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1

Ankylosing Spondylitis  

Science.gov (United States)

... associated with susceptibility to ankylosing spondylitis is called HLA-B27. But while most people with ankylosing spondylitis have ... ankylosing spondylitis is one to check for the HLA-B27 gene, which is present in the majority of ...

2

Ankylosing Spondylitis  

Science.gov (United States)

Ankylosing spondylitis is a type of arthritis of the spine. It causes swelling between your vertebrae, which are ... in the joints between your spine and pelvis. Ankylosing spondylitis is an immune disease. The disease is more ...

3

Symptoms of Ankylosing Spondylitis  

Science.gov (United States)

Ankylosing Spondylitis (AS): Quick Links Overview >>> Symptoms >>> Diagnosis >>> Treatment >>> Medication >>> Doctor Q&A From Spondylitis Plus >>> ANKYLOSING SPONDYLITIS Most Common Symptoms It is important to note ...

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What Is Ankylosing Spondylitis?  

Science.gov (United States)

... Ankylosing Spondylitis Find a Clinical Trial Journal Articles Ankylosing Spondylitis PDF Version Size: 85 KB Publication Date: April 2011 What Is Ankylosing Spondylitis? Fast Facts: An Easy-to-Read Series of ...

5

Critical radioisotope studies on early diagnosis of ankylosing spondylitis  

International Nuclear Information System (INIS)

The assessment of uptake ratios of accreted sup(99m)Technetium-Methylene-Diphosphonate (MDP) in the sacroiliac joints and the sacrum of 153 men by the ROI-method is valid for the early diagnosis of the ankylosing spondylitis only if there is a positive clinical impression and a positive laboratory finding. The ratio is also elevated in many men without any sign of skeletal ailment. The use of the isotope ratio is no reliable method for the identification of an ankylosing spondylitis at rest without any sign of inflammation in the sacroiliac joints. There is no difference in ratios of men under 25 years of age and the group from 25 to 78 years. (orig.)

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

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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 spondyli...

Hodler Juerg; Kissling Rudolf O; Wa, Pfirrmann Christian; Weber Ulrich; Zanetti Marco

2007-01-01

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Alternative Treatments for Ankylosing Spondylitis  

Science.gov (United States)

... spondylitis. " Anyone with limited spinal mobility due to [ankylosing spondylitis] should avoid manipulation of their back or neck ... fusion (extra bone growth) due to spondylitis. ~From "Ankylosing Spondylitis: The Facts (Oxford Medical Publications)" by Dr. Muhammad ...

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Lung findings on high resolution CT in early ankylosing spondylitis  

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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.

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

2003-07-01

9

Lung findings on high resolution CT in early ankylosing spondylitis  

International Nuclear Information System (INIS)

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 interstlvement was found as frequent as interstitial lung disease in early AS

10

MRI appearances of inflammatory vertebral osteitis in early ankylosing spondylitis  

International Nuclear Information System (INIS)

Background: Undiagnosed and early ankylosing spondylitis (AS), especially in adolescent patients suffering from back pain, may present with the finding of vertebral osteitis on MRI. Aims: To identify the early MRI changes of vertebral osteitis in AS. Patients and methods: Five patients (three boys, two girls) aged 11-20 years (mean 15.4 years) suffering from back pain underwent MRI of the thoracolumbar spine. There was no initial diagnosis of AS. After clinical and radiological suspicion of AS, MRI of the sacroiliac (SI) joints was performed. Results: During the course of AS, destructive and reactive changes affect the discovertebral junctions that are initially seen in the thoracolumbar area. At this stage plain radiography of the spinal column may be normal. On MR images, inflammatory osteitis of the vertebrae is seen as hypointense areas on T1-weighted images and hyperintense areas on T2-W images. The lesions enhance homogenously with contrast material. Conclusions: Awareness of the MRI appearances of vertebral osteitis is helpful in suspecting AS. Radiological examination of the SI facilitates the diagnosis and unnecessary further imaging can be avoided. (orig.)

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MRI appearances of inflammatory vertebral osteitis in early ankylosing spondylitis  

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Background: Undiagnosed and early ankylosing spondylitis (AS), especially in adolescent patients suffering from back pain, may present with the finding of vertebral osteitis on MRI. Aims: To identify the early MRI changes of vertebral osteitis in AS. Patients and methods: Five patients (three boys, two girls) aged 11-20 years (mean 15.4 years) suffering from back pain underwent MRI of the thoracolumbar spine. There was no initial diagnosis of AS. After clinical and radiological suspicion of AS, MRI of the sacroiliac (SI) joints was performed. Results: During the course of AS, destructive and reactive changes affect the discovertebral junctions that are initially seen in the thoracolumbar area. At this stage plain radiography of the spinal column may be normal. On MR images, inflammatory osteitis of the vertebrae is seen as hypointense areas on T1-weighted images and hyperintense areas on T2-W images. The lesions enhance homogenously with contrast material. Conclusions: Awareness of the MRI appearances of vertebral osteitis is helpful in suspecting AS. Radiological examination of the SI facilitates the diagnosis and unnecessary further imaging can be avoided. (orig.)

Kurugoglu, Sebuh; Kanberoglu, Kaya; Mihmanli, Ismail; Cokyuksel, Oktay [Department of Radiology, Cerrahpasa Medical Faculty, Istanbul University (Turkey); Kanberoglu, Ayfer [Department of Physical Medicine, SSK Istanbul Hospital, Istanbul (Turkey)

2002-03-01

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Ankylosing Spondylitis and Psoriatic Arthritis  

Science.gov (United States)

... spine can lead to complete fusion - as in ankylosing spondylitis - or skip areas where, for example, only the ... offer a wide variety of Educational Materials on ankylosing spondylitis and related diseases. Click here to view what ...

13

Genetics Home Reference: Ankylosing spondylitis  

Science.gov (United States)

... 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 ...

14

Ankylosing spondylitis: an autoimmune disease?  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Identification of several autoantibodies in serum samples from patients with ankylosing spondylitis or suspected ankylosing spondylitis is reported. Five antibodies associated with ankylosing spondylitis were identified by applying cytoimmunofluorescence and immunoblotting techniques to antigen pools from insect tissue. At least one of these antibodies was found in 82% of serum samples from patients with ankylosing spondylitis. A 36 kD drosophila antigen, which showed the most common and most...

Lakomek, H. J.; Plomann, M.; Specker, C.; Schwochau, M.

1991-01-01

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Pulmonary manifestations of ankylosing spondylitis.  

Science.gov (United States)

Ankylosing spondylitis, a chronic multisystem inflammatory disorder, can present with articular and extra-articular features. It can affect the tracheobronchial tree and the lung parenchyma, and respiratory complications include chest wall restriction, apical fibrobullous disease with or without secondary pulmonary superinfection, spontaneous pneumothorax, and obstructive sleep apnea. Ankylosing spondylitis is a common cause of pulmonary apical fibrocystic disease; early involvement may be unilateral or asymmetrical, but most cases eventually consist of bilateral apical fibrobullous lesions, many of which are progressive with coalescence of the nodules, formation of cysts and cavities, fibrosis, and bronchiectasis. Mycobacterial or fungal superinfection of the upper lobe cysts and cavities occurs commonly. Aspergillus fumigatus is the most common pathogen isolated, followed by various species of mycobacteria. Prognosis of patients with fibrobullous apical lesions is mainly determined by the presence, extent, and severity of superinfection. Pulmonary function test results are nonspecific and generally parallel the severity of parenchymal involvement. A restrictive ventilatory impairment can develop in patients with ankylosing spondylitis because of either fusion of the costovertebral joints and ankylosis of the thoracic spine or anterior chest wall involvement. Chest radiographic findings may mirror the severity of clinical involvement. Pulmonary parenchymal disease is typically progressive, and cyst formation, cavitation, and fibrosis are seen in advanced cases. No treatment has been shown to alter the clinical course of apical fibrobullous disease. Although several antiinflammatory agents, such as infliximab, etanercept, and adalimumab, are being used to treat ankylosing spondylitis, their effects on pulmonary manifestations are unclear. PMID:20692546

Kanathur, Naveen; Lee-Chiong, Teofilo

2010-09-01

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Myocardial dysfunction in ankylosing spondylitis.  

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Echocardiographic evidence has suggested abnormalities of the myocardial function in patients with ankylosing spondylitis. In this work the cardiac function in patients with ankylosing spondylitis and in normal volunteers was evaluated. Twenty four normal volunteers and 21 patients with ankylosing spondylitis aged 18-45 were studied. None had overt cardiac disease. Cardiac function was assessed at rest with echocardiography, at rest and during supine bicycle exercise using radionuclide angiog...

Gould, B. A.; Turner, J.; Keeling, D. H.; Hickling, P.; Marshall, A. J.

1992-01-01

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Ankylosing Spondylitis: a Reflection and a Question  

Directory of Open Access Journals (Sweden)

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.

Annia Deysi Hernández Martín

2014-07-01

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

Directory of Open Access Journals (Sweden)

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.

Aggarwal A

2001-04-01

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Genetics of ankylosing spondylitis.  

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Ankylosing spondylitis (AS) is a common inflammatory arthritis of the spine and other affected joints, which is highly heritable, being strongly influenced by the HLA-B27 status, as well as hundreds of mostly unknown genetic variants of smaller effect. The aim of my research was to confirm some of the previously observed genetic associations and to identify new associations, many of which are in biological pathways relevant to AS pathogenesis, most notably the IL-23/TH17 axis (<...

Brown, MA; Wordsworth, Bp; Reveille, Jd

2002-01-01

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Chest pain--a common feature of ankylosing spondylitis.  

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We compared the incidence, nature and frequency of chest pain in a group of 45 ankylosing spondylitis patients with an age and sex matched group of normals. Twenty-five ankylosing spondylitis patients had experienced recurrent chest pain compared to three normals, and had a significantly reduced chest expansion. The presence of chest pain in ankylosing spondylitis can be an early presenting feature of the disease (eight patients had chest pain before spinal symptoms), and is associated with m...

Dawes, P. T.; Sheeran, T. P.; Hothersall, T. E.

1988-01-01

 
 
 
 
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Andersson Lesion in Ankylosing Spondylitis  

Directory of Open Access Journals (Sweden)

Full Text Available Andersson lesions are destructive foci that appear at the discovertebral junction in ankylosingspondylitis. We report three cases of ankylosing spondylitis with such lesions. These lesions simulatean infection and in our country, mimic spinal tuberculosis.

Manimegalai N, KrishnanKutty K, Panchapakesa Rajendran C, Rukmangatharajan S, Rajeswari S

2004-04-01

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Disseminated Tuberculosis Mimicking Ankylosing Spondylitis  

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Ankylosing spondylitis is a chronic inflammatory disorder affecting mainly the axial skeleton. Here we report a case of a man with a clinical suspicion of ankylosing spondylitis but with a persistence of increased inflammatory markers. In this case, 18F-FDG-PET/CT revealed multiple hypermetabolic lesions in axial skeleton, lymph nodes, and the lung, suggestive of either disseminated tuberculosis or lymphoma. Histological analysis of the pulmonary lesion revealed mycobacterium tuberculosis. Th...

Soyfoo, Muhammad S.; Valérie Huyge; Serge Goldman

2011-01-01

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Cardiopulmonary Manifestations of Ankylosing Spondylitis  

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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, ...

Mahnaz Momeni; Nora Taylor; Mahsa Tehrani

2011-01-01

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Spinal instability in ankylosing spondylitis  

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Background: Unstable spinal lesions in patients with ankylosing spondylitis are common and have a high incidence of associated neurological deficit. The evolution and presentation of these lesions is unclear and the management strategies can be confusing. We present retrospective analysis of the cases of ankylosing spondylitis developing spinal instability either due to spondylodiscitis or fractures for mechanisms of injury, presentations, management strategies and outcome. Materi...

Badve Siddharth; Bhojraj Shekhar; Nene Abhay; Varma Raghuprasad; Mohite Sheetal; Kalkotwar Sameer; Gupta Ankur

2010-01-01

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[Genetics of ankylosing spondylitis].  

Science.gov (United States)

Ankylosing spondylitis (AS) is a prototypical inflammatory disease of the locomotor system affecting axial skeleton. It is part of the general group of spondyloarthopathies (SpA). Its strong association with histocompatibility antigen HLA-B27 is known since 1973. However, HLA-B27 contribution to AS genetic risk is approximately 16%. Therefore, other genes are necessarily involved in the pathogenesis of the disease. Genomic development and the possibility of making genome wide screening have contributed enormously to the study of the disease. In this paper, we describe the actual knowledge about AS genetic risk, which has contributed to understand the influence of HLA-B27 on the etiology and pathogenesis of the disease. We also intend to foresee how these findings will result in an improvement of patients? quality of life. PMID:25517057

Castro-Santos, Patricia; Gutiérrez, Miguel A; Díaz-Peña, Roberto

2014-09-01

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Ankylosing spondylitis associated with Trichomonas vaginalis infection.  

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A patient is described who developed signs and symptoms of ankylosing spondylitis after prostatitis due to Trichomonas vaginalis. Chronic prostatitis of unknown cause had previously been reported as being common in patients with ankylosing spondylitis. The observations in this case raise the possibility that T. vaginalis might play a role in the prostatitis and pathogenesis of ankylosing spondylitis in some patients.

Kuberski, T. T.

1981-01-01

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Imaging in ankylosing spondylitis  

DEFF Research Database (Denmark)

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 conventional, albeit quite insensitive, gold standard method for assessment of structural damage in spine and sacroiliac joints, whereas MRI has gained a decisive role in monitoring disease activity in clinical trials and practice. MRI may also, if ongoing research demonstrates a sufficient reliability and sensitivity to change, become a new standard method for assessment of structural damage. Ultrasonography allows visualization of peripheral arthritis and enthesitis, but has no role in the assessment of axial manifestations. Computed tomography is a sensitive method for assessment of structural changes in the spine and sacroiliac joints, but its clinical utility is limited due to its use of ionizing radiation andlack of ability to assess the soft tissues. It is exciting that with continued dedicated research and the rapid technical development it is likely that even larger improvements in the use of imaging may occur in the decade to come, for the benefit of our patients.

Østergaard, Mikkel; Lambert, Robert G W

2012-01-01

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The study of early diagnosis value of radionuclide bone imaging on ankylosing spondylitis  

International Nuclear Information System (INIS)

Objective: To study the early diagnosis value of radionuclide bone imaging on ankylosing spondylitis (AS). Methods: Patients with early and questionable AS and control subjects underwent 99Tcm-methylene diphosphonate (MDP) whole-body, local and SPECT bone imaging, and the sacroiliac joint/ sacrum (SI/S) ratios were determined. Results: The SI/S ratios of patients with early and questionable AS were 1.53 +- 0.11 and 1.57 +- 0.10, respectively, significantly higher compared with that of control group (1.21 +- 0.10, P < 0.01). Whole-body bone imaging showed the lesions in lumbar vertebrae and other joints of 5 patients with AS but that were not found in plain films. Vertebrae SPECT could correctly show lesion location of patients with AS and vertebra lesion which were not found or indeterminate in plain imaging. Conclusions: The SI/S ratios determined with radionuclide bone imaging are more sensitive than plain film for diagnosing patients with early AS. Whole-body and SPECT bone imaging are obviously superior to plain imaging in observation of the lesions of different bone joints

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Current radiodiagnostic concept of ankylosing spondylitis  

International Nuclear Information System (INIS)

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.)

