, have been marketed over the past 10 years for the treatment of rheumatoid arthritis (RA, ankylosing spondylitis (AS, and psoriatic arthritis (PsA. Randomized controlled trials (RCTs of anti-cytokine agents in RA (including the anti-tumor necrosis factor alpha (TNFα drugs infliximab, etanercept, adalimumab, golimumab, certolizumab, anti-interleukin (IL-1 anakinra, and anti-IL-6 tocilizumab demonstrated a significant efficacy compared to traditional therapies, if combined with methotrexate (MTX, as measured by ACR 20, 50 and 70 response criteria. The new therapies have also been demonstrated to be superior to MTX in slowing or halting articular damage. RCTs have shown the efficacy of anti-TNFα in AS patients through significant improvement of symptoms and function. Trials of anti-TNFα in PsA patients showed marked improvement of articular symptoms for psoriasis and radiological disease progression. More recent studies have demonstrated the efficacy of B-cell depletion with rituximab, and T-cell inactivation with abatacept. All these drugs have a satisfactory safety profile. This paper reviews the different aspects of efficacy and tolerability of biologics in the therapy of RA, AS, and PsA.Keywords: anti-TNF, anti-cytokine agents, rituximab, abatacept, rheumatoid arthritis, psoriatic arthritis, ankylosing spondylitis

  18. Analysis of PPARGC1B, RUNX3 and TBKBP1 polymorphisms in Chinese Han patients with ankylosing spondylitis: a case-control study.

    Zijian Lian

    Full Text Available BACKGROUND: Susceptibility to and severity of ankylosing spondylitis (AS are largely genetically determined. PPARGC1B, RUNX3 and TBKBP1 have recently been found to be associated with AS in patients of western European descent. Our purpose is to examine the influence of PPARGC1B, RUNX3 and TBKBP1 polymorphisms on the susceptibility to and the severity of ankylosing spondylitis in Chinese ethnic majority Han population. METHODS: Blood samples are drawn from 396 AS patients and 404 unrelated healthy controls. All the patients and the controls are Han Chinese and the patients are HLA-B27 positive. The AS patients are classified based on the severity of the disease. Twelve tag single nucleotide polymorphisms (tagSNPs in PPARGC1B, RUNX3 and TBKBP1 are selected and genotyped. Frequencies of different genotypes and alleles are analyzed among the different severity AS patients and the controls. RESULTS: After Bonferroni correction, the rs7379457 SNP in PPARGC1B shows significant difference when comparing all AS patients to controls (p = 0.005. This SNP also shows significant difference when comparing normal AS patients to controls (p = 0.002. The rs1395621 SNP in RUNX3 shows significant difference when comparing severe AS patients to controls (p = 0.007. The rs9438876 SNP in RUNX3 shows significant difference when comparing normal AS patients to controls (p = 0.007. The rs8070463 SNP in TBKBP1 shows significant difference in genotype distribution when comparing severe AS patients to controls (p = 0.003. CONCLUSIONS: The rs7379457 SNP in PPARGC1B is related to susceptibility to AS in Chinese Han population. The rs7379457 SNP in PPARGC1B, the rs1395621 and rs9438876 SNPs in RUNX3, and the rs8070463 SNP in TBKBP1 are related to the severity of AS in Chinese Han population.

  19. Comparative Study on X-ray CT MRI of Sacroiliac Joint in Ankylosing Spondylitis%早期强直性脊柱炎骶髂关节病变的X线CT和MRI对比研究

    马亚宁; 朱亚男; 李小民; 周和平; 王婷

    2013-01-01

    Objective: To study the imaging features of early ankylosing spondylitis( AS ). Method:59 cases of AS imaging data were analyzed and reviewed retrospectively. Result: Only 42 cases of the saemoiliae joints that suspicious singular were found in X-ray and 53 in CT and 59 MRI. It showed significant difference of diagnosis rats in the three method. The major expression of X-ray and CT were bone sclerosis parcel, cystic change of the articular subsurface bone structure, erosion and speculation. The major expression of MRI were bone marrow edema at the articular subsurface, articular-cartilage damage. In the enhanced sca-ning, the major Expression were bone marrow, synovial, articular-cartilage, the joint ligament showed different degrees of strengthening. Articular-cartilage( 8 cases ), the joint ligament( 5 cases )showed different degrees of strengthening. Conclusion: For the imaging diagnostic of early lesions in ankylosing spondylitis,CR exam-nination is the basic method that the value is very limited. CT ingrading lesions is more external, and can show the bone lesions more clearly. There is obvious advantage on MRI, by which AS can be early diagnosed with clinical.%目的:探讨强直性脊柱炎骶髂关节病变早期的影像学诊断价值.方法:收集经临床确诊的59例强直性脊柱炎早期病例,回顾分析其骶髂关节CR、CT及MRI表现.结果:X线发现42例骶髂关节可疑异常,CT发现53例表现异常,59例患者MRI表现均有异常,检出病例数对比差异显著(P﹤0.05).X线和CT的主要表现为:局部骨质硬化、侵蚀或囊性变、关节面欠光滑和毛刺感.MRI主要表现为骨髓水肿、关节软骨破坏,增强扫描可显示滑膜、关节软骨及关节韧带呈现不同程度强化.结论:强直性脊柱炎的早期影像学诊断,X线检查最为基本,但诊断意义有限;CT对分级较为客观,且能较好地显示骨质病变情况;MRI具有明显优势,结合临床,可做出早期诊断.

  20. HLA-B27与强直性脊柱炎的相关性研究进展%Research progress in the relationship between HLA-B27 and ankylosing spondylitis

    方懿; 蒋宗滨

    2011-01-01

    Background Ankylosing Spondylitis (AS) is a common autoimmune joint disease, which mostly occurs to young men. Early diagnose of AS is difficult and the treatment is not satisfactory at present. Studies have been released that there is a strong relationship bewteen Human leucocyte antigen-B27 (HLA-B27). It is estimated that 90% AS patients were HLA-B27 positive, which was thought of vital importance for early diagnosis of AS. Objective This paper will review the relationship between AS and HLA -B27 which would provide the base on diagnosis and treatment of AS. Content This paper focuses on AS pathogenesis, pathology and clinical manifestations to summarize the relationship and diagnosis significance between HLA -B27 and AS. Trend The HLA-B27 antigen has a high correlation with AS, which can be used as an important clinical indicator for early diagnosis of AS. However it should be mentioned that any exaggeration of the role of HLA-B27 in the diagnosis of AS should be avoided, particular in HLA-B27 negative patients.%背景 强直性脊柱炎(ankylosing spondylitis,AS)是一种常见的自身免疫性关节病,好发于年轻男性,该疾病目前早期诊断较闲难,治疗效果不理想,以往研究表明HLA-B27与AS有很强的相关性,90%左右的AS患者HLA-B27呈阳性,但是仍有10%的患者HLA-B27呈阴性,值得临床进一步研究.目的 现对HLA-B27与AS之间的相关性作一综述,以求为AS的临床诊断和治疗提供帮助.内容 从AS的发病机制、病理学改变和临床表现入手,总结HLA-B27与AS的关系及其对AS诊断的意义.趋向 HLA-B27 抗原的榆测与AS有很高的相关性,可作为临床上早期诊断的重要指标之一,但不能夸大HLA-B27的诊断作用尤其是HLA-B27阴性的患者.

  1. Diagnostic delay in patients with rheumatoid arthritis, psoriatic arthritis and ankylosing spondylitis

    Sørensen, Jan; Hetland, Merete Lund

    2015-01-01

    BACKGROUND/PURPOSE: Early diagnosis of inflammatory rheumatic diseases is important in order to improve long-term outcome. We studied whether delay in diagnosis (time between onset of symptoms and establishment of diagnosis) in patients with rheumatoid arthritis (RA), psoriatic arthritis (PSA) and......). Sensitivity analyses including patients who were included after 2005, patients who had received biological treatment or had symptom onset less than 2 and 5 years prior to first entry into DANBIO showed similar results. CONCLUSION: Since the year 2000, a significant reduction in diagnostic delay was observed...

  2. Golimumab therapy-induced indicators of X-ray inflammation progression and magnitude according to magnetic resonance imaging evidence in patients with rheumatoid arthritis, ankylosing spondylitis, or psoriatic arthritis

    Aleksandr Viktorovich Smirnov

    2013-01-01

    Full Text Available The paper gives data on the progression of X-ray and magnetic resonance imaging changes in the hand and foot joints of patients with rheumatoid arthritis and psoriatic arthropathy and in the axial skeleton of those with ankylosing spondylitis when golimumab is used. Golimumab therapy is shown to retard the progression of structural changes in the peripheral joints and vertebral column. There is a significant correlation between magnetic resonance imaging evidence and blood C-reactive protein concentrations.

  3. Golimumab: A novel human anti-TNF-α monoclonal antibody for the treatment of rheumatoid arthritis, ankylosing spondylitis, and psoriatic arthritis

    Jonathan Kay

    2009-07-01

    Full Text Available Jonathan Kay1, Mahboob U Rahman2,31Division of Rheumatology, UMass Memorial Medical Center, University of Massachusetts Medical School, Worcester, MA, USA; 2Centocor Research and Development, inc., Malvern, PA, USA; 3University of Pennsylvania School of Medicine, Philadelphia, PA, USAIntroduction: The introduction of tumor necrosis factor-α (TNF-α inhibitors represented a significant advance in the management of rheumatoid arthritis (RA and other chronic inflammatory diseases. Although three TNF-α inhibitors have been approved for the treatment of RA by the US Food and Drug Administration (FDA and the European Medicinal Products Evaluation Agency (EMEA, not all patients achieve a satisfactory clinical improvement with these therapeutic agents. The mode of administration of these medications is inconvenient for some patients.Aims: Golimumab is a novel anti-TNF-α monoclonal antibody that is in clinical development for the treatment of RA, psoriatic arthritis (PsA, and ankylosing spondylitis (AS, either as a first-line biologic therapy or an alternative after other TNF-α inhibitors have been discontinued. This review summarizes the development of, and clinical evidence achieved with, golimumab.Evidence review: Golimumab has demonstrated significant efficacy in randomized, double-blind, placebo-controlled trials when administered subcutaneously once every four weeks. It has been generally well tolerated in clinical trials and demonstrates a safety profile comparable with currently available TNF-α inhibitors.Outcomes summary: Golimumab has been confirmed to be an effective treatment for patients with RA, PsA, and AS in phase III clinical trials as evaluated by traditional measures of disease activity, such as signs and symptoms, as well as measures of physical function, patient reported outcomes, and health economic measures. The efficacy and safety profile of golimumab in RA, PsA, and AS appears to be similar to other anti-TNF agents. However

  4. Disease-modifying anti-rheumatic drugs til behandling af ankyloserende spondylitis

    Madsen, Ole Rintek; Egsmose, Charlotte

    2009-01-01

    Ankylosing spondylitis (AS) is an inflammatory disorder affecting the axial skeleton, peripheral joints, entheses and extra-articular sites. Patients with early disease, a higher level of erythrocyte sedimentation rate and/or peripheral arthritis might benefit from sulfasalazine. Otherwise, there...

  5. Higher Level of Dickkopf-1 is Associated with Low Bone Mineral Density and Higher Prevalence of Vertebral Fractures in Patients with Ankylosing Spondylitis.

    Rossini, Maurizio; Viapiana, Ombretta; Idolazzi, Luca; Ghellere, Francesco; Fracassi, Elena; Troplini, Sonila; Povino, Maria Rosaria; Kunnathully, Vidya; Adami, Silvano; Gatti, Davide

    2016-05-01

    Patients with ankylosing spondylitis (AS) have an increased risk of bone loss and vertebral fractures. In this study, we explored the hypothesis that the excess bone loss and vertebral fractures might be related with the activity of the Wingless signaling pathway, and in particular with the serum levels of its circulating inhibitors, Sclerostin and Dickkopf-1 (DKK1). We recruited 71 patients diagnosed with AS. Lateral radiographs of the total spine were analyzed to detect the presence of vertebral fractures, and bone mineral density (BMD) was assessed in all patients using dual X-ray absorptiometry at lumbar spine and proximal femoral site. Blood samples were obtained and levels of C-reactive protein (CRP), DKK1, and Sclerostin were measured. Blood samples from 71 healthy sex- and age-matched volunteers were collected to be used as controls. Vertebral fractures were detected more commonly among men than in women (29 vs 8 %, respectively). DKK1, but not Sclerostin serum levels, were inversely correlated to lumbar spine Z-score BMD. Patients with one or more prevalent vertebral fractures had significantly higher DKK1 levels, without significant difference in Sclerostin serum levels. A significant positive correlation was found between DKK1 serum levels and CRP (r = 0.240, p = 0.043). The association we found between serum DKK1 levels and BMD values and vertebral fracture prevalence suggests that DKK1 might contribute to the severity of osteoporosis in AS. PMID:26645432

  6. Serum Heme Oxygenase-1 and BMP-7 Are Potential Biomarkers for Bone Metabolism in Patients with Rheumatoid Arthritis and Ankylosing Spondylitis

    Yuan, Tong-ling; Chen, Jin; Tong, Yan-li; Zhang, Yan; Liu, Yuan-yuan; Wei, James Cheng-Chung; Liu, Yi; Herrmann, Martin

    2016-01-01

    Backgrounds. Heme oxygenase-1 (HO-1) has been reported to play a regulatory role in osteoclastogenesis. Bone morphogenetic protein (BMP) pathways induce osteoblastic differentiation and bone remodeling. Aims. To identify serum levels of HO-1, BMP-7, and Runt related-transcription factor 2 (Runx2) in patients with rheumatoid arthritis (RA) and ankylosing spondylitis (AS) and to investigate the relationships between HO-1, BMP-7, Runx2, and other common biomarkers for bone metabolism. Results. Serum levels of HO-1 and BMP-7 were revealed to be significantly higher in patients with RA or AS than in healthy controls (p < 0.01). In RA group, HO-1 was positively correlated with BMP-7, Runx2, and tartrate-resistant acid phosphatase-5b (TRAP-5b) (p < 0.05, resp.), BMP-7 was positively correlated with Runx2 and TRAP-5b (p < 0.05, resp.), and Runx2 was negatively correlated with N-terminal midfragment of osteocalcin (NMID) (p < 0.05). In AS group, we observed identical correlation between HO-1 and BMP-7, but opposite correlations between BMP-7 and TRAP-5b and between Runx2 and NMID, when comparing with the RA cohort. Conclusion. Our findings suggest that HO-1 and BMP-7 are potential biomarkers for bone metabolism in patients with RA and AS. The different correlations between the bone markers point to distinct differences in bone remodeling pathways in the two types of arthritis. PMID:27314037

  7. ERAP1 variants are associated with ankylosing spondylitis in East Asian population: a new Chinese case-control study and meta-analysis of published series.

    Chen, C; Zhang, X

    2015-06-01

    Endoplasmic reticulum aminopeptidase 1 (ERAP1) has been confirmed to be associated with ankylosing spondylitis (AS) in Caucasian. However, whether they are associated with AS in East Asian population remains unidentified. We investigated this relationship by a new Chinese case-control study and a meta-analysis of published series. 368 cases and 460 controls were recruited in the Chinese case-control study. Genotyping was completed using the chip-based matrix-assisted laser desorption ionization time-of-flight mass spectrometry. Allelic associations were analysed using contingency tables. In the meta-analysis, up to 2748 cases and 2774 controls from seven different studies and the new Chinese study were combined using Review Manager software version 5.1.1. Mantel-Haenszel or Inverse Variance test was used to calculate fixed or random-effects pooled ORs. In the new Chinese study, strong association with AS was observed for marker rs10050860, rs27434 and rs1065407 at P value of ERAP1 variants are associated with AS in East Asian population, indicating a common pathogenic mechanism for AS in East Asians and Caucasians. PMID:25817437

  8. Imbalance between HAT and HDAC activities in the PBMCs of patients with ankylosing spondylitis or rheumatoid arthritis and influence of HDAC inhibitors on TNF alpha production.

    Eric Toussirot

    Full Text Available OBJECTIVE: Acetylation or deacetylation of histone proteins may modulate cytokine gene transcription such as TNF alpha (TNF. We evaluated the balance between histone deacetytlase (HDAC and histone acetyltransferase (HAT in patients with rheumatoid arthritis (RA or ankylosing spondylitis (AS compared to healthy controls (HC and determined the influence of HDAC inhibitors (trichostatin A -TSA- or Sirtinol -Sirt- on these enzymatic activities and on the PBMC production of TNF. METHODS: 52 patients with RA, 21 with AS and 38 HC were evaluated. HAT and HDAC activities were measured on nuclear extracts from PBMC using colorimetric assays. Enzymatic activities were determined prior to and after ex vivo treatment of PBMC by TSA or Sirt. TNF levels were evaluated in PBMC culture supernatants in the absence or presence of TSA or Sirt. RESULTS: HAT and HDAC activities were significantly reduced in AS, while these activities reached similar levels in RA and HC. Ex vivo treatment of PBMC by HDACi tended to decrease HDAC expression in HC, but Sirt significantly reduced HAT in RA. TNF production by PBMC was significantly down-regulated by Sirt in HC and AS patients. CONCLUSION: HAT and HDAC were disturbed in AS while no major changes were found in RA. HDACi may modulate HDAC and HAT PBMC expression, especially Sirt in RA. Sirtinol was able to down regulate TNF production by PBMC in HC and AS. An imbalance between HAT and HDAC activities might provide the rationale for the development of HDACi in the therapeutic approach to inflammatory rheumatic diseases.

  9. Patellar Tendon Properties and Lower Limb Function in Rheumatoid Arthritis and Ankylosing Spondylitis versus Healthy Controls: A Cross-Sectional Study

    Verena Matschke

    2013-01-01

    Full Text Available Objective. Rheumatoid arthritis (RA and ankylosing spondylitis (AS lead to inflammation in tendons and peritendinous tissues, but effects on biomechanical tendon function are unknown. This study investigated patellar tendon (PT properties in stable, established RA and AS patients. Methods. We compared 18 RA patients (13 women, 59.0 ± 2.8 years, mean ± SEM with 18 age- and sex-matched healthy controls (58.2 ± 3.2 years, and 12 AS patients (4 women, 52.9 ± 3.4 years with 12 matched controls (54.5 ± 4.7 years. Assessments with electromyography, isokinetic dynamometry, and ultrasound included quadriceps muscle force and cross-sectional area (CSA, PT stiffness, and PT CSA. Additionally, measures of physical function and disease activity were performed. Results. PT stiffness and physical function were lower in RA and AS patients compared to healthy controls, without a significant difference in force production. PT CSA was significantly larger leading to reduction in Young’s modulus (YM in AS, but not in RA. Conclusion. The adverse changes in PT properties in RA and AS may contribute to their impaired physical function. AS, but not RA, leads to PT thickening without increasing PT stiffness, suggesting that PT thickening in AS is a disorganised repair process. Longitudinal studies need to investigate the time course of these changes and their response to exercise training.

  10. A computational docking study on the pH dependence of peptide binding to HLA-B27 sub-types differentially associated with ankylosing spondylitis.

    Serçinoğlu, Onur; Özcan, Gülin; Kabaş, Zeynep Kutlu; Ozbek, Pemra

    2016-07-01

    A single amino acid difference (Asp116His), having a key role in a pathogenesis pathway, distinguishes HLA-B*27:05 and HLA-B*27:09 sub-types as associated and non-associated with ankylosing spondylitis, respectively. In this study, molecular docking simulations were carried out with the aim of comprehending the differences in the binding behavior of both alleles at varying pH conditions. A library of modeled peptides was formed upon single point mutations aiming to address the effect of 20 naturally occurring amino acids at the binding core peptide positions. For both alleles, computational docking was applied using Autodock 4.2. Obtained free energies of binding (FEB) were compared within the peptide library and between the alleles at varying pH conditions. The amino acid preferences of each position were studied enlightening the role of each on binding. The preferred amino acids for each position of pVIPR were found to be harmonious with experimental studies. Our results indicate that, as the pH is lowered, the capacity of HLA-B*27:05 to bind peptides in the library is largely lost. Hydrogen bonding analysis suggests that the interaction between the main anchor positions of pVIPR and their respective binding pocket residues are affected from the pH the most, causing an overall shift in the FEB profiles. PMID:27506766

  11. Ectopic Germinal Centers and IgG4-Producing Plasmacytes Observed in Synovia of HLA-B27+ Ankylosing Spondylitis Patients with Advanced Hip Involvement

    Xiugao Feng

    2015-01-01

    Full Text Available Introduction. Ectopic lymphoid neogenesis and the presence of IgG4-positive plasmacytes have been confirmed in chronic inflammatory sclerosing diseases. This study aims to investigate hip synovial tissues of ankylosing spondylitis (AS patients for IgG4-positive plasma cells and ectopic lymphoid tissues with germinal centers (GCs. Methods. Synovial samples were collected from 7 AS patients who received total hip replacement and were evaluated using immunohistochemistry for the presence of CD20+ B-cells, CD3+ T-cells, CD21+ follicular dendritic cells (FDC, and CD38+ plasma cells. Furthermore, immunoglobulin G (IgG and IgG4, IgA, IgM, and complement components C3d and C4d in synovia were evaluated. Both synovial CD21+ FDCs and IgG4-producing plasmacytes were analyzed. Results. All seven patients had severe fibrosis. Massive infiltrations of lymphocytes were found in 5 out of 7 patients’ synovia. Ectopic lymphoid tissues with CD21+ FDC networks and IgG4-positive plasma cells were observed coincidentally in two patients’ synovia. Conclusion. The pathophysiological mechanism of AS patients’ hip damage might be related to the coincidental presence of ectopic lymphoid tissue with FDCs network and IgG4-positive plasma cells identified here for the first time in AS patients’ inflamed synovial tissue.

  12. Influence of Anti-TNF and Disease Modifying Antirheumatic Drugs Therapy on Pulmonary Forced Vital Capacity Associated to Ankylosing Spondylitis: A 2-Year Follow-Up Observational Study

    Alberto Daniel Rocha-Muñoz

    2015-01-01

    Full Text Available Objective. To evaluate the effect of anti-TNF agents plus synthetic disease modifying antirheumatic drugs (DMARDs versus DMARDs alone for ankylosing spondylitis (AS with reduced pulmonary function vital capacity (FVC%. Methods. In an observational study, we included AS who had FVC% <80% at baseline. Twenty patients were taking DMARDs and 16 received anti-TNF + DMARDs. Outcome measures: changes in FVC%, BASDAI, BASFI, 6-minute walk test (6MWT, Borg scale after 6MWT, and St. George’s Respiratory Questionnaire at 24 months. Results. Both DMARDs and anti-TNF + DMARDs groups had similar baseline values in FVC%. Significant improvement was achieved with anti-TNF + DMARDs in FVC%, at 24 months, when compared to DMARDs alone (P=0.04. Similarly, patients in anti-TNF + DMARDs group had greater improvement in BASDAI, BASFI, Borg scale, and 6MWT when compared to DMARDs alone. After 2 years of follow-up, 14/16 (87.5% in the anti-TNF + DMARDs group achieved the primary outcome: FVC% ≥80%, compared with 11/20 (55% in the DMARDs group (P=0.04. Conclusions. Patients with anti-TNF + DMARDs had a greater improvement in FVC% and cardiopulmonary scales at 24 months compared with DMARDs. This preliminary study supports the fact that anti-TNF agents may offer additional benefits compared to DMARDs in patients with AS who have reduced FVC%.

  13. Influence of Anti-TNF and Disease Modifying Antirheumatic Drugs Therapy on Pulmonary Forced Vital Capacity Associated to Ankylosing Spondylitis: A 2-Year Follow-Up Observational Study

    Rocha-Muñoz, Alberto Daniel; Brambila-Tapia, Aniel Jessica Leticia; Zavala-Cerna, María Guadalupe; Vásquez-Jiménez, José Clemente; De la Cerda-Trujillo, Liliana Faviola; Vázquez-Del Mercado, Mónica; Rodriguez-Jimenez, Norma Alejandra; Díaz-Rizo, Valeria; Díaz-González, Viviana; Cardona-Muñoz, Ernesto German; Dávalos-Rodríguez, Ingrid Patricia; Salazar-Paramo, Mario; Gamez-Nava, Jorge Ivan; Nava-Zavala, Arnulfo Hernan; Gonzalez-Lopez, Laura

    2015-01-01

    Objective. To evaluate the effect of anti-TNF agents plus synthetic disease modifying antirheumatic drugs (DMARDs) versus DMARDs alone for ankylosing spondylitis (AS) with reduced pulmonary function vital capacity (FVC%). Methods. In an observational study, we included AS who had FVC% <80% at baseline. Twenty patients were taking DMARDs and 16 received anti-TNF + DMARDs. Outcome measures: changes in FVC%, BASDAI, BASFI, 6-minute walk test (6MWT), Borg scale after 6MWT, and St. George's Respiratory Questionnaire at 24 months. Results. Both DMARDs and anti-TNF + DMARDs groups had similar baseline values in FVC%. Significant improvement was achieved with anti-TNF + DMARDs in FVC%, at 24 months, when compared to DMARDs alone (P = 0.04). Similarly, patients in anti-TNF + DMARDs group had greater improvement in BASDAI, BASFI, Borg scale, and 6MWT when compared to DMARDs alone. After 2 years of follow-up, 14/16 (87.5%) in the anti-TNF + DMARDs group achieved the primary outcome: FVC% ≥80%, compared with 11/20 (55%) in the DMARDs group (P = 0.04). Conclusions. Patients with anti-TNF + DMARDs had a greater improvement in FVC% and cardiopulmonary scales at 24 months compared with DMARDs. This preliminary study supports the fact that anti-TNF agents may offer additional benefits compared to DMARDs in patients with AS who have reduced FVC%. PMID:26078986

  14. Golimumab 3-year safety update: an analysis of pooled data from the long-term extensions of randomised, double-blind, placebo-controlled trials conducted in patients with rheumatoid arthritis, psoriatic arthritis or ankylosing spondylitis

    Kay, Jonathan; Fleischmann, Roy; Keystone, Edward; Hsia, Elizabeth C.; Hsu, Benjamin; Mack, Michael; Goldstein, Neil; Braun, Jürgen; Kavanaugh, Arthur

    2013-01-01

    Objective To assess pooled golimumab safety up to year 3 of rheumatoid arthritis (RA), psoriatic arthritis (PsA) and ankylosing spondylitis (AS) trials. Methods Golimumab 50 and 100 mg, administered subcutaneously (SC) every 4 weeks (q4wk), were assessed in patients with active RA (methotrexate-naïve, methotrexate-experienced and anti-TNF (tumour necrosis factor)-experienced), PsA or AS, despite conventional therapy. Placebo control continued up to week (wk) 24 (wk 52, methotrexate-naïve), wi...

  15. Antibody activity in ankylosing spondylitis sera to two sites on HLA B27.1 at the MHC groove region (within sequence 65-85), and to a Klebsiella pneumoniae nitrogenase reductase peptide (within sequence 181-199)

    1990-01-01

    74 overlapping peptides of varying lengths from Klebsiella pneumoniae nitrogenase reductase (residues 181-199) and from the HLA B27.1 molecule (residues 65-85) were synthesized and tested by ELISA against sera from HLA B27+ ankylosing spondylitis (AS) patients, and sera from HLA B27+ and HLA B27- healthy first-degree relatives. Antibody activity in AS sera to Klebsiella peptides of four to eight amino acids was maximal with the peptide NSRQTDR. Activity to HLA B27 peptides was maximal with th...

  16. Autoantibodies to HLA B27 in the sera of HLA B27 patients with ankylosing spondylitis and Reiter's syndrome. Molecular mimicry with Klebsiella pneumoniae as potential mechanism of autoimmune disease

    1987-01-01

    Ankylosing spondylitis (AS) and Reiter's syndrome (RS) both show a strong correlation with the HLA B27 haplotype. We studied whether sharing of homologous amino acid sequences in the HLA B27 antigen with an invading microbe might occur, and if so, what is the biological significance of such homology. In a computer search of the Dayhoff data bank, we found a homology of six consecutive amino acids between HLA B27.1 antigen residues 72-77 and Klebsiella pneumoniae nitrogenase residues 188-193. ...