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The diagnostic value of sacroiliac CT for detecting early changes of ankylosing spondylitis  

International Nuclear Information System (INIS)

We wanted to evaluate the diagnostic value of the various findings on sacroiliac CT for detecting the early changes of ankylosing spondylitis (AS). Between April 2005 and March 2006, 51 sacroiliac CT images with the clinical suspicion of AS, but no definite evidence of AS on the plain radiograph only, were retrospectively reviewed. Finally, 36 patients (mean age: 28.6 years; 34 males and 2 females), who were clinically diagnosed as AS (AS group, n = 26) or they had no evidence of AS (non-AS group, n = 10), were evaluated. Two musculoskeletal radiologists analyzed the presence of marginal irregularity, bony erosion and subchondral sclerosis. A statistical analysis was performed to evaluate the incidence, sensitivity and specificity of each finding. Marginal irregularity was seen in 21 of 26 AS subjects, and in 8 of 10 non-AS subjects. Bony erosion was only seen in 13 of 26 AS subjects. Subchondral sclerosis was observed in 19 of 26 AS subjects and in 8 of 10 non-AS subjects. The sensitivity/specificity for each findings were 72.4%/28.6%, 100%/43.5% and 70.4%/22.2%, respectively. Except for bony erosions, these results showed no statistical significance (? = .006). Bony erosion on CT is a very sensitive finding for the early changes of AS, whereas marginal irregularity or subchondral sclerosis is not so helpful in differentiating AS from non-AS. Attention to these results may further enhance the accurate diagnosis of the early changes in AShanges in AS

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The diagnostic value of sacroiliac CT for detecting early changes of ankylosing spondylitis  

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We wanted to evaluate the diagnostic value of the various findings on sacroiliac CT for detecting the early changes of ankylosing spondylitis (AS). Between April 2005 and March 2006, 51 sacroiliac CT images with the clinical suspicion of AS, but no definite evidence of AS on the plain radiograph only, were retrospectively reviewed. Finally, 36 patients (mean age: 28.6 years; 34 males and 2 females), who were clinically diagnosed as AS (AS group, n = 26) or they had no evidence of AS (non-AS group, n = 10), were evaluated. Two musculoskeletal radiologists analyzed the presence of marginal irregularity, bony erosion and subchondral sclerosis. A statistical analysis was performed to evaluate the incidence, sensitivity and specificity of each finding. Marginal irregularity was seen in 21 of 26 AS subjects, and in 8 of 10 non-AS subjects. Bony erosion was only seen in 13 of 26 AS subjects. Subchondral sclerosis was observed in 19 of 26 AS subjects and in 8 of 10 non-AS subjects. The sensitivity/specificity for each findings were 72.4%/28.6%, 100%/43.5% and 70.4%/22.2%, respectively. Except for bony erosions, these results showed no statistical significance ({rho} = .006). Bony erosion on CT is a very sensitive finding for the early changes of AS, whereas marginal irregularity or subchondral sclerosis is not so helpful in differentiating AS from non-AS. Attention to these results may further enhance the accurate diagnosis of the early changes in AS.

Park, Ju Hyun; Park, Ji Seon; Ryu, Kyung Nam [Kyunghee University Medical Center, Seoul (Korea, Republic of); Jin, Wook [East-West Neo Medical Center, Seoul (Korea, Republic of)

2007-02-15

32

The role of MRI in early ankylosing spondylitis: emphasis on the sacroiliac and hip joints  

International Nuclear Information System (INIS)

In clinically suspected ankylosing spondylitis of sacroiliac (SIJ) and hip joints with normal or minimal secondary bone change in simple X-ray films, we evaluated the role of MRI in sacroiliac and hip joints. Authors evaluated 11 cases (36 joints; SIJ 14 hip 22) confirmed as ankylosing spondylitis by clinical, laboratory, and radiologic findings, and compared the detectability of involvement of joints by simple X-ray film and MRI. Authors analysed MR findings for the presence of pannus and its signal intensities (SI), change of articular cartilage, bony erosion and sclerosis, subchondral bone cysts, osteophytosis, bone marrow edema, joint effusion, adjacent soft tissue change, and contrast enhancement of pannus. MRI detected not only 20 joints (SIJ 11, hip 9) detected in simple X-ray, but also additional 7 joints (SIJ 3, hip 4). MRI depicted simultaneous involvement of SIJ and hip joints in 5 of 11 cases (SIJ 10 joints, hip 9 joints), and bilateral involvement of SIJ and hip joints in 4 among the 5 cases. MRI also demonstrated pannus, which were not detected in conventional films, as intermediate SI on T1WI and high SI on T2WI, in all 27 joints (SIJ 14, hip 13). Gd-DTPA enhanced T1WI revealed enhancement of pannus in 7 cases (17 joints). MRI was a valuable modality in evaluation of clinically suspected ankylosing spondylitis of SIJ or hip joints with normal or minimal secondary bone change in simple X-ray. Simultaneous evaluation of SIJ and hip joints is suggested in ion of SIJ and hip joints is suggested in clinically suspected ankylosing spondylitis or other joint diseases

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

International Nuclear Information System (INIS)

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)d. Turetschek, K., (2000)

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

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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)

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

2000-08-01

35

Conventional treatments for ankylosing spondylitis  

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Management of ankylosing spondylitis (AS) is challenged by the progressive nature of the disease. To date, no intervention is available that alters the underlying mechanism of inflammation in AS. Currently available conventional treatments are palliative at best, and often fail to control symptoms in the long term. Current drug treatment may perhaps induce a spurious state of "disease remission," which is merely a low level of disease activity. Non-steroidal anti-inflammatory drugs are first ...

Dougados, M.; Dijkmans, B.; Khan, M.; Maksymowych, W.; Linden, S.; Brandt, J.

2002-01-01

36

Treat Ankylosing Spondylitis with Methazolamide  

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Background: Increased bone resorption and new bone information are two characteristics of ankylosing spondylitis (AS). Much evidence has shown that carbonic anhydrase inhibitors can restrain bone resorption. We had detected increased expression of carbonic anhydrase I (CA1) in synovium of patients with AS. This study aimed to evaluate the effectiveness and safety of methazolamide, an anti-carbonic anhydrase drug, for treating patients with AS.Methods: Two patients, cal...

Xiaotian Chang, Xinfeng Yan

2011-01-01

37

Scintigraphic findings in ankylosing spondylitis  

International Nuclear Information System (INIS)

A prospective study of bone scintigraphic findings has been carried out in 63 patients, firmly diagnosed as having ankylosing spondylitis. In addition to abnormal uptake of the radiotracer at the sacroiliac joints, a peripheral arthropathy has been a common finding, particularly in the proximal joints, occurring in up to 50 percent of patients. Increased uptake of radiotracer in the spine has also been found both diffusely and focally. Focal increases have been noted at the apophyseal joints in 40 percent of patients and in three patients with a sterile intervertebral diskitis, an unusual complication of this disease only diagnosed in two patients after bone scintigraphy

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Costovertebral joint erosion in ankylosing spondylitis.  

Science.gov (United States)

We describe a patient with ankylosing spondylitis who had severe pain in the thoracic spine area owing to a destructive arthropathy of a costovertebral joint. A computed tomographic scan revealed severe osteolysis of the head of the right eleventh rib, with hypertrophic sclerotic arthropathy of the joint as the source of the patient's pain. Costovertebral arthropathy should be considered in ankylosing spondylitis patients with severe thoracic pain. PMID:11138957

Le, T; Biundo, J; Aprill, C; Deiparine, E

2001-01-01

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Scientists Gain New Insights into Genetic Mechanisms of Ankylosing Spondylitis  

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... Scientists Gain New Insights into Genetic Mechanisms of Ankylosing Spondylitis New research supported, in part, by the National ... step closer to understanding the genetic mechanisms underlying ankylosing spondylitis, a chronic inflammatory form of arthritis that predominantly ...

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Bone scintigraphy in ankylosing spondylitis  

International Nuclear Information System (INIS)

Twelve patients with ankylosing spondylitis (11 males and one female) were examined by both bone scintigraphy and dual energy X-ray absorptiometry (DEXA). Bone scintigraphy revealed increased accumulation in the sacroiliac joint in 6 patients, the spines in 10, and the other joints, including the sternoclavicular joint, in 8 patients. Each one patient had an intense tracer uptake in the finger and toe joints. In 4 patients in whom DEXA was concurrently performed at the level of 2nd to 4th lumbar vertebrae, there was no consistent tendency for mean bone mineral density. In 2 of 3 patients receiving DEXA for the radius, bone marrow density was within the normal range. (N.K.)

 
 
 
 
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Traumatic death in ankylosing spondylitis  

DEFF Research Database (Denmark)

Ankylosing spondylitis (AS) is a chronic rheumatic disease that causes spinal rigidity with an increased risk of spinal fractures. We present a case report where a middle-aged man, in apparent good health, died following a fall from his bike. Postmortem computed tomography (CT) showed several fractures in the cervical and thoracic spine, with displacement into the spinal canal as well as spinal changes consistent with AS. The cause of death was determined to be upper spinal cord injury caused by cervical spinal fractures that were facilitated by spinal rigidity from AS. Further investigation into the medical records revealed that the decedent had previously been treated for AS. This case report illustrates the importance of obtaining a detailed medical history when investigating deaths, including nonfatal conditions, such as AS. Furthermore, it shows the value of CT in the evaluation of the mechanism and manner of death.

Thomsen, Asser H; Jurik, Anne Grethe

2010-01-01

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Andersson lesion in ankylosing spondylitis.  

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A middle-aged male patient developed acute back pain and a lumbar vertebral lesion following trivial physical trauma. The lesion was considered as tuberculous on vertebral x-rays and MRI. After biopsy of the lesion and spinal fixation, the patient was kept on empirical antituberculous treatment (ATT) to which he did not respond. On re-evaluation he was diagnosed to have an Andersson lesion in ankylosing spondylitis (AS). ATT was stopped and he was successfully managed by rest, steroids, methotrexate and sulfasalazine. A careful look at the patient's plain x-ray spine and awareness about the lesion can avoid misdiagnosis of this characteristic vertebral lesion found in AS. PMID:23559648

Dhakad, Urmila; Das, Siddharth K

2013-01-01

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Spinal pseudarthrosis in ankylosing spondylitis  

International Nuclear Information System (INIS)

Spinal pseudarthrosis is an important mechanical complication in longstanding ankylosing spondylitis. Thirty-five patients with 40 lesions were studied. Three lesions through vertebral bodies resulted from complete fractures. The rest occured at interspaces, more common at the lower thoracic and upper lumbar segments. Double pseudarthrotic lesions were observed in 5 patients. Progressive osteolysis of the anterior elements was prominent, with variable sclerosis, osteophytes, vacuum phenomenon, subluxation and fragmentation. A posterior element weak link, as a bony break or facet joint non-fusion, was an essential component in every lesion, playing an initiating or perpetuating role in its pathogenesis. Mechanical derangement from trauma, severe round kyphosis, spondylodiscitis, hip disease, spinal operation and unusual activities may be contributing factors. Initial treatment is conservative, but 16 patients required operative stabilisation. (orig.)

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A new method to ankylosing spondylitis diagnosis  

International Nuclear Information System (INIS)

Objective: Discussing the value of radionuclide bone imaging and HLA-B27 detection for early ankylosing spondylitis (AS) diagnosis. Methods: Thirty five patients with newly started buttock pain and without abnormal X ray findings were given radionuclide bone imaging and HLA-B27 detection to make a primary diagnosis, and followed-up for 0.5 - 2.5 years. A second diagnosis according to the New York Conference Standard was made. Results: There were 30 patients who were diagnosed with AS at the first work-up, and 29 of them were confirmed as with AS according to New York Conference Standard after followed-up , the first and second diagnosis coincidence rate was 96.7%. Conclusions: Radionuclide bone imaging combined with HLA-B27 antigen detection is of a very high value for early diagnosis of AS and can provide a reliable basis for early treatment

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Early-onset ankylosing spondylitis is associated with a functional MICA polymorphism.  

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Major histocompatibility complex (MHC) class I chain-related A (MICA) molecules deliver activating signals through the NKG2D receptor expressed on the surface of natural killer (NK), CD8alphabeta and gammadelta T cells, and the MICA gene is polymorphic. The recently described MICA amino acid substitution at position 129 (MICA-129) seems to affect its binding to NKG2D. We investigated whether this dimorphism (MICA-129met [methionine] and MICA-129val [valine]) is associated with susceptibility to ankylosing spondylitis (AS) in a cohort of Algerian patients stratified according to their HLAB27 status and the age of onset of the disease. DNA from 129 patients and 76 healthy individuals were analyzed to determine the HLA-B generic type as well as MICA-129 polymorphism. Statistical analysis revealed: (1) a weaker association between AS and HLA-B27 in Algerians than in that reported for European patients (63% versus 80-90%), suggesting a possible influence of other genetic/environmental determinants in the studied population and (2) an association between MICA-129 met/met genotype and juvenile AS (p = 0.02) independent of HLA-B27 status. These data suggest a potential role for a functionally relevant MICA gene polymorphism in autoimmune/inflammatory disease susceptibility. PMID:16386647

Amroun, Habiba; Djoudi, Hachemi; Busson, Marc; Allat, Rachida; El Sherbini, Shérif Mohsen; Sloma, Ivan; Ramasawmy, Rajendranath; Brun, Manuel; Dulphy, Nicolas; Krishnamoorthy, Rajagopal; Toubert, Antoine; Charron, Dominique; Abbadi, Mohamed Chérif; Tamouza, Ryad

2005-10-01

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Diagnostic capabilities of quantitative bone scintigraphy in ankylosing spondylitis: A comparison with radiography  

International Nuclear Information System (INIS)

In 576 patients quantitative scintigraphy of the sacroiliac joints and the spinal cord with 99mTc-pyrophosphate was performed. 328 were patients with proven ankylosing spondylitis according to the New York criteria. 120 were patients with a clinically and roentgenologically suspected ankylosing spondylitis and 128 persons formed a healthy control group. The count rate in small regions of interest (ROI) in the sacroiliac joints, the spinal cord and the os sacrum were compared on the basis of indexes. The scintigraphic data of patients with ankylosing spondylitis were compared with the healthy control group and with the radiographic findings and radiologic staging of the disease. In a longitudinal follow-up study during 1 to 6 years these investigations were continued together with clinical and roentgenological checks. Quantitative bone scintigraphy provides characteristic indexes for ankylosing spondylitis, indicating the increased mineral metabolism of the sacroiliac joints and the spinal cord. Skeletal scintigraphy is recommended for early detection and monitoring of ankylosing spondylitis. (author)

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The Association of Acromegaly and Ankylosing Spondylitis  

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Full Text Available Coexistence of acromegaly and anklosing spondylitis had been rarelyreported. Only two case reports were described coexistence of two diseasesin literature. These two diseases have some similar clinical andradiographic features. Calcaneal epin formation, enteshopathy and caudeequina syndrome can be seen both acromegaly and ankylosing spondylitis.Our case had clinical and radiological features of both acromegaly andankylosing spondylitis. Acral enlargement, coarsening of feature,malocclusion, non-suppressed growth hormone levels with oral glucosetolerance test and evidence of pituitary adenoma were support diagnose ofacromegaly. Morning stiffness, positive Schober and Moll test, elevatederythrocyte sedimentation rate and grade 4 sacroiletis of the patient lead usto diagnose ankylosing spondylitis at the same time. In this case report, weaim to discuss interesting coexistence of two disease

Alpaslan Tuzcu

2004-01-01

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Radiation-induced leukemias in ankylosing spondylitis  

International Nuclear Information System (INIS)

Three cases of leukemia occurred in patients with ankylosing spondylitis treated by radiotherapy. In each case, the leukemic process exhibited bizarre features suggesting that radiation is likely to induce atypical forms of leukemia possessing unusual attributes not shared by spontaneously developing leukemia. The likely distinctive aspects of radiation-induced leukemia are discussed

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Management of ankylosing spondylitis with infliximab  

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Éric Toussirot1,2,3, Ewa Bertolini1, Daniel Wendling1,21Rheumatology, University Hospital Jean Minjoz, Besançon, France; 2Equipe d’Accueil 3186 “Agents pathogènes et Inflammation” University of Franche-Comté, Besançon, France; 3CiC – Biotherapy, St-Jacques Hospital, Besançon, FranceAbstract: Ankylosing spondylitis (AS) is a systemic inflammatory rheumatic disease responsible for back pain...

Éric Toussirot; Ewa Bertolini; Daniel Wendling

2009-01-01

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Infertility improved by etanercept in ankylosing spondylitis  

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The effect of TNF-? and TNF-? antagonists on semen quality in men is controversial. TNF-? 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-?. In this report, we describe the development of pregnancy in a couple with a previously infertile husband, who received etanercept for ankylosing spondylitis.

Rezvani Aylin; Ozaras Nihal

2008-01-01

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Radon within therapeutic strategies of ankylosing spondylitis  

International Nuclear Information System (INIS)

For more than fifty years patients with rheumatic diseases have been treated in the thermal gallery of Bad Gastein, main indication is ankylosing spondylitis. Experiences of this kind of spa treatment on several hundred patients and randomised controlled clinical trials document the positive treatment effect of spa therapy with Radon which lasts for up to 40 weeks. (author)

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Treat Ankylosing Spondylitis with Methazolamide  

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Full Text Available Background: Increased bone resorption and new bone information are two characteristics of ankylosing spondylitis (AS. Much evidence has shown that carbonic anhydrase inhibitors can restrain bone resorption. We had detected increased expression of carbonic anhydrase I (CA1 in synovium of patients with AS. This study aimed to evaluate the effectiveness and safety of methazolamide, an anti-carbonic anhydrase drug, for treating patients with AS.Methods: Two patients, called as S and L, were diagnosed with active AS based on BASDAI and BASFI assessments, radiographic data and other clinical indices. They took methazolamide tablets at a dose of 25 mg twice every day.Results: Patient S's BASDAI score fell from 5.4 to 4.4, while patient L's BASDAI fell from 2.4 to 2. Patient S's BASFI score change from 2.7 to 2.9, while patient L's BASFI score fell from 1.2 to 0.2. The ESR values of patient S were considerably reduced, while the ESR value of patient L remained unchanged and in the normal range. The calcium concentration of patient S decreased from 3.05 mmol/L to 2.39 mmol/L. The CT evidence indicates that the articular surfaces of the erosive sacroiliac joints became clearer and the area of the calcium deposits began decreased. No significant systemic side effects were observed in either patient.Conclusions: The above results indicate that methazolamide was effective for active AS. Methazolamide may improve AS symptoms by inhibiting carbonic anhydrase activity during the processes of bone reporption and new bone formation.

Xiaotian Chang, Xinfeng Yan, Yunzhong Zhang

2011-01-01

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Increasing age at presentation for patients with ankylosing spondylitis.  

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An analysis of the age at first presentation was undertaken in patients with ankylosing spondylitis and mechanical back pain seen at the London Hospital department of rheumatology between 1952 and 1983. There was a significant positive correlation with the calendar year of presentation in the patients with ankylosing spondylitis but a negative correlation in those with mechanical back pain. An increasing age at presentation in ankylosing spondylitis is likely to be due to an increasing age at...

Will, R.; Calin, A.; Kirwan, J.

1992-01-01

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Sacroiliitis in ankylosing spondylitis: a comparison of radiography and scintigraphy  

International Nuclear Information System (INIS)

To evaluate the correlation between plain radiography and bone scintigraphy in the diagnosis of sacroiliitis, we analyzed 50 sacroiliac joints of 25 patients diagnosed as ankylosing spondylitis. The sacroiliac-sacral (SIS) ratio significantly increases in patients with sacroiliitis of Grade I, II, III and was normal in completely ankylosed sacroiliac joints (Grade IV). However, there was no correlation between the degree of increase of SIS ratio and that of the radiographic changes in Grade I, II, III groups. Bone scintigraphy might be useful in the early detection of sacroiliitis. but plain radiography is more valuable in evaluating progression

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Sacroiliitis in Ankylosing Spondylitis: Comparison with Multidetector Row CT and Plain Radiography  

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The objective of our study was to compare multidetector row CT and the plain radiographs for making the diagnosis and grading the sacroiliitis that accompanies ankylosing spondylitis. We wanted to determine the role of multidetector row CT for the evaluation of the sacroilitis in patients with ankylosing spondylitis. One hundred ninety two patients with clinically suspected ankylosing spondylitis were evaluated by conventional radiography and multidetector row CT. Two musculoskeletal radiologists retrospectively analyzed the images, and they graded the sacroiliitis using the modified New York Criteria. Multidetector row CT demonstrated a significantly higher sensitivity (74.5%, 83.3%) than did plain radiography (59.9%, 66.7%) for detecting early sacroiliitis (p<0.05). Multidetector row CT showed a higher grade of sacroiliitis in 114 and 127 of 384 sacroiliac joints. Performing multidetector row CT rather than plain radiography for making the diagnoses of accompanying ankylosing spondylitis allows an early start of treatment with a subsequently improved prognosis

Yu, Ji Youn; Joo, Kyung Bin; Choi, Byeong Kyoo; Ryu, Jeong Ah; Kim, Tae Hwan; Choi, Woo Jung [Hanyang University Hospital, Seoul (Korea, Republic of)

2009-03-15

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Sacroiliitis in Ankylosing Spondylitis: Comparison with Multidetector Row CT and Plain Radiography  

International Nuclear Information System (INIS)

The objective of our study was to compare multidetector row CT and the plain radiographs for making the diagnosis and grading the sacroiliitis that accompanies ankylosing spondylitis. We wanted to determine the role of multidetector row CT for the evaluation of the sacroilitis in patients with ankylosing spondylitis. One hundred ninety two patients with clinically suspected ankylosing spondylitis were evaluated by conventional radiography and multidetector row CT. Two musculoskeletal radiologists retrospectively analyzed the images, and they graded the sacroiliitis using the modified New York Criteria. Multidetector row CT demonstrated a significantly higher sensitivity (74.5%, 83.3%) than did plain radiography (59.9%, 66.7%) for detecting early sacroiliitis (p<0.05). Multidetector row CT showed a higher grade of sacroiliitis in 114 and 127 of 384 sacroiliac joints. Performing multidetector row CT rather than plain radiography for making the diagnoses of accompanying ankylosing spondylitis allows an early start of treatment with a subsequently improved prognosis

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Magnetic resonance imaging for ankylosing spondylitis  

International Nuclear Information System (INIS)

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 entitis), 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.)

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Interleukin 10 polymorphisms in ankylosing spondylitis.  

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Genetic polymorphisms of the IL10 promoter region have been implicated in many autoimmune diseases, including seronegative spondyloarthropathies. We studied three SNPs (IL10-1087, -824, and -597) and two microsatellites (IL10R and IL10G) lying within the promoter region of IL10 for association with susceptibility to and clinical manifestations of ankylosing spondylitis (AS), a common form of spondyloarthritis. Four hundred and sixty-eight individuals from 182 Finnish families affected with AS...

Goedecke, V.; Crane, Am; Jaakkola, E.; Kaluza, W.; Laiho, K.; Weeks, DE; Wilson, J.; Kauppi, M.; Kaarela, K.; Tuomilehto, J.; Wordsworth, Bp; Brown, MA

2003-01-01

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Prevalence of occult inflammatory bowel disease in ankylosing spondylitis.  

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Fifty-five patients with ankylosing spondylitis and 16 control patients matched for sex and age were examined for evidence of occult inflammatory bowel disease. In all patients evaluation included history and physical examination, barium enema, sigmoidoscopy, and rectal biopsy. The results of this study suggest that there is no increased prevalence of occult inflammatory bowel disease in patients with ankylosing spondylitis.

Costello, P. B.; Alea, J. A.; Kennedy, A. C.; Mccluskey, R. T.; Green, F. A.

1980-01-01

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Subacute bacterial endocarditis in a patient with ankylosing spondylitis.  

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A 57 year old white man with aortic insufficiency and previously undiagnosed ankylosing spondylitis, who developed subacute bacterial endocarditis (SBE), is described. Emergency aortic valve replacement was necessary, and the aortic valve pathology showed diffusely fibrosed and thickened valve leaflets with bacterial vegetations. This is the first recorded case of SBE in ankylosing spondylitis.

Hoppmann, R. A.; Wise, C. M.; Challa, V. R.; Peacock, J. E.

1988-01-01

 
 
 
 
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Atividade sexual na espondilite anquilosante Sexual activity in ankylosing spondylitis  

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OBJETIVO: Analisar a atividade sexual em pacientes com espondilite anquilosante, correlacionando com índices funcionais e de atividade da doença. PACIENTES E MÉTODOS: Foram analisados quanto a dor, fadiga, questionários de atividade de doença (Bath Ankylosing Spondylitis Disease Activity Index - BASDAI), funcionalidade (Bath Ankylosing Spondylitis Functional Index - BASFI) e atividade sexual (utilizando imagens de sete posições sexuais) 32 pacientes com diagnóstico de espondilite anqu...

Andrea Lopes Gallinaro; Lilian Lie Akagawa; Mariana Hissami Ichiba Otuzi; Percival Degrava Sampaio-Barros; Célio Roberto Gonçalves

2012-01-01

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Ankylosing Spondylitis and Postural Balance  

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Objective: In this study, we aimed to investigate that, due to postural changes, the patients with ankylosing spondyilitis (AS) have poorer postural balance than healthy subjects.Materials and Methods: Thirty patients with AS (19 female, 11 male) and 20 healthy subjects (13 female, 7 male) were tested by using the Tetrax Interactive Balance System. The general stability, Fourier analysis showing patterns of sway intensity within eight frequency bands between 0.1 and 3 Hz, and weight distribut...

Mahmut Nafiz Akman; Selda Bagis; Alper Nabi Erkan; Berrin Leblebici; Mehmet Adam

2008-01-01

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Management of ankylosing spondylitis with infliximab  

Directory of Open Access Journals (Sweden)

Full Text Available Éric Toussirot1,2,3, Ewa Bertolini1, Daniel Wendling1,21Rheumatology, University Hospital Jean Minjoz, Besançon, France; 2Equipe d’Accueil 3186 “Agents pathogènes et Inflammation” University of Franche-Comté, Besançon, France; 3CiC – Biotherapy, St-Jacques Hospital, Besançon, FranceAbstract: Ankylosing spondylitis (AS is a systemic inflammatory rheumatic disease responsible for back pain, stiffness and progressive loss of  functional capacity with limited therapeutic options. Regular physical exercises together with the use of nonsteroidal antiinflammatory drugs are the two recognized treatment options in AS. Infliximab is a chimeric anti-tumor necrosis factor-? monoclonal antibody that has been demonstrated to be highly effective in the treatment of AS, providing clinical amelioration at both axial and peripheral skeleton. Infliximab also improves quality of life, function, biological parameters (acute phase reactants and inflammatory lesions of the spine as detected by magnetic resonance imaging. It is given at a 5 mg/kg dosage, as an infusion at weeks 0, 2, 6, and every 6 to 8 weeks after. Open-label and placebo-controlled trials have well demonstrated its high level of efficacy, with an improvement of the disease activity of at least 50% in 60%–80% of patients. In a large placebo-controlled trial, Assessment in Ankylosing Spondylitis Response Criteria (ASAS20 responders were observed in 61.2% of patients receiving infliximab compared to 19.2% of patients under placebo. Long-term efficacy is maintained when infliximab is administered every 6–8 weeks. Consensus international guidelines for the initiation and the use of this expensive treatment are available. Some questions remain, including the long-term safety, in particular the risk of lymphoma, and the potential influence of infliximab on radiological progression which is not currently demonstrated. Despite these concerns, infliximab has revolutionized the management of AS and represents a considerable therapeutic advancement in this disabling disease.Keywords: anti-TNF?, infliximab, ankylosing spondylitis

Éric Toussirot

2009-06-01

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The image diagnosis of juvenile ankylosing spondylitis  

International Nuclear Information System (INIS)

Objective: To research the image change of JAS and improve the knowledge of this case. Method: 12 patients in this group, 11 males and 1 female. The morbidity age is between 9-16 years old and in average is 13 years old. All the cases use the pelvis platform and R F, HLA-B27 check. Four of them has made the CT and MRI level. Result: In this group, the case is extended over the sacroiliac joint. Among them, there are 5 samples that are referred to both of the coxa articution. The X-rays shows that under the sacroiliac joint, there has 2/3 sclerotin sclerotized and the side of sacroiliac shows this phenomenon especially. The sacroiliac joint is fuzziness and the size of articulation clearance is different, it shows as the sawtooth. When it refers to the coxa articulation, it shows as the acetabular and at the same time the articulation become abnormally. When it refers to the lumber, it shows as that the lumber articulation fuzziness while the articulation clearance disappear. CT level: when affected with this sickness it show that the size of the clearance is different. MRI level: T1WI shows that when affected with this case, it express that the size of the clearance is different and at the side of sacroiliac joint can see the low signal which can change into high signal when put it under the T2Wi, HLA-B27 is masculine. Conclusion: Because JAS is lack of the adjust ankylosing spondylitis special clinical in the early stage, so it is always be misdn the early stage, so it is always be misdiagnosed as the Juvenile rheumatoid arthritis. In fact they are two different cases and treatment is also different. The authors should improve our knowledge about this case. In our opinion, checking of the image and HLA-B27 can diagnose this sickness earlier and correctly. (authors)

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Ankylosing Spondylitis: From Cells to Genes  

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Ankylosing spondylitis (AS) is a chronic inflammatory disease of unknown etiology, though it is considered an autoimmune disease. HLA-B27 is the risk factor most often associated with AS, and although the mechanism of involvement is unclear, the subtypes and other features of the relationship between HLA-B27 and AS have been studied for years. Additionally, the key role of IL-17 and Th17 cells in autoimmunity and inflammation suggests that the latter and the cytokines involved in their genera...

José Francisco Zambrano-Zaragoza; Juan Manuel Agraz-Cibrian; Christian González-Reyes; Dur Xe N-avelar, Ma Jes Xfa S.; Norberto Vibanco-Pérez

2013-01-01

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The scintigraphic investigation of the sacroiliac joints in ankylosing spondylitis  

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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.)

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Concomitance of Ankylosing Spondylitis and Multiple Sclerosis: A Case Report  

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Full Text Available Multiple sclerosis and ankylosing spondylitis are two autoimmune diseases in which genetic and environmental factors play an important role in the etiopathogenesis. It has been shown in various studies that multiple sclerosis may be associated with various autoimmune pathological conditions such as thyroid disease and pernicious anemia. Moreover, other rheumatic diseases such as rheumatoid arthritis and lupus have been reported to be associated with multiple sclerosis. Also concomitant ankylosing spondylitis patients have been observed among reports in the medical literature. In this case report, a male patient, 39 years old, who was diagnosed as having ankylosing spondylitis and multiple sclerosis has been presented. The etiology and therapy approaches of the concomitance of ankylosing spondylitis and multiple sclerosis were discussed in the light of clinical findings of the case.

Nurettin TA?TEK?N

2009-03-01

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Ankylosing Spondylitis and Postural Balance  

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Full Text Available Objective: In this study, we aimed to investigate that, due to postural changes, the patients with ankylosing spondyilitis (AS have poorer postural balance than healthy subjects.Materials and Methods: Thirty patients with AS (19 female, 11 male and 20 healthy subjects (13 female, 7 male were tested by using the Tetrax Interactive Balance System. The general stability, Fourier analysis showing patterns of sway intensity within eight frequency bands between 0.1 and 3 Hz, and weight distribution index (WDI were evaluated. Data were also compared with disease duration and finger-floor distance, occiput-wall distance and Schober test. Statistical analyses were performed using SPSS 11.0 for Windows program. Mann-Whitney U test was used to compare groups and Pearson Correlation analysis was used for correlation. Results: There was no statistically significant difference on general stability, Fourier analysis scores, WDI between patients with AS and healthy subjects. A negative correlation was found between Schober test and general stability score. (r=-0,390 p=0,03. No other correlations were found between stability scores, Fourier analyses scores, WDI and occiput-wall distance, finger-floor distance and disease duration.Conclusion: The patients with AS have good postural balance. Disease duration and quantitative measurements of posture do not affect postural balance.