  17. 大灸疗法治疗强直性脊柱炎临床研究%Clinical Research on Moxibustion Therapy for the Treatment of Ankylosing Spondylitis

    张灵; 王振亮

    2012-01-01

    目的:观察大灸疗法治疗强直性脊柱炎的临床疗效.方法:将103例患者随机分为治疗组53例和对照组50例,对照组单独使用柳氮磺吡啶;治疗组在使用柳氮磺吡啶基础上加用通督开痹药饼(药物组成:淫羊藿15 g,狗脊30 g,怀牛膝30 g,杜仲15g,独活15 g,青风藤30 g,桂枝12 g,川芎15 g,红花10 g)进行大灸,均治疗3个月,观察治疗前后关节疼痛、腰部晨僵、“4”字试验、扩胸度、枕墙距、接地距;化验室检查C-反应蛋白(CRP)和血沉(ESR).结果:治疗组有效率96.23%,对照组有效率88.00%,两组有效率经统计处理,差异有统计学意义(P<0.05).对于各个观察指标治疗组与治疗前比较,差异有统计学意义(P<0.05),且关节疼痛、腰部晨僵、“4”字试验、CRP优于对照组(P<0.05).结论:大灸疗法治疗强直性脊柱炎疗效显著.%;Objective;To observe the clinical efficacy of moxibustion for the treatment of ankylosing spondylitis. Methods; 103 patients were randomly divided into the treatment group of S3 cases and control group of 50 cases. The control group was given salazosulfapyri-dine alone while the treatment group was given Tongdukaibi medicinal cake for moxibustion (Ingredients of the medicinal cake; Epimedi-um 15 g.Woodwardia 30 g,Achyranthes bidentata 30 g.eucommia 15 g.heracleum hemsleyanum michaux 15 g,Caulis 30 g.cinnamom twig 12 g,hemlock parsley 15 g.safflower 10 g) on the basis of the use of salazosulfapyridine. Both groups were treated for 3 months and then joint pain,lower back morning stiffness,Caenslen's test,degree of chest expanding,pillow-wall distance,ground distance were ob-served before and after treatment; laboratory tests such as C-reactive protein (CRP) and erythrocyte sedimentation rate(ESR) were checked before and after treatment. Results;The effective rate of the treatment group was 96.23% , while that of the control group was 88%. After statistical processing of the effective rates in

  18. Do patients with ankylosing spondylitis adapt to their disease? Evidence from a ‘then-test’ in patients treated with TNF inhibitors

    Essers, Ivette; van Tubergen, Astrid; Heldmann, Frank; Baraliakos, Xenofon; Braun, Jürgen; Kiltz, Uta; Boonen, Annelies

    2015-01-01

    Objective To investigate whether patients with ankylosing spondylitis (AS) adapt to their disease, using the ‘then-test’. Methods Data from patients participating in the AS Study for Evaluation of Recombinant Infliximab Therapy (ASSERT) and continuing in the European AS Infliximab Cohort (EASIC) were used. At 5 assessments in EASIC, patients were asked to rerate their global well-being before the start of infliximab in ASSERT. The patients evaluated their past situation by using a ‘then-test’ (‘retrospective patient global’). Initial and retrospective patient global were compared using a paired t test, and mixed linear models investigated whether the retrospective score of well-being was stable at all follow-up assessments in EASIC. Linear regression analysis explored whether treatment response was associated with the difference between the initial and retrospective score (‘gap’) while adjusting for possible confounders. Results 86 patients (mean age 39.8 years (SD=10.4), mean disease duration 10.8 years (SD=8.5)) contributed to the current analyses. At the time of starting infliximab, patients judged their global at 7.0 (SD=1.6), and with the ‘then-test’ at 7.2 (SD=2.3) (p=0.45). Time elapsed did not influence the ‘then-test’ (p=0.13). Multivariably, the gap was irrespective of treatment response, but associated with initial patient global (p<0.01) and initial Bath AS Disease Activity Index (p=0.02). Conclusions Patients with AS accurately judged their global well-being before starting treatment with tumour necrosis factor inhibition, even though substantial time had elapsed. The difference between initial and retrospective judgment was irrespective of treatment response. In this setting, the ‘then-test’ could not prove adaptation in AS. Trial registration number NCT01286545. PMID:26629367

  19. IMPACT OF THE THERAPY WITH TUMOR NECROSIS FACTOR α INHIBITORS ON THE FREQUENCY OF UVEITIS EXACERBATIONS IN PATIENTS WITH ANKYLOSING SPONDYLITIS

    Alla A Godzenko

    2014-01-01

    Full Text Available The course of uveitis in patients with ankylosing spondylitis (AS does not always correlate with inflammation in the axial skeleton and peripheral joints. Effect of tumor necrosis factor α (TNFα inhibitors on uveitis has been insufficiently studied yet, unlike their effect on the peripheral joints and spine.Objective. To compare the frequency of uveitis attacks in patients with AS during treatment with TNFα inhibitors and the conventional anti-inflammatory therapy.Materials and Methods. The study included 48 patients with AS and recurrent uveitis treated with TNFα inhibitors: 25 – infliximab, 15 – adalimumab, 9 – etanercept; 7 patients received two or more drugs sequentially. Median [25th, 75th percentiles] of the treatment duration was 3 [3.5; 5] years. The duration of treatment since the first attack of uveitis until administration of TNFα inhibitors was 5 [5; 9.7] years. Eighteen patients received only nonsteroidal anti-inflammatory drugs (NSAIDs, 30 patients received NSAIDs and basic anti-inflammatory drugs (DMARDs, including sulfasalazine (n = 23, methotrexate (n = 4, and cyclosporine (n = 4.Results. The median number of uveitis exacerbations during the standard anti-inflammatory therapy was 1 [0.4; 3] per year; during treatment with TNFα inhibitors – 0 [0; 0.5] per year (p = 0.0007. In 19 of 48 patients (40%, no exacerbations of uveitis were registered during therapy with these drugs. The frequency of uveitis attacks in patients treated with infliximab decreased from 1 [0.2; 2.75] to 0.1 [0; 0.8] episodes per year (p = 0.002, adalimumab – from 1.75 [1; 4.5] to 0 [0; 0.07] (p = 0.04, etanercept – from 0.95 [0.5; 1.75] to 0 [0; 0.07] (p = 0.001.Conclusion. Administration of TNFα inhibitors significantly reduces the frequency of uveitis attacks in patients with AS.

  20. Endoplasmic reticulum aminopeptidase-1 alleles associated with increased risk of ankylosing spondylitis reduce HLA-B27 mediated presentation of multiple antigens.

    Seregin, Sergey S; Rastall, David P W; Evnouchidou, Irini; Aylsworth, Charles F; Quiroga, Dionisia; Kamal, Ram P; Godbehere-Roosa, Sarah; Blum, Christopher F; York, Ian A; Stratikos, Efstratios; Amalfitano, Andrea

    2013-12-01

    Ankylosing spondylitis (AS) is a chronic systemic arthritic disease that leads to significant disability and loss of quality of life in the ∼0.5% of the worldwide human population it affects. There is currently no cure for AS and mechanisms underlying its pathogenesis remain unclear. AS is highly genetic, with over 70% of the genetic risk being associated with the presence of HLA-B27 and endoplasmic reticulum aminopeptidase-1 (ERAP1) alleles. Furthermore, gene-gene interactions between HLA-B27 and ERAP1 AS risk alleles have recently been confirmed. Here, we demonstrate that various ERAP1 alleles can differentially mediate surface expression of antigens presented by HLA-B27 on human cells. Specifically, for all peptides tested, we found that an ERAP1 variant containing high AS risk SNPs reduced the amount of the peptide presented by HLA-B27, relative to low AS risk ERAP1 variants. These results were further validated using peptide catalysis assays in vitro, suggesting that high AS risk alleles have an enhanced catalytic activity that more rapidly destroys many HLA-B27-destined peptides, a result that correlated with decreased HLA-B27 presentation of the same peptides. These findings suggest that one mechanism underlying AS pathogenesis may involve an altered ability for AS patients harboring both HLA-B27 and high AS risk ERAP1 alleles to correctly display a variety of peptides to the adaptive arm of the immune system, potentially exposing such individuals to higher AS risk due to abnormal display of pathogen or self-derived peptides by the adaptive immune system. PMID:24028501

  1. A cautionary note on the impact of protocol changes for genome-wide association SNP × SNP interaction studies: an example on ankylosing spondylitis.

    Bessonov, Kyrylo; Gusareva, Elena S; Van Steen, Kristel

    2015-07-01

    Genome-wide association interaction (GWAI) studies have increased in popularity. Yet to date, no standard protocol exists. In practice, any GWAI workflow involves making choices about quality control strategy, SNP filtering, linkage disequilibrium (LD) pruning, analytic tool to model or to test for genetic interactions. Each of these can have an impact on the final epistasis findings and may affect their reproducibility in follow-up analyses. Choosing an analytic tool is not straightforward, as different tools exist and current understanding about their performance is based on often very particular simulation settings. In the present study, we wish to create awareness for the impact of (minor) changes in a GWAI analysis protocol can have on final epistasis findings. In particular, we investigate the influence of marker selection and marker prioritization strategies, LD pruning and the choice of epistasis detection analytics on study results, giving rise to 8 GWAI protocols. Discussions are made in the context of the ankylosing spondylitis (AS) data obtained via the Wellcome Trust Case Control Consortium (WTCCC2). As expected, the largest impact on AS epistasis findings is caused by the choice of marker selection criterion, followed by marker coding and LD pruning. In MB-MDR, co-dominant coding of main effects is more robust to the effects of LD pruning than additive coding. We were able to reproduce previously reported epistasis involvement of HLA-B and ERAP1 in AS pathology. In addition, our results suggest involvement of MAGI3 and PARK2, responsible for cell adhesion and cellular trafficking. Gene ontology biological function enrichment analysis across the 8 considered GWAI protocols also suggested that AS could be associated to the central nervous system malfunctions, specifically, in nerve impulse propagation and in neurotransmitters metabolic processes. PMID:25939665

  2. Peptide handling by HLA-B27 subtypes influences their biological behavior, association with ankylosing spondylitis and susceptibility to endoplasmic reticulum aminopeptidase 1 (ERAP1).

    García-Medel, Noel; Sanz-Bravo, Alejandro; Alvarez-Navarro, Carlos; Gómez-Molina, Patricia; Barnea, Eilon; Marcilla, Miguel; Admon, Arie; de Castro, José A López

    2014-12-01

    HLA-B27 is strongly associated with ankylosing spondylitis (AS). We analyzed the relationship between structure, peptide specificity, folding, and stability of the seven major HLA-B27 subtypes to determine the role of their constitutive peptidomes in the pathogenicity of this molecule. Identification of large numbers of ligands allowed us to define the differences among subtype-bound peptidomes and to elucidate the peptide features associated with AS and molecular stability. The peptides identified only in AS-associated or high thermostability subtypes with identical A and B pockets were longer and had bulkier and more diverse C-terminal residues than those found only among non-AS-associated/lower-thermostability subtypes. Peptides sequenced from all AS-associated subtypes and not from non-AS-associated ones, thus strictly correlating with disease, were very rare. Residue 116 was critical in determining peptide binding, thermodynamic properties, and folding, thus emerging as a key feature that unified HLA-B27 biology. HLA-B27 ligands were better suited to TAP transport than their N-terminal precursors, and AS-associated subtype ligands were better than those from non-AS-associated subtypes, suggesting a particular capacity of AS-associated subtypes to bind epitopes directly produced in the cytosol. Peptides identified only from AS-associated/high-thermostability subtypes showed a higher frequency of ERAP1-resistant N-terminal residues than ligands found only in non-AS-associated/low-thermostability subtypes, reflecting a more pronounced effect of ERAP1 on the former group. Our results reveal the basis for the relationship between peptide specificity and other features of HLA-B27, provide a unified view of HLA-B27 biology and pathogenicity, and suggest a larger influence of ERAP1 polymorphism on AS-associated than non-AS-associated subtypes. PMID:25187574

  3. Long-term frequent use of non-steroidal anti-inflammatory drugs might protect patients with ankylosing spondylitis from cardiovascular diseases: a nationwide case-control study.

    Wen-Chan Tsai

    Full Text Available The objective of this case-control study was to investigate the risk of cardiovascular disease (CVD following non-steroidal anti-inflammatory drug (NSAID use in patients with ankylosing spondylitis (AS. A total of 10,763 new AS patients were identified from the National Taiwan Health Insurance claims database during the period from 1997 to 2008. In all, 421 AS patients with CVD were recruited as cases, and up to 2-fold as many sex- and age-matched controls were selected. Logistic regression models were used to estimate the odds ratio (OR between NSAID use and CVD incidence. The medication possession rate (MPR was used to evaluate NSAID exposure during the study period. AS patients had increased risk of CVD (OR, 1.68; 95% confidence interval (CI, 1.57 to 1.80. Among frequent (MPR≥80% COX II users, the risks for all types of CVD were ten times lower than those among non-users at 24 months (OR, 0.08; 95% CI, 0.01 to 0.92. Among frequent NSAID users, the risks of major adverse cardiac event (MACE were significantly lower at 12 months (OR, 0.23; 95% CI, 0.07 to 0.76--a trend showing that longer exposure correlated with lower risk. Regarding non-frequent NSAID users (MPR<80%, short-term exposure did carry higher risk (for 6 months: OR, 1.41; 95% CI, 1.07 to 1.86, but after 12 months, the risk no longer existed. We conclude that long-term frequent use of NSAIDs might protect AS patients from CVD; however, NSAIDs still carried higher short-term risk in the non-frequent users.

  4. Anti-tumor Necrosis Factor Alpha (Infliximab) Attenuates Apoptosis, Oxidative Stress, and Calcium Ion Entry Through Modulation of Cation Channels in Neutrophils of Patients with Ankylosing Spondylitis.

    Ugan, Yunus; Nazıroğlu, Mustafa; Şahin, Mehmet; Aykur, Mehmet

    2016-08-01

    Ankylosing Spondylitis (AS) is known to be associated with increased neutrophil activation and oxidative stress, however, the mechanism of neutrophil activation is still unclear. We have hypothesized that the antioxidant and anti-tumor necrosis factor properties of infliximab may affect intracellular Ca(2+) concentration in the neutrophils of AS patients. The objective of this study was to investigate the effects of infliximab on calcium signaling, oxidative stress, and apoptosis in neutrophils of AS patients. Neutrophils collected from ten patients with AS and ten healthy controls were used in the study. In a cell viability test, the ideal non-toxic dose and incubation time of infliximab were found as 100 μM and 1 h, respectively. In some experiments, the neutrophils were incubated with the voltage-gated calcium channel (VGCC) blockers verapamil + diltiazem (V + D) and the TRPM2 channel blocker 2-aminoethyl diphenylborinate (2-APB). Intracellular Ca(2+) concentration, lipid peroxidation, apoptosis, caspase 3, and caspase 9 values were high in neutrophils of AS patients and were reduced with infliximab treatment. Reduced glutathione level and glutathione peroxidase activity were low in the patients and increased with infliximab treatment. The intracellular Ca(2+) concentrations were low in 2-APB and V + D groups. In conclusion, the current study suggests that infliximab is useful against apoptotic cell death and oxidative stress in neutrophils of patients with AS, which seem to be dependent on increased levels of intracellular Ca(2+) through activation of TRPM2 and VGCC. PMID:26956056

  5. Increased occurrence of spinal fractures related to ankylosing spondylitis: a prospective 22-year cohort study in 17,764 patients from a national registry in Sweden

    Robinson Yohan

    2013-01-01

    Full Text Available Abstract Background Ankylosing spondylitis (AS is a rheumatoid disease leading to progressive ossification of the spinal column. Patients suffering from AS are highly susceptible to unstable vertebral fractures and often require surgical stabilisation due to long lever arms. Medical treatment of these patients improved during the last decades, but until now it is unknown whether the annual number of spinal fractures changed during the last years. Since the annual count of fracture is an effective measure for efficacy of injury prevention and patient safety in AS patients, the current recommendations of activity have to be revised accordingly. Methods Data for all patients with AS treated as inpatients between 01/01/1987 and 31/12/2008 were extracted from the Swedish National Hospital Discharge Registry (SNHDR. The data in the registry are collected prospectively, recording all inpatient admissions throughout Sweden. The SNHDR uses the codes for diagnoses at discharge according to the Swedish versions of the International Classification of Diseases (ICD-9 and ICD-10. Results During the years from 1987 to 2008 17,764 patients with AS were treated as inpatients; of these 724 patients were treated due to spinal fractures. The annual number of cervical, thoracic and lumbar fractures in the registry increased until 2008 (r = 0.94. Conclusions Despite the improved treatment of AS the annual number of vertebral fractures requiring inpatient care increased during the last two decades. Possible explanations are population growth, greater awareness of fractures, improved diagnostics, improved emergency care reducing fatalities, and a higher activity level of patients receiving modern medical therapy. Obviously the improvement of medical treatment did not reduce the susceptibility of these patients to unstable fractures. Thus the restrictive injury prevention recommendations for patients with AS cannot be defused, but must be critically revised to

  6. Interaction between HLA-B60 and HLA-B27 as a Better Predictor of Ankylosing Spondylitis in a Taiwanese Population.

    James Cheng-Chung Wei

    Full Text Available Ankylosing spondylitis (AS is a form of chronic inflammatory spondyloarthritis (SpA that causes pain and stiffness in spines or joints. Human leukocyte antigen B27 (HLA-B27 and B60 (HLA-B60 have been reported as major genetic risk factors of AS. In addition, rs13202464, located on major histocompatibility complex (MHC region, showed high sensitivity (98.7% and specificity (98.0% for HLA-B27.The aim of our study is to test whether the interaction between HLA-B60 and HLA-B27 (rs13202464 can serve as a better predictor of AS. We have genotyped HLA-B60 and rs13202464 among 471 patients with AS and 557 healthy subjects. Combined risk factors were investigated to test the biological interaction.Our results indicated that the relative risk (RR for HLA-B27+/HLA-B60- was 152 (95% CI 91 to 255 and it increased to 201 (95% CI 85 to 475 in HLA-B27+/HLA-B60+ patients (with HLA-B27-/HLA-B60- as reference. Combinational analysis of two risk factors (HLA-B27+/HLA-B60+ showed a relative excess risk due to interaction (RERI of 46.79 (95% CI: -117.58 to 211.16, attributable proportion (AP of 0.23 (95% CI: -0.41 to 0.88 and a synergy index (S of 1.31 (95% CI: 0.56 to 3.04.In conclusion, genetic interaction analysis revealed that the interaction between HLA-B60 and HLA-B27 is a better marker for the risk of AS susceptibility in a Taiwanese population.

  7. The health-related quality of life in rheumatoid arthritis, ankylosing spondylitis, and psoriatic arthritis: a comparison with a selected sample of healthy people

    Intorcia Michele

    2009-03-01

    Full Text Available Abstract Background The health-related quality of life (HRQL is an important indicator of the burden of musculoskeletal disease. The Medical Outcome Study Short-Term 36 (SF-36 is the most used tool that evaluates HRQL as a subjective perception about psychological and physical limitations due to an underlying illness. The purpose of this study was to compare the HRQL scores among patients with rheumatoid arthritis (RA, psoriatic arthritis (PsA and ankylosing spondylitis (AS and a selected sample of health people and determine their relationship with measures of clinical condition. Methods 799 patients (469 with RA, 164 with AS, 65 with axial PsA and 101 with peripheral PsA accepted the invitation to participate. 1579 healthy controls were used for the comparison. We calculated scores for the eight SF-36 subscales, the Physical Component Summary (PCS score, and the Mental Component Summary (MCS score, according to published algorithms. Disease-related characteristics included disease duration, comorbidity, a measure for disease activity and for radiographic damage. The presence of comorbidity was ascertained through patient's self-reports by the Self-Administered Comorbidity Questionnaire (SCQ. Comparison were performed with respect to sex and age, and s-scores were calculated for comparison with the norm. Multivariate analyses were used to assess the relationship between HRQL and radiographic damage, disease activity, and socio-demographic data. Results The four inflammatory rheumatic diseases (IRD, compared to controls, significantly impaired all eight health concepts of the SF-36 (p Conclusion Chronic IRD have a clearly detrimental effect on the HRQL in both sex and in age groups, and physical domain is more impaired than mental and social ones.

  8. Determination of IL1 R2, ANTXR2, CARD9, and SNAPC4 single nucleotide polymorphisms in Iranian patients with ankylosing spondylitis.

    Momenzadeh, Parisa; Mahmoudi, Mahdi; Beigy, Maani; Garshasbi, Masoud; Vodjdanian, Mahdi; Farazmand, Ali; Jamshidi, Ahmad Reza

    2016-03-01

    Ankylosing spondylitis (AS) is a chronic inflammatory disease of unknown origin, while both genetic and environmental factors have been demonstrated to be etiologically involved. Recent genome-wide association and replication studies have suggested that anthrax toxin receptor 2 (ANTXR2), interleukin-1 receptor 2 (IL1R2), caspase recruitment domain-containing protein 9 (CARD9), and small nuclear RNA-activating complex polypeptide 4 (SNAPC4) seem to be associated with AS pathogenesis. This case-control study was performed on 349 unrelated AS patients and 469 age- and gender-matched healthy controls, to investigate whether these non-MHC genes (IL1R2 rs2310173, ANTXR2 rs4333130, CARD9 rs4077515, and SNAPC4 rs3812571) influence the AS risk in Iranian population. ANTXR2 rs4333130 allele C (p = 0.0328; OR 0.744, 95% CI 0.598-0.927) and genotype CC (p = 0.0108; OR 0.273, 95% CI 0.123-0.605) were found to be significantly protective against AS. No other associations were found between AS and studied genes. The association between ANTXR2 rs4333130 and AS was independent of HLA-B27 status. Moreover, we found clinical disease severity scores (BASDAI and BASFI) and pain score were higher in ANTXR2 rs4333130 CT genotype. However, we observed that CARD9 allele C (p = 0.012) and genotype CC (p = 0.012) were significant protective factors against AS only in HLA-B27-negative patients, and IL1R2 rs2310173 genotype GT was mildly protective against AS only in HLA-B27-negative status. These findings support the role of non-MHC pathogenic pathways in susceptibility to AS and warrants more comprehensive studies focusing on these non-MHC pathways for developing novel therapeutic strategies. PMID:26590821

  9. Value of Combination Detection of HLA-B27 and Sacroiliac Joint CT Scanning in Diagnosis of Ankylosing Spondylitis%骶髂关节CT及HLA-B27联合检测在强直性脊柱炎诊断中的价值

    王红; 金笛; 肖红霞

    2012-01-01

    Objective To study the relativity between the feature of sacroiliac joint CT and the positive rate of HLA - B27 in the e-raly diogonosis of ankylosing spondylitis, in order to improve the diagnostic level of the ankylosing spondylitis. Methods Sacroiliac joint CT features and the positive rate of HLA - B27 of 162 cases diagnosed as ankylosing spondylitis were collectively analysed. Results 6. 2% of sacroiliac joints CT of 162 patients were normal but 93. 8% abnormal. Positive rate of HLA - B27 was 84% . Cases simultaneously existing both HLA - B27 posibility and abnormity of sacroiliac joints CT were 79% , but cases of HLA - B27 negativity and abnormity of sacroiliac joints CT were 14. 8% . Cases of HLA - B27 positive but sacroiliac joints CT normal were 6. 2% . Compared with the result of HLA - B27 and sacroilial joint CT,x2 =2.118,P>0.01. Conclusion HLA - B27 and sacroiliac joints CT are important reference indicators for diagnosing ankylosing spondylitis. The correspondence between the results of HLA - B27 and the sacroiliac joint CT is high. There is no significant differences in two kinds of results. Detection of HLA - B27 in combination of clinical symptoms is beneficial for early diagnosis. Characteristics of sacroiliac joints CT could be used as important foundation in early, developing and late phases.%目的 探讨骶髂关节CT及HLA-B27联合检测在强直性脊柱炎早期诊断中的应用,以提高强直性脊柱炎的诊断水平.方法 分析经临床诊断为强直性脊柱炎的162例患者HLA-B27的阳性率及骶髂关节CT的特点,对其结果进行总结性分析.结果 162例患者中骶髂关节CT异常者占93.8%.HLA-B27阳性率为85.2%.HLA-B27阳性及骶髂关节CT异常表现并存占79%;HLA-B27阴性、骶髂关节异常占14.8%;HLA-B27阳性而骶髂关节正常者6.2%.HLA-B27与骶髂关节CT两种结果比较,x2 =2.118,P >0.01.结论 HLA-B27及骶髂关节CT是诊断强直性脊柱炎的重

  10. Combined anterior and posterior surgery for treatment of cervical fracture-dislocation in patients with ankylosing spondylitis

    L(U) Guo-hua; WANG Bing; KANG Yi-jun; LU Chang; MA Ze-min; DENG You-wen

    2009-01-01

    To discuss the pathological characteristics of cervical spinal fracture complicating ankylosing spondyli-tis-(AS) and the effect of combined anterior and posterior operation. Methods: Eighteen AS patients with traumatic cervical fracture-dislocation were treated operatively from January 2000 to January 2006. The symptom duration of AS was 14.5 years on average. Three cases had undergone osteotomy in lumbar spine. There were 4 cases of Grade A, 3 cases of Grade B, 9 cases of Grade C and 2 cases of Grade D accord-ing to Frankel's score. There were 15 cases of Grade Ⅲ dislocation and 3 cases of Grade Ⅱ. All patients underwent surgical procedures by combined anterior and posterior approach.Results: There were 4 anterior-posterior procedures, 8 anterior-posterior-anterior procedures and 6 posterior-an-terior procedures. Seven patients had one stage operation and 11 cases underwent two stage surgeries. There was certain extent of neorological improvement in 14 incomplete paraplegic patients, but no improvement in 4 complete paraplegic patients. The follow-up period was 21.2 months on average and the time for bone fusion was 3.6 months. There were 4 complications during operation and a long-term complication in follow-up. Conclusions: The study suggests that anterior com-bined with posterior approach makes the spine stable and relieves the pressure immediately. It is a reasonable surgical strategy for treatment of cervical spinal fracture-dislocation with AS.

  11. KIR3DL1 interaction with HLA-B27 is altered by ankylosing spondylitis associated ERAP1 and enhanced by MHC class I cross-linking.

    Abdullah, Hasan; Zhang, Zhenbo; Yee, Kirby; Haroon, Nigil

    2015-01-01

    Ankylosing spondylitis (AS) is a chronic, inflammatory arthritis of the spine and peripheral joints linked to the antigen presenting molecule HLA-B27. The risk of AS is increased in patients possessing endoplasmic reticulum aminopeptidase-1 (ERAP1) polymorphisms rs30187 and rs27044 encoding amino acid changes K528R and Q730E, respectively. Dysfunction of ERAP1 is hypothesized to cause changes in expression of HLA-B27 classical (pHLA) and non-classical (FHC) conformers on antigen presenting cells (APCs), which interact with the natural killer (NK) cell receptor KIR3DL1. Dysregulation of this pathway may be pathogenic in AS. APC cell lines expressing HLA-B27 were found to inhibit cytokine production in KIR3DL1+ NK cells due to decreased APC-NK cell adhesion, and possibly activation of receptor down-regulation. Blocking pHLA and FHC reveals that both conformers inhibit cytokine production through KIR3DL1. KIR3DL1 affinity and HLA-B27 surface expression studies suggest that ERAP1 R528 and E730 expression protects from AS by generating sub-optimal pHLA, causing reduced KIR3DL1 affinity and weaker cytokine inhibition. Secondarily we observed that KIR3DL1 binding to C1R-B27 APCs is enhanced by blocking pHLA, but not FHC, raising the possibility that antibody mediated HLA-B27 cross-linking may be important in enhancing KIR3DL1+ NK cell function. This study establishes the role of both FHC and pHLA in modulating NK cell cytokine secretion and adhesion functions by interacting with KIR3DL1. This interaction varies depending on the AS association status of the ERAP1 variant expressed in APCs. Additionally antibody cross-linking of HLA-B27 enhances KIR3DL1 binding and as such could be an important pathogenic mechanism in AS. PMID:26321090

  12. Is nephrolithiasis an unrecognized extra-articular manifestation in ankylosing spondylitis? A prospective population-based Swedish national cohort study with matched general population comparator subjects.

    Ane Krag Jakobsen

    Full Text Available BACKGROUND: Ankylosing spondylitis (AS is associated with several extra-articular manifestations. Nephrolithiasis (NL has not been recognized as one of those, however, several factors known to increase the risk of NL are at play in AS patients. The objective was to estimate rates and predictors of NL in Swedish patients with AS compared to the general population. METHODS AND FINDINGS: We performed a prospective population-based nationwide cohort study based on linkage of data from Swedish registries. 8,572 AS patients were followed for 49,258 person-years (py and 39,639 matched general population comparators were followed for 223,985 py. Patients were followed prospectively together with comparator subjects from January 2001 through December 2009. The first occurrence of NL during follow-up was the primary outcome. Hazard Ratios (HR were used to compare these rates adjusting for comorbidities and treatment, and to assess predictors for NL. Mean age at study entry was 46 years (inter quartile range 36-56 years, 65% were males. Based on 250 vs. 466 NL events, the adjusted HR of NL in AS patients was 2.1 (95%CI 1.8 to 2.4. Predictors of NL within the AS group included prior diagnosis of inflammatory bowel disease (IBD (HR 2.3; 95%CI 1.7 to 3.3, prior diagnosis of NL (HR 16.4; 95%CI 11.5 to 23.4, and patients receiving anti-TNF treatment (HR 1.6; 95%CI 1.2 to 2.1. Male sex was a risk factor for NL both in AS patients and in the general population. LIMITATIONS: The risk for residual confounding and inability to study the chemical nature of NL were considered the main limitations of the study. CONCLUSIONS: Patients with AS are at increased risk of NL, which may be considered a novel extra-articular manifestation. Previous history of NL, IBD, AS disease severity and male sex were identified as predictors of NL in AS.

  13. Longitudinal Numbers-Needed-To-Treat (NNT for Achieving Various Levels of Analgesic Response and Improvement with Etoricoxib, Naproxen, and Placebo in Ankylosing Spondylitis

    Wang Hongwei

    2011-07-01

    Full Text Available Abstract Background Clinical analgesic trials typically report response as group mean results. However, research has shown that few patients are average and most have responses at the extremes. Moreover, group mean results do not convey response levels and thus have limited value in representing the benefit-risk at an individual level. Responder analyses and numbers-needed-to-treat (NNT are considered more relevant for evaluating treatment response. We evaluated levels of analgesic response and Bath Ankylosing Spondylitis Disease Activity Index (BASDAI score improvement and the associated NNTs. Methods This was a post-hoc analysis of a 6-week, randomized, double-blind study (N = 387 comparing etoricoxib 90 mg, etoricoxib 120 mg, naproxen 1000 mg, and placebo in AS. Spine pain and BASDAI were measured on a 100-mm visual analog scale. The number and percentage of patients achieving ≥30% and ≥50% improvement in both BASDAI and spine pain were calculated and used to determine the corresponding NNTs. Patients who discontinued from the study for any reason were assigned zero improvement beyond 7 days of the time of discontinuation. Results For etoricoxib 90 mg, etoricoxib 120 mg and naproxen 1000 mg, the NNTs at 6 weeks compared with placebo were 2.0, 2.0, and 2.7 respectively for BASDAI ≥30% improvement, and 3.2, 2.8, and 4.1 for ≥50% improvement. For spine pain, the NNTs were 1.9, 2.0, and 3.2, respectively, for ≥30% improvement, and 2.7, 2.5, and 3.7 for ≥50% improvement. The differences between etoricoxib and naproxen exceeded the limit of ±0.5 units described as a clinically meaningful difference for pain. Response rates and NNTs were generally similar and stable over 2, 4, and 6 weeks. Conclusions For every 2 patients treated with etoricoxib, 1 achieved a clinically meaningful (≥30% improvement in spine pain and BASDAI beyond that expected from placebo, whereas the corresponding values were approximately 1 in every 3 patients

  14. 影响强直性脊柱炎患者治疗依从性相关因素分析%Analysis on the related factors about treatment compliance of Ankylosing Spondylitis patients

    樊宇华; 孙瑾

    2012-01-01

    Objective To explore the current status of treatment compliance and the related factors among patients with Ankylosing Spondylitis. Method A total of 100 clients who were suffered from Ankylosing Spondylitis were enrolled and a self - designed questionnaire about general information and treatment compliance evaluation was employed. The factors such as sex,age,marital status,education level etc,was compared between the compliance group and non - compliance group. Results The compliance rate was 38.00%. The compliance rates of the female, married and high - level education were higher than those of the male, un - married and low - level education clients, and the differences were statistically significant (P < 0.05). The influencing factors were lack of knowledge, self - factors, high cost of treatment and so on. Conclusion There are many factors which affect the treatment compliance of Ankylosing Spondylitis patients,and the targeted nursing interventions should be proposed so as to improve the compliance.%目的 调查影响强直性脊柱炎患者治疗依从性及不依从的原因.方法 采用一般资料问卷和治疗依从性测评表调查100例强直性脊柱炎患者治疗依从性,比较依从组与不依从组患者性别、年龄、婚姻状况、文化程度等因素上的差异,并对不依从的原因进行调查.结果 强直性脊柱炎治疗依从率为38.00%;强直性脊柱炎患者的治疗依从性女性高于男性、已婚者高于未婚者、文化程度较高者高于较低者(P<0.05);强直性脊柱炎患者治疗依从差的原因为知识缺乏、自身因素、治疗费用昂贵等.结论 强直性脊柱炎患者治疗依从性较差,其原因较多,应实施有针对性的护理措施以提高其依从性.

  15. 强直性脊柱炎64例髋关节病变X线与MRI特点分析%Analysis of X-ray and MRI characteristic of hip-joint lesion in 64 patients with ankylosing spondylitis

    倪春五; 李志军

    2014-01-01

    目的 探讨强直性脊柱炎(AS)髋关节损害的x线与MRI表现特点,为AS的诊断、病情活动性判断、治疗反应、预后与鉴别诊断提供借鉴.方法 分析64例AS髋关节病变的X线片与MRI表现特点.结果 X线片示有髋关节囊变42例,髋关节骨质增生47例,髋关节间隙狭窄13例,髋关节骨质疏松11例.MRI发现:有滑膜炎症改变64例,软骨下骨髓水肿48例,关节软骨破坏、关节面下囊状骨改变42例,肌腱、韧带附着点炎24例,关节间隙改变13例.结论 AS髋关节病变X线片下通常只有髋关节囊性变、骨质增生及关节间隙狭窄等表现,通过MRI检查可以发现大多数AS患者有滑膜炎、软骨下骨髓水肿及关节软骨破坏、关节节面下囊状骨改变,提示病变活动;AS患者疑有髋关节病变者做MIR检查有利于病情活动性判断与治疗方案选择.%Objective To explore the X-ray and MRI manifestations of hip joint lesion in ankylosing spondylitis patients and give useful reference for diagnosis,assess of disease activity and therapeutic response and prognosis.Methods The X-ray manifestation and MRI manifestation of 64 cases of patients with ankylosing spondylitis were analyzed.Results In X-ray analyzed acetabulum joint changes 42,hip joint hyperostosis 47,hip joint interval narrow 13,hip joint osteoporosis 11,MRI analyzed synovial inflammatory change 64,subcartilaginous bone marrow edema 48,joint cartilage lesion and joint surface saccular change 42,tendon and ligament of enthesopathy 24,joint space change 13.Conclusion In patients with ankylosing spondylitis,X-ray manifestation of hip-joint lesion commonly included leacetabulum joint changes,hip joint hyperostosis and hip joint space narrowing while MRI manifestation included inflammation of synovium,edema of subcartilaginous bone marrow,and tendon of enthesopathy which suggested high disease activity.To suspicious hip-joint lesion in patients with ankylosing spondylitis

  16. Long-term effect of total hip arthroplasty on ankylosing spondylitis complicated with ankylosing hip%全髋关节置换术治疗强直性脊柱炎髋关节强直84例的长期效果观察

    于鸿; 王秀利; 张弛; 王义生

    2016-01-01

    Objective To investigate the long-term effect of total hip arthroplasty on ankylosing spondylitis compli-cated with ankylosing hip. Methods From June 1992 to June 2006,84 cases(146 hips)of ankylosing spondylitis com-plicated with ankylosing hip were treated by total hip arthroplasty. Preoperative and postoperative outcomes with hip pain in-dex(0 - 10),Harris score,the improvement of hip joint activity and complications were observed to evaluate the curative effect. Results The mean follow-up was 12. 5 years(9 - 20 years). To the final follow-up,hip pain index,Harris score and hip joint activity were obviously improved,there were significant differences(P < 0. 05)between preoperative and final follow-up;the incidence of postoperative complications was 6. 2% ,among which 6 hips(4. 1% )with aseptic loosening and sinking,2 hips(1. 4% )with acetabulum loosening and shift,and heterotopic ossification in 1 case(0. 7% ),no nerve and vascular injury,prosthesis dislocation,or infection. Conclusions Total hip arthroplasty is an effective method for the treatment of ankylosing spondylitis complicated with ankylosing hip,with satisfying long-term effect.%目的:探讨全髋关节置换术治疗强直性脊柱炎髋关节强直的长期效果。方法1992年6月至2006年6月采用全髋关节置换术治疗强直性脊柱炎髋关节强直84例(146髋),术后对患者进行随访,观察手术前后髋关节疼痛指数、髋关节 Harris 评分、髋关节活动度的改善情况及术后并发症,评估疗效。结果术后平均随访12.5年(9~20年),至末次随访:患者髋关节疼痛指数、髋关节 Harris 评分、髋关节活动度均得到明显改善,术前与末次随访之间比较差异有统计学意义(P <0.05);术后并发症发生率为6.2%,其中股骨柄无菌性松动下沉者6髋(4.1%),髋臼松动移位2髋(1.4%),异位骨化1例(0.7%),未发现神经血管损伤、假体脱位、感染等并发

  17. 强直性脊柱炎伴发葡萄膜炎18例临床分析%Clinical analysis of ankylosing spondylitis associated with uveitis in 18 cases

    陈丽华; 伍雪芬; 许福荣; 黄碧文; 冯劲

    2014-01-01

    目的:探讨强直性脊柱炎( ankylosing spondylitis ,AS)伴发葡萄膜炎的临床特征、诊断、治疗及预后。  方法:对2006-06/2012-06在我院就诊的18例18眼葡萄膜炎患者的临床表现、实验室检查以及临床诊疗情况进行系统回顾分析。  结果:AS伴发葡萄膜炎患者18例,男16例,女2例。 AS发病年龄为33±11岁;葡萄膜炎发病年龄29±13岁。其中13例患者先确诊为AS后就诊于眼科,5例患者以葡萄膜炎首诊于眼科后确诊为AS。18例患者葡萄膜炎持续时间为15~46(平均27±7)d,其中13例有明确葡萄膜炎复发病史。所有患者X线影像学检查均显示骶髂关节炎,其中13例(72%) HLA-B27检查阳性,12例(66.6%)血沉升高,7例(38.8%) C反应蛋白>10 mg/L。经过糖皮质激素和睫状肌麻痹剂滴眼液治疗后18例患者前部葡萄膜炎均治愈。  结论:AS伴发葡萄膜炎多累及中青年男性,多单眼发病,易复发;根据典型的临床特征及影像学检查结果可明确诊断;及时有效的治疗均能取得良好效果。%AIM: To investigate the clinical characteristics, diagnosis, treatment and prognosis of ankylosing spondylitis ( AS) associated with uveitis. METHODS: The retrospective analysis of clinical manifestation, laboratory examination and clinical diagnosis and treatment on 18 patients with uveitis ( 18 eyes) from June 2006 to June 2012 in our hospital. RESULTS:A total of 18 patients with AS associated with uveitis, including sixteen males and two females were included.Onset age of AS patients was ( 33 ±11 ) years old, while uveitis patient was (29±13) years old.Thirteen patients were diagnosed as AS first and then went to ophthalmology department; other five patients were diagnosed as uveitis first but later as AS.Uveitis duration of 18 patients was 15-46 (27±7) days and thirteen patients among them had clear recurrent history. All patients

  18. Biologisk behandling af spondylitis ankylopoietica

    Freiesleben, S.; Schou, M.

    2008-01-01

    All of the three well-known TNF alpha inhibitors (infliximab, adalimumab and etanercept) have a rapidly occurring and long-lasting effect in ankylosing spondylitis (AS). The IL-1 antagonist, anakinra, has been investigated in two open label studies with partially conflicting results. Apart from...

  19. Clinical diaglosis and treatment of uveitis associated with ankylosing spondylitis%强直性脊柱炎伴发葡萄膜炎的临床特征与治疗

    沈蕾

    2010-01-01

    目的 探讨强直性脊柱炎伴发葡萄膜炎的临床特征和治疗.方法 收集2004年1月至2009年1月就诊的强直性脊柱炎伴发葡萄膜炎的患者31例(31只眼),进行视力、裂隙灯检查、眼压、B超、扩瞳后90D前置镜检查眼底,必要的患者行眼底荧光造影,除局部糖皮质激素和睫状肌麻痹剂治疗外,部分患者给予低剂量的口服糖皮质激素,分别于3d、7d、15d复诊并检查视力.结果 31例患者均为男性,葡萄膜炎的发病年龄为(32±15)岁.所有患眼均表现为急性非肉芽肿性前葡萄膜炎,23例眼底无特殊,8例眼底视盘边界不清,血管迂曲扩张,荧光造影证实视盘高荧光,黄斑及网膜无异常荧光.加用口服糖皮质激素视力提高.所有患者在15d复诊时视力均有明显好转.结论 虽然强直性脊柱炎所伴发的葡萄膜炎主要以前葡萄膜炎为主,但对患者进行眼底检查是必要的.%Objective To investigate the clinical features and treatment of uveitis associated with ankylosing spondylitis. Methods Thirty-one patients were diagnosed as uveitis associated with ankylosing spondylitis from January 2004 to January 2009 in Wuhan Aier Eye Hospital. Examinations of naked eyesight,slit-lamp biomicroscopy, tonometry, B-scan, slit-lamp biomicroscopy with 90D fundus contact lens were performed on every patients, fundus fluorescein angiography were carried on some patient if necessary. Treatment with corticosteroids eye drops and cycloplegic agent was used in all patients, low dose of oral corticosteroid combined with eye drops were given for serious cases. All patients were followed up at the 3rd, 7th, 15th day.Results All of the patients were male. The age of the patients at onset ofuveitis was (32± 15) years old. The images of FFA indicated hyperfluorescence of optic disc in 8 eyes at the late phase. All patients showed acute nongranulamatous anterior uveitis. There was obvious improvement in naked eyesight of all patients

  20. Equilíbrio estático e dinâmico no indivíduo com espondilite anquilosante: revisão da literatura Static and dynamic balance in subjects with ankylosing spondylitis: literature review

    José Eduardo Pompeu

    2012-06-01

    Full Text Available Com o objetivo de analisar as alterações musculoesqueléticas dos indivíduos com espondilite anquilosante (EA e suas repercussões sobre o controle postural, realizou-se uma revisão bibliográfica nas bases de dados da BIREME e EBSCO HOTS e no site Pubmed com as palavras-chave: "ankylosing spondylitis", "postural balance" e "posture". Foram selecionados artigos envolvendo seres humanos e que analisavam o controle postural e a biomecânica dos indivíduos com EA, nos idiomas inglês e português, publicados no período entre 1999 e 2010. Do total de artigos encontrados, apenas quatro preencheram os requisitos. Desses, três compararam os resultados de pacientes com EA com os dados obtidos de indivíduos saudáveis, e um analisou apenas indivíduos com EA. Nenhum artigo continha o mesmo método de análise postural. Para avaliação do equilíbrio foram utilizadas a Escala de Equilíbrio de Berg, a Plataforma de Força e a Magnometria. Os principais desvios posturais encontrados foram aumento da cifose torácica e flexão do quadril, que levam a uma anteriorização do centro de gravidade corporal, apresentando flexão do joelho e plantiflexão do tornozelo como compensação para manter o equilíbrio. Apenas um autor encontrou piora do equilíbrio funcional nos sujeitos com EA. Todos os métodos de avaliação utilizados foram considerados capazes de mensurar o equilíbrio, não havendo uma escala específica para pacientes com EA.To analyze the musculoskeletal changes of individuals with ankylosing spondylitis (AS and their repercussions on postural control, a literature review was carried out in the BIREME and EBSCO HOTS databases and Pubmed site with the following keywords: "ankylosing spondylitis", "postural balance", and "posture". Articles involving human beings, assessing the postural control and balance of individuals with AS, written in English or Portuguese and published between 1999 and 2010, were selected. Of the total number of

  1. A randomised, double-blind, multicentre, parallel-group, prospective study comparing the pharmacokinetics, safety, and efficacy of CT-P13 and innovator infliximab in patients with ankylosing spondylitis: the PLANETAS study

    Park, Won; Hrycaj, Pawel; Jeka, Slawomir; Kovalenko, Volodymyr; Lysenko, Grygorii; Miranda, Pedro; Mikazane, Helena; Gutierrez-Ureña, Sergio; Lim, MieJin; Lee, Yeon-Ah; Lee, Sang Joon; Kim, HoUng; Yoo, Dae Hyun; Braun, Jürgen

    2013-01-01

    Objectives To compare the pharmacokinetics (PK), safety and efficacy of innovator infliximab (INX) and CT-P13, a biosimilar to INX, in patients with active ankylosing spondylitis (AS). Methods Phase 1 randomised, double-blind, multicentre, multinational, parallel-group study. Patients were randomised to receive 5 mg/kg of CT-P13 (n=125) or INX (n=125). Primary endpoints were area under the concentration-time curve (AUC) at steady state and observed maximum steady state serum concentration (Cmax,ss) between weeks 22 and 30. Additional PK, efficacy endpoints, including 20% and 40% improvement response according to Assessment in Ankylosing Spondylitis International Working Group criteria (ASAS20 and ASAS40), and safety outcomes were also assessed. Results Geometric mean AUC was 32 765.8 μgh/ml for CT-P13 and 31 359.3 μgh/ml for INX. Geometric mean Cmax,ss was 147.0  μg/ml for CT-P13 and 144.8 μg/ml for INX. The ratio of geometric means was 104.5% (90% CI 94% to 116%) for AUC and 101.5% (90% CI 95% to 109%) for Cmax,ss. ASAS20 and ASAS40 responses at week 30 were 70.5% and 51.8% for CT-P13 and 72.4% and 47.4% for INX, respectively. In the CT-P13 and INX groups more than one adverse event occurred in 64.8% and 63.9% of patients, infusion reactions occurred in 3.9% and 4.9%, active tuberculosis occurred in 1.6% and 0.8%, and 27.4% and 22.5% of patients tested positive for anti-drug antibodies, respectively. Conclusions The PK profiles of CT-P13 and INX were equivalent in patients with active AS. CT-P13 was well tolerated, with an efficacy and safety profile comparable to that of INX up to week 30. PMID:23687259

  2. Early diagnosis of the Spondyloarthropathies

    Spondyloarthropathies are a cluster of chronic inflammatory diseases that primarily include ankylosing spondylitis, reactive arthritis, psoriatic arthritis; arthritis associated with inflammatory bowel diseases and undifferentiated spondyloarthropathies. The most common subgroups of spondyloarthropathies are ankylosing spondylitis and undifferentiated spondyloarthropathy. The diagnosis of ankylosing spondylitis is mainly based on unequivocal radiographic sacroiliitis of at least grade 2 bilaterally or grade 3 unilaterally. How ever, in the early phase of disease, conventional radiographs are often too insensitive to show sacroiliitis and it usually takes several years for definite radiographic sacroiliitis to evolve. Thus, the diagnosis of ankylosing spondylitis is a commonly delayed by 8 to 11 years after the onset of symptoms. As a result, diagnosing axial spondyloarthropathy in the absence of radiographic sacroiliitis is very difficult to rheumatologists. In the early phase of disease, HLA B27 test and magnetic resonance imaging of sacroiliac joints may be helpful to the early diagnosis. In the presence of chronic low back pain the probability of axial spondyloarthropathy is about 5% and is about 14% if the back pain is inflammatory. The presence of = 3 features of spondyloarthropathy (heel pain, uveitis, dactylitis, positive family history, alternating buttock pain, psoriasis, inflammatory bowel disease, asymmetrical arthritis, positive response to anti-inflammatory drugs) increase the probability of axial spondyloarthropathy to 90%. Both, the positive HLA B27 and magnetic resonance imaging with signs of sacroiliitis increase the probability of spondyloarthropathy, particularly in patients without spondyloarthropathies features or with only 1 or 2 features. Since ankylosing spondylitis in association with psoriasis and inflammatory bowel disease is often HLA B27 negative, this test is of limited value under theses circumstances. Is important to consider that

  3. 异体输血缓解强直性脊柱炎的髋关节疼痛%Allogeneic blood transfusion alleviates hip joint pain induced by ankylosing spondylitis

    张鑫; 王鹏; 吴燕峰; 杨睿; 黄霖; 唐勇; 李玉希; 高梁斌; 沈慧勇

    2014-01-01

    BACKGROUND:Pain is the main clinical manifestation for ankylosing spondylitis. At present, nonsteroid anti-inflammatory drugs are oral y taken, but the effects are limited and toxic and side effects are more. Thus, there is no effective scheme for treatment of pain induced by ankylosing spondylitis. OBJECTIVE:To investigate the correlation between postoperative joint pain al eviation and al ogeneic blood transfusion, and the mechanisms. METHODS:We retrospectively analyzed clinical data of 88 ankylosing spondylitis patients combined with kyphosis who received only one section of osteotomy surgery merging hip joint pain. We compared the visual analog scale score of hip joint and detected the variation of leucocytes, lymphocytes and immunoglobulin concentrations before and after the operation in the groups of fresh al ogeneic whole blood transfusion, autologous whole blood transfusion, and mixed transfusion of al ogeneic and autologous whole blood. Flow cytometry was used to analyze the number and ratio of peripheral blood Th17 cells and Treg cells which were both highly associated with autoimmune diseases. RESULTS AND CONCLUSION:The symptom of hip arthralgia obviously improved in both groups transfused by fresh al ogeneic whole blood or al ogeneic-autologous mixed whole blood. However, no obvious variation was detected in leucocytes, lymphocytes and immunoglobin concentration. However, flow cytometry results indicated that Th17/Treg proportion associated with autoimmune diseases was increased remarkably in peripheral blood of ankylosing spondylitis patients. Results suggested that al ogeneic whole blood transfusion can al eviate patients’ joint pain by correcting the imbalance of Th17/Treg which may improve their immune state.%背景:疼痛一直为强直性脊柱炎的主要临床表现,目前治疗多以口服非类固醇抗炎药为主,效果有限且毒副作用大,目前尚没有一种经济、有效治疗强直性脊柱炎疼痛

  4. Relationship between Ankylosing Spondylitis and HLA-B27,HLA-Cw and KIRs%HLA-B27、HLA-Cw、KIRs与强直性脊柱炎

    张谷香

    2012-01-01

    强直性脊柱炎(AS)是一种慢性进行性炎症性关节炎,具有明显的家族倾向.虽然,人类白细胞抗原B27(HLA-B27)被认为与AS的发病密切相关,但是由于AS发病机制复杂,HLA-B27仅为导致AS易感的主要基因之一.近年来研究发现,自然杀伤细胞免疫球蛋白样受体(KIRs)和HLA-Cw基因与AS的发生发展也有一定的相关性,且HLA-Cw与活化性/抑制性KIRs之间的失衡可能是影响AS发病机制的关键因素.%Ankylosing spondylitis( AS )is a kind of chronic progressive arthritis which presents clear familial predisposition. Although it has been confirmed that the expression of human leukocyte an-tigen-B27( HLA-B27 )closely related to AS,it is not the only susceptibility genes on AS. Recent studies found that killer immunoglobulin-like receptors( KIR )and HLA-Cw also participated the generation and development of AS. The imbalance between HLA-Cw and activation/inhibition of KIRs might play an important role in the pathogenes is of AS.

  5. Assessment of clinical efficacy and safety in a randomized double-blind study of etanercept and sulfasalazine in patients with ankylosing spondylitis from Eastern/Central Europe, Latin America, and Asia.

    Damjanov, Nemanja; Shehhi, Waleed Al; Huang, Feng; Kotak, Sameer; Burgos-Vargas, Ruben; Shirazy, Khalid; Bananis, Eustratios; Szumski, Annette; Llamado, Lyndon J Q; Mahgoub, Ehab

    2016-05-01

    Despite the demonstrated efficacy of etanercept for the treatment of ankylosing spondylitis (AS), sulfasalazine is often prescribed, especially in countries with limited access to biologic agents. The objective of this subset analysis of the ASCEND trial was to compare the efficacy of etanercept and sulfasalazine in treating patients with AS from Asia, Eastern/Central Europe, and Latin America. A total of 287 patients, 190 receiving etanercept 50 mg once weekly and 97 receiving sulfasalazine 3 g daily, from eight countries were included in this subset analysis. Differences in disease activity and patient-reported outcomes assessing health-related quality-of-life (HRQoL) parameters in response to treatment were analyzed using the Cochran-Mantel-Haenszel test for categorical efficacy endpoints and analysis of covariance model for continuous variables. At week 16, a significantly greater proportion of patients receiving etanercept achieved ASAS20 (79.0 %) compared with patients receiving sulfasalazine (61.9 %; p = 0.002). At week 16, treatment with etanercept also resulted in significantly better responses than sulfasalazine for ASAS40 (64.7 vs. 35.1 %; p Etanercept was significantly more effective than sulfasalazine in the treatment of patients with AS from Asia, Central/Eastern Europe, and Latin America. PMID:26968844

  6. 强直性脊柱炎股骨近端前倾角和颈干角测量结果%Measurement outcome of femoral proximal anteversion angle and neckshaft angle in ankylosing spondylitis

    张亮; 周一新; 柳剑; 郭卫

    2012-01-01

    背景:强直性脊柱炎(ankylosing spondylitis,AS)的股骨近端形态学参数,包括前倾角(femoral proximal anteversion angle,FPA)和颈干角(neckshaft angle,NSA),可能随脊柱-骨盆-髋关节整体结构的变化而发生改变,进而影响全髋关节置换术(total hip arthroplasty,THA)术后的生物力学机制和关节稳定性.目前相关临床研究甚少且不够深入.目的:测量AS股骨近端形态学参数结果,分析其对于THA股骨假体选择的提示意义.方法:选择2010年9月至2011年10月行THA的AS患者30例和健康对照者30例.分别通过双髋关节正位X线片和股骨CT扫描测量FPA和NSA.结果:AS组平均NSA显著高于对照组(138.00°±12.67°VS132.23°±5.88°,P=0.002),两组FPA无显著性差异(13.41°±10.02°VS11.55°±9.11°,P=0.29).AS组中融合组平均NSA显著高于非融合组(145.29°±15.27°vs133.46°±8.07°,P<0.001),两组FPA无显著性差异(14.99°±11.08°VS12.43°±9.33°,P=0.674).结论:AS组与对照组相比呈明显髋外翻趋势,但并未表现出FPA增大趋势.AS组中融合组患者髋外翻趋势更加明显,但FPA并未显著增大.个别AS患者FPA过大或股骨近端后倾,可能是AS自身炎症、骨化过程以及胸腰段后凸畸形继发骨盆、髋关节和膝关节代偿变化而综合影响的结果,提示AS髋关节融合的位置和角度具有较大的变异度,需要术者具体分析,选择合理的股骨假体.%Background: The morphological variables of proximal femur in patients with ankylosing spondylitis (AS), including femoral proximal anteversion angle (FPA) and neckshaft angle (NSA) may alter secondary to the changes of spine-pelvis-hip integrity and possibly produce an effect on the biomechanics and joint stability of hips after total hip arthroplasty (THA). While the relevant research on documents of this subject is limited. Objective: The purpose of the study is to measure FPA and NSA in AS patients and investigate their effect on stem selection

  7. Diet and Spondylitis

    ... Spondylitis Info For Teens Message Boards & Forums Donate Diet & Spondylitis Learn About Spondyloarthritis / Diet & Spondylitis Overview For ... Diet Blood Work and Spondylitis Spondylitis Awareness Month Diet's Effect On Spondylitis Symptoms In recent years many ...