Mahmut Nafiz Akman

2008-09-01

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Surgical outcome after spinal fractures in patients with ankylosing spondylitis  

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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 ex...

Brilakis Emmanuel; Galanakos Spyros; Papadakis Stamatios A; Kateros Konstantinos; Sapkas George; Machairas George; Katonis Pavlos

2009-01-01

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T lymphocyte subset imbalances in patients contribute to ankylosing spondylitis.  

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Ankylosing spondylitis is a chronic inflammatory rheumatic disease, which is characterized by inflammation of the spine and the sacroiliac joints. To date, the disease etiology remains unclear. In the present study, the correlation of T lymphocyte subset changes with the progression of ankylosing spondylitis was investigated. A total of 55 patients with ankylosing spondylitis (22 severe and 23 mild cases) and 20 healthy individuals were selected. Firstly, the punctured cells in the lesions and the serum were collected, and the lymphocytes and the peripheral blood mononuclear cells were prepared. Secondly, quantitative PCR, ELISA and flow cytometry analyses were carried out to detect the levels of a series of immunoglobulins, complements, helper T cells, cytotoxic T cells, regulatory cells and cytokines. The expression levels of ?-globulin, ?-globulin, immunoglobulin (Ig)G, IgA, IgM, serum complement C3, and complement C4 were found to be significantly increased in ankylosing spondylitis patients. In addition, the percentage of Th1 and Th17 cells was found to be significantly higher in the ankylosing spondylitis groups (mild and severe) compared with the healthy individuals. As a result, the Th1/Th2 and Th17/Treg ratios were significantly higher in patients with ankylosing spondylitis. In addition, T lymphocyte subset ratio imbalances contributed to an increased expression of immune mediators, including interferon (IFN)-? and interleukin (IL)-17A. The mRNA and protein expression levels of IFN-? and IL-17A were found to be higher in the ankylosing spondylitis groups compared with the control group. The present study provided further evidence on the function and underlying mechanism of T lymphocyte subsets, which may be useful in the diagnosis and treatment of ankylosing spondylitis. PMID:25452811

Wang, Chenggong; Liao, Qiande; Hu, Yihe; Zhong, DA

2015-01-01

71

Coexistence of Behçet's Disease and Ankylosing Spondylitis: A Case Report  

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Full Text Available Although overlap syndrome is frequently encountered in rheumatology practice, only a few cases of coexisting Behçet’s disease and ankylosing spondylitis have been reported in the literature. Thus, in this article, we aimed to present a 55-year-old male patient with coexisting Behçet’s disease and ankylosing spondylitis who had HLA-B5 positivity, HLA-B27 negativity, and oral and genital lesions.

Hikmet Koçyi?it

2010-12-01

72

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

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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...

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

1983-01-01

73

Paraspinal muscle fibrosis: a specific pathological component in ankylosing spondylitis.  

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The histological appearance of percutaneous superficial paraspinal muscle biopsy specimens from eight patients with ankylosing spondylitis was compared with that of biopsy specimens from 13 control patients with similar degrees of disability and spinal immobility due to severe, chronic mechanical back pain. In both groups marked type II muscle fibre atrophy was shown. Additionally, in patients with ankylosing spondylitis there were obvious increases in perifibre connective tissue in associati...

Cooper, R. G.; Freemont, A. J.; Fitzmaurice, R.; Alani, S. M.; Jayson, M. I.

1991-01-01

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Ankylosing spondylitis. Not just another pain in the back.  

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OBJECTIVE: To review recent developments in diagnosis and treatment of ankylosing spondylitis (AS). QUALITY OF EVIDENCE: Level I evidence from three randomized placebo-controlled trials shows that AS is highly responsive to anti-tumour necrosis factor-alpha (anti-TNFalpha) therapies when the standard approach of nonsteroidal anti-inflammatory drugs (NSAIDs) and physical modalities fails. MAIN MESSAGE: Ankylosing spondylitis is associated with disability comparable to that of rheumatoid arthri...

Wp, Maksymowych

2004-01-01

75

[Clinico-radiological evaluation of patients with ankylosing spondylitis].  

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The authors prospectively investigated 20 ankylosing spondylitis patients with 11 years of mean disease duration. The researched variables were related to patients activity and severity of symptoms, as well to the main axial skeleton radiological changes. The results showed that all the patients presented different degrees of radiological sacroiliitis, while 90% revealed apophyseal joints ankylosis, therefore demonstrating the importance of these radiological signs for the diagnosis of the ankylosing spondylitis. PMID:1843740

Meirelles, E S; Fazzi, A; Marcolino, F M; Zerbini, C A

1991-01-01

76

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

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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 genera...

Wariaghli Ghizlane; Allali Fadoua; Berrada Kenza; Idrissi Zineb; Hmamouchi Ihsane; Abouqal Redouane; Hajjaj-Hassouni1 Najia

2012-01-01

77

Chronic otitis media: a new extra-articular manifestation in ankylosing spondylitis?  

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Following a study reporting a fourfold increase in the occurrence of chronic otitis media in patients with ankylosing spondylitis, this prospective study examines this association with respect to severity, duration of disease, and acute phase in ankylosing spondylitis. Forty two consecutive patients with classical ankylosing spondylitis seen at the rheumatology clinic of a teaching hospital where the features of ankylosing spondylitis were recorded had an otological examination by an otolaryn...

Camilleri, A. E.; Swan, I. R.; Murphy, E.; Sturrock, R. D.

1992-01-01

78

Chromosome aberrations in irradiated ankylosing spondylitis patients  

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At the previous International Symposium held in this Unit in 1966, entitled 'Human Radiation Cytogenetics', the cytogenetic information available from peripheral blood lymphocytes of patients who had undergone a course of radiotherapy was presented. Cytogenetic changes following partial-body irradiation (1500 rad in ten fractions to the whole spine and sacroiliac joints, which was and is standard radiotherapy treatment in Edinburgh for ankylosing spondylitis) were seen to persist for up to at least ten years, the time interval of the study. A report is now presented on the fate of the radiation-damaged cells following this treatment regime for up to twenty years. Information is also available for up to thirty years post-treatment, but this includes patients that had higher doses, 2000 and 2500 rad to standard fields, and a variety of treatments. (author)

79

Evaluation of serum paraoxonase and arylesterase activities in ankylosing spondylitis patients  

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Full Text Available SciELO Brazil | Language: English Abstract in english OBJECTIVES: The aim of this study was to investigate the activities of serum paraoxonase and arylesterase in patients with ankylosing spondylitis with respect to those of healthy controls, to assess whether these enzyme levels are related to disease activity and functional capacity. METHODS: The stu [...] dy included 32 patients with ankylosing spondylitis whose diagnoses were made according to the modified New York criteria as well as 25 healthy controls matched for age and sex. The Bath Ankylosing Spondylitis Disease Activity Index and the Bath Ankylosing Spondylitis Functional Index were applied to the ankylosing spondylitis patients. As laboratory parameters, the erythrocyte sedimentation rate and serum C-reactive protein level were measured in patients and control subjects. Paraoxonase and arylesterase enzyme activities were measured using appropriate methods. RESULTS: No statistically significant differences (p>0.05) were found between the ankylosing spondylitis patients and controls in terms of serum paraoxonase or arylesterase levels. Furthermore, there was no correlation between clinical and laboratory parameters in patients with ankylosing spondylitis. CONCLUSION: Serum paraoxonase and arylesterase levels in ankylosing spondylitis patients may not differ from those of healthy controls, and there is no significant correlation between antioxidant parameters and the Bath Ankylosing Spondylitis Disease Activity Index or Bath Ankylosing Spondylitis Functional Index scores in ankylosing spondylitis patients. Further research is needed to provide deeper understanding of this disease.

Fazile Hatipoglu, Erdem; Saliha, Karatay; Kadir, Yildirim; Ahmet, Kiziltunc.

80

Coexistence of ankylosing spondylitis and systemic lupus erythematosus.  

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Coexistence of ankylosing spondylitis with connective tissue diseases is uncommon. We describe here the coexistence of ankylosing spondylitis and systemic lupus erythematosus in a 35-year-old man. He presented with a 4-year history of pain in the hip joint and lower spine, and he later developed a malar rash and discoid rash. Immunological tests revealed that antinuclear antibody and double stranded DNA antibody were positive. The human leukocyte antigen B27 antigen was also found to be positive. We propose that development of systemic lupus erythematosus in this case may have been due to low grade chronic inflammation. PMID:20685593

Singh, Sangeeta; Sonkar, Gyanendra Kumar; Singh, Usha

2010-05-01

 
 
 
 
81

Ankylosing Spondylitis Associated With Bilateral TMJ Ankylosis  

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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.

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

82

Ankylosing Spondylitis Associated With Bilateral TMJ Ankylosis  

International Nuclear Information System (INIS)

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.

83

Ankylosing Spondylitis: From Cells to Genes  

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Ankylosing spondylitis (AS) is a chronic inflammatory disease of unknown etiology, though it is considered an autoimmune disease. HLA-B27 is the risk factor most often associated with AS, and although the mechanism of involvement is unclear, the subtypes and other features of the relationship between HLA-B27 and AS have been studied for years. Additionally, the key role of IL-17 and Th17 cells in autoimmunity and inflammation suggests that the latter and the cytokines involved in their generation could play a role in the pathogenesis of this disease. Recent studies have described the sources of IL-17 and IL-23, as well as the characterization of Th17 cells in autoimmune diseases. Other cells, such as NK and regulatory T cells, have been implicated in autoimmunity and have been evaluated to ascertain their possible role in AS. Moreover, several polymorphisms, mutations and deletions in the regulatory proteins, protein-coding regions, and promoter regions of different genes involved in immune responses have been discovered and evaluated for possible genetic linkages to AS. In this review, we analyze the features of HLA-B27 and the suggested mechanisms of its involvement in AS while also focusing on the characterization of the immune response and the identification of genes associated with AS. PMID:23970995

Zambrano-Zaragoza, José Francisco; Agraz-Cibrian, Juan Manuel; González-Reyes, Christian; Durán-Avelar, Ma. de Jesús; Vibanco-Pérez, Norberto

2013-01-01

84

Integrative structural biomechanical concepts of ankylosing spondylitis.  

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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. PMID:22216409

Masi, Alfonse T; Nair, Kalyani; Andonian, Brian J; Prus, Kristina M; Kelly, Joseph; Sanchez, Jose R; Henderson, Jacqueline

2011-01-01

85

Ankylosing spondylitis presenting as juxta-articular masses in females  

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Juxta-articular inflammatory masses, sternomanubrial or sternoclavicular, were noted in two women who were subsequently found to have ankylosing spondylitis. The differential diagnosis of juxta-articular masses should include systemic rheumatic disorders as well as tumor or infection. (orig.)

86

Evaluation of the T helper 17 axis in ankylosing spondylitis.  

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To evaluate the T helper 17 (Th17) axis and its relation to tumor necrosis factor (TNF) alpha blockage and disease activity in ankylosing spondylitis (AS). The study included 127 AS patients (100M/27F) and 38 (27M/11F) controls. Spinal mobility was assessed by the bath ankylosing spondylitis metrology index (BASMI). Patients were also evaluated with the bath ankylosing spondylitis functional (BASFI) and bath ankylosing spondylitis disease activity index. Cytokines including IL-6, IL-12, TGF-?, IL-17A, and IL-23 were measured in serum sample using commercially available ELISA kits. Cytokines including IL-6, IL-12, TGF-?, IL-17, and IL-23 were significantly higher in the AS patients than the controls (P 0.05). Cytokines were also similar between patients with active and inactive disease (P > 0.05). On correlation analysis, IL-17 was correlated with IL-23 and IL-12 (P < 0.05) and IL-23 showed correlations with IL-12 and BASMI (P < 0.05). We found serum levels of Th-17-related cytokines to be significantly increased in the sera of AS patients. Disease activity and treatment type did not affect the level of these cytokines. PMID:21833527

Taylan, Ali; Sari, Ismail; Kozaci, Didem L; Yuksel, Arif; Bilge, Safak; Yildiz, Yasar; Sop, Gulten; Coker, Isil; Gunay, Necati; Akkoc, Nurullah

2012-08-01

87

Autoimmune thyroid disease in ankylosing spondylitis.  

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Although autoimmune thyroid disease is well known to be associated with primary Sjögren's syndrome (SjS) and with various autoimmune diseases, it is less clear whether a similar association also exists for ankylosing spondylitis (AS). Therefore, we investigated the frequency of autoimmune thyroid disease in patients with AS. In this cross sectional study, 80 patients with AS fulfilling the 1984 Modified New York Criteria and 80 healthy subjects, age and sex-matched with AS patients, were included. As the positive control group, 62 female patients with primary SjS were also studied. All cases underwent thyroid ultrasonography (USG) by a single endocrinologist. Thyroid function tests and thyroid autoantibodies were measured. The diagnosis of Hashimoto's thyroiditis (HT) was made if the patient had thyroid autoantibody positivity plus at least one of the following criteria: diffuse goiter with physical examination, abnormality in thyroid function tests, and parenchymal heterogeneity with USG. The chi-squared test and Fisher's exact test were used to compare cases and controls. The p values <0.05 were considered statistically significant. The frequencies of parenchymal heterogeneity with USG (30 vs 11.3 %, p?=?0.045), thyroid autoantibody positivity (13.8 vs 2.5 %, p?=?0.017), and concomitant diagnosis of HT (10 vs 1.3 %, p?=?0.034) were significantly higher in AS group compared to healthy controls. Among AS patients having HT, subclinical hypothyroidism was detected only in a single patient. Frequency of autoimmune thyroid disease was significantly higher in AS group, compared to healthy controls. Prospective studies are needed to see the clinical relevance of these findings and outcome in the long term. PMID:24384825

Emmungil, Hakan; Erdogan, Mehmet; Kalfa, Melike; Karabulut, Gonca; Kocanaogullar?, Hayriye; Inal, Vedat; Aksu, Kenan; Oksel, Fahrettin; Kabasakal, Yasemin; Keser, Gokhan

2014-07-01

88

Sjögren's syndrome in patients with ankylosing spondylitis.  

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There are few reports about the coexistence of Sjögren's syndrome (SS) and ankylosing spondylitis (AS). To evaluate the frequency of SS in patients with AS. We studied 70 patients with AS presenting to the university outpatient clinic between January 2002 and November 2003. All the patients were asked about sicca symptoms by using sicca questionnaire. Rheumatoid factor, anti-nuclear antibody, anti-Ro, and anti-La antibodies were examined for each of the patients. Salivary flowmetry for the existence of xerostomia, Schirmer's test, and break-up time for the existence of xerophtalmia were performed in all patients with AS. Minor salivary gland biopsy was performed on the patients with at least three positive responses to the sicca questionnaire and positive xerostomia/xerophtalmia tests. Biopsies were regarded as pathological when they showed focal grade iii and grade IV sialoadenitis according to Chisholm grading criteria. Among 70 AS cases, 56 (80%) were men, 14 (20%) were women, and the mean age was 42 years old. Minor salivary gland biopsy was performed on the 16 patients. Of 16 minor salivary gland biopsies, 7 were assessed as pathological--5 of them showed grade III, and 2 of them showed grade IV sialoadenitis. Of these seven patients, one was anti-Ro-positive, and two were anti-La-positive. There was no patient with normal salivary gland biopsy and anti-Ro and/or anti-La positivity. In our study group, 7 (10%) of 70 AS patients had concomitant SS. Therefore, it seems likely that AS may have pathogenetic association with SS. PMID:16547690

Kobak, Senol; Kobak, Arzu Celebi; Kabasakal, Yasemin; Doganavsargil, Eker

2007-02-01

89

Sequential appearance of ankylosing spondylitis, retroperitoneal fibrosis and achalasia: Coincidental association or evidence of autoimmunity?  