  8. 强直性脊柱炎伴发葡萄膜炎的临床治疗与分析%Clinical treatment and analysis of uveitis associated with ankylosing spondylitis

    张中宇; 何欣; 王秀云; 王雅; 孙大卫

    2012-01-01

    目的 探讨强直性脊柱炎(ankylosing spondylitis,AS)伴发葡萄膜炎的临床特征、诊断,分析其治疗及预后.方法 回顾性分析19例葡萄膜炎患者临床资料,对AS伴发葡萄膜炎的患者进行临床观察及分析.结果 AS发病年龄11 ~42岁,平均(27± 11)岁,葡萄膜炎发病年龄13~46岁,平均(29±12)岁.12例患者先行确诊为AS后就诊于眼科,7例患者以眼部葡萄膜炎为首诊病历后确诊为AS.葡萄膜炎病史:4天~5年,病程:14 ~ 37天,平均(27±7)天.13例患者有明确葡萄膜炎复发病史.X线影像学检查显示均为骶髂关节炎,HLA-B27阳性:15例(78.9%)、红细胞沉降率升高:12例(63.2%)、CRP> 10 mg/L:7例(36.8%).经过糖皮质激素和睫状肌麻痹剂眼液系统治疗后19例患者前部葡萄膜炎均治愈.结论 AS伴发葡萄膜炎多累及中青年男性,多单眼发病,易复发,具有典型的临床特征及明确的确诊依据.给予及时有效的治疗均能取得良好效果.%Objective To investigate the clinical characteristics and diagnosis of uveitis associated with ankylosing spondylitis ( AS) , and to analyze the treatment and prognosis of the disease. Methods The clinical, laboratory and treatment data of 19 patients with uveitis associated AS were analyzed retrospectively. Patients suffering from uveitis associated with AS were observed and analyzed. Results The age of the patients at onset of AS was 11- 42 (27 ±11) years old, and was 13 -46(29 ± 12) years old. There were 12 patients who had been diagnosed as AS before they went to see ophthalmologist, and 7 patients with first-diagnosis records as ocular uveitis who were diagnosed as AS later. Uveitis history was 4 days - 5 years; course was 14 -37 days; average course was (27 ±7) days. Thirteen patients had clear history of recurrence of uveitis. All cases had typical definitely radiological evidences of sacroiliitis. HLA-B27 of 15 (78. 9% ) cases were positive, 12 cases (63. 2% ) were

  9. Avaliação do ombro em pacientes portadores de espondilite anquilosante por meio de ultra-som Evaluation of the shoulder in patients with ankylosing spondylitis with ultrasound

    Ciro Yoshida Junior

    2008-04-01

    Full Text Available OBJETIVO: Descrever as principais alterações nos ombros de pacientes portadores de espondilite anquilosante (EA por meio de ultra-som (US e correlacionar os achados de imagem com a idade e o tempo de doença. MÉTODOS: Foram selecionados 35 pacientes com diagnóstico clínico de EA. Os pacientes foram submetidos a exame de ultra-sonografia dos ombros, sendo avaliados os tendões do manguito rotador quanto à sua ecotextura e espessura, o tendão do bíceps, a articulação acromioclavicular, os tubérculos umerais, a bursa subacromial-subdeltóidea, e a face posterior da articulação glenoumeral. Foram colhidos dados de tempo de doença, presença de dor nos ombros e freqüência das alterações das estruturas avaliadas. Os dados foram comparados com a idade e o tempo de doença, utilizando-se teste qui-quadrado e teste t de Student. RESULTADOS: Foi observada prevalência de 20% de alterações no manguito rotador, sendo 10% de tendinose/calcificação tendínea e 10% de rupturas tendíneas. A espessura média dos tendões do manguito rotador foi de 5,8 mm. As alterações ósseas nos tubérculos do úmero ocorreram em 84,3% dos ombros e as alterações acromioclaviculares em 54,3% dos ombros. CONCLUSÃO: Não há modificação da espessura dos tendões do manguito rotador relacionadas com o tempo de doença. Os principais achados de US, que se correlacionam com o tempo de doença na EA, são alterações ósseas nos tubérculos umerais e na articulação acromioclavicular. Não houve relação entre tempo de doença e presença de lesão tendínea.PURPOSE: To describe shoulder involvement and its prevalence with ultrasound in patients with ankylosing spondylitis and correlate the findings with age and duration of disease. METHODS: Ultrasound scans of both shoulders were performed in thirty five selected patients with clinical diagnosis of ankylosing spondylitis. Rotator cuff texture and thickness were evaluated as well as the biceps tendon

  10. Risk of leukaemia following intravenous treatment with {sup 224}Ra - results of a long term follow-up study of ankylosing spondylitis patients; Leukaemierisiko nach intravenoeser {sup 224}Ra-Behandlung - Ergebnisse einer Langzeitstudie an Bechterew-Patienten

    Wick, R.R. [GSF - Forschungszentrum fuer Umwelt und Gesundheit Neuherberg GmbH, Oberschleissheim (Germany). Inst. fuer Strahlenbiologie; Chmelevsky, D. [GSF - Forschungszentrum fuer Umwelt und Gesundheit Neuherberg GmbH, Oberschleissheim (Germany). Inst. fuer Strahlenschutz; Goessner, W. [GSF - Forschungszentrum fuer Umwelt und Gesundheit Neuherberg GmbH, Oberschleissheim (Germany). Inst. fuer Pathologie

    1993-12-31

    In an epidemiological study of the somatic late effects risk following incorporation of a short lived {alpha}-emitter, 1473 ankylosing spondylitis patients treated with repeated intravenous injections of {sup 224}Ra in the years 1948 - 75, have been observed in the GSF. The usual therapeutic plan consisted of a total of 10 - 12 injections of 1.036 MBq (28 {mu}Ci) of {sup 224}Ra each, given at weekly intervals; this would result in an cumulative {alpha}-dose of 0.56 - 0.67 Gy to the marrow-free skeleton of a 70-kg-man (standard man). These patients have been followed together with a control group of ankylosing spondylitis patients not treated with radioactive drugs and/or X-rays. Until May 1993 (mean follow-up time 19.9 yr), 595 patients of the exposure group and 722 patients of the control group have died, causes of death have been ascertained for 578, resp. 668 patients. Among others we observed in the exposure group 10 cases of leukaemia (vs. 2.7 - 2.8 cases expected, p < 0.001) and 6 cases of leukaemia in the control group (vs. 3.3 - 3.5 exp., p = 0.14). Subclassification of the leukaemias shows a clear preference for chronic myeloid leukaemia (CML) in the exposure group (4 cases obs. vs. 0.8 cases exp., p = 0.009), whereas in the control group the observed cases of CML are within the range of expectancy. Similar observations have not been made in another group of patients, now observed by Spiess and co-workers, who have been treated at a higher dose/dose rate range. This increased incidence of leukaemias in our exposure group is in one line with results from animal experiments with bone seeking {alpha}-emitters given at low dose rates. The induction of myeloid leukaemia has been demonstrated in mice down to dose rates of only a few mGy/day also for {sup 239}Pu, an {alpha}-emitter which like {sup 224}Ra deposits preferentially on the bone surface. (orig.) [Deutsch] Im Rahmen einer epidemiologischen Studie zum somatischen Strahlenspaetschadenrisiko nach

  11. Molecular mechanism of the susceptibility difference between HLA-B*27:02/04/05 and HLA-B*27:06/09 to ankylosing spondylitis: substitution analysis, MD simulation, QSAR modelling, and in vitro assay.

    Cheng, X; Mei, Y; Ji, X; Xue, Q; Chen, D

    2016-05-01

    The human leukocyte antigen HLA-B27 is directly involved in the disease pathogenesis of ankylosing spondylitis (AS). HLA-B27 has a high degree of genetic polymorphism, with 105 currently known subtypes; the presence of aspartic acid at residue 116 (Asp116) has been found to play an essential role in AS susceptibility. Here, we systematically investigated the molecular mechanism of the susceptibility difference between the AS-associated subtypes HLA-B*27:02/04/05 and AS-unassociated subtypes HLA-B*27:06/09 to AS at sequence, structure, energetic and dynamic levels. In total seven variable residues were identified among the five studied HLA-B27 subtypes, in which Asp116 can be largely stabilized by a spatially vicinal, positively charged His114 through a salt bridge, while five other variable residues seem to have only a marginal effect on AS susceptibility. We also employed a quantitative structure-activity relationship approach to model the statistical correlation between peptide structure and affinity to HLA-B*27:05, a genetic ancestor of all other HLA-B27 subtypes and associated strongly with AS. The built regression predictor was verified rigorously through both internal cross-validation and external blind validation, and was then employed to identify potential HLA-B*27:05 binders from >20,000 cartilage-derived self-peptides. Subsequently, the binding potency of the top five antigenic peptides to HLA-B*27:05 was assayed in vitro using a FACS-based MHC stabilization experiment. Consequently, two (QRVGSDEFK and LRGAGTNEK) out of the five peptides were determined to have high affinity (BL50 = 5.5 and 15.8 nM, respectively) and, as expected, both of them possess positively charged Lys at the C-terminus. PMID:27228481

  12. 父母育龄及胎次效应对强直性脊柱炎发病的影响%Influence of parental age at delivery and birth order on ankylosing spondylitis

    杨波; 韩星海; 蔡青

    2004-01-01

    目的:研究强直性脊柱炎(ankylosing spondylitis,AS)是否有父母育龄及胎次效应.方法:用Haldane和Smith方法研究215例AS患者的父母育龄及胎次效应,对41例B27阴性患者和164例B27阳性患者资料进行对比分析,并用统计学方法分析首胎患者和末胎患者的同胞数.结果:用Haldane和Smith方法的计算公式算得215例AS患者X=4.02>2,164例B27阳性患者X=3.54>2,41例B27阴性患者X=1.58<2;首胎AS患者的数目明显少于期望值(χ2=6.71,P<0.01),而末胎AS患者的数目明显高于期望值(χ2=6.30,P<0.05).结论:父母育龄越大或胎次晚者易患AS;B27阴性和B27阳性AS有遗传异质性.首胎比非首胎的儿女有更低的AS罹患风险率,而末胎比非末胎的儿女有更高的AS罹患风险率.

  13. Efficacy of golimumab in the treatment of patients with ankylosing spondylitis (according to the data of a long-term follow-up

    A. V. Smirnov

    2015-01-01

    Full Text Available The paper summarizes the data of a randomized placebo-controlled phase 3 GO-RAISE trial of spondylitis (AS patients receiving two different doses (50 and 100 mg of golimumab (GLM, which evaluates its efficiency and safety and X-ray progression of changes in the axial skeleton. In AS patients, GLM therapy leads to a rapid long-lasting clinical and radiological response. The tolerability of long-term therapy with GLM generally complies with the safety profile of the entire class of tumor necrosis factor-р (TNF-р inhibitors.The data of the GO-RAISE trial has substantiated once again the established fact that the high baseline level of C-reactive protein (CRP and the presence of syndesmophytes are predictors for a rapider X-ray progression. At the same time, the results of the trial may question the recent assumptions that TNF-р suppression can exert a stimulating effect on the formation of new bone tissue with time. Further studies are to determine whether there is an association between the presence of syndesmophytes and elevated CRP levels and whether they have a combined effect on X-ray progression, and if so, whether the development of structural changes may be prevented with TNF-р inhibitors to be used at the earlier stages of the disease.

  14. Ankyloserende spondylitis er associeret med øget kardiovaskulær morbiditet og mortalitet

    Madsen, Ole Rintek; Lindhardsen, Jesper

    2011-01-01

    Ankylosing spondylitis is an inflammatory disorder primarily affecting the axial skeleton. The disease is associated with increased cardiovascular morbidity and mortality. Structural changes in the heart, and arteriosclerosis secondary to inflammation may be of importance. The role of traditional...

  15. Long-term investigation of the risk of malignant diseases following intravenous radium-224 treatment for ankylosing spondylitis; Langzeituntersuchung zum Risiko maligner Erkrankungen nach intravenoeser Behandlung des Morbus Bechterew mit Radium-224

    Schulte, Tobias L. [Klinik und Poliklinik fuer Allgemeine Orthopaedie und Tumororthopaedie, Universitaetsklinikum Muenster (Germany); Nekolla, Elke A. [Bundesamt fuer Strahlenschutz (BfS), Neuherberg (Germany); Wick, Roland R. [Inst. fuer Strahlenbiologie, Helmholtz-Zentrum Muenchen, Deutsches Forschungszentrum fuer Gesundheit und Umwelt, Neuherberg (Germany)

    2009-09-15

    Background and purpose: in German-speaking countries, the intravenous treatment of ankylosing spondylitis (AS) with radium-224 ({sup 224}Ra) was common between the late 1940s and 2005. In this long-term investigation, the risk of malignant diseases following intravenous {sup 224}Ra treatment for AS was assessed. Patients and methods: in a prospective long-term study, 1,471 patients with AS who were treated with {sup 224}Ra between 1948 and 1975 have been followed together with a control group of 1,324 AS patients treated neither with radioactive drugs nor with X-rays. Standardized questionnaires to evaluate the patients' health status were used. Observed numbers of malignant diseases were compared with those of the control group as well as with expected numbers for a normal population. Results: After 26 years of follow-up, causes of death have been certified for 1,006 patients of the exposure group (control group: 1,072 patients). Significantly increased rates of myeloid leukemia (12 cases observed vs. 2.9 expected; p < 0.001), kidney cancer (18 vs. 9.1; p < 0.01), thyroid cancer (4 vs. 1.2; p = 0.03) and borderline significantly increased rates of cancer of female genital organs (10 vs. 5.6; p = 0.06) were found in the exposure group in contrast to no significant increases of these diseases in the control group. Rates of pulmonary and gastrointestinal malignancies were not increased. Lymphatic leukemia (exposure group: 8 vs. 2.7; p < 0.01; control group: 7 vs. 3; p = 0.03) was significantly elevated due to a high rate of chronic lymphatic leukemia in both, the exposure as well as the control group. Conclusion: treatment of AS with {sup 224}Ra led to increased incidences of myeloid leukemia and malignancies of kidneys, thyroid and female genital organs. Although this kind of therapy is now abandoned, there is a need for close follow-up of patients who received it. (orig.)

  16. Immunologische und immunpathologische Untersuchungen zur Pathogenese der Ankylosierenden Spondylitis

    Appel, Heiner

    2010-01-01

    HLA-B27 is found to be positive in 90-95% of patients with ankylosing spondylitis (AS), which is the highest known MHC calls I association for human diseases. There is a strong correlation between the overall HLA-B27 prevalence in a population and the prevalence of ankylosing spondylitis and other spondyloarthritides, suggesting that additional environmental factors are rather ubiquituous. Twenty to forty percent of these patients develop the full clinical picture of AS 10-20 years after the...

  17. Concomitância de artrite reumatoide e espondilite anquilosante em um único paciente: importância dos novos critérios de classificação Concurrent rheumatoid arthritis and ankylosing spondylitis in one patient: the importance of new classification criteria

    Valderilio Feijó Azevedo

    2013-02-01

    Full Text Available Relatamos um caso de concomitância de espondilite anquilosante e artrite reumatoide em um paciente caucasiano de 65 anos, com achados clínicos de poliartrite simétrica com erosão de metacarpofalangeana ao raio X convencional e dor lombar infl amatória, HLA-B27+, associada à sacroiliíte. O paciente apresentou valores elevados de fator reumatoide e antipeptídeo citrulinado cíclico (anti-CCP. Realizamos uma revisão da literatura na qual as principais características de casos previamente reportados foram comparadas às deste caso. Este é o primeiro relato de caso de concomitância das duas doenças em que se utilizou teste laboratorial para dosagem do anti-CCP associado ao preenchimento das últimas versões dos critérios ASAS axial e ACR/EULAR para a classificação de espondilite anquilosante e artrite reumatoide, respectivamente.We report the case of concomitant ankylosing spondylitis and rheumatoid arthritis in a 65-year-old Caucasian male, who had symmetric polyarthritis with erosion of the metacarpophalangeal joint on conventional X-ray, infl ammatory low back pain with HLA-B27 positivity, and sacroiliitis. Laboratory analysis showed high levels of rheumatoid factor and anti-cyclic citrullinated peptide antibody (anti-CCP. Clinical features of previously reported cases were compared with those of our case. This is the first case report on the coexistence of both diseases in the same patient, for whom anti- CCP testing and the latest versions of axial ASAS criteria and ACR/EULAR criteria for the classification of ankylosing spondylitis and rheumatoid arthritis, respectively, were used.

  18. The Combination of MR Imaging and HLA-B27 on the Diagnosis of Sacroiliac Joints Lesions in Ankylosing Spondylitis%MRI与HLA-B27诊断强直性脊柱炎骶髂关节病变的联合应用

    王东; 江华堂; 陈武标; 吴永峻

    2012-01-01

    目的 探讨MRI与HLA-B27联合对诊断强直性脊柱炎(AS)骶髂关节(SIJ)病变的临床应用价值.方法 回顾性分析48例经临床确诊的AS的MRI和HLA-B27检测资料,并比较MRI与MRI联合HLA-B27对AS SIJ病变诊断的阳性率.结果 48例AS病例中,MRI检查诊断AS的阳性率为79.2%;HLA-B27检测阳性率为89.6%;MRI联合HLA-B27检测阳性为91.7%; MRI联合HLA-B27诊断AS的阳性率高于单纯MRI检查组,其差异有统计学意义(x2=11.759,P<0.01).结论 MRI与HLA-B27联合可提高AS诊断的阳性率,有利于AS的早期发现、及时治疗.%Objective To investigate the clinical value of combination of MR imaging and HLA-B27 on the diagnosis of sacroiliac joints (SIJ) lesions in ankylosing spondylitis (AS). Methods The MRI and HLA-B27 data of 48 AS cases proved by clinical examination were retrospectively analyzed. The positive rates in detecting the SIJ lesions of AS were compared between MRI and combination MRI and HLA-B27. Results Among the 48 patient of AS, the positive rate of MRI diagnosis was 79.2%, the positive rate of HLA-B27 examination was 89.6%, the positive rate of MRI combined with HLA-B27 was 91.7%. The positive rate of MRI combined with HLA-B27 was higher than that of MRI, which were showing significant difference (X2=1.759, P < 0.01). Conclusion The combination of MRI and HLA-B27 examination can increase the positive rate of AS diagnosis, which may be helpful for AS early detection and prompt treatment.

  19. Surgical treatment of temporomandibular joint ankyloses: meniscus conservation and relocation.

    Rinna, Claudio; Reale, Gabriele; Calvani, Francesco; Cascone, Piero

    2013-03-01

    Ankylosis of the temporomandibular joint is a serious complication, mainly after trauma and local or systemic infection. In rare cases, ankylosis is associated with systemic disease such as ankylosing spondylitis, rheumatoid arthritis, and psoriasis. According to the functional restriction and the provoked disturbances of facial growth in the youth, an early and effective therapy is desirable. There is a wide variety of surgical approaches to temporomandibular joint ankylosis, ranging from chondro-osseous grafts to prothesis. In the article the authors present the clinical case of a 60-year-old patient who, at the age of 6, accidentally fell from a height of about 2 m. In 60 years old, after removing the temporomandibular ankylosis with surgical technique, patient showed a marked improvement of mandibular kinetics. PMID:23524812

  20. Evaluation of the effects of tumor necrosis factor-а inhibitors versus nonsteroidal anti-inflammatory drugs on spinal inflammatory changes from magnetic resonance imaging data in patients with ankylosing spondylitis

    Ekaterina Yuryevna Tyukhova

    2012-01-01

    Full Text Available Objective: to evaluate the time course of inflammatory changes (ICs in the spinal column and sacroiliac articulations (SIA from magnetic resonance imaging (MRI data in patients with ankylosing spondylitis (AS during treatment with tumor necrosis factor-α (TNF-а inhibitors or nonsteroidal anti-inflammatory drugs (NSAIDs, which were first used. Subjects and methods. MRI of the most painful part of the spine and SIA was performed in 58 patients with AS at baseline and 12 weeks later. MRI T2 STIR and T1 (SIGNA EXCITE, General Electrics; 0.35 T, matrix 288x192 regimens were used. Bone marrow edema was regarded as active inflammation. Active ICs in the most painful part of the spine were assessed by the AS spinal MRI activity (ASspiMRI-a score and those in SIA by the Leeds scoring system. MRI was interpreted independently by two specialists; one of them did not know about the number of a visit and performed therapy. The patients were divided into two groups: 1 those who first used TNF-а inhibitors and 2 those who were first given NSAIDs. Both groups were matched for demographic indicators. Results. In both groups, the mean pain level in the spinal part under study decreased significantly in both groups: from 5.7±1.7 to 2.3±1.8 in the TNF-а inhibitor group (p = 0.000006 and from 4.8±2.3 to 2.6±2.3 in the NSAID group (р = 0.00001. After 12 weeks of treatment, the patients receiving TNF-а inhibitors (n = 28 showed a considerable reduction in the MRI signs of spinal ICs from 4.8±2.3 to 1.6±1.6 (p = 0.00001; moreover, this trend was more pronounced in patients (n = 17 with more baseline IC foci (≥ 5 than in those (n = 11 with fewer baseline IC foci (< 5 (the mean а was 4.3±1.5 and 1.6±1.4, respectively; р = 0.0003. In the patients taking NSAIDs (n = 30, the decrease in the number of spinal MRI ICs (from 2.8±2.5 to 2.3±2.1 was insignificant (p = 0.17. After 12 weeks, regression of active sacroiliitis was noted in 28 patients from the TNF

  1. Meta Analysis of Primary Treatment for Ankylosing Spondylitis by Long Snake Moxibustion%铺灸疗法为主治疗强直性脊柱炎的Meta分析

    刘安国; 严兴科; 阚丽丽; 董莉莉; 王军燕

    2013-01-01

    目的:评价铺灸疗法治疗强直性脊柱炎(Ankylosing Spondylitis,AS)疗效的优越性、远期疗效及安全性。方法:计算机检索从2000年到2012年在中国知网(CNKI)、万方数据库(WF)中收录的有关铺灸疗法为主治疗AS的随机对照试验(randomized controlled trial,RCT)文献,对文献进行质量评价,并用Review Manager 5.1软件进行荟萃分析(Meta分析)。结果:总共纳入临床随机对照试验文献17篇,涉及患者共1700名。 Meta分析结果显示铺灸疗法治疗强直性脊柱炎的总体有效率优于口服西药疗法和单纯针刺疗法。与口服西药疗法比较,合并后效应指标RR=1.24,95%(Confidence Interval,CI)为(1.14,1.35);与针刺疗法比较,合并后效应指标RR=1.27,95%CI(1.05,1.53)。结论:此次纳入研究文献质量普遍偏低:全部为单中心RCT研究,无多中心研究。其次,随机分组方法不够准确,多数文献未描述随访、脱落、远期疗效情况,诊断标准、疗效评价指标种类繁多,未能采取国际公认的标准。与口服西药疗法比较,铺灸疗法的总体有效率远高于口服西药疗法,疗效优越且复发率较低,无毒副作用,安全可靠;和针刺疗法比较,虽然药物铺灸疗法总体有效率较高,由于纳入研究数目较少,总病例数亦少,无远期疗效和安全性方面对比,其结果有待于大样本、多中心、方法科学的高质量临床研究加以验证。%Objective:To evaluate the advantages of long snake moxibustion in treating ankylosing spondylitis (AS),theraprutic effect and the safety. Method:All the papers about randomized controlled trial of spreading moxi-bustion for AS were searched from 2000 to 2012 in CNKI and WanFang database, quality estimation was performed and all the papers were analyzed with Review Manager 5.1 software. Result:There were 17 pieces included, involv-ing 1 700 patients. Meta analysis results

  2. Internal fixation for stress fractures of the ankylosed spine.

    Marsh, C H

    1985-01-01

    Three cases of stress fractures affecting the rigid spine of ankylosing spondylitis are reported. Even without the typical destructive features of the Romanus lesion, symptoms may be very prolonged and disabling and the diagnosis difficult. Internal fixation produces immediate pain relief and rapid fracture union.

  3. Intestinal bacteria as triggering agents in murine ankylosing enthesopathy

    Řeháková, Z.; Čapková, Jana; Šinkora, J.; Osterreicher, J.; Ivanyi, P.

    2004-01-01

    Roč. 3, Suppl. 2 (2004), s. 108. ISSN 1568-9972. [International Congress of Autoimmunity /4./. Budapešť, 03.11.2004-07.11.2004] R&D Projects: GA ČR GA305/03/0287 Keywords : ankylosing spondylitis * ANKENT * HLA-B27 Subject RIV: EC - Immunology

  4. Men's Experiences of Living with Ankylosing Spondylitis

    Madsen, Mette; Jensen, Kim Vilbek; Esbensen, Bente Appel

    2015-01-01

    . RESULTS: The analysis revealed four categories: (1) 'Approaching a diagnosis'; (2) 'Ill in a social context'; (3) 'Challenged as a man'; and (4) 'The importance of remaining physically well'. Based on these categories, the overall category of 'An invisible companion for life' emerged, which captures...... the experience of living with an invisible, life-long disease. CONCLUSIONS: These findings demonstrate that AS impacts men's perceptions of themselves as men, relationships as a partner and father, social lives, and masculine identity. Physical activity was highlighted as an important part of being a man...

  5. MRI Findings of Brucellar Spondylitis: A Case Report

    Brucellosis is a systemic infectious disease, and musculoskeletal involvement is a frequent complication. Particularly, spondylitis is a common involvement. However, early diagnosis of brucellar spondylitis is often difficult due to non-specific clinical symptoms and long latent period. Especially in Korea, where tuberculosis is an endemic disease, differentiation between tuberculous and brucellar spondylitis is clinically and radiologically more challenging. A 59-year-old male cattle farmer, who presented with non-specific back pain, had spondylitis on magnetic resonance imaging (MRI), and serologic test finally confirmed brucellar spondylitis. Therefore, we report a case of a rather rare disease in Korea, brucellar spondylitis with a review of MRI findings.

  6. MRI Findings of Brucellar Spondylitis: A Case Report

    Kim, Jin Woo; Kim, Myung Soon; Kim, Young Ju [Dept. of Radiology, Wonju Christian Hospital, Yonsei University Wonju College of Medicine, Wonju (Korea, Republic of)

    2013-03-15

    Brucellosis is a systemic infectious disease, and musculoskeletal involvement is a frequent complication. Particularly, spondylitis is a common involvement. However, early diagnosis of brucellar spondylitis is often difficult due to non-specific clinical symptoms and long latent period. Especially in Korea, where tuberculosis is an endemic disease, differentiation between tuberculous and brucellar spondylitis is clinically and radiologically more challenging. A 59-year-old male cattle farmer, who presented with non-specific back pain, had spondylitis on magnetic resonance imaging (MRI), and serologic test finally confirmed brucellar spondylitis. Therefore, we report a case of a rather rare disease in Korea, brucellar spondylitis with a review of MRI findings.

  7. Study on correlation between ankylosing spondylitis and HLA -B27 subgenotype%强直性脊柱炎与 HLA-B27基因亚型的相关性研究

    王华; 甄拴平; 党丽君; 张树琪

    2016-01-01

    目的:探讨不同人类白细胞抗原B27(HLA‐B27)基因亚型与强直性脊柱炎(AS)的相关性。方法采集骨科、针灸风湿科门诊及住院患者静脉全血,应用基因分析法定性检测HLA‐B27,其中HLA‐B27阳性的AS确诊患者380例,并选取HLA‐B27阳性健康对照组50例,同时通过序列特异性引物PCR(PCR‐SSP)技术检测AS患者和健康对照组的 HLA‐B27基因亚型。结果380例A S患者中,检出 HLA‐B2704亚型217例(57.1%),HLA‐B2705亚型143例(37.6%),HLA‐B2707亚型11例(2.9%),HLA‐B2711亚型9例(2.4%);50例 HLA‐B27阳性健康对照组中,检出 HLA‐B2706亚型23例(46.0%),HLA‐B2709亚型21例(42.0%),HLA‐B2704亚型4例(8.0%),HLA‐B2705亚型2例(4.0%),两组比较差异有统计学意义( P=0.002)。结论宝鸡地区AS患者HLA‐B27基因亚型以B2704和B2705为主,与宝鸡地区汉族人群AS的发病呈强相关;B2706及B2709为该地区保护亚型。%Objective To explore the correlation between different HLA‐B27 subgenotype and ankylosing spondylitis (AS ) . Methods The whole venous blood was collected from the outpatients and inpatients of the orthopedics ,acupuncture and rheuma‐tism departments and HLA‐B27 was qualitatively detected by using the gene analysis method .Among them ,380 cases of AS were HLA‐B27 positive ,and 50 cases of HLA‐B27 positive were selected as the healthy control group .Then the HLA‐B27 subgenotypes were detected by using the sequence specific primers PCR (PCR‐SSP) technology .Results Among 380 cases of AS ,217 cases (57 .1% ) of HLA‐AS B2704 subgenotype ,143 cases (37 .6% ) of HLA‐B2705 subgenotype ,11 cases (2 .9% ) of HLA‐B2707 sub‐genotype and 9 cases (2 .4% ) of HLA‐B2711 subgenotype were detected out ;among 50 cases of HLA‐B27 positive in the healthy control group ,23 cases (46 .0% ) of HLA‐B2706 subgenotype

  8. Clinical characteristics of uveitis associated with ankylosing spondylitis and integrated treatment of traditional Chinese and western medicine%强直性脊柱炎伴发葡萄膜炎的临床特点和中西医结合治疗

    滕克禹

    2012-01-01

    OBJECTIVE To observe clinical manifestations and treatment efficacy with combination of traditional Chinese and western medicine of uveitis associated with ankylosing spondylitis(AS). METHODS Twenty-nine uveitis patients(34 eyes)associated with AS were retrospectively analyzed. RESULTS 1. Gender and age of onset: 28 patients were male, 1 was female; the average age of AS patients was 27years old, and the average age of uveitis was 33 years old. 2. Clinical manifestations: All of the 29 patients had lumbosacral discomfort, and all patients had radiological evidences of sacroiliitis. When uveitis outbroke, lumbosacral discomfort increased; when patients were examined, 26 patients(28 eyes)had anterior uveitis and non-granulomatous uveitis. Both eyes were attacked in turn.Three patients(6 eyes)had panuveitis. 3. The treatment effect: after treatment, vision improved, eye inflammation disappeared, and lumbosacral discomfort reduced.CONCLUSIONS Uveitis associated with AS has certain characteristics, and could be effectively treated by combination of traditional Chinese and western medicine.%目的 观察强直性脊柱炎(ankylosing spondylitis,AS)伴发葡萄膜炎的临床表现和中西医结合治疗的效果.方法 中西医结合治疗AS伴发葡萄膜炎患者29例(34只眼),对其临床表现和治疗效果进行回顾性分析.结果 1.性别与发病年龄:男28例,女1例;AS平均发病年龄27岁,葡萄膜炎平均发病年龄33岁.2.临床表现:29例患者均有腰骶部不适,X线检查提示骶髂关节炎,葡萄膜炎发作时腰骶部不适加重;26例28只眼为非肉芽肿性前部葡萄膜炎,双眼交替发作;3例6只眼为全葡萄膜炎.3.治疗效果:治疗后视力提高,眼部炎症消失,腰骶部不适减轻.结论 AS伴发的葡萄膜炎有一定的特点,中西医结合治疗有效.

  9. Effect of daily log combined with multimedia technology on functional exercise in patients with ankylosing spondylitis%锻炼日志联合多媒体技术对强直性脊柱炎患者功能锻炼的效果

    李则宾; 李素娟; 张力; 雷敏

    2015-01-01

    目的:探讨功能锻炼日志联合多媒体技术对强直性脊柱炎患者功能锻炼的效果。方法将61例强直性脊柱炎患者采用随机数字表法分为研究组31例与对照组30例,两组患者均接受相同的药物治疗方案,研究组采用多媒体授课及视频引导下的同步功能锻炼方式,锻炼完毕记录锻炼日志;对照组进行传统的健康教育及功能锻炼指导。比较两组干预前和干预后3个月的脊柱活动度( BASMI评分)、Bath强直性脊柱炎功能指数(BASFI)评价和功能锻炼依从性。结果干预前研究组的BASMI评分和BASFI评分分别为(4.6±1.8),(47.67±17.31)分,干预后分别降至(2.6±1.6),(16.72±12.91)分,改善程度均优于对照组,两组干预后比较差异有统计学意义( t值分别为3.125,3.213;P<0.01)。干预3个月后,研究组的依从性良好率为83.9%,对照组为46.7%,差异有统计学意义(χ2=9.348,P <0.01)。结论锻炼日志联合多媒体技术应用于强直性脊柱炎患者功能锻炼指导,有利于患者掌握锻炼方法,改善患者脊柱活动度和机体功能。%Objective To investigate the effect of daily log combined with multimedia technology on functional exercise in patients with ankylosing spondylitis .Methods A total of 61 patients were randomly assigned to experimental group ( 31 ) and control group ( 30 ) .Two groups of patients accept the same drug therapy.The patients in the experimental group underwent multimedia course and synchronous training of function excise guided by simultaneous video , and they were requested to write daily log about functional exercise .The patients in the control group took use of conventional health education and conventional functional exercise guidance .We assessed patients by Bath ankylosing spondylitis functional index ( BASMI ) , Bath ankylosing spondylitis metrology index ( BASFI

  10. 强直性脊柱炎患者血液HLA-B27的临床参考值的预测%The Predicted Clinical Reference Value of HLA-B27 in the Peripheral Venous Blood of Ankylosing Spondylitis Patients

    张金飞

    2012-01-01

    目的 以实时荧光定量PCR(FQ-PCR)检测可疑患者HLA-B27的定量水平,研究强直性脊柱炎(AS)与HLA-B27的相关性,明确HLA-B27的检测值范围并用于AS的确诊诊断.方法 针对本院2005年~2010年收集的168例骶髂关节及下腰部疼痛等症状疑似AS病例进行回顾性分析,获得所有病例外周静脉血标本,然后通过实时荧光定量PCR进行HLA-B27的定量检测,疑似病例分为AS患者、HLA-B27阳性的非AS患者、HLA-B27阴性的非AS患者三组,根据临床体征、影像学进行确诊病情,同时选取健康体检者52例外周静脉血标本的HLA B-27测定结果进行对照,统计分析各变量与AS存在之间的关系.结果 AS患者、HLA-B27阳性的非AS患者、HLA-B27阴性的非AS患者、健康体检者的HLA-B27循环阈值(ct)平均值分别为:26.3 copies/ml、17.5 copies/ml、6.2 copies/ml、4.9 copies/ml,单变量分析表明,HLA-B27与化脓性关节炎明显相关(P<0.05).结论 AS患者HLA-B27定量分析循环阈值(ct)的95%参考值范围为(17.3~35.3)copies/ml,HLA-B27定量分析可作为疾病发病的参照影响因素及预测因素.%A fhuorogenic quantitative polymerase chain reaction( FQ-PCR) was used to detect quantitative level of the suspicious ankylosing spondylitis patients, to detennine the relativity between ankylosing spondylitis and HLA-B27, and the predicted reference value got from this experiment was used to diagnose ankylosing spondylitia. Methods 168 suspicous ankylosing spondylitia cases with the pain of sacroiliac joints and lower waist collected from 2002 to 2010, was to do retrospective analysis, all the blood specimen was got to analyze the quantitative level of HLA-B27. All patients on the basis of clinic and this experiment were divided into 3 groups; AS patients, non-AS patients with HLA-B27-positive patients group, non-AS patients with HLA-B27-negative patients group. 52 cases were collected as control group. Statistical analysis was to analyze the

  11. Analysis of the effect of short interval staged bilateral replacement in the treatment of ankylosing spondylitis combined with bilateral hip bony ankylosis%短间隔分期双侧置换治疗强直性脊柱炎伴双髋关节骨性强直的疗效分析

    韩博闻; 殷力; 韩奇财; 娄超举; 李弘帅; 胡明鑫

    2015-01-01

    Objective To discuss the clinical effects of short interval staged bilateral replacement in the treatment of ankylo-sing spondylitis(AS)combined with bilateral hip bony ankylosis. Methods 21 cases(42 hips)of ankylosing spondylitis com-bined with bilateral hip bony ankylosis hospitalized from October of 2010 to October of 2014 were enrolled and received short in-terval(bilateral operation interval < 1 month)staged bilateral total hip arthroplasty. The Harris score,visual analogue score (VAS),total hip joint activity,short form health survey(SF - 36)were compared between pre - operation and the last follow -up,and the postoperative complications were observed. Results The Harris score,total hip joint activity and SF - 36 score on the last follow - up day were markedly increased than those before operation. The VAS score of the last follow - up day were markedly decreased than those before operation. 6 hips had mild heterotopic ossification,and 3 hips had femoral anterolateral in-termittent pain,but those had no obvious effect on the function. There were no femoral nerve injury. Conclusion SISBTHA can reconstruct the hip joint function,improve the quality of life,which is an effective and reliable method.%目的:探讨短间隔分期双侧置换治疗强直性脊柱炎(ankylosing spondylitis,AS)伴双髋关节骨性强直的临床疗效。方法回顾性研究2010年10月至2014年10月收治的21例(42髋)强直性脊柱炎双髋关节骨性强直患者,采用短间隔(双侧手术间隔<1个月)分期双侧人工全髋关节置换术(short interval staged bilateraltotal hip arthroplasty,SISBTHA)。比较患者术前及末次随访的 Harris 评分、疼痛视觉模拟评分(VAS)、髋关节总活动度、健康调查简表(SF -36),以及观察术后并发症发生情况。结果末次随访时 Harris 评分、髋关节总体活动度和 SF -36评分均较术前显著升高(P <0.05),VAS 评分较术前显著降低(P <0

  12. Infectious spondylitis in adults

    In adults, infectious spondylitis is a rare but sever disease, caused by a bacterial thrombus in tissue of reduced resistance. In conventional radiographs initial findings are a narrowing of the intervertebral space, local osteoporosis and poorly defined erosive borders of the vertebral endplates. These changings can be found at least three to six weeks after the onset of disease. However, in Szintigraphy and MRT pathologic alterations are evident after ten to twelve days. Thus, early diagnosis and treatment becomes possible. In early stages of the disease of localized lysis surrounded by a reactive sclerosis appears in predisposed areas of the vertebral body (subchondral, anterobasal, ventral, central). Apparently, a soft tissue tumor is associated. Sclerosis and reduction of the soft tissue tumor are the first signs of repair processes. After at least 12 weeks, computed tomography can reveal typical sintering of the vertebral body and occasionally the development of a bony sequester. In addition, MRT as well as CT can be helpful in the detection and localization of complications as abscesses or affection of the vertebral canal. The tuberculous spondylitis can sometimes cause difficulties in differential diagnosis. Clinical findings, affection of several vertebral bodies, large soft tissue tumors with appearance of calcification as well as not typical locations are strongly suggestive of tuberculous spondylitis, but these findings are not specific of the disease. Degenerative disorders such as erosive osteochondrosis or changings due ot chronic dialysis (e.g amyloid or crystal arthropathies) may cause even more problems in differential diagnosis. Typical for a blastomatous process is the integrity of the interverebral disc space, which is a rare finding in spondylitis. (orig.)

  13. Infectious spondylitis and its differential diagnosis; Spondylitis und ihre Differenzialdiagnosen

    Erlemann, Rainer [Helios St. Johannes Klinik, Duisburg (Germany). Inst. fuer Radiologie; Hoogeveen, Anja [AKH Viersen (Germany)

    2012-06-15

    Infectious spondylitis can be diagnosed early and reliably by MRI, given that the most important diagnostic criteria are present. These criteria are bone marrow edema adjacent to two contiguous vertebral end plates, disk space of high signal intensity and enhancement of bone adjacent to two contiguous vertebral end plates and of the disk space. If not all of these criteria are present, diagnostic accuracy decreases. Erosive osteochondritis, spondylarthritis, osteoporotic fractures of two contiguous vertebral end plates, active Schmorl's nodes as well as neuropathic spine may mimic an infectious spondylitis. This paper presents typical and atypical morphologic patterns of infectious spondylitis as well as the differentiation criteria from the above mentioned diseases. (orig.)

  14. MRI characteristics of tuberculous spondylitis

    Currie, S. [Leeds and West Yorkshire Radiology Academy, Leeds General Infirmary, Great George Street, Leeds (United Kingdom); Galea-Soler, S., E-mail: sandro.galeasoler@uhb.nhs.uk [Queen Elizabeth Medical Centre, Edgbaston, Birmingham (United Kingdom); Barron, D. [Leeds and West Yorkshire Radiology Academy, Leeds General Infirmary, Great George Street, Leeds (United Kingdom); Chandramohan, M.; Groves, C. [Department of Musculoskeletal Radiology, Bradford Teaching Hospitals NHS Trust, Bradford (United Kingdom)

    2011-08-15

    Spondylitis is the most common osseous manifestation of Mycobacterium tuberculosis infection. Although treatable, it continues to cause significant mortality and morbidity. Early diagnosis through familiarity with its imaging characteristics is essential to permit rapid treatment and prevent potential life-limiting consequences. In this review, we demonstrate the key magnetic resonance imaging features of this disease.

  15. 广东潮州地区强直性脊柱炎患者 HLA-B27的检测与临床相关性研究%Investigation of the relationship between clinical manifestation of ankylosing spondylitis and HLA-B27 antigen in Chaozhou, Guangdong Province

    刘潮坚; 蔡拉加; 石昭宏; 林剑雄

    2013-01-01

      目的检测强直性脊柱炎(Ankylosing spondylitis,AS)患者 HLA-B27抗原表达情况,并分析其与临床情况的关系.方法选择我院2008年5月到2011年5月期间150例 AS 患者,按 HLA-B27抗原表达分为两组:HLA-B27阳性组(n=108)及 HLA-B27阴性组(n=42).分别检测两组血标本血沉、C 反应蛋白、α1-酸性糖蛋白水平,并检查心电图、骨盆正位片和腰椎正侧位,比较两组的发病年龄、性别比、临床症状.结果① HLA-B27阴性组以31~45岁年龄段为主(占阴性组52.4%),阳性组以16~30岁年龄段为主(占阳性组57.4%);② HLA-B27阳性组较阴性组全身症状更为严重(P0.05);③ HLA-B27阴性组较多表现为在窦缓和/或传导阻滞,而 HLA-B27阳性组则较多表现为左室高电压(P0.05).结论 AS 患者临床症状与 HLA-B27抗原有很高的相关性,HLA-B27抗原阴性患者与阳性患者相比病情较轻,预后较好.%Objective To investigate the relationships between clinical manifestation of ankylosing spondylitis (AS) and HLA-B27 antigen by analyzing the expression level of HLA-B27 antigen. Methods During May 2008 and May 2011, 150 AS patients attended our study. According to the expression level of HLA-B27 antigen, these patients were classified into two groups: HLA-B27 negative group and HLA-B27 positive group. The erythrocyte sedimentation rate (ESR), CRP, and α1-AGP, electrocardiogram, anterioposterior radiograph of pelvis, anterior and lateral lumbar vertebral X ray were also examined. The age of onset, sex proportion, and clinical manifestation were compared in the two groups. Results ① HLA-B27 negative expression mainly ranged from 31 to 45 years old (52.4%), but positive expression group mainly ranged from 16 to 30 years old (57.4%). ② The rate of systemic symptom such as fever, night sweat, and fatigue were higher in HLA-B27 positive group than that in negative group(P0.05). ③ The major clinical symptom in HLA-B27 negative patients were sinus

  16. Diet and Spondylitis

    ... Spondylitis About the Spondylitis Association of America Join Today Renew Your Membership Contact Us News Who We Are Major Accomplishments Publications / Educational Materials Research Advocacy Connect with Others Support Groups Message Boards / ...

  17. Spontaneous course of an untreated fungal spondylitis

    After 29 known cases in the world, we report another case of fungal spondylitis being not yet treated. Within four months with increasing clinical complaints and without neurological defects the disease led to a complete involvement of two vertebras and their partial resorption. An early radiologic hint in fungal spondylitis is possible, a sure diagnosis, however, depends on puncture. Pathogenetic aspects and the importance of a new method to identify candida infection in blood-sample are discussed. (orig.)

  18. Diagnosis of spondylitis by MR tomography

    Reiser, M.; Kahn, T.; Weigert, F.; Lukas, P.; Buettner, F.

    1986-09-01

    The results of MR tomography in 13 patients with specific and non-specific spondylitis are reported. There were characteristic changes in signal intensity and in the configuration of the vertebral bodies and the intervertebral discs. The extent of intraspinal stenosis can be demonstrated accurately by MR. Paravertebral abscesses can be shown accurately and their position can be clarified by means of multiplanar sections. The early diagnosis of spondylitis by MR tomography is discussed.

  19. Therapeutic Effect of Artificial Total Hip Arthroplasty for the Treatment of the Hip Lesions in the Patients with Ankylosing Spondylitis%人工全髋关节置换术治疗强直性脊柱炎髋关节病变的临床疗效

    刘亮; 张星火; 于振山; 张亚奎; 赵峰; 刘喜波

    2012-01-01

    目的 观察人工全髋关节置换治疗强直性脊柱炎髋关节病变的手术方法和临床效果.方法 对2001年3月至2009年6月26例(31髋)强直性脊柱炎髋关节病变患者行人工全髋关节置换并随访,置换前患者日常活动均明显受限或者严重疼痛,Harris评分平均(43.2±5.8)分,髋关节活动度平均51.8°±9.7°.记录术后末次随访的Harris评分,X线检查结果,观察假体有无松动、脱位及异位骨化. 结果 所有病例得到随访,平均随访24.9(8 ~125)个月.末次随访患者均疼痛消失,步态正常.Harris评分平均(82.4±4.7)分;髋关节活动度平均148.6°±7.4°;髋关节Harris评分及关节活动度均显著高于置换前(P<0.05).2髋出现异位骨化,为Brooker分级Ⅰ、Ⅲ级.无脱位、骨折及假体松动下沉,无患者进行翻修. 结论 人工全髋关节置换是治疗强直性脊柱炎晚期髋关节病变的有效方法,可以恢复关节功能,缓解关节疼痛并改善患者生活质量.%Objective To investigate the operative methods and clinical outcomes of total hip arthroplas-ty (THA) in the treatment of patients with hip lesions due to ankylosing spondylitis (AS). Methods From March 2001 to June 2009, 26 patients (31 hips) with AS received THA. All the hips were severe pain and an-kylosed in average 51. 8° ± 9. 7° of flexion. Preoperative Harris hip score was (43. 2 ±5.8) points. Radio-graphic examination and last Harris score were performed completely at the last time of follow-up. Results All the patients were followed up for average 24.9(8 ~ 125) month. Postoperatively.all patient get pain free and normal gait. According to Brooker system, 2 hips appeared heterotopic ossification, one was of Brookers Class I and the other Class III. No loosening or subsidence occurred in all patients. Harris hip score at final follow-up was (82.4±4.7) points (P <0.05), range of motion of hip were average 148. 6° ±7.4°(P <0. 05). Conclusion THA is effective

  20. 内蒙古地区疑似强直性脊柱炎患者HLA-B27抗原阳性率观察%Investigation of positive rate of HLA-B27 antigen in patients with suspected ankylosing spondylitis in Inner Mongolia

    托娅; 张军力

    2013-01-01

    Objective To investigate the relationship between suspected ankylosing spondylitis and HLA-B27 antigen in Inner Mongolia by detecting the positive rate and expression intensity of HLA-B27 antigen in 998 suspected AS patients, and evaluate its clinical significance. Methods The positive rate and the mean fluorescence intensity (MFI) of HLA-B27 antigen on the peripheral blood T lymphocytic detected by flow cytometer. Results Among the 998 suspected AS patients, the majority patients (77.35%) were aged from 21 to 50 years old, and the ratio between male and female was 1.4∶1. Among the all patients, the positive rate of antigen HLA-B27 was 28.86%, and the male and female patients' positive rates of HLA-B27 antigen were 33.05% and 23.02%, respectively (P<0.05). The MFI of male and female patients were significantly different (P<0.05). Conclusion The patients with AS in Inner Mongolia are strongly associated with HLA-B27 antigen. Detection of HLA-B27 antigen expression intensity in suspected AS patients with FCM is helpful to diagnosis and differential diagnosis of AS.%目的通过检测998例疑似强直性脊柱炎(Ankylosing spondylitis,AS)患者HLA-B27抗原阳性率和表达强度,了解内蒙古地区AS与HLA-B27抗原的相关性,并初步探讨其临床意义。方法采用流式细胞术检测患者外周血T淋巴细胞膜上的HLA-B27抗原和其平均荧光强度(mean fluorescence intensity,MFI)。结果998例疑似AS患者以21~50岁青壮年为主,占77.35%;男女比例为1.4∶1;998例疑似AS患者的HLA-B27抗原阳性率28.86%;男女患者HLA-B27抗原阳性率分别为33.05%和23.02%(P<0.05);男女阳性患者的MFI有明显差异(P<0.05)。结论内蒙古地区AS患者与HLA-B27抗原有着很强的相关性。采用流式细胞技术检测临床疑似AS患者T淋巴细胞HLA-B27表达强度有助于诊断和鉴别诊断AS。

  1. Relevant factors on the degree of anterior uveitis in patients with ankylosing spondylitis%强直性脊柱炎伴发前葡萄膜炎患者眼前段病变严重程度的相关因素

    宋国祥; 黄进贤; 邓亚玲; 尹志华; 梁张翼; 叶志中

    2014-01-01

    AlM: To investigate the association between the degree of anterioruveitis and related factors including inflammatory markers as well as sacroiliac joint imaging in patients with ankylosing spondylitis ( AS) . METHODS: Anterior changes evaluated by slit lamp, erythrocyte sedimentation rate ( ESR ) , C - reactive protein ( CRP ) and magnetic resonance imaging of 55 cases with AS associateduveitis were retrospectively analyzed. A modified endotoxin-induced uveitis ( ElU ) clinical standard was used for uveitis grading. SPARCC sacroiliac scoring was used to evaluate bone edema of sacroiliac joint. The correlation between the degree of uveitis and sacroiliitis was assessed. RESULTS: ln the 55 patients with AS, ElU grading scored 2-10, and SPARCC index scored 0-22. Further analysis showed that the severity of uveitis was significantly correlated with ESR (r=0. 869, P CONCLUSlON: Local autoimmunity of uveitis and sacroiliac joint inflammation with subsequent bone formation in AS might be mutually independent processes.%目的:分析强直性脊柱炎( AS)伴发前葡萄膜炎患者眼前段病变严重程度和炎性指标以及骶髂关节的影像学表现等相关因素的相互关系。  方法:回顾性分析55例AS伴前葡萄膜炎患者裂隙灯下眼前段病变情况与红细胞沉降率( ESR )、C 反应蛋白( CRP)以及骶髂关节的核磁共振表现。前葡萄膜炎严重程度根据EIU的临床标准改良,骶髂关节骨髓水肿的程度根据SPARCC的骶髂关节( SIJ)评分,分析二者之间的相互关系。  结果:AS患者55例中,EIU评分为2~10分,SPARCC评分为0~22分。进一步分析表明,葡萄膜炎评分与ESR (r=0.869,P  结论:强直性脊柱炎患者前葡萄膜炎局部自身免疫炎症和骶髂关节的炎症及后续的骨化可能是各自独立的两个进程。

  2. 强直性脊柱炎FcRL基因与环境暴露因素交互作用研究%Interaction of FcRL Gene and Environmental Factors in Ankylosing Spondylitis.

    葛锐; 李桂兴; 徐胜前; 张立; 潘发明; 夏果; 梅杨; 沈蓓蓓; 高静; 段振华; 王笙; 曾臻

    2011-01-01

    Objective To study interaction of FcRL gene and environmental factors in anky losing spondylitis. Methods 169 AS patients were genotyped using a panel of single-nucleotide polymorphism (SNP) markers within FcRL3 and FcRL5 by lipase detection reactions (LDR). Polymerase chain reaction (PCR) using sequence-specific primer (SSP) methods were used to determine HLA-B27 subtypes. We analyzed the interaction of G x E in AS patients by using a case-only study. ResultsFrom 169 patients with AS,five HLA-B27 subtypes were detected in our study,including B *2704,B * 2705,B * 2710,B * 2702,B * 2715; Salty taste interacts with FcRL3 rs7522061 and FcRL5 rsl2036228; there are interactions of FcRL5 rs6427384 with drinking and salty taste. ConclusionSalty taste may be a risk exposure factor to interact with FcRL5 gene which may increase the incident risk of AS. Moderate alcohol intake may reduce the susceptibility of AS causing by FcRL5 rs6427384. FcRL3 rs7522061 would take an modification effect with salty taste in AS patients.%目的 研究强直性脊柱炎(AS)中环境因素与FcRL基因的交互作用.方法 对169例AS患者环境因素进行调查,PCR-SSP技术检测HLA-B27亚型,连接酶检测反应方法检测FcRL3、FcRL5基因SNP位点,采用单纯病例研究方法就AS基因与环境交互作用进行研究.结果 本次研究中169例AS病人HLA-B27共检测出B * 2704、B*2705、B* 2710、B*2702和B*2715 五个亚型;FcRL3基因中rs7522061位点与饮食偏咸存在交互作用,与其他环境因素无交互作用;FcRL5基因中rs12036228位点只与饮食偏咸因素存在交互作用;FcRL5基因rs6427384位点分别与饮酒和饮食偏咸有交互作用.结论 饮食偏咸可能作为环境风险因素与易感基因FcRL5共同作用增加AS的发病风险;适度饮酒可能减低FcRL5基因(rs6427384)诱发AS的危险性;FcRL3基因(rs7522061)在存在饮食偏咸因素时起到效应修饰作用,增加疾病风险.

  3. Effects and mechanism of bee-venom-acupuncture based on Midnight-Noon Ebb-Flow doctrine on ankylosing spondylitis%子午流注蜂针对强直性脊柱炎的疗效及机制研究

    温伟强; 黄胜光; 陈辉; 谭宁; 周汝云; 朱辉军

    2012-01-01

    Objective To observe the effects and safety of bee-venom-acupuncture based on Midnight-Noon Ebb-Flow doctrine on ankylosing spondylitis (AS), and its impacts on IL-6, TNF-α and sex hormone levels, and to explore its mechanisms. Methods 120 AS patients were randomly divided into 3 groups: 40 patients in treatment group were treated with bee-venom-acupuncture based on Midnight -Noon Ebb -Flow doctrine and syndrome differentiation; 40 patients in control group A were treated with bee-acupuncture based on syndrome differentiation; and 40 patients in the control group B were treated with sulfasalazine(SSZ) and diclofenac sodium. A treat- ment course was 4 weeks. Before and after 3 courses, indexes were observed and recorded, such as Bath AS disease activity index (BAS-DAI), Bath AS functional index (BASFI), duration of morning stiffness, likert' 4-grade score of whole body pain and spinal pain, evaluation by doctors and patients, the erythrosedi mentation (ESR), C-reactive protein (CRP), and the levels of IL-6, TNF-α and sex hormones. Adverse effects of medicines were also observed. Results The total effective rate was 82.5%, 72.5% and 70.0% in treatment group, control group A and control group B respectively; the statistic differences were significant (P0.05). The incidence rate of adverse effects in treatment group was 10%, while that in the control group A and B was 12% and 30% respectively. Conclusion Bee-venom-acupuncture based on Midnight-Noon Ebb-Flow doctrine presents significant efficacy on AS with less adverse effects. The mechanism may be related to inhibition of IL-6, TNF-α and Testosterone production.%目的 观察子午流注蜂针时强直性脊柱炎(ankylosing spondylitis,AS)的疗效、安全性及对患者血清白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)、性激素水平的影响,探讨其产生疗效的机制.方法 将120例AS患者随机分为3组,治疗组40例采用子午流注加辨证取定蜂针治疗,对照1组40例用

  4. Infectious spondylitis in adults; Infektioese Spondylitis beim Erwachsenen

    Vorbeck, F. [Abt. fuer Osteologie, Universitaetsklinik fuer Radiodiagnostik, Wien (Austria); Morscher, M. [Universitaetsklinik fuer Orthopaedie, Wien (Germany); Ba-Ssalamah, A. [Abt. fuer Osteologie, Universitaetsklinik fuer Radiodiagnostik, Wien (Austria); Imhof, H. [Abt. fuer Osteologie, Universitaetsklinik fuer Radiodiagnostik, Wien (Austria)

    1996-10-01

    In adults, infectious spondylitis is a rare but sever disease, caused by a bacterial thrombus in tissue of reduced resistance. In conventional radiographs initial findings are a narrowing of the intervertebral space, local osteoporosis and poorly defined erosive borders of the vertebral endplates. These changings can be found at least three to six weeks after the onset of disease. However, in Szintigraphy and MRT pathologic alterations are evident after ten to twelve days. Thus, early diagnosis and treatment becomes possible. In early stages of the disease of localized lysis surrounded by a reactive sclerosis appears in predisposed areas of the vertebral body (subchondral, anterobasal, ventral, central). Apparently, a soft tissue tumor is associated. Sclerosis and reduction of the soft tissue tumor are the first signs of repair processes. After at least 12 weeks, computed tomography can reveal typical sintering of the vertebral body and occasionally the development of a bony sequester. In addition, MRT as well as CT can be helpful in the detection and localization of complications as abscesses or affection of the vertebral canal. The tuberculous spondylitis can sometimes cause difficulties in differential diagnosis. Clinical findings, affection of several vertebral bodies, large soft tissue tumors with appearance of calcification as well as not typical locations are strongly suggestive of tuberculous spondylitis, but these findings are not specific of the disease. Degenerative disorders such as erosive osteochondrosis or changings due ot chronic dialysis (e.g amyloid or crystal arthropathies) may cause even more problems in differential diagnosis. Typical for a blastomatous process is the integrity of the interverebral disc space, which is a rare finding in spondylitis. (orig.) [Deutsch] Die Spondylitis des Erwachsenen ist eine zwar seltene, aber vor allem bei verzoegerter Diagnose eine ernste und langwierige Erkrankung, die auf einen Bakterienembolus im

  5. MRI in the diagnosis of the sacroiliac joints in ankylosing spondylitis%强直性脊柱炎骶髂关节病变的MRI诊断探讨

    王毅; 赖清泉

    2015-01-01

    目的 探讨强直性脊柱炎(AS)骶髂关节病变的早期MRI表现与临床分级之间的联系.方法 搜集临床确诊为AS的患者37例,均行骨盆X线和骶髂关节CT、MRI扫描,其中9例同时行MRI增强扫描.先分析X线平片、CT和MRI表现,再根据临床分级对患者进行分组,观察主要MRI征象对应的临床分期.结果 MRI扫描能清晰显示骨髓水肿、软骨损伤、脂肪沉积等表现;软骨成像序列能清晰显示骶髂关节软骨的损伤程度.增强扫描可显示早期反应.结论 X线、CT扫描不能显示病变骶髂关节的早期表现及判断炎症程度.MRI能敏感和准确地显示早期AS患者骶髂关节的滑膜增厚、骨髓水肿、关节软骨损伤等变化,并可以反映AS疾病所处的不同临床分期.%Objective Discussion early MRI findings of AS sacroiliac joint. And explore the links between MRI findings and the clinical classification. Methods Collecting 37 cases of AS patients. Underwent pelvic X ray and CT, MRI scans about sacroiliac joint. 9 cases simultaneously enhanced MRI scan. First analysis X-ray, CT and MRI features. Then according to the clinical classification for patients grouping, Observe the corresponding to the main MRI findings and the clinical staging.Results MRI scans can clearly show bone marrow edema, cartilage damage, joint effusion, fat deposition and other performance. Cartilage imaging sequences can clearly show the extent of damage to the articular cartilage of the sacroiliac joint. Enhanced scan can early response the synovitis response of sacroiliac joint.Conclusion X-ray, CT scan can not show an early manifestation of disease sacroiliac joint and determine the sacroiliac inflammation. MRI can accurately and sensitively show the synovial thickening, bone marrow edema, joint surface cartilage damage, joint effusion, cysts, fat deposition and other changes about the sacroiliac joints of early AS patients, and reflect the different clinical stages of AS.