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SUMMARY The association of idiopathic achalasia with ankylosing spondylitis and retroperitoneal fibrosis, to our knowledge not previously reported, is described in a 54 year old woman. We suggest that the consecutive occurrence of ankylosing spondylitis and retroperitoneal fibrosis, two well-known autoimmune disorders, before the presence of achalasia, reinforces the theory of autoimmunity in etiopathogenesis of achalasia. Key words: Achalasia, Ankylosing spondylitis, Retroperitoneal fibrosis...

Katsinelos P.; Christodoulou K.; Pilpilidis I.; Papagiannis A.; Kalomenopoulou M.; Katsiba D.; Tarpagos A.; Katsos I.; Evgenidis N.

2007-01-01

90

Comparison of statistically derived ASAS improvement criteria for ankylosing spondylitis with clinically relevant improvement according to an expert panel  

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Objective: To investigate whether the recently developed (statistically derived) "ASsessment in Ankylosing Spondylitis Working Group" improvement criteria (ASAS-IC) for ankylosing spondylitis (AS) reflect clinically relevant improvement according to the opinion of an expert panel.

Tubergen, A.; Heijde, D.; Anderson, J.; Landewe, R.; Dougados, M.; Braun, J.; Bellamy, N.; Udrea, G.; Linden, S.

2003-01-01

91

Cervical Spinal Cord Injury with a Minor Trauma in A Patient with Ankylosing Spondylitis: A Case Report  

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Patients with advanced ankylosing spondylitis are prone to fractures of cervical spine following minor injuries. In this case report, we present a case of ankylosing spondylitis where the patient sustained cervical spinal cord injury after a minor traffic accident

Ahmet Yesildag; A?k?n Gorgulu; Erdem Ilgun; Serpil Savas

2008-01-01

92

Improved CT imaging in diagnosis of ankylosing spondylitis  

International Nuclear Information System (INIS)

Objective: To evaluate the improved CT imaging of sacroiliac joint in diagnosis of ankylosing spondylitis (AS). Methods: 22 patients, diagnosed as AS by clinical and radiography, undertook both conventional and improved CT imaging. All images were comparatively studied. Results: With conventional CT imaging, in the 44 joints of 22 cases, unremarkable images were obtained in 3 cases; early stage AS was found in 15 joints of 9 cases; AS in progressive stage was revealed in 8 cases/16 joints, stabled AS was presented in 2 cases/4 joints. There were 23 joints in 12 cases diagnosed as early term by improved imaging, progressive staged AS was shown in 8 cases/16 joints as, stable AS was demonstrated in 2 cases/4 joints. Conclusion: The improved imaging is sensitive in the diagnosis of early staged AS, for the application of thin slice scan, which helps to reduce partial volume effect. Scanning along the longitudinal axis of the sacroiliac joint extends the observation of erosion of the joint surface. For progressive or stable staged AS, the alterations of bone and joint space are prominent, improved CT imaging is not superior to the conventional. (authors)

93

Ankylosing spondylitis: a dual perspective of current issues and challenges.  

Science.gov (United States)

This series of articles on ankylosing spondylitis (AS) provides insight into the burden of disease and focuses on early diagnosis and effective management. AS leads to progressive functional impairment over time and has tremendous impact on society at large in terms of economic costs and indirect costs associated with physical impairment and loss of employment. Early diagnosis is crucial now that we have more effective therapy with tumor necrosis factor (TNF) antagonists, which suppress disease activity and improve the functional ability of patients whose disease is refractory to conventional drug therapy. Early identification of variables that help predict severe disease with bad functional prognosis is needed. If biological therapy with TNF inhibitors is proven to retard disease progression and prevent or delay functional limitations, insight into such prognosticators will help us offer the correct treatment to the correct patient at the correct time. There is also a need to demonstrate longterm benefits of such a therapy as well as a favorable cost/benefit ratio to help convince healthcare authorities, insurance companies, and others of the utility of these drugs for treating patients with AS refractory to conventional drug therapy. PMID:17042054

Khan, Muhammad Asim

2006-09-01

94

Radiological changes of the symphysis in ankylosing spondylitis  

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Purpose: To evaluate the symphyseal changes in patients with ankylosing spondylitis. Material and Methods: Radiological-morphological changes of the symphysis were studied in 68 patients (66 men, 2 women) with ankylosing spondylitis whose age ranged from 21 to 75 years. The duration of the disease was from 2 to 50 years. Results and Conclusion: Changes in the symphysis were found in 16 patients (23.5%) and were less prominent than findings in the sacroiliac joints. We classified these changes into four stages: minimal changes, apparent destruction, reparation and ankylosis. The third and the fourth stages of the changes in the symphysis were found more frequently in patients who suffered from the disease for more than 15 years. Radiological evaluation of symphyseal changes can be helpful in the evaluation of disease progression as well as in establishing a differential diagnosis

95

Radiological changes of the symphysis in ankylosing spondylitis  

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Purpose: To evaluate the symphyseal changes in patients with ankylosing spondylitis. Material and Methods: Radiological-morphological changes of the symphysis were studied in 68 patients (66 men, 2 women) with ankylosing spondylitis whose age ranged from 21 to 75 years. The duration of the disease was from 2 to 50 years. Results and Conclusion: Changes in the symphysis were found in 16 patients (23.5%) and were less prominent than findings in the sacroiliac joints. We classified these changes into four stages: minimal changes, apparent destruction, reparation and ankylosis. The third and the fourth stages of the changes in the symphysis were found more frequently in patients who suffered from the disease for more than 15 years. Radiological evaluation of symphyseal changes can be helpful in the evaluation of disease progression as well as in establishing a differential diagnosis.

Jajic, Z.; Jajic, I.; Grazio, S. [Univ. Hospital Sestre Milosrdnice, Zagreb (Croatia). Dept. for Rheumatology, Physical Medicine and Rehabilitation

2000-07-01

96

Pulmonary function and maximal transrespiratory pressures in ankylosing spondylitis.  

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Clinical measurements and pulmonary functions, including maximal transrespiratory pressures, were studied in 30 patients (age 43 (SD 10) years) with ankylosing spondylitis. Vital capacity (VC) was slightly reduced to 79 (16)% and forced expiratory volume in one second (FEV1) was similarly reduced to 82 (20)% such that the average FEV1/VC ratio was 77.8 (6.65). Total lung capacity was slightly reduced to 85 (13)%. Transfer factor of the lung for carbon monoxide (TLCO) averaged 88 (17)% and TLCO per unit lung volume was 114 (26)%. Reductions in lung volumes correlated well with clinical measurements. Both maximal expiratory pressures (PEmax) and inspiratory pressures (PImax) were clearly reduced to 56 (17)% and 76 (28)% respectively. This suggests that spirometrically determined volumes were better preserved than respiratory muscle strength in ankylosing spondylitis. It is speculated that the reduction in respiratory muscle strength may be due to intercostal muscle atrophy. PMID:2782973

Vanderschueren, D; Decramer, M; Van den Daele, P; Dequeker, J

1989-08-01

97

Relapsing Polychondritis in a Patient with Ankylosing Spondylitis Using Etanercept  

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Relapsing polychondritis (RP) is an autoimmune disease characterized by recurrent episodes of inflammation and progressive destruction of cartilaginous tissues, especially of the ears, nose, joints, and tracheobronchial tree. Its etiology is not well understood, but some studies have linked its pathophysiology with autoimmune disease and autoantibody production. We described a case of a 46-year-old male patient with ankylosing spondylitis who developed RP after the use of etanercept. Few simi...

Valderilio Feijó Azevedo; Natalia Bassalobre Galli; Alais Daiane Fadini Kleinfelder; Ippolito, Julia Farabolini D. X.; Andressa Gulin Tolentino; Eduardo Paiva

2014-01-01

98

Investigation of Spatial Clusters of Patients with Ankylosing Spondylitis  

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Full Text Available Objective: The Geographic Information System (GIS, in health area studies especially topics such as the distribution, clustering and mapping of disease, the geographic location of health services and the determination of healthcare distribution, are frequently used. Limited regional studies on these subjects are available in our country. The aim of this work is to investigate the distribution and clustering status of ankylosing spondylitis disease in Duzce by the GIS based global spatial clustering methods. Materials and Methods: 52 patients with ankylosing spondylitis who admitted to Physical Therapy and Rehabilitation polyclinic in Duzce University Researching and Training Hospital on various dates for diagnosis or treatment were included in study. With the help of the patient data collected from reports in 2013 year, spatial clusters of the disease were examined by Nearest neighbor, Moran I, Getis ORD, and Ripley's K function methods. The study was conducted in ArcGIS program. Results: With the examined global spatial clustering methods, in the center of Duzce the distribution of ankylosing spondylitis patients was obtained and it was determined a significant spatial cluster for this disease. However, thence a few collected data set and the used only the data of a health center, due to the rarity of ankylosing spondylitis disease, clustering may not reflect the truth. Because the health center where data is collected is the largest and most comprehensive in Duzce, it should not be ignored that results are important like a preliminary study. Conclusion: To raise the level of public health and to improve remedial policies it is recommended to examine the clustering structures in the issues such as the distribution and location of disease, staff, health center which have important role in the planning, protection, and the diagnosis-treatment process.

Özge PAS?N

2014-10-01

99

Cervical osteotomy in ankylosing spondylitis: evaluation of new developments  

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Objectives: Cervical osteotomy can be performed on patients with cervical kyphosis due to ankylosing spondylitis. This study reviews the role of two new developments in cervical osteotomy surgery: internal fixation and transcranial electrical stimulated motor evoked potential monitoring (TES-MEP). Methods: From 1999 to 2004, 16 patients underwent a C7-osteotomy with internal fixation. In 11 patients, cervical osteotomy was performed in a sitting position with halo-cast immobilization (group S...

Langeloo, Danielle D.; Journee, Henricus L.; Pavlov, Paul W.; Kleuver, Marinus

2006-01-01

100

X-ray therapy in the treatment of ankylosing spondylitis  

International Nuclear Information System (INIS)

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)

 
 
 
 
101

Cost-of-illness of rheumatoid arthritis and ankylosing spondylitis  

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OBJECTIVES: To assess, quantify and summarise the cost of illness of rheumatoid arthritis (RA) and ankylosing spondylitis (AS) from the societal perspective. METHODS: Original studies reporting costs of RA or AS were searched systematically. Both cost-of-illness studies and economic evaluations of therapies were included. Studies were appraised for patient and study characteristics, type of costs and actual costs. Reported costs were aggregated by cost categories and overall mean co...

Franke, L. C.; Ament, A. J. H. A.; Laar, M. A. F. J.; Boonen, A.; Severens, J. L.

2009-01-01

102

MRI of the axial skeletal manifestations of ankylosing spondylitis  

International Nuclear Information System (INIS)

Magnetic resonance imaging (MRI) is a valuable tool in the imaging and assessment of patients with ankylosing spondylitis. MRI can demonstrate the acute and chronic changes of sacroiliitis, osteitis, discovertebral lesions, disc calcifications and ossification and arthopathic lesions, which characterize the disease, as well as the complications, which include fracture and the rare cauda equina syndrome. This article reviews the range of MRI findings commonly seen within the axial skeleton in patients with this condition

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Polyarthritis flare in patient with ankylosing spondylitis treated with infliximab  

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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 (TNF? 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.

E. Filippucci

2011-06-01

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MRI of the axial skeletal manifestations of ankylosing spondylitis  

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Magnetic resonance imaging (MRI) is a valuable tool in the imaging and assessment of patients with ankylosing spondylitis. MRI can demonstrate the acute and chronic changes of sacroiliitis, osteitis, discovertebral lesions, disc calcifications and ossification and arthopathic lesions, which characterize the disease, as well as the complications, which include fracture and the rare cauda equina syndrome. This article reviews the range of MRI findings commonly seen within the axial skeleton in patients with this condition.

Levine, D.S.; Forbat, S.M.; Saifuddin, A. E-mail: asaifuddin@aol.com

2004-05-01

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Management of Acute Spinal Fractures in Ankylosing Spondylitis  

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Ankylosing Spondylitis (AS) is a multifactorial and polygenic rheumatic condition without a well-understood pathophysiology (Braun and Sieper (2007)). It results in chronic pain, deformity, and fracture of the axial skeleton. AS alters the biomechanical properties of the spine through a chronic inflammatory process, yielding a brittle, minimally compliant spinal column. Consequently, this patient population is highly susceptible to unstable spine fractures and associat...

Chaudhary, Saad B.; Heidi Hullinger; Vives, Michael J.

2011-01-01

106

Ankylosing spondylitis is associated with upper lobe lung fibrosis  

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A patient diagnosed as having ankylosing spondylitis 6 months later developed symptoms resembling lung tuberculosis, although no bacterial evidence could be obtained to support that diagnosis. Because a large solitary cavity of the left upper lobe was observed, a thoracotomy was performed which yielded histological evidence supporting a diagnosis of lung fibrosis. The etiology, clinical appearance and therapy of the syndrom, first described in 1949 by Hamilton, is discussed. (orig.)

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Evaluation of various endothelial biomarkers in ankylosing spondylitis.  

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Atherosclerosis has been shown to be increased in chronic inflammatory diseases including ankylosing spondylitis (AS). Impaired endothelial function, the first step in atherosclerosis, may be reflected by changes in various endothelial biomarkers of hemostasis and the release of several cellular adhesion molecules or cytokines. In this study, we investigated changes in the levels of various possible markers with regard to disease activity and treatment regimen with/without anti-TNF-? drugs. Fifty-six AS patients (44 males) and 27 controls (19 males) with no known cardiovascular risk factors were included in the study. Spinal mobility was assessed by the Bath Ankylosing Spondylitis Metrology Index, and patients were evaluated with the Bath Ankylosing Spondylitis Functional Index and the Bath Ankylosing Spondylitis Disease Activity Index. Cytokines and various endothelial biomarkers were measured in serum samples using commercially available ELISA kits. Age, sex, BMI, waist circumference, fasting glucose, MAP, lipids are all similar between patients and controls. von Willebrand factor (vWF), soluble thrombomodulin (sTM), and urotensin (UT-II) were found to be significantly higher in the sera of the patients compared to the controls. Treatment with anti-TNF-? compared to conventional therapy and disease activity in AS patients seemed to have no effect on the blood levels of UT-II, sTM, CD146, vWF, plasminogen activator inhibitor-1, tissue plasminogen activator, or the thrombin-antithrombin complex. The increased UT-II, sTM, and vWF in AS patient sera regardless of treatment and disease activity suggest an increased tendency for atherosclerosis. PMID:21556780

Taylan, Ali; Sari, Ismail; Kozaci, Didem L; Yildiz, Yasar; Bilge, Safak; Coker, Isil; Maltas, Sergir; Gunay, Necati; Akkoc, Nurullah

2012-01-01

108

Asymptomatic sacral arachnoid cyst in a patient with ankylosing spondylitis.  