  6. Comparative analysis of clinical features of patients from the south and north China with ankylosing spondylitis%中国南北方强直性脊柱炎患者临床特点对比分析——附807例报告

    宋慧; 胡载颖; 吴沪生; 杨明灿; 古洁若

    2011-01-01

    Objectives: To analyze the clinical features of patients from the south and north China with ankylosing spondylitis ( AS), and to discuss the impact of these factors on disease.Methods: Information of 807 patients with AS were collected, and grouped according to birthplace.Patients with birthplace in the south and north of Qinling-Huaihe River were assigned into south group and north group, respectively.Clinical features, including the age of disease onset, duration, family history, onset joints, associated symptoms, medication history and living habits of these patients were analyzed.Results: There was no significant difference in age, sex, age of disease onset , duration, family history, joints involved and uveitis prevalence between the two groups (P > 0.05 ).Significantly more patients with onset of axial joints and alcohol consumption habit were observed in south group, while significantly higher prevalence of onset of peripheral joints, sausage-like swelling digits and smoking habit was found in north group ( P < 0.05 ).Significantly different usage of drugs was observed between groups, while traditional Chinese medicine and sulfasalazine were more popularly used in the north group ( P < 0.05 ).However, no significant difference was revealed in usage of non-steroidal anti-inflammatory drugs and biological agents between groups.Conclusions: There are some differences of the clinical features between patients with AS from the south and north China, thus further study will be necessary.%目的:对比分析中国南北方AS患者临床特点的异同,探讨各种因素对疾病的影响.方法:收集AS病例共807例,以籍贯为分组依据,秦岭-淮河为界区分南北方组,总结南北方两组患者的临床特点,包括起病年龄、病程、家族史、首发部位、累及关节、伴随症状、用药情况及个人生活习惯等.结果:两组患者的年龄、性别、起病年龄、病程、家族史、累及各关节部位的比例

  7. 杀伤细胞免疫球蛋白样受体及HLA-Cw基因多态性与强直性脊柱炎遗传易感性研究%Gene polymorphism of killer cell immunoglobulin-like receptors and HLA-Cw in patients with ankylosing spondylitis

    张炳昌; 卢志明; 刘芸; 焦玉莲; 赵跃然; 李建峰

    2008-01-01

    Objective To investigate the alterations in killer cell immunoglobulin-like receptors (KIRs)2D and their specific HLA-Cw ligands in patients with ankylosing spondylitis(AS)and determine whether the changes were correlate to the pathogenesis of AS.Methods Polymerase chain reaction of sequence specific primerB(PCR-SSP)was employed for genotyping the presence or absence of five KIR2D genes(KIR2DL1,2DS1,KIR2DL2,2DL3,2DS2)as well as HLA-Cw01-08 alleles from genomic DNA in 105 individuals with AS,together with 51 individuals with osteoarthritis(OA)and 120 healthy controls.Then HLA-C10-08 was divided into two groups.HLA-Cwasn and HLA-Cwlys to calculate the frequency of KIRID genotype.HLA-Gu alleles and KIR/HLA-Cw genotypes.Results The frequencies of HLA-Cwlys genes were significandy higher in patients with AS(0.269 7)compared with those in OA controls(0.148 2)and healthy controls(0.138 8,P=0.024,P=0.001,respectively).The frequency of KIR2DS1/HLA-Cwlys combination Was also markedly higher in AS group(26.67%)than that in OA controls(11.76%)and healthy controls(13.33%,P=0.039,P=0.018,respectively).Condusion The data suggest that the HLA-Cwlys allele may be associated with genetic susceptibility to AS and moreover.in the existence of HLA-Cwlys.the individuals with KIR2DS1 gene are likely to be at increased risk of AS.%目的 探讨杀伤细胞免疫球蛋白样受体(KIRs)2D基因及其配体HLA-Cw等位基因与强直性脊柱炎的遗传易感性是否相关.方法 以PCR-SSP基因分型技术检测105例强直性脊柱炎患者KIR2D基因(KIR2DL1、2DS1、2DL2、2DL3、2DS2)和HLA-Cw01~08等位基因,并将HLA-Cw01~08分成HLA-Cwlys和HLA-Cwan两组,分别计算KIR2D基因、HLA-Cw等位基因及活化性KIR/HLA-Cw组合基因型频率,并与51例骨关节炎患者和120名健康人群比较.结果 强直性脊柱炎组患者HLA-Cwlys基因频率为0.269 7,高于骨关节炎组患者的0.148 2(P=0.024)和健康对照者的0.138 8(P=0.001).

  8. HLA-B27基因亚型、KIR基因和HLA-Cw基因与强直性脊柱炎病情活动的关系%The Relationship of the Subtypes of HLA-B27,HLA-Cw and KIRs with the Activity of Ankylosing Spondylitis

    张谷香; 赵福涛

    2016-01-01

    Objective To study the association of the polymorphism of human leukocyte antigen-B27 (HLA-B27),Killer immunoglobulin receptor(KIR),and human leukocyte antigen-Cw(HLA-Cw) genes with the activity of ankylosing spondylitis(AS).Methods Total of 25 patients with active AS admitted to Shanghai Third People′s Hospital Affiliated to Shanghai Jiaotong University from Jun .2011 to Mar.2013 were selected as trial group,41 patients with stable AS were inlcuded as control group.HLA-B27 subtype,KIR gene and HLA-Cw gene were detected by polymerase chain reaction with with sequence-specific primers (PCR-SSP).Results The gene frequency of HLA-Cw02,HLA-Cwlys and KIR3DS1 in the trial group were significantly higher than those in the control group[44.0%(11/25)vs 15.4%(6/41),48.0%(12/25) vs 22.0%(9/41),68.0%(17/25) vs 41.5%(17/41)],the differences were statistically significant(P <0.05).Conclusion The dramatic increase of frequencies of KIR3DS1,HLA-Cw02 and HLA-Cwlys in the active AS patients indicates KIRs gene and HLA-Cw gene is associated with the activity of AS .%目的 分析人类白细胞抗原( HLA)-B27 基因多态性、杀伤细胞免疫球蛋白样受体( KIR)基因和HLA-Cw基因与强直性脊柱炎( AS)病情活动的关系. 方法 选择2011 年6 月至2013 年3月上海交通大学医学院附属第三人民医院收治的活动期 AS患者25 例作为试验组,稳定期 AS患者41例作为对照组,采用特异性引物聚合酶链反应( PCR-SSP )技术进行 HLA-B27 亚型、KIR 基因、HLA-Cw基因检测. 结果 试验组 HLA-Cw02 和 HLA-Cwlys、 KIR3DS1 的基因频率显著高于对照组[44.0%(11/25)比15.4%(6/41),48.0%(12/25)比22.0%(9/41),68.0%(17/25)比41.5%(17/41)],差异有统计学意义(P<0.05). 结论 HLA-Cw02 和 HLA-Cwlys、KIR3DS1 基因频率在活动期AS患者中明显增高,表明KIRs基因和HLA-Cw基因与AS的病情活动有关.

  9. Comparison of Clinical Features in Ankylosing Spondylitis Patients with HLA-B27 Negative Expression and Positive Expression%HLA-B27阴性和阳性强直性脊柱炎患者临床情况比较

    刘波; 胡友红

    2011-01-01

    Objective To compare the clinical situation of the patients diagnosed as ankylosing spondylitis( AS ) with negative expression and positive expression of human leukocyte antigen B27( HLA-B27 ).Methods Use flow cytometry to measure HLA-B27 among the 301 patients diagnosed as AS in our hospital . And a comparative analysis has been done between the HLA-B27 negative and HLA-B27 positive patients.Results ①The incidence in male was significantly higher than in female in HLA-B27 negative expression group and positive expression group. The average onset age of HLA-B27-negative patients are older than those of the positive ones of the same sex; ②The age of the patients with HLA-B27 negative expression was mainly 31 ~45,and the positive ones 16 ~30. ③The major first symptoms of both the positive and negative patients were axial and peripheral arthritis. The major clinical symptoms include low back pain and hip pain. The rate of systemic symptom such as fever, night sweat and fatigue in negative patients was significant lower than that in the positive group. Conclusion The average age and onset age of HLA-B27-negative patients are older than those of the positive ones of the same sex,and part of HLA-B27 negative patients'condition was relatively mild. The different clinical features of HLA-B27 negative expression and positive expression patients call for due attention in diagonosing suspected AS patients with negative HLA-B27 expression.%目的 比较HLA-B27检测阴性与阳性的确诊强直性脊柱炎(AS)患者临床情况.方法 用流式细胞仪对在本院确诊的301例AS患者进行人类白细胞抗原B27(HLA-B27)检测,并对HLA-B27阴性和阳性患者进行比较研究.结果 ①HLA-B27阴性和阳性患者男性发病率明显高于女性,阴性与同性别阳性患者平均发病年龄明显偏晚.②HLA-B27阴性患者以31~45岁为主,阳性患者以16~30岁为主.③HLA-B27阴性和阳性患者首发症状均以中轴关节炎和外周关节

  10. The clinical and laboratory features of patients with ankylosing spondylitis and rheumatoid arthritis together%强直性脊柱炎合并类风湿关节炎患者的临床及实验室特征分析

    张维; 王梅英; 张源潮

    2008-01-01

    目的 探讨强直性脊柱炎(AS)合并类风湿关节炎(RA)患者的临床及实验室特征,并与单纯AS及单纯RA患者进行比较,了解AS合并RA(AS-RA)患者的临床及血清学特点.方法 入选AS患者208例,RA患者372例,将其中既符合AS诊断标准又符合RA诊断标准者作为研究对象,并与单纯AS(65例)和单纯RA(83例)比较其特点.结果 在208例AS患者和372例RA患者中有15例既符合AS诊断标准,也符合RA诊断标准,发生频率为AS 7.21%(15/208),RA 4.03%(15/372).与单纯RA及单纯AS比较,AS-RA患者病情炎性活动指标高,骨质破坏重,RF阳性率60.0%(9/15),HLA-B27抗原阳性率为66.7%(10/15),二者同时阳性率为53.3%(8/15),明显不同于RF在单纯RA阳性率(78.2%)和HLA-B27在单纯AS阳性率(92.2%).结论 AS-RA在临床并不少见,具有与单纯AS及单纯RA不同的临床及实验室特征.%Objective To investigate the clinical and serologic features of patients with ankylosing spondylitis(AS)and rheumatoid arthritis(RA) together,and to compare the information of patients with AS alone or with RA alone,respectively.Methods Two hundred and eight AS patients and three hundred and seventy two RA patients who were admitted to the hospital from 2001 to 2006 were studied retrospectively.The clinical and laboratory features of AS-RA patients were compared with AS alone(n=65)and with RA alone(n=83),respectively.Results fifteen patients were identified with AS and RA together in 208 AS patients (7.21%)and 372 RA patients(4.03%).Compared with the AS patients and with RA patients,patients with AS-RA showed higher disease active parameters and bone erosion.Rheumatic fever(RF) was postive in 9 of 15(60.0%)patients and the HLA-B27 antigen was presenting in 10 of 15(66.7%)patients.The coincidence rate of RF and HLA-B27 was 53.3%(8/15).The postive rate of RF and HLA-B27 in AS-RA patients was different from those in RA alone(78.2%)and AS alone(92.2%),respectively.Conclusion AS-RA patients have distinct

  11. 温肾通督法治疗肾虚督寒型强直性脊柱炎的临床疗效观察%Clinical Curative Effect Observation on Treating Ankylosing Spondylitis of Kidney-deficiency and Du-Channel-coldness by Warming Kidney And Unblocking Du Channel

    杜旭召; 邓素玲

    2014-01-01

    目的:探讨温肾通督法治疗肾虚督寒型强直性脊柱炎的临床疗效及安全性。方法:选取河南中医学院第二附属医院风湿骨病科的年龄在16~45岁强直性脊柱炎患者138例,随机分为治疗组和对照组各69例。治疗组采用温肾通督法(服用温肾通督汤配合督灸)治疗;对照组采用西医联合用药方案;观察期12周;随访期24周。结果:经过治疗,两组患者的症状均有不同程度的缓解,温肾通督法组总有效率为92.8%,西药组总有效率为72.5%,组间差异有统计学意义(P<0.05)。结论:温肾通督法治疗肾虚督寒型强直性脊柱炎疗效确切,不良反应少,值得临床推广。%Objective: To investigate the clinical efficacy and safety of warming kidney and unblocking Du Channel in the treatment of ankylosing spondylitis (AS) of kidney-deficiency and Du Channel coldness. Methods: 138 AS cases treated in rheumatic osteopathy Department of the Second Affiliated Hospital of Henan University of Traditional Chinese Medicine,aged from 16 to 45 years old, were randomly divided into treatment group and control group with 69 cases in each group. The treatment group was treated by warming kidney and unblocking Du Channel Supervision Law (taking orally Warming-Kidney and Unblocking-Du decoction combined with Du moxibustion) treatment; the control group was treated with combination schemes; observation period of 12 week and follow-up period of 24 weeks. Results: after treatment,both two groups of patients got some improvements. The warming kidney and unblocking Du Channel treatment had the total effective rate of 92.8% while the western medicine had the total effective rate of 72.5% that there was significant difference between the groups (P < 0.05). Conclusion: the effect warming kidney and unblocking Du Channel supervision method for the treatment of AS of kidney-deficiency and Du Channel coldness. is accurate with less adverse

  12. Spondylitis Association of America

    ... Newsletter Keeping you informed of spondylitis news and research updates, upcoming programs and events, breaking news, new educational materials and resources, and more! Sign up today for our free monthly eSUN and receive it ...

  13. Endoplasmic reticulum aminopeptidases in the pathogenesis of ankylosing spondylitis.

    Kenna, Tony J; Robinson, Philip C; Haroon, Nigil

    2015-09-01

    There has been significant progress in our understanding of the pathogenesis of AS. The advent of genome-wide association studies has increased the known loci associated with AS to more than 40. The endoplasmic reticulum resident aminopeptidases (ERAP) 1 and 2 were identified in this manner and are of particular interest. There appears to be a genetic as well as a functional interaction of ERAP1 and 2 with HLA-B27 based on the known functions of these molecules. Recent studies on the structure, immunological effects and the peptide-trimming properties of ERAP 1 and 2 have helped to provide insight into their pathogenic potential in AS. In this review, we explore the role of ERAP 1 and 2 in the pathogenesis of AS. PMID:26070942

  14. Etanercept (enbrel) administration in patients with ankylosing spondylitis

    A G Bochkova

    2009-01-01

    Этанерцепт (ЭТЦ, Энбрел) – димерный человеческий растворимый рецептор р75 фактора некроза опухолей (ФНО), соединенный с Fc-фрагментом человеческого иммуноглобулина G1 (IgG1). Этанерцепт был зарегистрирован для применения у пациентов анкилозирующим спондилитом (АС) в США в 2003 г. и в странах Европейского Союза в 2004 г. В России препарат зарегистрирован летом2009 г. под торговым названием Энбрел. Для оценки эффективности и переносимости ЭТН было проведено 5 многоцентровых рандомизированных пл...

  15. HLA-B27 Misfolding and Ankylosing Spondylitis

    Colbert, Robert A.; Tran, Tri M.; Layh-Schmitt, Gerlinde

    2013-01-01

    Understanding how HLA-B27 contributes to the pathogenesis of spondyloarthritis continues to be an important goal. Current efforts are aimed largely on three areas of investigation; peptide presentation to CD8 T cells, abnormal forms of the HLA-B27 heavy chain and their recognition by leukocyte immunoglobulin-like receptors on immune effector cells, and HLA-B27 heavy chain misfolding and intrinsic biological effects on affected cells. In this chapter we review our current understanding of the ...

  16. Etanercept (enbrel administration in patients with ankylosing spondylitis

    A G Bochkova

    2009-12-01

    Full Text Available Этанерцепт (ЭТЦ, Энбрел – димерный человеческий растворимый рецептор р75 фактора некроза опухолей (ФНО, соединенный с Fc-фрагментом человеческого иммуноглобулина G1 (IgG1. Этанерцепт был зарегистрирован для применения у пациентов анкилозирующим спондилитом (АС в США в 2003 г. и в странах Европейского Союза в 2004 г. В России препарат зарегистрирован летом2009 г. под торговым названием Энбрел. Для оценки эффективности и переносимости ЭТН было проведено 5 многоцентровых рандомизированных плацебо-контролируемых клинических исследований (РКИ [1,2,3,4

  17. Radiological diagnosis of spondylitis

    Roentgenography, CT and bone scintigraphy of 14 cases of spondylitis (pyogenic, 11 and tuberculous, 3) are investigated. Roentgenographic findings appear to be complexed since atypical forms of the diseases are common. The usefulness of CT to defect bone destruction as well as to delineate the extent of soft tissue involvement is emphasized. Bone scintigraphy with sup(99m)Tc-phosphate plays an important role in differentiation between pyogenic and tuberculous spondylitis, since the latter shows slight or minimal accumulation of the radioactivity in the affected sites, in contrast that the pyogenic one usually shows marked accumulation. (author)

  18. 超声观察英夫利西单抗治疗强直性脊柱炎患者骨质改变的研究%Study of therapeutic effects of infliximab on bone in patients with ankylosing spondylitis using ultrasonography

    薛勤; 汪年松; 吴燕; 朱家安; 程东生

    2015-01-01

    Objective To observe the bone change before and after infliximab treatment in patients with ankylosing spondylitis ( AS) using ultrasonography, and to explore its clinical significance.Methods All the 48 cases of active AS patients met the modified New York criteria (1984), signed informed consent forms, and received 6 times of intravenous infusion of infliximab 5 mg/kg.Bone change on lower limb joints and tendon insertion sites in terms of morphology and blood flow after infliximab treatment was observed using high-resolution B ultrasonography and energy Doppler ultrasonography.Back pain VAS scores, joint swelling and pain, CRP, ESR, BASDAI, DASFI, and BASMI were recorded on week 0 and week 30, respectively.Results Forty-eight cases of AS patients completed the trial, and 31 of them had recheck using ultrasonography.Before the treatment, 37 sites of bone erosion, 2 sites of osteophyte, 17 sites of tendon thickening, 15 sites of bursitis, 1 site of tendon calcification, 22 sites of abnormal blood flow, 11 sites of joint effusion, and 1 site of synovial proliferation were found among the 48 cases using ultrasonography.Thirty weeks after infliximab treatment, 8 sites of bone erosion and 1 site of abnormal blood flow were found among the 31 patients who underwent recheck using ultrasonography.The difference was statistically significant ( P 0.05 ) .All the clinical indicators improved after the treatment, and the difference was statistically significant ( P<0.01 ) compared to those before the treatment.Conclusion Ultrasonography can clearly show the formation of bone erosion and osteophyte on tendon insertion sites and joints, and indentify abnormities such as tendon thickening, bursitis, synovial proliferation, and abnormal blood flow. Particularly, it can reflect bone change in AS patients in a real-time manner and monitor the treatment efficacy.%目的:应用超声观察英夫利西单抗治疗前、后强直性脊柱炎患者骨质改变的情况,并

  19. 强直性脊柱炎合并IgA肾病与原发性IgA肾病临床资料对比研究%A comparative study of IgA nephropathy secondary to ankylosing spondylitis and primary IgA nephropathy

    张洁; 黄烽; 张江林

    2015-01-01

    目的 通过对比强直性脊柱炎(AS)合并IgA肾病与原发性IgA肾病的临床资料,了解AS合并IgA肾病的特点.方法 检索2007年1月-2015年9月在我院行肾脏活检并确诊为IgA肾病的资料,其中AS合并IgA者纳入AS合并IgA肾病组,按1∶5比例随机抽取同期原发性IgA肾病者为原发性IgA肾病组;对比两组患者的临床资料、病理表现及预后转归.结果 AS合并IgA肾病组15例,原发性IgA肾病组75例;与原发性IgA肾病组比,AS合并IgA肾病组病程较短[(10.1±8.3)个月比(20.2±27.9)个月],出现肾功能不全和高血压的比例更低[1/15、1/15比52.0%(39/75)、46.7%(35/75)].AS合并IgA肾病组24 h尿蛋白定量、血肌酐水平低于原发性IgA肾病组[(1.42±0.67)g比(2.88±1.35)g;(79.0±18.2) mmol/L比(145.3 ±77.6) mmol/L].两组患者肾活检肾脏病理分型Lee分级为Ⅲ~Ⅴ级,差异无统计学意义.两组患者均接受糖皮质激素、免疫抑制剂、血管紧张素转化酶抑制剂或血管紧张素受体拮抗剂治疗.治疗1~6年后随访,AS合并IgA肾病组有3例(3/11)患者病情进一步恶化发展,而原发性IgA肾病组有13例(22.8%,13/57).结论AS合并IgA肾病患者较原发性IgA肾病患者病程更短,病情更轻,但针对原发病的治疗(包括糖皮质激素、免疫抑制剂、生物制剂)无法改变患者预后.%Objective To study the characteristics of IgA nephropathy (IgAN) secondary to ankylosing spondylitis (AS) compared with primary IgAN.Methods Clinical and pathologic data were collected in patients who were diagnosed with IgAN by renal biopsy and admitted to our hospital from Jan 2007 to Sep 2015.Patients with IgAN secondary to AS were recruited by the ratio 1 ∶ 5 of patients with primary IgAN as control group at the same period.Results There were 15 patients in AS group,proportionately 75 patients in the control group.Compared with those in control group,patients in AS group had shorter disease course [(10.1 ± 8

  20. 自我管理模式对强直性脊柱炎患者疾病相关知识、关节功能和生活质量的影响%Self-management mode on disease-related knowledge,joint function and quality of life in patients with ankylosing spondylitis

    张萍萍; 牟一坤; 戈兰; 古洁若

    2015-01-01

    目的:评价自我管理模式对强直性脊柱炎(AS)患者疾病相关知识、关节功能和生活质量的影响。方法采取俱乐部、病友会的自我管理形式对84例 AS 患者进行心理指导、疼痛指导、饮食指导、生活指导,于治疗前及治疗后6个月以 AS 健康管理问卷、毕氏 AS 功能指数(BAS-FI)对84例患者的疾病知识水平、关节功能、心理质量和生活质量进行评定。结果与参与前比较,84例 AS 患者在参与自我管理模式半年后的疾病相关知识得分从(58.1±11.6)分增加至(74.8±10.2)分,BASFI 评分从(5.25±1.93)分改善至(3.90±1.87)分,参与前后比较差异均有统计学意义(P 均<0.001);悲观绝望认为自己将来无法像正常人一样工作的患者减少,相信疾病可以控制、愿意配合医生治疗、勇于面对生活的患者比例上升,因为害怕药物不良反应而不愿长期药物治疗的患者比例下降,戒烟、戒酒,饮食合理的患者增多(P 均<0.05),对健康教育的满意度提高到从73%提高至100%(P <0.001)。结论AS 患者俱乐部、病友会可充分调动患者的主观能动性,从而积极配合治疗和护理,提高了患者全面的健康知识,改善了关节功能,同时也增加了患者自我管理的能力和战胜疾病的信心,有利于提高患者的生活质量。%Objective To evaluate the effect of self-management mode upon disease-related knowl-edge,joint function and quality of life in patients with ankylosing spondylitis (AS).Methods Eighty four AS patients received guidance in the aspects of psychology,pain,diet and life through self-management mode in the pattern of AS patient club or gathering.Before and six months after treatment,disease-related knowledge, compliance,joint function,psychological quality and life quality were evaluated by questionnaire of AS health management and Bath AS

  1. Attempt to modify klebsiella carriage in ankylosing spondylitic patients by diet: correlation of klebsiella carriage with disease activity.

    Shinebaum, R; Neumann, V; Hopkins, R; Cooke, E. M.; Wright, V

    1984-01-01

    Patients with ankylosing spondylitis were asked to follow a 'klebsiella exclusion diet' for 5 months of a 10-month study. The same percentage of faecal samples were positive for klebsiella whether the patients were on or off the experimental diet. The diet also failed to influence variability of klebsiella serotypes. We found no correlation between acquisition of klebsiella and deterioration of disease symptoms, as recorded by the patients. Furthermore, carriage of klebsiella did not correlat...

  2. Aspergillus Spondylitis involving the Cervico-Thoraco-Lumbar Spine in an Immunocompromised Patient: a Case Report

    Aspergillosis is a rare cause of spondylitis. Moreover, early diagnosis by MR imaging and adequate treatment can prevent the serious complications of fungal infection. To our knowledge, the MR findings of multilevel aspergillus spondylitis in the cervico-thoraco-lumbar spine have not been previously described. Here, we report the MR findings of aspergillus spondylitis involving the cervical, thoracic, and lumbar spine in a liver transplant recipient. spergillosis is a rare cause of spondylitis, and early diagnosis by MR imaging and adequate treatment are essential for a good outcome. Although the MR findings of bacterial spondylitis have been fully described, the findings of aspergillus spondylitis have been rarely described, and to the best of our knowledge multilevel involvement of cervico-thoraco-lumbar spine has not been previously reported. Here, we report the MR imaging findings of aspergillus spondylitis involving the cervico-thoraco-lumbar spine in a liver transplant recipient. In conclusion, aspergillus spondylitis should be considered in the differential diagnosis of immunocompromised patients with MR findings resembling those of tuberculous spondylitis

  3. Aspergillus Spondylitis involving the Cervico-Thoraco-Lumbar Spine in an Immunocompromised Patient: a Case Report

    Son, Jeong-Min; Jee, Won-Hee; Jung, Chan-Kwon; Kim, Sang-Il; Ha, Kee-Yong [The Catholic University of Korea, Seoul (Korea, Republic of)

    2007-10-15

    Aspergillosis is a rare cause of spondylitis. Moreover, early diagnosis by MR imaging and adequate treatment can prevent the serious complications of fungal infection. To our knowledge, the MR findings of multilevel aspergillus spondylitis in the cervico-thoraco-lumbar spine have not been previously described. Here, we report the MR findings of aspergillus spondylitis involving the cervical, thoracic, and lumbar spine in a liver transplant recipient. spergillosis is a rare cause of spondylitis, and early diagnosis by MR imaging and adequate treatment are essential for a good outcome. Although the MR findings of bacterial spondylitis have been fully described, the findings of aspergillus spondylitis have been rarely described, and to the best of our knowledge multilevel involvement of cervico-thoraco-lumbar spine has not been previously reported. Here, we report the MR imaging findings of aspergillus spondylitis involving the cervico-thoraco-lumbar spine in a liver transplant recipient. In conclusion, aspergillus spondylitis should be considered in the differential diagnosis of immunocompromised patients with MR findings resembling those of tuberculous spondylitis.