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A sacral arachnoid cyst was found incidentally in a patient with ankylosing spondylitis. The clinical manifestations were perithecal bony erosions and thecal sac displacement while no associated neurological deficit was detected. This peculiar situation is of special interest as cauda equina syndrome invariably presented in such clinical complex. The pathogenesis of the arachnoid cyst remains unclear. And surgical intervention is only indicated in patients with evidence of nerve root compression. PMID:7837326

Lan, M Y; Chang, Y Y; Chen, W H; Lin, S H; Liu, J S; Chen, S S

1994-11-01

109

Coexisting Ankylosing Spondylitis and Gouty Arthritis Case Report  

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Coexsisting ankylosing spondylitis (AS) and gouty arthritis have rarely been reported in the literature previously. We present a 43-year-old male patient with AS who had been diagnosed as having gout based on some clinical and laboratory findings. In this paper, the clinical features of both rheumatic diseases are discussed in light of the recent literature. The gouty arthritis should be considered in the differential diagnosis of acute peripheral arthritis in patients with AS. Turk J Phys Me...

Necmettin Y?ld?z; Serap Tomruk Sütbeyaz; Füsun Köseo?lu

2011-01-01

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Ankylosing spondylitis in north Jordan: descriptive and analytical study  

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OBJECTIVE—A study of ankylosing spondylitis in Jordan, which has been underinvestigated in this region.?METHODS—Twenty two patients were studied according to standard methodology during a period of four years. Information on HLA, the presence of uveitis, cardiac disease, and peripheral arthritis was recorded. Other variables such as age, sex, employment, and level of disability were also recorded.?RESULTS—The results reflected the characteristics of the illness and the impact of the...

Askari, A.; Al-bdour, M.; Saadeh, A.; Sawalha, A.

2000-01-01

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ASAS/EULAR recommendations for the management of ankylosing spondylitis  

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Objective: To develop evidence based recommendations for the management of ankylosing spondylitis (AS) as a combined effort of the `ASsessment in AS' international working group and the European League Against Rheumatism.Methods: Each of the 22 participants was asked to contribute up to 15 propositions describing key clinical aspects of AS management. A Delphi process was used to select 10 final propositions. A systematic literature search was then performed to obtain scientific evidence for ...

Zochling, J.; Heijde, D.; Burgos-vargas, R.; Collantes, E.; Davis Jr, J. C.; Dijkmans, B.; Dougados, M.; Ge?her, R. D. And Khan; Royen, B. J.; Braun, J.; Inman, R. D.; Khan, M. A.; Kvien, T. K.; Leirisalo-repo, M.; Olivieri, I.

2006-01-01

112

MRI manifestations of lumbar active inflammation in ankylosing spondylitis  

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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, 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)

113

Relation Between Clinical Parameters and Pulmonary Function in Ankylosing Spondylitis  

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Full Text Available Objective: The aim of this study was to determine pulmonary function in ankylosing spondylitis (AS patients and to assess the relationship with clinical parameters.Material and Methods: A total of 30 patients with definite AS (Group 1 and 20 age-matched healthy controls (Group 2 were recruited for the study. Patients and healthy controls were assessed according to visual analog scale (VAS pain, 6 minute walk test (6MWT, chest expansion, the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI, and the Bath Ankylosing Spondylitis Functional Index (BASFI. Pulmonary function was assessed by forced vital capacity (FVC, forced expiratory volume in 1 second (FEV1, and vital capacity (VC.Results: There was no statistically significant difference in age or body mass index between groups (p>0.05. There were significant differences in VAS pain, chest expansion, BASDAI and BASFI scores and pulmonary function parameters FVC, FEV1, VC and 6MWT between groups (p<0.05. There were significant correlations between all pulmonary function parameters and clinical and functional measures.Conclusion: Based on these results, we conclude that there is a correlation among functional performance, pulmonary capacities and clinical parameters in AS patients.

Dilek Durmu?

2009-12-01

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Update on ankylosing spondylitis: current concepts in pathogenesis.  

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Ankylosing spondylitis is an insidiously progressive and debilitating form of arthritis involving the axial skeleton. The long delay in diagnosis and insufficient response to currently available therapeutics both advocate for a greater understanding of disease pathogenesis. Genome-wide association studies of this highly genetic disease have implicated specific immune pathways, including the interleukin (IL)-17/IL-23 pathway, control of nuclear factor kappa B (NF-?B) activation, amino acid trimming for major histocompatibility complex (MHC) antigen presentation, and other genes controlling CD8 and CD4 T cell subsets. The relevance of these pathways has borne out in animal and human subject studies, in particular, the response to novel therapeutic agents. Genetics and the findings of autoantibodies in ankylosing spondylitis revisit the question of autoimmune vs. autoinflammatory etiology. As environmental partners to genetics, recent attention has focused on the roles of microbiota and biomechanical stress in initiating and perpetuating inflammation. Herein, we review these current developments in the investigation of ankylosing spondylitis pathogenesis. PMID:25447326

Smith, Judith A

2015-01-01

115

Clinical feature and imaging findings of juvenile ankylosing spondylitis  

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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

116

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

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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.

Urmila Palaria; Mohd Asim Rasheed; Punera, D. C.; Bhadani, Umesh K.

2011-01-01

117

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

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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.

Urmila Palaria

2011-11-01

118

Ankylosing spondylitis in a military aviator: air medical considerations.  

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Rheumatologic diseases are a challenging diagnosis when it comes to air medical disposition decision making because many of these diseases overlap and their initial presentation is insidious and relapsing remitting in future scope. Many rheumatologic diseases have musculoskeletal and other organ complications. One of these diagnoses is spondyloarthritides. These disorders include ankylosing spondylitis (AS), reactive arthritis, psoriatic arthritis and spondylitis, enteropathic arthritis and spondylitis, juvenile-onset spondyloarthritis, and undifferentiated spondyloarthritis. The prevalence of spondyloarthropathy is estimated to be between 0.1% and 2.5%,(1) although figures vary from 1 study to another. In this article, we report the case of a military pilot diagnosed with AS who had a favorable response to treatment with etanercept therapy. PMID:24787516

Eslami, Reza; Momenzadeh, Mahmud; Ebadi, Ahmad

2014-01-01

119

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

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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

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Atividade sexual na espondilite anquilosante / Sexual activity in ankylosing spondylitis  

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Full Text Available SciELO Brazil | Language: Portuguese Abstract in portuguese OBJETIVO: Analisar a atividade sexual em pacientes com espondilite anquilosante, correlacionando com índices funcionais e de atividade da doença. PACIENTES E MÉTODOS: Foram analisados quanto a dor, fadiga, questionários de atividade de doença (Bath Ankylosing Spondylitis Disease Activity Index - BAS [...] DAI), funcionalidade (Bath Ankylosing Spondylitis Functional Index - BASFI) e atividade sexual (utilizando imagens de sete posições sexuais) 32 pacientes com diagnóstico de espondilite anquilosante e 32 controles saudáveis. Após a entrevista, os pacientes foram divididos em dois grupos: grupo A (com atividade sexual) e grupo B (sem atividade sexual). RESULTADOS: O grupo B apresentou associação estatística com maior duração da doença (P = 0,01), pior funcionalidade (P = 0,0007) e maior atividade de doença (P = 0,03). Não houve correlação entre idade e capacidade funcional. O homem deitado de costas e a mulher sobre ele foi a posição mais frequente, agradável e menos dolorosa. A figura com a mulher de costas e o homem deitado sobre ela foi a posição menos escolhida. Indivíduos-controle relataram maior frequência e duração mais longa das relações sexuais, menos fadiga e dor, embora a frequência de orgasmos tenha sido semelhante nos dois grupos. CONCLUSÃO: A natureza crônica da espondilite anquilosante, com pior capacidade funcional e maior atividade da doença, interferiu no comportamento sexual dos pacientes. Quando o sexo se tornou possível, orgasmo e satisfação sexual não diferiram dos controles saudáveis. Abstract in english OBJECTIVE: To assess the sexual activity of patients with ankylosing spondylitis, correlating it with disease activity and functional indices. PATIENTS AND METHODS: Thirty-two patients with ankylosing spondylitis and 32 healthy controls were assessed regarding pain, fatigue, sexual activity (by use [...] of pictures of seven sexual positions), disease activity (by use of Bath Ankylosing Spondylitis Disease Activity Index - BASDAI), and functional capacity (by use of Bath Ankylosing Spondylitis Functional Index - BASFI). After the interview, the patients were divided into two groups: group A (with sexual activity) and group B (no sexual activity). RESULTS: Group B showed statistical association with longer disease duration (P = 0.01), and higher BASFI (P = 0.0007) and BASDAI (P = 0.03) scores. No correlation was observed between age and functional capacity. Man lying on his back and woman on top was the most frequent, enjoyable and least painful position. The position with the woman on her back and a man lying on top was the least chosen. Control individuals reported a higher frequency of sexual activity, longer duration of intercourse, and less pain and fatigue; the reported frequency of orgasms, however, was similar in both groups. CONCLUSION: The chronic nature of ankylosing spondylitis, with poor functional capacity and higher disease activity, interferes with sexual intercourse. When sexual activity was possible, orgasm and sexual satisfaction did not differ from those of healthy controls.

Andrea Lopes, Gallinaro; Lilian Lie, Akagawa; Mariana Hissami Ichiba, Otuzi; Percival Degrava, Sampaio-Barros; Célio Roberto, Gonçalves.

2012-12-01

 
 
 
 
121

Atividade sexual na espondilite anquilosante Sexual activity in ankylosing spondylitis  

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Full Text Available OBJETIVO: Analisar a atividade sexual em pacientes com espondilite anquilosante, correlacionando com índices funcionais e de atividade da doença. PACIENTES E MÉTODOS: Foram analisados quanto a dor, fadiga, questionários de atividade de doença (Bath Ankylosing Spondylitis Disease Activity Index - BASDAI, funcionalidade (Bath Ankylosing Spondylitis Functional Index - BASFI e atividade sexual (utilizando imagens de sete posições sexuais 32 pacientes com diagnóstico de espondilite anquilosante e 32 controles saudáveis. Após a entrevista, os pacientes foram divididos em dois grupos: grupo A (com atividade sexual e grupo B (sem atividade sexual. RESULTADOS: O grupo B apresentou associação estatística com maior duração da doença (P = 0,01, pior funcionalidade (P = 0,0007 e maior atividade de doença (P = 0,03. Não houve correlação entre idade e capacidade funcional. O homem deitado de costas e a mulher sobre ele foi a posição mais frequente, agradável e menos dolorosa. A figura com a mulher de costas e o homem deitado sobre ela foi a posição menos escolhida. Indivíduos-controle relataram maior frequência e duração mais longa das relações sexuais, menos fadiga e dor, embora a frequência de orgasmos tenha sido semelhante nos dois grupos. CONCLUSÃO: A natureza crônica da espondilite anquilosante, com pior capacidade funcional e maior atividade da doença, interferiu no comportamento sexual dos pacientes. Quando o sexo se tornou possível, orgasmo e satisfação sexual não diferiram dos controles saudáveis.OBJECTIVE: To assess the sexual activity of patients with ankylosing spondylitis, correlating it with disease activity and functional indices. PATIENTS AND METHODS: Thirty-two patients with ankylosing spondylitis and 32 healthy controls were assessed regarding pain, fatigue, sexual activity (by use of pictures of seven sexual positions, disease activity (by use of Bath Ankylosing Spondylitis Disease Activity Index - BASDAI, and functional capacity (by use of Bath Ankylosing Spondylitis Functional Index - BASFI. After the interview, the patients were divided into two groups: group A (with sexual activity and group B (no sexual activity. RESULTS: Group B showed statistical association with longer disease duration (P = 0.01, and higher BASFI (P = 0.0007 and BASDAI (P = 0.03 scores. No correlation was observed between age and functional capacity. Man lying on his back and woman on top was the most frequent, enjoyable and least painful position. The position with the woman on her back and a man lying on top was the least chosen. Control individuals reported a higher frequency of sexual activity, longer duration of intercourse, and less pain and fatigue; the reported frequency of orgasms, however, was similar in both groups. CONCLUSION: The chronic nature of ankylosing spondylitis, with poor functional capacity and higher disease activity, interferes with sexual intercourse. When sexual activity was possible, orgasm and sexual satisfaction did not differ from those of healthy controls.

Andrea Lopes Gallinaro

2012-12-01

122

Evaluation of inflammation and oxidative stress in ankylosing spondylitis: a role for macrophage migration inhibitory factor.  

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Ankylosing spondylitis (AS) is a chronic inflammatory disease mainly affecting the spine and sacroiliac joints. Mediators such as macrophage migration inhibitory factor (MIF) and interleukin-10 (IL-10) are thought to be involved in several inflammatory conditions, including AS. Proinflammatory cytokines regulate the production of oxidative stress markers, such as nitric oxide (NO) and malondialdehyde (MDA). Although oxidative stress and lipid peroxidation have been reported in AS, the association of AS with commonly known oxidative stress markers and cytokines remains uncertain. We have therefore studied whether serum MIF levels are elevated in patients with AS and whether the levels correlate with oxidative stress markers and disease activity parameters. Twenty-five AS patients and 18 healthy controls participated in this study; subjects with hypertension, diabetes, hyperlipidemia, and obesity were excluded. The levels of acute phase reactants, serum levels of glucose, lipids, MIF, IL-10, NO and MDA were studied. Spinal mobility was assessed by the Bath Ankylosing Spondylitis Metrology Index (BASMI). Patients were also assessed using with the Bath Ankylosing Spondylitis Functional Index and the Bath Ankylosing Spondylitis Disease Activity Index. Age and sex distribution were found to be comparable between AS patients and controls (p > 0.05). Acute phase reactants and MIF levels were significantly higher (p < 0.05) and IL-10 levels were significantly lower (<0.001) in the AS patients than in controls. There was a significant correlation between BASMI and MIF levels in AS patients (r = 0.714, p < 0.001). Based on these results, MIF may be involved in the pathogenesis of the chronic inflammation in AS and, consequently, targeting MIF may be beneficial in preventing complications or in initiating early treatment of the disease. PMID:19787418

Kozaci, Leyla Didem; Sari, Ismail; Alacacioglu, Ahmet; Akar, Servet; Akkoc, Nurullah

2010-02-01

123

Comparative evaluation of the quantitative bone scintigraphy and the radiography in patients with ankylosing spondylitis  

International Nuclear Information System (INIS)

In 620 patients quantitative bone scintigraphy with 99mTc pyrophosphate of the sacroiliac joints and of the spine was performed: 365 patients with confirmed ankylosing spondylitis, 125 patients with clinical radiological suspicion for ankylosing spondylitis (probable Bechterev) and control group of 130 healthy individuals. By comparison of the activity in zones of interest of the sacroiliac joints, the spine and sacrum, the following indices were determined: sacroiliac (separately for the left and right sacroiliac joints), index D10/sacrum, index L4/sacrum and index C7/sacrum. The scintigraphic finding was compared to the X-ray one and to the radiological stage of the disease. A long-term follow-up of the patients was carried out during 1-6 years with scintigraphic, X-ray and clinical investigations. Emphasis was laid upon the posibilities for quantitative scintigraphy for early diagnostics of ankylosing spondylitis. The combination of scintigraphic with X-ray investigation improved the posibilities for establishment of a more precise diagnosis of the disease and check up of its evolution

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Lumboperitoneal shunt for treatment of dural ectasia in ankylosing spondylitis.  

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Neurological complications of ankylosing spondylitis (AS) are reported in 2.1% of patients. Cauda equina syndrome (CES) is rare and occurs at the ankylosing stage. MRI and CT of the lumbar spine show a cauda equina deformation with dural ectasia and bony erosion. We report three patients with AS presenting with progressive CES. These patients underwent lumboperitoneal shunting (LPS) surgery. The motor deficit improved in all cases. We suggest that CES develops from arterial pulsation of the CSF on a dural sac with reduced elasticity and that LPS reduces these intradural pressure shock waves. A meta-analysis by Ahn et al. [Ahn NU, Ahn UM, Nallamshetty L, et al. Cauda equina syndrome in ankylosing spondylitis (the CES-AS syndrome): meta-analysis of outcomes after medical and surgical treatments. J Spinal Disord 2001;14:427-33] concludes that surgical treatment has a better outcome than conservative or no treatment. Adding our 3 patients to this analysis, it appears that LPS for CES in AS is more efficient than laminectomy. LPS is a routine procedure for a rare indication, which promises improvement or atleast a stabilization of this disabling evolution of the disease. PMID:18710808

Dinichert, A; Cornelius, J F; Lot, G

2008-10-01

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Epicardial adipose tissue thickness in patients with ankylosing spondylitis.  

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The purpose of our study was to measure epicardial adipose tissue (EAT) thickness as a novel indicator of atherosclerosis and cardiovascular risk factor in ankylosing spondylitis (AS) patients and to show the relationship with clinical parameters and inflammatory markers. Forty AS patients (42.75?±?12.43 years) and 40 healthy individuals with no cardiovascular risk factor as the control group (43.02?±?14.78 years) were included in the study. Carotid intima-media thickness (CIMT) and EAT thickness were measured in AS patients and the control group. Total cholesterol, high-density lipoprotein (HDL) cholesterol, low-density lipoprotein (LDL) cholesterol, glucose, erythrocyte sedimentation rate, urea, and blood pressure were investigated in both groups. In addition, the Bath Ankylosing Spondylitis Functional Index (BASFI) and the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) were used to evaluate the association between clinical findings and CIMT and EAT in the patient group. CIMT and EAT thickness were higher in the AS patients compared to the control group. CIMT was 0.76?±?0.19 and 0.57?±?0.12 mm (p?

Resorlu, Hatice; Akbal, Ayla; Resorlu, Mustafa; Gokmen, Ferhat; Ates, Can; Uysal, Fatma; Adam, Gurhan; Aylanc, Nilufer; Arslan, Muhammet; Inceer, Besir Sahin

2014-03-21

126

Epidemiology and Outcome of Ankylosing Spondylitis in Northern Norway  

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The papers of this thesis are not available in Munin:
1. Gunnstein Bakland1, Hans C. Nossent and Jan T. Gran: 'Incidence and prevalence of Ankylosing Spondylitis in Northern Norway', Arthritis & Rheumatism (2005), vol. 15;53(6):850-5. Available at http://dx.doi.org/10.1002/art.21577
2. Gunnstein Bakland, Jan T. Gran, Andrea Becker-Merok, Bjørn Y. Nordvåg and Johannes C. Nossent: 'Work Disability in patients with Ankyl...

Bakland, Gunnstein

2012-01-01

127

Surgical outcome after spinal fractures in patients with ankylosing spondylitis  

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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 due to the operation performed. Conclusion The operative treatment of these injuries is useful and effective. It usually succeeds the improvement of the patients' neurological status. Taking into consideration the cardiovascular problems that these patients have, anterior and posterior stabilization aren't always possible. In these cases, posterior approach can be performed and give excellent results, while total operation time, blood loss and other possible complications are decreased.

Brilakis Emmanuel

2009-08-01

128

Coexisting Ankylosing Spondylitis and Gouty Arthritis Case Report  

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Full Text Available Coexsisting ankylosing spondylitis (AS and gouty arthritis have rarely been reported in the literature previously. We present a 43-year-old male patient with AS who had been diagnosed as having gout based on some clinical and laboratory findings. In this paper, the clinical features of both rheumatic diseases are discussed in light of the recent literature. The gouty arthritis should be considered in the differential diagnosis of acute peripheral arthritis in patients with AS. Turk J Phys Med Rehab 2011;57:111-3.

Necmettin Y?ld?z

2011-06-01

129

Hodgkin's lymphoma following treatment with etanercept in ankylosing spondylitis.  

Science.gov (United States)

It has been well known that anti-TNF drugs might increase lymphoma risk in rheumatoid arthritis (RA), where the rate of lymphoma has already been increased. However, unlike RA, an increased rate of lymphoma has not been reported in ankylosing spondylitis (AS). Hereby, we present a case with AS developing Hodgkin's lymphoma (HL) following 6 months of etanercept treatment. Pathological analysis revealed mixed cellular type of HL. Although we report a single case, it should be kept in mind that anti-TNF drugs might cause lymphoma development not only in RA, but also in AS. PMID:17622534

Aksu, Kenan; Donmez, Ayhan; Ertan, Yesim; Keser, Gokhan; Inal, Vedat; Oder, Gonca; Tombuloglu, Murat; Kabasakal, Yasemin; Doganavsargil, Eker

2007-12-01

130

Pulmonary function and maximal transrespiratory pressures in ankylosing spondylitis.  

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Clinical measurements and pulmonary functions, including maximal transrespiratory pressures, were studied in 30 patients (age 43 (SD 10) years) with ankylosing spondylitis. Vital capacity (VC) was slightly reduced to 79 (16)% and forced expiratory volume in one second (FEV1) was similarly reduced to 82 (20)% such that the average FEV1/VC ratio was 77.8 (6.65). Total lung capacity was slightly reduced to 85 (13)%. Transfer factor of the lung for carbon monoxide (TLCO) averaged 88 (17)% and TLC...

Vanderschueren, D.; Decramer, M.; Den Daele, P.; Dequeker, J.

1989-01-01

131

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

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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-B27-positive white males. Its etiology and pathogenesis are not completely understood, and its diagnosis is diffi cult. Clinical control and treatment are frequently satisfactory. Acute anterior uveíte is the most common extra-articular manifestation, occurring in 20%-30% of the patients with ankylosing spondylitis. Approximately half of the acute anterior uveíte cases are associated with the presence of the HLA-B27 antigen. It can be the first manifestation of an undiagnosed rheumatic disease, usually having a good prognosis and appropriate response to treatment. In conclusion, for better assessment and treatment of patients with uveitis, ophthalmologists and rheumatologists should work together.

Enéias Bezerra Gouveia

2012-10-01

132

Espondilite anquilosante e uveíte: revisão / Ankylosing spondylitis and uveitis: overview  

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Full Text Available SciELO Brazil | Language: Portuguese Abstract in portuguese 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 (MEDLI [...] NE), 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. Abstract in english 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 inflammat [...] ory 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-B27-positive white males. Its etiology and pathogenesis are not completely understood, and its diagnosis is diffi cult. Clinical control and treatment are frequently satisfactory. Acute anterior uveíte is the most common extra-articular manifestation, occurring in 20%-30% of the patients with ankylosing spondylitis. Approximately half of the acute anterior uveíte cases are associated with the presence of the HLA-B27 antigen. It can be the first manifestation of an undiagnosed rheumatic disease, usually having a good prognosis and appropriate response to treatment. In conclusion, for better assessment and treatment of patients with uveitis, ophthalmologists and rheumatologists should work together.

Enéias Bezerra, Gouveia; Dório, Elmann; Maira Saad de Ávila, Morales.

2012-10-01

133

Polymorphonuclear cell motility, ankylosing spondylitis, and HLA B27.  

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Polymorphonuclear leucocyte (PMN) function was studied in 29 subjects with ankylosing spondylitis (AS). Of these, 20 were HLA B27+ve and 9 B27-ve. There were 30 controls and, of these, 15 were B27+ve. Random and directed cell migration was measured by 2 techniques: migration through a micropore filter and migration under an agar film. The chemo-attractant was either case in-activated serum or zymosan-activated serum. By both techniques directed motility was increased in subjects with B27 or w...

Pease, C. T.; Fordham, J. N.; Currey, H. L.

1984-01-01

134

Ankylosing spondylitis without B27: no evidence for gene conversion.  

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Isoelectric focusing gel electrophoresis was used to look for variant HLA molecules in five patients with HLA-B27 negative ankylosing spondylitis (AS). The isoelectric points of the HLA-A and B antigens from these patients and HLA paired controls were identical. This implies that the HLA-A and B antigens from the patients with AS and the controls are similar. Gene conversion of a nucleotide sequence from a B27 positive gene is thus unlikely to be the explanation for the existence of AS in pat...

Pease, Ct; Ellis, Sa; Mcmichael, Aj; Brewerton, Da

1988-01-01

135

Evaluation of the MR imaging findings of ankylosing spondylitis involving the thoracolumbar spine  

International Nuclear Information System (INIS)

To evaluate the MR imaging findings of ankylosing spondylitis involving the thoracolumbar spine. We retrospectively analyzed MR imaging findings in ten patients with ankylosing spondylitis involving the thoracolumbar spine. All were male and ranged in age from 24 to 47 (mean, 33) years. MR images were obtained using a 1.5T imager, and signal intensity changes of vertebral bodies were evaluated on sagittal T1- and T2-weighted images. Plain radiographic findings were also evaluated. Characteristics MR imaging findings of ankylosing spondylitis involving the thoracolumbar vertebral bodies were focal signal intensity changes at the corners and along the anterior borders of the vertebral bodies. (author). 19 refs., 4 figs

136

Evaluation of the MR imaging findings of ankylosing spondylitis involving the thoracolumbar spine  

Energy Technology Data Exchange (ETDEWEB)

To evaluate the MR imaging findings of ankylosing spondylitis involving the thoracolumbar spine. We retrospectively analyzed MR imaging findings in ten patients with ankylosing spondylitis involving the thoracolumbar spine. All were male and ranged in age from 24 to 47 (mean, 33) years. MR images were obtained using a 1.5T imager, and signal intensity changes of vertebral bodies were evaluated on sagittal T1- and T2-weighted images. Plain radiographic findings were also evaluated. Characteristics MR imaging findings of ankylosing spondylitis involving the thoracolumbar vertebral bodies were focal signal intensity changes at the corners and along the anterior borders of the vertebral bodies. (author). 19 refs., 4 figs.

Park, Jun Kyoon; Choi, Jeong Yeol [Chosun Univ., Kwangju (Korea, Republic of). Coll. of Medicine; Park, Jin Gyoon [Chonnam Univ., Kwangju (Korea, Republic of). Coll. of Medicine

1998-02-01

137

Gender differences in Iranian patients with ankylosing spondylitis.  

Science.gov (United States)

Inequalities in features and severity of ankylosing spondylitis (AS) have been noticed between men and women, suggesting a possible influence of gender on disease phenotypes. Comparing disease features and characterization of gender differences in clinical features and medications could help elucidate the potential influence of gender on the severity of AS in patients. This study aims to assess the influence of gender on disease patterns in Iranian patients with AS. Three hundred and twenty patients diagnosed with primary AS were assessed for demographic variables, clinical manifestations, HLA status, disease severity, functional capacities, quality of life, and treatment status. Sixty-seven women and 253 men were included corresponding to a male to female ratio of 3.78:1. Both groups were similar regarding ethnicity, positive family history, and juvenile onset AS. HLA-B27 was more frequent among males (78.3 vs. 55.2 %; p?Early detection and specialized care would be of great practical importance. PMID:24288047

Shahlaee, Abtin; Mahmoudi, Mahdi; Nicknam, Mohammad Hossein; Farhadi, Elham; Fallahi, Sasan; Jamshidi, Ahmad Reza

2015-02-01

138

Late effects in ankylosing spondylitis patients treated with 224Ra.  

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This study is comprised of 1577 ankylosing spondylitis patients from 9 German hospitals who have been treated with multiple injections of (224)Ra. The majority of the patients, most of them treated in the years 1948-1975, received one series of 10 weekly intravenous injections of about 1 MBq of (224)Ra each. This dose leads to a mean absorbed dose due to alpha-particle radiation of 0.56 Gy to the marrow-free skeleton of a 70- kg man (mean bone surface dose of about 5 Gy). To provide comparative information on causes of death and on health effects possibly related to the basic disease itself, a control group of 1462 ankylosing spondylitis patients with roughly the same age distribution has been established. By the end of 1998, 649 patients in the exposed group and 762 control patients had died. Among other observations, it is of particular interest that 13 cases of leukemia in the exposed group have been observed. This is a highly significant excess (P risk coefficient that predicts about 8 excess malignant bone tumors for the irradiated cohort in this study. In actuality, 4 cases of malignant tumors in the skeleton have been observed so far. However, excess of breast cancer has not been observed in either the irradiated or the control group, which is in contrast to the findings in the earlier (224)Ra cohort of Study I. PMID:10564926

Wick, R R; Nekolla, E A; Gössner, W; Kellerer, A M

1999-12-01

139

Surgical Treatment of Spinal Pseudoarthrosis in Ankylosing Spondylitis  

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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.

Lih-Huei Chen

2005-09-01

140

Efficacy and safety of adalimumab in ankylosing spondylitis  

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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-?

Mounach A

2014-08-01

 
 
 
 
141

ICF based comparison of disease specific instruments measuring physical functional ability in ankylosing spondylitis  

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Objectives: To link validated and widely used instruments measuring physical functional ability in ankylosing spondylitis to the International Classification of Functioning, Disability, and Health (ICF) and to compare their contents, based on the results of the linking process.

Sigl, T.; Cieza, A.; Heijde, D.; Stucki, G.

2005-01-01

142

Coexistence of Behçet’s Disease and Ankylosing Spondylitis: A Case Report  

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Although overlap syndrome is frequently encountered in rheumatology practice, only a few cases of coexisting Behçet’s disease and ankylosing spondylitis have been reported in the literature. Thus, in this article, we aimed to present a 55-year-old male patient with coexisting Behçet’s disease and ankylosing spondylitis who had HLA-B5 positivity, HLA-B27 negativity, and oral and genital lesions.

Hikmet Koçyi?it; Yasemin Turan; Korhan Bayram; Alev Gurgan; Hülya Deveci; An?l Güvenç

2008-01-01

143

MRI of cauda equina syndrome in ankylosing spondylitis: a case report  

International Nuclear Information System (INIS)

Cauda equina syndrome is a rare neurologic complication in patient with long-standing ankylosing spondylitis. Authors report a case of cauda equina syndrome in ankylosing spondylitis. On plain radiographs, typical 'bamboo spine' and fusion of sacroiliac joints were noted. MRI of the lumbar spine revealed arachnoid diverticulae which were isointense to cerebrospinal fluid on all spin echo sequences, and showed bony erosion and scalloping of posterior arches

144

Atlantoaxial Ankylosis Detected on Neck CT Scans in a Patient with Ankylosing Spondylitis: A Case Report  

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Ankylosing spondylitis is a chronic inflammatory disorder of unknown cause that principally affects the axial skeleton. The cervical spine is also vulnerable to this disease process and the characteristic feature of cervical involvement is atlantoaxial subluxation. However, only a few cases of atlantoaxial ankylosis have been reported to date. We report a case of atlantoaxial ankylosis in a patient with ankylosing spondylitis with radiologic findings incidentally detected on neck CT scans.

Lee, Jeong Ah; Lee, Seung Hun; Joo, Kyung Bin [Dept. of Radiology, Seoul Hospital, Hanyang University College of Medicine, Seoul (Korea, Republic of); Ryu, Jeong Ah [Dept. of Radiology, Guri Hospital, Hanyang University College of Medicine, Guri (Korea, Republic of); Kim, Tae Hwan [Dept. of Rheynmatology, Seoul Hospital, Hanyang University College of Medicine, Seoul (Korea, Republic of)

2011-07-15

145

Ankylosing spondylitis complicated by trauma: MR findings correlated with plain radiographs and CT  

International Nuclear Information System (INIS)

Four patients with ankylosing spondylitis sustained a traumatic spinal injury. In three cases, pseudoarthrosis developed at the discovertebral junction, while involvement of the neural arch occurred in the fourth. Although the diagnosis of ankylosing spondylitis was readily established on plain radiographs, magnetic resonance more effectively indentified the complicating injury and in two cases demonstrated the presence of cord compression. Computed tomography was also contributory in delineating bony and ligamentous abnormalities of the neural arch. (orig.)