  4. The value of computed tomography in nonspecific spondylitis

    The computed tomographic symptoms of nonspecific spondylitis, observed in 14 patients, are described. In 9 patients the spondylitis occurred as complication following operations for lumbar disc hernias. The most common computed-tomographic symptoms were: edematous dilatation of the paravertebral soft tissues, osteolytic destructive changes of the discal surfaces of the vertebral bodies, low densitometric values of the affected disc, soft-tissue masses in the spinal canal. Computed tomography is considered as a method of crucial importance for early and accurate diagnosis of nonspecific spondylitis. The method is of particular value also in the dynamic study of the evolution of the inflammatory process. An optimal organization scheme is suggested of an early diagnosis of nonspecific spondilytis, includung computed tomography, bone scintigraphy, conventional roentgenography and CT-guided puncture

  5. Die aktuelle Situation von Patienten mit Ankylosierender Spondylitis (AS) in Deutschland im Vergleich zwischen Mitgliedern der Patientenorganisation DVMB (Deutsche Vereinigung Morbus Bechterew) und Nichtmitgliedern

    Brenneis, Cornelia

    2014-01-01

    Background: Although joining patient self-help groups is recommended to patients with ankylosing spondylitis (AS) the evidence for benefits of membership is limited. Objective: To evaluate differences between AS patients who are members of a patient self- help group and AS patients who are non-members. Methods: An anonymous questionnaire which consisted of 82 questions regarding demographics, diagnosis, smoking habits, acquisition of information about the disease, disease activity, func...

  6. Ankylosing spondyloarthritis in the rheumatology practice of Karelia

    Irina Mikhailovna Marusenko; A A Brazhnik; N N Vezikova; O A Vaskova

    2012-01-01

    The paper describes the pathological aspects of an inflammatory process in ankylosing spondyloarthritis (AS), the role of muscle spasm in maintaining the intensity of pain syndrome and stiffness, the need for the early diagnosis of AS, and the significance of the early use of nonster-oidal anti-inflammatory drugs in these patients. The results of clinical trials and the authorsX data demonstrate the high efficacy and good tolerance of nimesulide (nise) in AS.

  7. Ankylosing spondyloarthritis in the rheumatology practice of Karelia

    Irina Mikhailovna Marusenko

    2012-12-01

    Full Text Available The paper describes the pathological aspects of an inflammatory process in ankylosing spondyloarthritis (AS, the role of muscle spasm in maintaining the intensity of pain syndrome and stiffness, the need for the early diagnosis of AS, and the significance of the early use of nonster-oidal anti-inflammatory drugs in these patients. The results of clinical trials and the authorsX data demonstrate the high efficacy and good tolerance of nimesulide (nise in AS.

  8. Ankylosing spondyloarthritis in the rheumatology practice of Karelia

    Irina Mikhailovna Marusenko

    2012-01-01

    Full Text Available The paper describes the pathological aspects of an inflammatory process in ankylosing spondyloarthritis (AS, the role of muscle spasm in maintaining the intensity of pain syndrome and stiffness, the need for the early diagnosis of AS, and the significance of the early use of nonster-oidal anti-inflammatory drugs in these patients. The results of clinical trials and the authorsX data demonstrate the high efficacy and good tolerance of nimesulide (nise in AS.

  9. PROGRESSION AND OUTCOMES OF UVEITIS IN PATIENTS WITH ANKYLOSING SPONDILITIS

    A. A. Godzenko

    2014-01-01

    Full Text Available Uveitis is a common extraskeletal manifestation of ankylosing spondylitis (AS occurring in 20–40% of patients. Mostauthors underline a favorable prognosis for AS-associated uveitis.Objective: to study features of clinical picture and progression of AS-associated uveitis and to estimate the occurrence of its complications.Subjects and methods. Across-sectional study of 140 patients (98 males and 42 females with AS, who had at least one uveitis attack over the period of disease and was followed up at V.A. Nasonova Research Institute of Rheumatology during 2008–2012. In addition to standard rheumatologic examination all patients were examined by ophthalmologist. Biomicroscopy, ophthalmoscopy, tonometry, computer-assisted perimetry, ultrasonography (B-scanning of eyes and, if needed, fluorescein angiography and electrophysiological examination of retina were performed. Localization of uveitis, presence of complications affecting vision, total number of uveitis attacks by the moment of examination, mean number of uveitis attacks per year, correlation between the frequency of attacks and complications, presence of other extraskeletal manifestations and peripheral arthritis were assessed. The total number of uveitis attacks was defined from patients' interviews and respective medical documentation. Mean number of uveitis attacks was calculated as ratio of total number of uveitis attacks to the duration of disease for each patient. In the case of more than two attacks per year uveitis progression was consideredrefractory.Results.Mean duration of the disease was 17.7±11.03 years. In 19 patients (14% AS manifested before and in 121 (86% – after the age of 16 years. HLA-B27 was revealed in 135 (96% patients, peripheral arthritis – in 43 (30%, whereas other extraskeletal manifestations – in 46 (32%. Early onset of uveitis in first 10 years of the disease was recorded in 81 (58% patients, after10 years – in 21 (15%. Uveitis was the

  10. Scintigraphic evaluation of the sacroiliac joints in anklylosing spondylitis

    The sedimentation of sup(99m)Tc-phosphate complexes into the sacroiliac joints was investigated in 94 patients with loin pains and suspected of ankylosing spondylitis (SpA) and a control group of 96 healthy patients. The investigation yields the following results: 1. the visual evaluation of the scintigrams does not allow a reliable diagnosis and should be replaced by a semi-quantitative technique, 2. the index ISC/sacrum does remarkably depend on age, 3rd even in young patients the scintigraphic examination appears to be useful to alidate the clinical suspicion of sacroilictis which is in contradiction to literature, 4th with increasing SpA the scintigraphic detectability of changes in the ISG decreases. 5th the floriditily of the ISG process determines the scintigraphic detectability of the process of the disease, 6th the scintigraphic finding is unspecific. Inflammatory states of the disease of different genesis and degenerative processes in the ISG equally yield pathological index values. (orig./MG)

  11. Radiological evaluation of tuberculous spondylitis with computed tomography

    Spinal tuberculosis is curable disease, and early diagnosis is mandatory for early treatment. We reviewed conventional radiographers and computed tomograms (CT) from Histopathologically confirmed 30 cases of spinal tuberculosis, and compared these findings with radiologic findings from 2 cases of pyogenic spondylitis and 4 cases of metastasis. The results were as follows: 1. The frequent site of involvement were thromboembolic junction and low lumbar vertebrae, and the most frequent type is multisegmented subligamentous type (93.3%). 2. CT was not of great use in the differential diagnosis of the tuberculosis. Dominant CT findings of tuberculous spondylitis were anterior vertebral body destruction, paravertebral soft-tissue mass and thick walled abscess formation occasionally containing calcification and disc space narrowing in the setting of an indolent or relatively benign course. 3. CT is the best modality for imaging the extent and anatomy of the destructive process, the degree of canal encroachment, and the change of adjacent vital structure. So CT was particularly useful in pre-operative planning of debridement and stabilization surgery. 4. The most common causes of neurologic manifestations in tuberculous spondylitis were the compression of spinal cord by sequestrated bony fragments and disc material, granulation tissue or abscess in the spinal canal.

  12. Atlantoaxial Subluxation after Pyogenic Spondylitis around the Odontoid Process

    Atsushi Hasegawa

    2015-01-01

    Full Text Available Study Design. A case report and review of the literature. Objective. The aim of this study was to describe the conservative management of pyogenic spondylitis around the odontoid process. Summary of Background Data. Atlantoaxial subluxation after pyogenic spondylitis is rare. The therapeutic approach to infection of the upper cervical spine is controversial. Methods. Medical chart and radiological images of a 76-year-old male patient were retrospectively reviewed. Radiography revealed atlantoaxial subluxation, and an abscess was seen around the odontoid process on magnetic resonance images. Intravenous antibiotics and a halo vest were used to treat the patient. We then observed the patient’s conservative treatment course. Results. C-reactive protein levels returned to normal 4 weeks after administration of the intravenous antibiotics. The patient’s muscle weakness also completely recovered 8 weeks after administration of the intravenous antibiotics. Because the patient was able to walk without any support, surgical treatment was not necessary. Conclusions. Pyogenic spondylitis of the upper cervical spine is a rare manifestation. Surgical or conservative treatment must be selected carefully based on the patient’s symptoms. If early diagnosis and treatment can be provided to the patients, conservative treatment can be achieved.

  13. Espondilite anquilosante e anestesia Espondilitis anquilosante y anestesia Ankylosing spondylitis and anesthesia

    Carlos Rogério Degrandi Oliveira

    2007-01-01

    JUSTIFICATIVA E OBJETIVOS: A espondilite anquilosante (EA) é uma doença inflamatória crônica das articulações, incluída no grupo das espondiloartropatias soronegativas. A característica principal dessa doença é a fusão óssea da coluna vertebral que leva à perda permanente da flexibilidade do dorso e do pescoço. Outras grandes articulações e tecidos conectivos poderão estar afetados pelo processo inflamatório. A EA acomete principalmente homens entre 20 e 40 anos; é rara após os 50 anos. As mu...

  14. Ankylosing spondylitis: genomic and functional characterization of candidate genes and their repercussion in clinical practice

    Santos, Fernando Manuel Pimentel dos 

    2012-01-01

    RESUMO: Introdução: A espondilite anquilosante (EA) é uma doença inflamatória crónica caracterizada pela inflamação das articulações sacroilíacas e da coluna. A anquilose progressiva motiva uma deterioração gradual da função física e da qualidade de vida. O diagnóstico e o tratamento precoces podem contribuir para um melhor prognóstico. Neste contexto, a identificação de biomarcadores, assume-se como sendo muito útil para a prática clínica e representa hoje um grande desafio para a comunidade...

  15. Adaptation of the Bath measures on disease activity and function in ankylosing spondylitis into Danish

    Pedersen, Ole Birger; Hansen, G O; Svendsen, Anders Jørgen;

    2007-01-01

    Denmark. METHODS: The BASDAI, BASFI, and BASG were translated into Danish and subsequently field-tested among 17 AS patients for relevance, face, and content validity. Reliability and validity were assessed by administering the new measures and a comparator instrument to 113 AS patients on two occasions...

  16. Scoring inflammatory activity of the spine by magnetic resonance imaging in ankylosing spondylitis: a multireader experiment

    Lukas, Cédric; Braun, Jürgen; van der Heijde, Désirée;

    2007-01-01

    considered by the reader as the most abnormal, with additional scores for "depth" and "intensity." Both the order of the methods used by each reader and the timepoints (before/after treatment) were randomized. Feasibility of each scoring system was evaluated by measuring the mean time needed to score each....... Discriminatory ability was assessed using Z-scores (Mann-Whitney test) comparing change in score between patients treated with TNF-blocking drug and placebo. RESULTS: The mean time to score one set of MRI was shortest for the Berlin method. SDC was lowest for the Berlin method and highest for SPARCC. Overall...

  17. Association of HLA-B27 status and gender with sacroiliitis in patients with ankylosing spondylitis

    Xiong, Jiangbiao; Chen, Jing; Tu, Jianxin; Ye, Wenjing; Zhang, Zhiyong; Liu, Qiaoqiong; Zhu, Xiaochun

    2014-01-01

    Objective: To observe the influence of human leucocyte antigen B27 (HLA-B27) status and gender on sacroiliitis on computed tomography (CT) in ankylosingspondylitis (AS). Methods: We reviewed the archived medical records of the AS inpatients admitted in the Rheumatology Department of the First Affiliated Hospital of Wenzhou Medical University during the period from January 2007 through January 2013 and finally 386 patients were included in the study. The severity of sacroiliitis on CT was eval...

  18. Serum nitrate and nitrite levels in patients with rheumatoid arthritis, ankylosing spondylitis, and osteoarthritis

    Ersoy, Y.; Ozerol, E; Baysal, O; Temel, I; MacWalter, R; Meral, U; Altay, Z

    2002-01-01

    Methods: Thirty five patients with RA, 32 patients with AS, and 36 patients with OA were entered into this study. In addition, 30 healthy volunteers acted as a control group. Concentrations of nitrate and nitrite in serum were determined by direct and indirect Griess reactions. C reactive protein and erythrocyte sedimentation rate levels were determined as markers of systemic activity of disease (SAD) in RA and AS groups.

  19. Radiology changes in brucella spondylitis, experience with 26 cases

    Background/objective: brucellosis is an endemic zoonosis in the Middle East and despite all public health efforts it has not yet been eradicated in Iran. We aimed to highlight and categorize the imaging features of Brucella spondylitis. Material and method: twenty six cases of Brucella spondylitis were treated by the authors from 1982 up to 2003. The available imaging studies of all the cases are reviewed and include X-ray films, conventional myelography, computerized tomographic (CT Scan) and magnetic resonance imaging. Results: there were 21 male and 5 female patients with an age range of 5 to 62 years and the majority (60 %) in the 4 Th and 5 Th decades of life. Wright hemagglutination tests were positive in all cases. Plain x-ray films typically showed lysis of the end plates with osteophyte formation involving affected vertebrae, followed by narrowing of the inter spaces and destruction or collapse of the vertebral bodies in 7 cases. Myelography demonstrated various types of epidural filling defects and obstruction to the flow of contrast material in 10 cases. CT scan, available in 3 cases, showed erosion and cauliflower-like proliferation at the bony edges of the vertebral bodies and end plates. MRI findings varied depending upon the acute or chronic stages of the illness with hypo- or hyper-intense changes on T1 sequences, and primarily hyper-intense changes of T2 sequences in 8 cases. Conclusion: The findings in this series of patients suggest that imaging findings of Brucella spondylitis are scarcely specific. However when considering the medical history, place of origin of the patients, clinical presentation and laboratory findings, the early diagnosis of the illness may be possible before proceeding to surgical intervention

  20. Tuberculous spondylitis vs pyogenic spondylitis: focusing on the discriminative MR findings for differentiation

    The purpose of this study is to analyze the most discriminative MR findings for making the differential diagnosis of tuberculous and pyogenic spondylitis. Sixty MR scans of 18 pyogenic spondylitis patients and 42 tuberculous spondylitis patients were retrospectively reviewed. The statistical analysis was performed using stepwise discriminant analysis and Student's T-test. The patients with tuberculous spondylitis had a significantly higher incidence of MRI findings as follows (ρ < 0.05): smooth margin of a paraspinal mass/abscess in 67% [28/42] of the tuberculous spondylitis patients vs 6% [1/8] in the pyogenic spondylitis patients, mild endplate erosion in 52% [22/42] vs 38% [7/18], respectively, the presence of paraspinal mass/abscess in 100% [42/42] vs 6% [1/18], respectively, central dark signal intensity of the abscess in 86% [36/42] vs 39% [7/18]), respectively, subligamentous spread in 81% [34/42] vs 50% [9/18]), respectively, severe vertebral collapse in 20% [8/42] vs 11% [2/18]), respectively, and posterior extension in 62% [26/42] vs 33% [6/18]), respectively. Among of them, the significant discriminative MR findings were the margin of a paraspinal mass, the grade of endplate erosion and the presence of absence of a paraspinal mass in that order. In the differentiation of tuberculous and pyogenic spondylitis, the margin of the paraspinal mass, the grade of endplate erosion and the presence or absence of a paraspinal mass are the most three discirminating MR findings in that order

  1. Description of spinal findings and determining the MR positive spondylitis

    Full text: Spondyloarthritis (SpA) is an umbrella term applied to a family of rheumatic diseases that have both features in common with, as well as being distinct from, other inflammatory arthritides, particularly rheumatoid arthritis (RA). Recently, the ASAS working group established classification criteria to distinguish 2 broad categories of SpA: peripheral SpA and axSpA (Rudwaleit, 2011; Rudwaleit, 2010; Rudwaleit, 2009c). This division is based on the body part predominantly involved in the inflammatory process and those areas of the body that may respond similarly well to medication. Therefore, peripheral SpA includes diseases affecting mainly peripheral joints, such as reactive arthritis and psoriatic arthritis (PsA), whereas axSpA comprises those diseases with mainly axial involvement (sacroiliac joints and spine), including ankylosing spondylitis (AS) and nonradiographic axSpA (nr-axSpA). Patients with AS have definitive evidence of structural changes in the sacroiliac joint (sacroiliitis) on x-ray, fulfilling the Modified New York classification criteria (mNY-positive) (van der linden, 1984), whereas in those with nr-axSpA structural changes on conventional radiographs do not meet the mNy criteria (mNY-negative) (Rudwaleit, 2005; Dougados, 1991). Axial SpA is a chronic inflammatory disease that impacts a substantial proportion of the population. Limited evidence exists regarding the exact prevalence of axSpA. In the US, however, recent data suggest that the prevalence is similar to that of RA (axSpA: 0.7% to 1.4%; RA: 0.5% to 1.0%) (Reveille; 2012; Myasoedova, 2010; Helmick, 2008). In patients with axSpA, the disease typically originates in the sacroiliac joints, then progresses to the spine. In the sacroiliac joints and the spine, active inflammation results in erosions, sclerosis, and fatty lesions. However, the most characteristic feature is new bone formation leading to ankylosis of the sacroiliac joints and syndesmophytes attached to the vertebral

  2. Tuberculous Spondylitis Following Kyphoplasty: A Case Report and Review of the Literature.

    Ge, Chao-Yuan; He, Li-Ming; Zheng, Yong-Hong; Liu, Tuan-Jiang; Guo, Hua; He, Bao-Rong; Qian, Li-Xiong; Zhao, Yuan-Tin; Yang, Jun-Song; Hao, Ding-Jun

    2016-03-01

    Tuberculous spondylitis of the augmented vertebral column following percutaneous vertebroplasty or kyphoplasty has rarely been described. We report an unusual case of tuberculous spondylitis diagnosed after percutaneous kyphoplasty (PKP).A 61-year-old woman presented to our institution complaining of back pain following a fall 7 days before. Radiologic studies revealed an acute osteoporotic compression L1 fracture. The patient denied history of pulmonary tuberculosis (TB) and there were no signs of infection. The patient was discharged from hospital 4 days after undergoing L1 PKP with a dramatic improvement in her back pain. Two years later, the patient was readmitted with a 1 year history of recurrent back pain. Imaging examinations demonstrated long segmental bony destruction involving L1 vertebra with massive paravertebral abscess formation. The tentative diagnosis of tuberculous spondylitis was made, after a serum T-SPOT. The TB test was found to be positive. Anterior debridement, L1 corpectomy, decompression, and autologous rib graft interposition, and posterior T8-L4 instrumentation were performed. The histologic examination of the resected tissue results confirmed the diagnosis of spinal TB. Anti-TB medications were administered for 12 months and the patient recovered without sequelae.Spinal TB and osteoporotic vertebral compression fractures are similar clinically and radiologically. Spinal surgeons should consider this disease entity to avoid misdiagnosis or complications. Early surgical intervention and anti-TB treatment should be instituted as soon as the diagnosis of spinal TB after vertebral augmentation is made. PMID:26986102

  3. Case report 469: Spondylitis (lumbar spine) due to Brucella abortus

    The current case is interesting in that, although the plain radiographs were diagnostic of infection and the patient's work history suggested brucellosis, both the negative serum antibody titers to brucella and the CT appearance of large calcified psoas abscesses made the diagnosis of tuberculous spondylitis most probable. Open biopsy with tissue culture proved brucella. From this experience it appears that the presence of large calcified psoas abscesses should not eliminate the diagnosis of brucella spondylitis in the proper clinical setting. (orig.)

  4. Case report 469: Spondylitis (lumbar spine) due to Brucella abortus

    Manaster, B.J.

    1988-03-01

    The current case is interesting in that, although the plain radiographs were diagnostic of infection and the patient's work history suggested brucellosis, both the negative serum antibody titers to brucella and the CT appearance of large calcified psoas abscesses made the diagnosis of tuberculous spondylitis most probable. Open biopsy with tissue culture proved brucella. From this experience it appears that the presence of large calcified psoas abscesses should not eliminate the diagnosis of brucella spondylitis in the proper clinical setting.

  5. Titanium luque SSI for rheumatoid spondylitis with myelopathy. Clinical results and postoperative magnetic resonance imaging

    Taniguchi, Mutsumi; Maruo, Soji; Tateishi, Hiroomi; Matsumoto, Manabu; Otsuka, Seiji; Yokoyama, Hiroshi [Hyogo Coll. of Medicine, Nishinomiya (Japan)

    1995-12-01

    Nineteen rheumatoid patients suffering from rheumatoid spondylitis with myelopathy were surgically treated using Luque segmental spinal instrumentation (SSI). We studied 7 cases of patients who underwent postoperative magnetic resonance imaging (MRI) evaluation after being treated with titanium Luque SSI. Titanium implants were imaged safely and there was no evidence of implant migration or local tissue heating effect. MRI also allowed postoperative cervical spine imaging without significant image distortion. This titanium Luque SSI method affords rigid fixation, allows early mobilization and MRI serial imaging in the patient`s lifelong medical care. (author).

  6. Titanium luque SSI for rheumatoid spondylitis with myelopathy. Clinical results and postoperative magnetic resonance imaging

    Nineteen rheumatoid patients suffering from rheumatoid spondylitis with myelopathy were surgically treated using Luque segmental spinal instrumentation (SSI). We studied 7 cases of patients who underwent postoperative magnetic resonance imaging (MRI) evaluation after being treated with titanium Luque SSI. Titanium implants were imaged safely and there was no evidence of implant migration or local tissue heating effect. MRI also allowed postoperative cervical spine imaging without significant image distortion. This titanium Luque SSI method affords rigid fixation, allows early mobilization and MRI serial imaging in the patient's lifelong medical care. (author)

  7. Ankylosing spondylitis in Danish and Norwegian twins: occurrence and the relative importance of genetic vs. environmental effectors in disease causation

    Pedersen, O B; Svendsen, Anders Jørgen; Ejstrup, L;

    2008-01-01

    .3%) participated in validation of the diagnosis. After validation, 39 probands were diagnosed with AS. Subsequent invitation of co-twins resulted in 27 complete pairs. The point prevalence and the annual incidence of AS was 0.1% and 3/100,000 person-years (pyr) among the Danish twins. The positive predictive value...

  8. Impact of tobacco smoking on response to tumour necrosis factor-alpha inhibitor treatment in patients with ankylosing spondylitis

    Glintborg, Bente; Højgaard, Pil; Lund Hetland, Merete;

    2016-01-01

    .29-4.95)), P < 0.0001). Similar results were found in multivariate analyses (current versus never smokers, HR 1.41 (95% CI 1.21-1.65), P < 0.001), most pronounced among men. Current smokers had poorer 6 months' BASDAI50%/20 mm-response rate than never smokers (42%/58%, P < 0.001). In multivariate analyses......OBJECTIVES: To investigate the association between tobacco smoking and disease activity, treatment adherence and treatment responses in patients with AS treated with their first tumour necrosis factor-alpha inhibitor (TNFi) therapy in routine care. METHODS: Observational cohort study based on the...... Danish nationwide DANBIO registry. Kaplan-Meier plots, Cox and logistic regression analyses by smoking status (current/never/previous) were calculated for treatment adherence and BASDAI 50%/20 mm-response. Additional stratified analyses were performed for gender and TNFi-type. RESULTS: Of 1576 AS...

  9. HLA-B27和强直性脊柱炎%HLA-B27 antigen and ankylosing spondylitis

    陶赞英; 郑明慈

    2006-01-01

    HLA-B27与强直性脊柱炎呈强相关,但它在强直性脊柱炎中作用仍不详.近年来人群中HLA-B27基因亚型的研究和人类B27转基因动物模型的建立都有力地证实了HLA-B27分子是强直性脊柱炎原发关联成分.

  10. Primary pyogenic spondylitis following kyphoplasty: a case report

    Heyse Thomas J

    2011-03-01

    Full Text Available Abstract Introduction Only ten cases of primary pyogenic spondylitis following vertebroplasty have been reported in the literature. To the best of our knowledge, we present the first reported case of primary pyogenic spondylitis and spondylodiscitis caused by kyphoplasty. Case presentation A 72-year old Caucasian man with an osteoporotic compression fracture of the first lumbar vertebra after kyphoplasty developed sensory incomplete paraplegia below the first lumbar vertebra. This was caused by myelon compression following pyogenic spondylitis with a psoas abscess. Computed tomography guided aspiration of the abscess cavity yielded group C Streptococcus. The psoas abscess was percutaneously drained and laminectomy and posterior instrumentation with an internal fixator from the eleventh thoracic vertebra to the fourth lumbar vertebra was performed. In a second operation, corpectomy of the first lumbar vertebra with cement removal and fusion from the twelfth thoracic vertebra to the second lumbar vertebra with a titanium cage was performed. Six weeks postoperatively, the patient was pain free with no neurologic deficits or signs of infection. Conclusion Pyogenic spondylitis is an extremely rare complication after kyphoplasty. When these patients develop recurrent back pain postoperatively, the diagnosis of pyogenic spondylitis must be considered.

  11. Pyogenic Spondylitis after Vertebroplasty - A Report of Two Cases -

    Lee, Chang Bum; Kim, Hyung Sup; Kim, Yong Jin

    2007-01-01

    Vertebroplasty is now extensively used worldwide for thoracic and lumbar osteoporotic compression fractures. Although percutaneous vertebroplasty is considered a minimally invasive procedure, it may result in several complications. In this report, we present two patients where pyogenic spondylitis developed after vertebroplasty surgery was required. The serious nature of these infections, surgical management and complication avoidance are discussed.

  12. CT imaging features of tuberculous spondylitis in children

    Objective: To investigate CT imaging features of tuberculous spondylitis in children. Methods: The CT imagings of two groups of patients with Tuberculous Spondylitis between January 2004 and March 2008 were retrospectively reviewed. One group included 28 children from 0 to 14 years old. Another group included 159 adults. All the patients were diagnosed as tuberculous spondylitis by pathology or biopsy, or by anti-turboelectric therapy. The CT imagings of the two groups were read retrospectively, including infections of vertebras and its appendix, the proportion of the total length of paravertebral abscess to the height of relative vertebra, the information of paravertebral abscess and dura mate of spinal cord and nerve root compression. Results The ratio of kyphosis in children group was 75% (21/28), higher than that in adults'. Tuberculous spondylitis in children was most often involved thoracic vertebra (53.7%,51/95). In children, involvement was more often seen than that of cervical vertebra and lumbar. The ratio of tuberculous spondylitis of children's cervical vertebrae was 10.5% (10/95)and of lumbar was 31.6% (30/95, while in adults that of cervical vertebrae was 3.3% (16/479)and of lumbar was 44.5% (213/479). There was statistical difference between them. The percentages of central type of tuberculous vertebral osteitis in chlidren was 57.1% (16/28)and was different with that in adults'(P=0.0010.05). The incidence of dura mate of spinal cord or nerve root compression in children was 78.6%(22/28), much higher than that in adults (49.7%(79/159), P=0.005 <0.05). Conclusion: Special features of tuberculous spondylitis in childrencan be observed on CT imaging, kyphosis is often seen. The incidence of tuberculous spondylitis of thoracic vertebra and cervical vertebrae is high, central type of tuberculous vertebral osteitis in children is more popular than that in adults, but there is higher ratio of dura mate of spinal cord or nerve root compression in children

  13. Apicotomy: surgical management of maxillary dilacerated or ankylosed canines.

    Araújo, Eustáquio A; Araújo, Cristiana V; Tanaka, Orlando M

    2013-12-01

    This clinical article reports a technique, apicotomy, for managing dilacerated or ankylosed canines. The records of 3 patients successfully treated with apicotomy are presented. Orthodontists observe clinically significant incidences of impacted maxillary canines in their daily practices. Several procedures have been described to bring an ankylosed, impacted tooth into occlusion. Luxation is the most widely used solution, but there are risks involved with that approach, and the success rate is low. Surgical repositioning has also been used, but morbidity is high, and the aggressiveness of the procedure might also contraindicate it. Ankylosis might be related to the anatomic position of the canine's root apex and its adjacent anatomic structures. Apicotomy is a guided fracture of a canine root apex, followed by its orthodontic traction. It is a conservative surgical alternative for treating impacted canines with dilacerations or apical root ankylosis. PMID:24286914

  14. Operative stabilization of the remaining mobile segment in ankylosed cervical spine in systemic onset - juvenile idiopathic arthritis: A case report

    Suhodolčan, Lovro; Mihelak, Marko; Brecelj, Janez; Vengust, Rok

    2016-01-01

    We describe a case of a 19-year-old young man with oligoarthritis type of juvenile idiopathic arthritis, who presented with several month duration of lower neck pain and progressive muscular weakness of all four limbs. X-rays of the cervical spine demonstrated spontaneous apophyseal joint fusion from the occipital condyle to C6 and from C7 to Th2 with marked instability between C6 and C7. Surgical intervention began with anterolateral approach to the cervical spine performing decompression, insertion of cage and anterior vertebral plate and screws, followed by posterior approach and fixation. Care was taken to restore sagittal balance. The condition was successfully operatively managed with multisegmental, both column fixation and fusion, resulting in pain cessation and resolution of myelopathy. Postoperatively, minor swallowing difficulties were noted, which ceased after three days. Patient was able to move around in a wheelchair on the sixth postoperative day. Stiff neck collar was advised for three months postoperatively with neck pain slowly decreasing in the course of first postoperative month. On the follow-up visit six months after the surgery patient exhibited no signs of spastic tetraparesis, X-rays of the cervical spine revealed solid bony fusion at single mobile segment C6-C7. He was able to gaze horizontally while sitting in a wheelchair. Signs of myelopathy with stiff neck and single movable segment raised concerns about intubation, but were successfully managed using awake fiber-optic intubation. Avoidance of tracheostomy enabled us to perform an anterolateral approach without increasing the risk of wound infection. Regarding surgical procedure, the same principles are obeyed as in management of fracture in ankylosing spondylitis or Mb. Forestrier. PMID:27458558

  15. Operative stabilization of the remaining mobile segment in ankylosed cervical spine in systemic onset - juvenile idiopathic arthritis: A case report.

    Suhodolčan, Lovro; Mihelak, Marko; Brecelj, Janez; Vengust, Rok

    2016-07-18

    We describe a case of a 19-year-old young man with oligoarthritis type of juvenile idiopathic arthritis, who presented with several month duration of lower neck pain and progressive muscular weakness of all four limbs. X-rays of the cervical spine demonstrated spontaneous apophyseal joint fusion from the occipital condyle to C6 and from C7 to Th2 with marked instability between C6 and C7. Surgical intervention began with anterolateral approach to the cervical spine performing decompression, insertion of cage and anterior vertebral plate and screws, followed by posterior approach and fixation. Care was taken to restore sagittal balance. The condition was successfully operatively managed with multisegmental, both column fixation and fusion, resulting in pain cessation and resolution of myelopathy. Postoperatively, minor swallowing difficulties were noted, which ceased after three days. Patient was able to move around in a wheelchair on the sixth postoperative day. Stiff neck collar was advised for three months postoperatively with neck pain slowly decreasing in the course of first postoperative month. On the follow-up visit six months after the surgery patient exhibited no signs of spastic tetraparesis, X-rays of the cervical spine revealed solid bony fusion at single mobile segment C6-C7. He was able to gaze horizontally while sitting in a wheelchair. Signs of myelopathy with stiff neck and single movable segment raised concerns about intubation, but were successfully managed using awake fiber-optic intubation. Avoidance of tracheostomy enabled us to perform an anterolateral approach without increasing the risk of wound infection. Regarding surgical procedure, the same principles are obeyed as in management of fracture in ankylosing spondylitis or Mb. Forestrier. PMID:27458558

  16. Ankylosing pelvitrochanteric heterotopic ossification in a patient with spinal cord injury

    Gurcan, Serkan; Ozyurek, Selahattin; Kose, Ozkan; Sehirlioglu, Ali

    2013-01-01

    Heterotopic ossification is a frequent complication after spinal cord injury. It usually develops around major weight bearing joints. However, ankylosing hip is a rare presentation. Various treatment methods have been reported and advocated as efficacious methods for management of heterotopic ossification. We report a case of ankylosing pelvitrochanteric heterotopic ossification treated with surgical excision before full maturation, postoperative radiation therapy and indomethacine without re...

  17. Clinical results of 31 patients with pyogenic spondylitis

    We studied 31 patients with pyogenic spondylitis who were treated at our hospital from 1996 to 2004. They consisted of 17 male and 14 female patients ranging in age from 37 to 76 years (mean: 63 years). The follow-up period ranged from six to 26 months (mean: 13 months). Sixteen cases were treated conservatively with antibiotics and brace, and 15 cases surgically. Twenty patients (64.5%) had an impaired immune system secondary to diabetes mellitus, cancer, renal or hepatic failure. The infection in 18 patients (58.4%) was caused by organisms. The source of the infection was confirmed in seven (22.6%) with the urinary tract being the most frequent source. MRI is very sensitive and often quite specific for spinal infection. But it is difficult to evaluate the healing phase of chronic pyogenic spondylitis. (author)

  18. Can a functional assay on cytokine kinetics be used for the identification of a disease-related role for Single Nucleotide Polymorphisms (SNPs) in Ankolysing spondylitis?

    Carlsen, Thomas Gelsing; Kjærsgaard, Pernille; Jørgensen, Trine;

    2014-01-01

    -like protease to a nuclear -associated 16 kDa propiece and a secreted 17 kDa mature IL-1α peptide. However, the full understanding of its dual function is missing. Recently, SNPs in the gene for IL-1α was also associated with the risk of developing ankylosing spondylitis (AS), a subgroup of the...... spondyloarthropathies. These findings lead us to produce antibodies towards the N- and C-terminal region of IL-1α to investigate IL-1α kinetics in human macrophages. This would eventually be used to asses any correlation between a defect in the production of the cytokine and a disease related SNP found in the IL-1α......α. We obtained a MAb specific for the N-terminal propiece and for the C-terminal mature form of IL-1α, respectively. Assays, including DNA sequencing, immunofluorescence microscopy, qPCR and FACS are now available for the analysis of IL-1α kinetics in blood samples from AS patients....

  19. Multifocal Scedosporium apiospermum spondylitis in a cystic fibrosis patient.

    Guignard, S; Hubert, D; Dupont, B; Anract, P; Alioua, D; Guerini, H; Paugam, A; Dougados, M

    2008-01-01

    We report the first case of multifocal Scedosporium apiospermum spondylitis in a cystic fibrosis patient. The infection, which occurred during voriconazole prophylaxis, disseminated contiguously from the base of the left lung and pleura and spread to vertebrae via the epidural space. S. apiospermum osteoarticular infections are rare, and are difficult to diagnose and cure because of their resistance to anti-fungal drugs. PMID:17567545

  20. Ankylosing pelvitrochanteric heterotopic ossification in a patient with spinal cord injury

    Gurcan, Serkan; Ozyurek, Selahattin; Kose, Ozkan; Sehirlioglu, Ali

    2013-01-01

    Heterotopic ossification is a frequent complication after spinal cord injury. It usually develops around major weight bearing joints. However, ankylosing hip is a rare presentation. Various treatment methods have been reported and advocated as efficacious methods for management of heterotopic ossification. We report a case of ankylosing pelvitrochanteric heterotopic ossification treated with surgical excision before full maturation, postoperative radiation therapy and indomethacine without recurrence after 1 year. Treatment options are discussed in this particular case. PMID:23697455

  1. Possible radiotherapy of Morbus Bechterew

    Early diagnosis is most important for an effective therapy of ankylosing spondylitis (Morbus Bechterew). Especially the radiologic findings improve the diagnosis in the early stage of the disease. Concerning the treatment modalities, which are reviewed in detail, the radiation therapy is of special interest. There is no risk for the patient treating with low dose radiation. In the last years the therapy with 224Ra (Thorium X) has become important enough to be included in the treatment planing of the ankylosing spondylitis. Indications, contraindications, risks as well as results of different therapeutic modalities are discussed. (orig.)

  2. Possible radiotherapy of Morbus Bechterew

    Haase, W.

    1982-10-11

    Early diagnosis is most important for an effective therapy of ankylosing spondylitis (Morbus Bechterew). Especially the radiologic findings improve the diagnosis in the early stage of the disease. Concerning the treatment modalities, which are reviewed in detail, the radiation therapy is of special interest. There is no risk for the patient treating with low dose radiation. In the last years the therapy with /sup 224/Ra (Thorium X) has become important enough to be included in the treatment planing of the ankylosing spondylitis. Indications, contraindications, risks as well as results of different therapeutic modalities are discussed.

  3. Assessment of efficience of purification of chromic waster water with application of spondyle green clay

    Франчук, Г. М.; Національний авіаційний університет; Бовсуновський, Є.О.; Національний авіаційний університет; Рябчевський, О.В.; Національний авіаційний університет

    2010-01-01

    Results of conducted experiments on spondyle green clay applying as a natural ecologically safe coagulant for waste water purification from Cr ions was presented. Optimal quantity of coagulant that provides the maximum level of purification was defined.

  4. Assessment of efficience of purification of chromic waster water with application of spondyle green clay

    Г.М. Франчук

    2010-02-01

    Full Text Available Results of conducted experiments on spondyle green clay applying as a natural ecologically safe coagulant for waste water purification from Cr ions was presented. Optimal quantity of coagulant that provides the maximum level of purification was defined.

  5. The diagnostic use of MRT in cases of suspected spondylitis; MRT-Differentialdiagnose bei Verdacht auf Spondylitis

    Lehner, K. [Inst. fuer Roentgendiagnostik, Klinikum rechts der Isar der Technischen Univ. Muenchen (Germany)

    1994-11-01

    In cases where MRT fails to reveal abscess formation or typical vertebral changes to confirm the preliminary diagnosis, further examinations are necessary to exclude diseases other than spondylitis. More remote possibilities like insufficiency fracture, rheumatic disorders and neoplasm can mostly be ruled out on the basis of conventional X-ray pictures. Conventional tomography and computed tomography should also be carried out in addition to MRT in the rare case of unconfirmed activated arthrosis or disc removal syndrome. In order to distinguish between infective and non-infective/reactive changes, contrast-enhanced repeat MRT following antibiotic treatment may be very helpful. (orig.) [Deutsch] Wenn bei einer Spondylitis ein dafuer beweisender Abszess oder eine typische Destruktion des Wirbelkoerpers nicht vorliegt, ist auch nach Durchfuehrung einer MRT oft eine differentialdiagnostische Abgrenzung gegenueber anderen Ursachen erforderlich. Ferner stehende Differentialdiagnosen wie Insuffizienzfraktur, rheumatische Erkrankungen und eine Neoplasie koennen mit den Moeglichkeiten des konventionellen Roentgenbildes meist ausgeschlossen werden. An die konventionelle- und Computertomographie sollte - auch nach Durchfuehrung der MRT - noch in unklaren Einzelfaellen von aktivierter Arthrose oder Postdisketomie-Syndrom gedacht werden. Eine gute differentialdiagnostische Moeglichkeit zur Unterscheidung zwischen einem Infekt und einem nicht infektioesen/reaktivem Geschehen ist die Wiederholungs-MRT mit KM-Applikation nach durchgefuehrter antibiotischer Behandlung. (orig.)

  6. Microorganisms causing pyogenic spondylitis: Comparison of community and hospital-acquired types

    Sasaji, Tatsuro; Yamada, Noboru; Iwai, Kazuo

    2012-01-01

    Staphylococcus aureus Pyogenic spondylitis is a common infectious disease caused by various microorganisms. It is difficult to predict the infecting microorganism at the time of initiation of treatment. Pneumonia is generally clarified into community or hospital-acquired types based on where the infection was acquired, and the infecting microorganisms are different for each type. We retrospectively analyzed 20 cases of pyogenic spondylitis treated in our hospital and categorized the cases int...

  7. Spondyloarthritides: evolving therapies.

    Barr, Andrew; Keat, Andrew

    2010-01-01

    TNF blockade therapy has substantially advanced the treatment of peripheral spondyloarthritides but revolutionised the treatment of severe ankylosing spondylitis. The capacity of biologic treatment to improve dramatically symptoms and quality of life in patients with spinal disease is undoubted, although important questions remain. Notable amongst these are concerns about skeletal disease modification and the true balance between costs and effectiveness. Guidelines for the biologic treatment of ankylosing spondylitis and psoriatic arthritis have been introduced in North America and Europe with considerable consensus. However, the absence of clear criteria for the diagnosis of early disease leaves the issue of biologic treatment of ankylosing spondylitis at the pre-radiographic stage unresolved. Newer biologic agents are entering the field, although superiority over TNF blockers will be difficult to demonstrate. PMID:21205283

  8. Serum antibodies from patients with ankylosing spondylitis and Reiter's syndrome are reactive with HLA-B27 cells transfected with the Mycobacterium tuberculosis hsp60 gene.

    Kellner, H; Wen, J.; Wang, J; Raybourne, R B; Williams, K. M.; Yu, D T

    1994-01-01

    HLA-B27-related arthritis is probably mediated by an immune response against HLA-B27 complexed with peptides derived from proteins of arthritis-causing bacteria. Immunogenic proteins with a high degree of homology among bacteria, such as in the hsp60 family, are likely candidates. To create such complexes experimentally, we transfected an HLA-B27 cell line with the Mycobacterium tuberculosis hsp60 gene. Because of previous observations that HLA-B27-peptide complexes can be distinguished by an...

  9. The effect of comedication with conventional synthetic disease modifying antirheumatic drugs on TNF inhibitor drug survival in patients with ankylosing spondylitis and undifferentiated spondyloarthritis

    Lie, Elisabeth; Kristensen, Lars Erik; Forsblad-d'Elia, Helena;

    2015-01-01

    -dependent covariate, and the associations were retained when adjusting for erythrocyte sedimentation rate, C-reactive protein, patient global, swollen joints, uveitis, psoriasis and inflammatory bowel disease. CONCLUSIONS: In this large register study of patients with AS and uSpA, use of csDMARD comedication was...

  10. A case of infliximab-induced lupus in a patient with ankylosing spondylitis: is it safe switch to another anti-TNF-α agent?

    Santiago, T.; Santiago, MG; Rovisco, J; Duarte, C; Malcata, AB; Pereira da Silva, JA

    2013-01-01

    Anti-TNF-α therapies are the latest class of medications found to be associated with drug-induced lupus, a distinctive entity known as anti-TNF-α-induced lupus (ATIL) (Williams et al., Rheumatology (Oxford) 48:716-20, 2009; De Rycke et al., Lupus 14:931-7, 2005; De Bandt et al., Clin Rheumatol 22:56-61, 2003). With the widespread use of these agents, it is likely that the incidence of ATIL will increase. The onset of ATIL in patients with rheumatoid arthritis and Crohn's disease has been desc...

  11. Ankylosing spondylitis patients display altered dendritic cell and T cell populations that implicate pathogenic roles for the IL-23 cytokine axis and intestinal inflammation

    Wright, Pamela B.; McEntegart, Anne; McCarey, David; McInnes, Iain B.; Siebert, Stefan; Milling, Simon W F

    2015-01-01

    Objective. AS is a systemic inflammatory disease of the SpA family. Polymorphisms at loci including HLA-B27, IL-23R and ERAP-1 directly implicate immune mechanisms in AS pathogenesis. Previously, in an SpA model, we identified HLA-B27–mediated effects on dendritic cells that promoted disease-associated Th17 cells. Here we extend these studies to AS patients using deep immunophenotyping of candidate pathogenic cell populations. The aim of our study was to functionally characterize the immune p...

  12. A cautionary note on the impact of protocol changes for Genome-Wide Association SNP x SNP Interaction studies: an example on ankylosing spondylitis

    Bessonov, Kyrylo; Gusareva, Elena; Van Steen, Kristel

    2015-01-01

    Genome-wide association interaction (GWAI) studies have increased in popularity. Yet to date, no standard protocol exists. In practice, any GWAI workflow involves making choices about quality control strategy, SNP filtering, linkage disequilibrium (LD) pruning, analytic tool to model or to test for genetic interactions. Each of these can have an impact on the final epistasis findings and may affect their reproducibility in follow-up analyses. Choosing an analytic tool is not st...

  13. Investigation of two novel biochemical markers of inflammation, matrix metalloproteinase and cathepsin generated fragments of C-reactive protein, in patients with ankylosing spondylitis

    Skjøt-Arkil, Helene; Schett, Georg; Zhang, Chen;

    2012-01-01

    prognostic marker for AS has not provided the sought accuracy and specificity. We hypothesized that local enzymatic activity in the disease-affected tissue, which is associated with extensive tissue turnover may, by cleavage, modify the CRP produced in the liver. These cleavage products may provide...

  14. HLA-B27检测对强直性脊柱炎诊断的价值%Diagnostic Value of HLA- B27 for Ankylosing Spondylitis

    沈云; 程涌江; 刘光平

    2001-01-01

    [目的]评价人白细胞抗原b27(HLA-B27)对诊断强直性脊柱炎(AS)的价值.[方法]选择92例AS确诊病人作病例组,70例非AS病人为对照组,均采用美国国立卫生院(NIH)微量淋巴细胞毒试验技术定性检测其HLA-B27含量.[结果]HLA-B27检测对诊断AS的敏感性为87.0%,特异性为91.4%;随机人群试验后HLA-B27阳性的患病概率为2.57%;当患病概率为50%时,试验后HLA-B27阳性患病概率为91.01%.[结论]HLA-B27检测对AS有重要的辅助诊断价值,但不能用作AS的确诊标准.

  15. The Diagnostic Value of MRI in Brucella Spondylitis With Comparison to Clinical and Laboratory Findings

    Bagheri, Ali Baradaran; Ahmadi, Koorosh; Chokan, Niaz Mohamad Jafari; Abbasi, Bita; Akhavan, Reza; Bolvardi, Ehsan; Soroureddin, Somayeh

    2016-01-01

    Background: Brucellosis is an endemic zoonotic disease, especially in the Middle East and Mediterranean regions and can involve many organs and tissue. Osteoarticular involvement is the most common complication. Spondylitis is its most prevalent clinical form in adults, and there may be difficult in diagnosis and treatment. In present study, we aimed to assess these diagnostic value of MRI, in patients with spondylitis due to brucella, comparing with clinical and laboratory findings. Method: Patients with low back pain who were admitted to Sheikhol-raees MRI center were included in this study. None of these patients had any documented infectious disease. Diagnosis of brucellosis was made, based on MRI findings, which would be approved by serology. After confirmation with serology, the group with positive serology were compared with the negative group, in sex, age, MRI findings level of vertebral involvements, signal intensity in T1 weighted and T2 weighted. Results: Among 53 patients with diagnosis of brucella spondylitis, 33 underwent serology study, 20 were positive and 13 were negative and the others consider out of study. From these 20, 3 had tuberculosis spondylitis, whose mean age was 56 and the 67% of them were male. Mean age in the positive brucella spondylitis were 46 and 67% of them were male. In negative group mean age was 55, and of whom 57% were male. There was no statistically significant difference in MRI findings such as changes in signal intensity, disk space narrowing, Intracanalicular mass, Abscess formation. Level of invlovment in vertebrae. Conclusion: The results of this study shows that although MRI is Modality of choice in diagnosis of spondylitis, it is not enough specific to diagnosis the reasons of spondylitis. PMID:27147801

  16. Video-Assisted Thoracic Surgery for Tubercular Spondylitis

    Roop Singh

    2014-01-01

    Full Text Available The present study evaluated the outcome of video-assisted thoracic surgery (VATS in 9 patients (males = 6, females = 3 with clinico-radiological diagnosis of tubercular spondylitis of the dorsal spine. The mean duration of surgery was 140.88 ± 20.09 minutes, mean blood was 417.77 ± 190.90 mL, and mean duration of postoperative hospital stay was 5.77 ± 0.97 days, Seven patients had a preoperative Grade A neurological involvement, while at the time of final followup the only deficit was Grade D power in 2 patients. In patients without bone graft placement (n = 6, average increase in Kyphosis angle was 16°, while in patients with bone graft placement (n = 3 the deformity remained stationary. At the time of final follow up, fusion was achieved in all patients, the VAS score for back pain improved from a pretreatment score of 8.3 to 2, and the function assessment yielded excellent (n = 4 to good (n = 5 results. In two patients minithoracotomy had to be resorted due to extensive pleural adhesions (n = 1 or difficulty in placement of graft (n = 1. Videoassisted thoracoscopic surgery provides a safe and effective approach in the management of spinal tuberculosis. It has the advantages of decreased blood loss and post operative morbidity with minimal complications.

  17. The diagnostic usefulness of CT-guided needle biopsy or aspiration in infectious spondylitis

    To determine the diagnostic value of CT-guided biopsy or aspiration of the spine and paraspinal soft tissue in infectious spondylitis. Between January 2000 and June 2002, 58 patients underwent 67 biopsies and/or aspirations under CT guidance to identify the organism causing infectious spondylitis, and were included in this study. Nine underwent rebiopsy. In all patients, MR images were available before biopsy and/or aspiration. In 63 of 67 procedures, the specimens or aspirates obtained were prepared for culture and smear, and for histological examination, four procedures involved aspiration only. In ten patients with suspected tuberculosis, a polymerase chain reaction test was performed. For all procedures, the transpedicular, transcostovertebral or paravertebral route was involved, according to the level and shape of the lesions, and 14-, 16-, or 18-gauge core biopsy needles and/or 20-gauge aspiration needles were employed. Lesions involved a paravertebral (n=17), psoas (n=8) or epidural (n=1) abscess; an intervertebral disc (n=20); or a vertebral body (n=21). The levels at the mid-thoracic spine were T4-T10 (n=11); at the thoracolumbar junction, T11-L1 (n=14); at the lumbar spine, L1-L4 (n=25); and at the lumbo-sacral junction, L5-S1 (n=17). In nine of 58 patients, rebiopsy was performed. Diagnosis was confirmed in 22 of 58 patients (38%), and was as follows: tuberculous spondylitis (n=17), pyogenic spondylitis (n=4), and fungal spondylitis (n=1). Thirty-six unconfirmed cases were diagnosed as nonspecific inflammation (n=21), fibrosis involving cortical bone (n=1), necrotic material (n=5) and inadequate specimen without evidence of malignancy (n=9). Only one of the nine cases in which biopsy was repeated was confirmed as tuberculous spondylitis. Diagnosis was confirmed in 7 of 17 paravertebral abscesses (41%), 8 of 21 vertebral bodies (38%), 6 of 20 intervertebral discs (30%) and 1 of 8 psoas abscesses (13%). In infectious spondylitis, the overall diagnostic

  18. Early

    Houssiau, F A; Vasconcelos, C; D'Cruz, D; G.D. Sebastiani; DE RAMON GARRIDO, E.; Danieli, M.G.; ABRAMOVICZ, D.; Blockmans, D; Mathieu, A; Direskeneli, H; Galeazzi, M; Gul, A; Levy, Y; Petera, P.; Popovic, R.

    2004-01-01

    Arthritis Rheum. 2004 Dec;50(12):3934-40. Early response to immunosuppressive therapy predicts good renal outcome in lupus nephritis: lessons from long-term followup of patients in the Euro-Lupus Nephritis Trial. Houssiau FA, Vasconcelos C, D'Cruz D, Sebastiani GD, de Ramon Garrido E, Danieli MG, Abramovicz D, Blockmans D, Mathieu A, Direskeneli H, Galeazzi M, Gül A, Levy Y, Petera P, Popovic R, Petrovic R, Sinico RA, Cattaneo R, Font J, Depresseux G, Cosyns JP, Cervera R. Universi...

  19. CLINICAL HETEROGENEITY OF EARLY AXIAL SPONDYLOARTHRITIS: ANALYSIS OF CLINICAL AND RADIOLOGICAL FINDINGS IN CRIMEA’S PATIENTS

    A. V. Petrov

    2015-01-01

    Full Text Available Ankylosing spondylitis (AS is characterized  by considerable variation in the rate of development of structural changes in the vertebral column and joints. As of now, the clinical and laboratory predictors of progression of undifferentiated axial spondyloarthritis  (SpA to AS have not been adequately explored.         Objective: to study the clinical features of early axial SpA in view of radiographic changes in the sacroiliac and hip joints and spinal column.Subjects and methods. The rate of different clinical syndromes of axial SpA was analyzed in 162 patients. The study included less than 35-year-old  patients with a 2-to-5-year history of axial SpA that was first diagnosed according to the 2009 ASAS criteria, by excluding psoriatic and reactive arthritis and inflammatory  bowel diseaserelated arthritis.Results and discussion. The examinees were diagnosed with undifferentiated SpA (52.5%, advanced AS (43.2%, and late AS (in the presence of syndesmophytes (4.3%. 38.3% of patients had peripheral arthritis (PA, 8.6% – dactylitis, 28.4% – enthesitis , and 4.9% – uveitis. The patients with advanced AS had higher C-reactive  protein (CRP  levels (38.7 [22.3; 45.8] and lower rates of PA (27% than those with undifferentiated axial SpA (14.4 [4.2;18.6] mg/l and 48%, respectively; p < 0.05. The patients with late AS had more commonly enthesitis (71.4% and HLA-B27 (100% than those with undifferentiated axial SpA (31.4 and 78.8% and those with advanced AS (22.3 and 81.4%, respectively; p < 0.05. Radiographic  narrowing of the hip joint space was accompanied by increases in the rate of enthesitis up to 56.2% and HLA-B27 up to 93.7% (the remaining patients exhibited 24.6 and 79.5% increases, respectively (p < 0.05.Conclusion. High CRP levels, presence of enthesitis and HLA-B27 may be regarded as predictors for rapid progression of structural changes in patients with early axial SpA.DOI: http://dx.doi.org/10.14412/1995-4484-2015-139-142

  20. Osteoporose bei Spondylitis ankylosans - Einfluß von Lebensgewohnheiten

    Aglas F

    2004-01-01

    Full Text Available Krankheitsbedingte Artefakte können bei der SpA (Spondylitis ankylosans; Mb. Bechterew die Sensitivität einer Knochendichtemessung im Lumbalbereich beeinträchtigen. Das bei dieser rheumatischen Erkrankung bekannte Osteoporoserisiko ist neben genetischen Faktoren und Entzündungsmechanismen auch von verschiedenen exogenen Einflüssen abhängig. An 47 SpA-Patienten wurde mittels DEXA eine vergleichende Knochendichtemessung (BMD an der Hüfte (Schenkelhals und Ward'sches Dreieck sowie im Bereich der Wirbelsäule (L1-L4 vorgenommen. Zusätzlich erfolgte eine Erhebung der Lebens-Ernährungsgewohnheiten der SpA-Patienten in bezug auf die BMD, um exogene Einflüsse erfassen zu können. Die Knochendichtemessungen ergaben an der LWS wesentlich häufiger eine BMD im Normbereich als am proximalen Femur. Besonders deutliche Unterschiede traten im höheren Lebensalter auf, bei dem aufgrund von Kalzifizierungsvorgängen und Syndesmophyten an der LWS fälschlicherweise eine Dichtezunahme vorgetäuscht wird. Es kann daher bei SpA empfohlen werden, die wesentlich sensitivere Dichtemessung am Schenkelhals durchzuführen. Die über einen Zeitraum von 3 Jahren beobachteten, signifikant erhöhten, medianen CRP-Spiegel zeigen, daß eine permanente Aktivierung von Entzündungsprozessen bei SpA auch einen negativen Faktor betreffend des Knochenmasseverlustes darstellt. Die Analyse der Lebensgewohnheiten ergab, daß SpA-Patienten mit normaler BMD ausnahmslos regelmäßig kalziumreiche Nahrungsmittel zu sich nehmen; bei verminderter BMD wurde in der Mehrheit ein fehlender Konsum an Milchprodukten beobachtet. Leider war auch mit abnehmender BMD eine Verminderung der bei SpA empfohlenen Bewegungsübungen festzustellen. Aufgrund der Resultate ergibt sich eine generelle Empfehlung zu regelmäßigen Bewegungsübungen plus Osteoporosediät bei allen Bechterew-Patienten.