146

Patient perspectives of managing fatigue in Ankylosing Spondylitis, and views on potential interventions: a qualitative study  

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Background: Fatigue is a major component of living with ankylosing spondylitis (AS), though it has been largely over-looked, and currently there are no specific agreed management strategies. Methods: This qualitative exploratory study involved participants who are members of an existing population-based ankylosing spondylitis (PAS) cohort. Participants residing in South West Wales were invited to participate in a focus group to discuss; (1) effects of fatigue, (2) self-managemen...

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

2013-01-01

147

Atlantoaxial Ankylosis Detected on Neck CT Scans in a Patient with Ankylosing Spondylitis: A Case Report  

International Nuclear Information System (INIS)

Ankylosing spondylitis is a chronic inflammatory disorder of unknown cause that principally affects the axial skeleton. The cervical spine is also vulnerable to this disease process and the characteristic feature of cervical involvement is atlantoaxial subluxation. However, only a few cases of atlantoaxial ankylosis have been reported to date. We report a case of atlantoaxial ankylosis in a patient with ankylosing spondylitis with radiologic findings incidentally detected on neck CT scans.

148

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

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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...

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; Veys, E.; Appel, Am

2004-01-01

149

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

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To date, anti-tumor necrosis factor alfa (anti-TNF-?) 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...

Senabre-gallego, Jose? Miguel; Santos-rami?rez, Carlos; Santos-soler, Gregorio; Salas-heredia, Esteban; Sa?nchez-barrioluengo, Mabel; Barber, Xavier; Rosas, Jose?

2013-01-01

150

Arachnoid ossificans of thoracolumbosacral spine in the advanced ankylosing spondylitis: a case report.  

Science.gov (United States)

Arachnoid ossificans is a rare type of chronic arachnoiditis characterised by the presence of calcification or ossification of the dura and arachnoid. There are a few reports of these findings in relation to various disease entities, but only one case has been reported in relation to ankylosing spondylitis. We describe a 76-year-old man of ankylosing spondylitis with arachnoiditis ossificans, who has suffered from low back pain and neuropathic leg pain. PMID:22198660

Joo, Kyung Bin; Lee, Seunghun; Kang, Chang-Nam; Kim, Tae-Hwan

2013-06-01

151

Ankylosing spondylitis in West Africans--evidence for a non-HLA-B27 protective effect.  

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OBJECTIVE: To determine the prevalence of ankylosing spondylitis in the Fula ethnic group in The Gambia, and relate the disease prevalence to the B27 frequency and subtype distribution of that population. METHODS: 215 first degree relatives of 48 B27 positive Fula twin pairs, and 900 adult Fula males were screened for ankylosing spondylitis by clinical and, where appropriate, radiographic means. The B27 prevalence was determined by PCR/sequence specific oligonucleotides on finger prick sample...

Brown, Ma; Jepson, A.; Young, A.; Whittle, Hc; Greenwood, BM; Wordsworth, Bp

1997-01-01

152

MRI of cauda equina syndrome in ankylosing spondylitis: a case report  

Energy Technology Data Exchange (ETDEWEB)

Cauda equina syndrome is a rare neurologic complication in patient with long-standing ankylosing spondylitis. Authors report a case of cauda equina syndrome in ankylosing spondylitis. On plain radiographs, typical 'bamboo spine' and fusion of sacroiliac joints were noted. MRI of the lumbar spine revealed arachnoid diverticulae which were isointense to cerebrospinal fluid on all spin echo sequences, and showed bony erosion and scalloping of posterior arches.

Kim, Ji Yang; Choi, Pil Yeob; Sung, Young Soon; Kwon, Jae Soo [Masan Samsung General Hospital, Masan (Korea, Republic of)

1995-10-15

153

Relapsing polychondritis in a patient with ankylosing spondylitis using etanercept.  

Science.gov (United States)

Relapsing polychondritis (RP) is an autoimmune disease characterized by recurrent episodes of inflammation and progressive destruction of cartilaginous tissues, especially of the ears, nose, joints, and tracheobronchial tree. Its etiology is not well understood, but some studies have linked its pathophysiology with autoimmune disease and autoantibody production. We described a case of a 46-year-old male patient with ankylosing spondylitis who developed RP after the use of etanercept. Few similar cases have been described in the literature. However, they show a possible association between the use of biological inhibitors of tumor necrosis factor (anti-TNF?), which potentially produces autoantibodies, and the development of RP. The treatment was based on data in the literature and included the cessation of biological therapy and the addition of corticosteroids with substantial improvement. PMID:25276463

Azevedo, Valderilio Feijó; Galli, Natalia Bassalobre; Kleinfelder, Alais Daiane Fadini; D'Ippolito, Julia Farabolini; Gulin Tolentino, Andressa; Paiva, Eduardo

2014-01-01

154

Normal anti-Klebsiella lymphocytotoxicity in ankylosing spondylitis  

International Nuclear Information System (INIS)

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

155

Late effects of x-ray treatment of ankylosing spondylitis  

International Nuclear Information System (INIS)

Following a single course of x-ray treatment, patients with ankylosing spondylitis have suffered a mortality rate from leukemia about five times higher than that of the general population. The peak risk occurs 3 to 5 years after irradiation and subsequently declines, such that by 20 years after exposure the risk may be near normal levels, though more data will be necessary to confirm this. There is no clear relationship between the excess risk of leukemia and the estimated mean bone marrow dose of radiation. The excess risk of a radiation-induced leukemia appears to be greater for patients irradiated at an older age compared to the risk experience by patients irradiated at a younger age (but it should be noted that children were not included in the study)

156

Osteotomy of the cervical spine in ankylosing spondylitis.  

Science.gov (United States)

Fifteen patients with ankylosing spondylitis who had developed a severe flexion deformity of the cervical spine which restricted their field of vision to their feet, were treated by an extension osteotomy at the C7/T1 level. The operation was performed under general anaesthesia with the patient in the prone position and wearing a halo-jacket. Three had internal fixation using a Luque rectangle and wiring. Their mean age was 48 years. Before operation the mean cervical kyphosis was 23 degrees; this was corrected to a mean of 31 degrees of lordosis, a mean correction of 54 degrees. All the patients were able to see straight ahead. One patient with normal neurology soon after operation became quadriparetic after one week; two others had unilateral palsy of the C8 root, which improved. There was subluxation at the site of osteotomy in four patients, and two of them developed a pseudarthrosis which required an anterior fusion. PMID:9119841

McMaster, M J

1997-03-01

157

Studies of circulating immune complexes in ankylosing spondylitis.  

Science.gov (United States)

Circulating immune complexes (CIC) were sought, by a fluorescent antibody immunophagocytosis (FIP) assay, in the sera of 30 patients with ankylosing spondylitis (AS), 62 with rheumatoid arthritis (RA), 27 with systemic lupus erythematosus (SLE) and 67 normal controls. Component analysis of CIC revealed significant elevations of total immunoglobulin (TIg), IgM and C3 for all patient study groups. In contrast to RA and SLE, CIC in AS sera contained significantly increased IgA and decreased IgG components. Categorization of AS patients as Grade I (mild disease) or Grade II (moderate/advanced disease) revealed no significant differences between the 2 groups in mean serum levels, component composition or prevalence of CIC. These results confirm the occurrence of CIC in AS but do not clarify the pathogenetic influence, if any, of CIC in this disease. PMID:7160109

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

1982-01-01

158

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

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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...

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

1984-01-01

159

MR imaging features of foot involvement in ankylosing spondylitis  

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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%). Conclusion: In our experience, MR imaging may detect inflammatory and/or erosive bone, soft tissue, cartilage, tendon, and joint abnormalities in AS patients, even if AS patients did not have clinical signs and symptoms of foot involvement. If these data prove to be confirmed in further MR studies, MR imaging may be of importance especially in early diagnosis of inflammatory changes in the foot.

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

2005-01-01

160

MR imaging features of foot involvement in ankylosing spondylitis  

International Nuclear Information System (INIS)

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 na), 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%). Conclusion: In our experience, MR imaging may detect inflammatory and/or erosive bone, soft tissue, cartilage, tendon, and joint abnormalities in AS patients, even if AS patients did not have clinical signs and symptoms of foot involvement. If these data prove to be confirmed in further MR studies, MR imaging may be of importance especially in early diagnosis of inflammatory changes in the foot

 
 
 
 
161

MRI of cervical spine injuries complicating ankylosing spondylitis  

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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.)

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

2008-09-15

162

MRI of cervical spine injuries complicating ankylosing spondylitis  

International Nuclear Information System (INIS)

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 excessivpossible due to a rigid collar or excessive kyphosis. (orig.)

163

Biomechanical assessment of balance and posture in subjects with ankylosing spondylitis  

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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-? 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.

Sawacha Zimi

2012-08-01

164

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

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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

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

2013-09-01

165

Identification of multiple risk variants for ankylosing spondylitis through high-density genotyping of immune-related loci  

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Ankylosing spondylitis is a common, highly heritable inflammatory arthritis affecting primarily the spine and pelvis. In addition to HLA-B*27 alleles, 12 loci have previously been identified that are associated with ankylosing spondylitis in populations of European ancestry, and 2 associated loci have been identified in Asians. In this study, we used the Illumina Immunochip microarray to perform a case-control association study involving 10,619 individuals with ankylosing spondylitis (cases) and 15,145 controls. We identified 13 new risk loci and 12 additional ankylosing spondylitis–associated haplotypes at 11 loci. Two ankylosing spondylitis–associated regions have now been identified encoding four aminopeptidases that are involved in peptide processing before major histocompatibility complex (MHC) class I presentation. Protective variants at two of these loci are associated both with reduced aminopeptidase function and with MHC class I cell surface expression. PMID:23749187

Cortes, Adrian; Hadler, Johanna; Pointon, Jenny P; Robinson, Philip C; Karaderi, Tugce; Leo, Paul; Cremin, Katie; Pryce, Karena; Harris, Jessica; lee, Seunghun; Joo, Kyung Bin; Shim, Seung-Cheol; Weisman, Michael; Ward, Michael; Zhou, Xiaodong; Garchon, Henri-Jean; Chiocchia, Gilles; Nossent, Johannes; Lie, Benedicte A; Førre, Øystein; Tuomilehto, Jaakko; Laiho, Kari; Jiang, Lei; Liu, Yu; Wu, Xin; Bradbury, Linda A; Elewaut, Dirk; Burgos-Vargas, Ruben; Stebbings, Simon; Appleton, Louise; Farrah, Claire; Lau, Jonathan; Kenna, Tony J; Haroon, Nigil; Ferreira, Manuel A; Yang, Jian; Mulero, Juan; Fernandez-Sueiro, Jose Luis; Gonzalez-Gay, Miguel A; lopez-Larrea, Carlos; Deloukas, Panos; Donnelly, Peter; Bowness, Paul; Gafney, Karl; Gaston, Hill; Gladman, Dafna D; Rahman, Proton; Maksymowych, Walter P; Xu, Huji; Crusius, J Bart A; van der Horst-Bruinsma, Irene E; Chou, Chung-Tei; Valle-Oñate, Raphael; Romero-Sánchez, Consuelo; Hansen, Inger Myrnes; Pimentel-Santos, Fernando M; Inman, Robert D; Videm, Vibeke; Martin, Javier; Breban, Maxime; Reveille, John D; Evans, David M; Kim, Tae-Hwan; Wordsworth, Bryan Paul; Brown, Matthew A

2013-01-01

166

Some pathological features of ankylosing spondylitis as revealed by microradiography and tetracycline labelling.  

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Five spine specimens obtained at autopsy and five biopsies of sacroiliac joints from subjects with ankylosing spondylitis were submitted to microradiography and to fluorescence microscopy for detection of tetracycline. Decalcified histological sections were also prepared. Microradiography provides a link between the clinical X-ray picture and the classical decalcified section; it enables calcified cartilage, and hence the early stage of most syndesmophytes to be recognised more easily and accurately; It revealed a peculiar calcification of elastic fibers of the ligamentum flavum. Tetracycline labels showed that: in an early case of sacro-iliac arthritis, calcification of the articular cartilage might partly explain the desification of the X-ray picture; syndesmophytes were thickening at both their superficial and deep faces; thickening, lengthening and internal remodelling of the intervertebral bridges occurred together; and calcium was deposited at the end-plates as well. PMID:7188497

Francois, R J

1982-03-01

167

Is there a relationship between endothelial nitric oxide synthase gene polymorphisms and ankylosing spondylitis?  

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Full Text Available OBJECTIVE: Nitric oxide is produced by endothelial nitric oxide synthase, and its production can be influenced by polymorphisms of the endothelial nitric oxide synthase gene. Because candidate genes responsible for susceptibility to ankylosing spondylitis are mostly unknown and available data suggest that there may be problems related to the nitric oxide pathway, such as endothelial dysfunction and increased asymmetric dimethylarginine, this study aimed to assess the association of common endothelial nitric oxide synthase gene polymorphisms with ankylosing spondylitis. METHODS: One hundred ninety-four unrelated Turkish ankylosing spondylitis patients and 113 healthy without apparent cardiovascular disease, hypertension or diabetes mellitus were included. All individuals were genotyped by PCR-RFLP for two single-nucleotide polymorphisms, namely 786T>C (rs2070744, promoter region and 786 Glu298Asp (rs1799983, exon 7. Variable numbers of tandem repeat polymorphisms in intron 4 were also studied and investigated by direct electrophoresis on agarose gel following polymerase chain reaction analysis. The Bath ankylosing spondylitis metrology index of the patients was calculated, and human leukocyte antigen B27 was studied. RESULTS: All studied polymorphisms satisfied Hardy-Weinberg equilibrium. Sex distributions were similar between the patient and control groups. No significant differences were found in the distributions of allele and genotype frequencies of the studied endothelial nitric oxide synthase polymorphisms between patients and controls. There were no correlations between endothelial nitric oxide synthase polymorphisms, disease duration, Bath ankylosing spondylitis metrology index or human leukocyte antigen B27. CONCLUSION: The results presented in this study do not support a major role of common endothelial nitric oxide synthase polymorphisms in Turkish ankylosing spondylitis patients.

Ismail Sari

2013-01-01

168

Is there a relationship between endothelial nitric oxide synthase gene polymorphisms and ankylosing spondylitis?  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: English Abstract in english OBJECTIVE: Nitric oxide is produced by endothelial nitric oxide synthase, and its production can be influenced by polymorphisms of the endothelial nitric oxide synthase gene. Because candidate genes responsible for susceptibility to ankylosing spondylitis are mostly unknown and available data sugges [...] t that there may be problems related to the nitric oxide pathway, such as endothelial dysfunction and increased asymmetric dimethylarginine, this study aimed to assess the association of common endothelial nitric oxide synthase gene polymorphisms with ankylosing spondylitis. METHODS: One hundred ninety-four unrelated Turkish ankylosing spondylitis patients and 113 healthy without apparent cardiovascular disease, hypertension or diabetes mellitus were included. All individuals were genotyped by PCR-RFLP for two single-nucleotide polymorphisms, namely 786T>C (rs2070744, promoter region) and 786 Glu298Asp (rs1799983, exon 7). Variable numbers of tandem repeat polymorphisms in intron 4 were also studied and investigated by direct electrophoresis on agarose gel following polymerase chain reaction analysis. The Bath ankylosing spondylitis metrology index of the patients was calculated, and human leukocyte antigen B27 was studied. RESULTS: All studied polymorphisms satisfied Hardy-Weinberg equilibrium. Sex distributions were similar between the patient and control groups. No significant differences were found in the distributions of allele and genotype frequencies of the studied endothelial nitric oxide synthase polymorphisms between patients and controls. There were no correlations between endothelial nitric oxide synthase polymorphisms, disease duration, Bath ankylosing spondylitis metrology index or human leukocyte antigen B27. CONCLUSION: The results presented in this study do not support a major role of common endothelial nitric oxide synthase polymorphisms in Turkish ankylosing spondylitis patients.

Ismail, Sari; Yusuf Ziya, Igci; Gercek, Can; Ali, Taylan; Dilek, Solmaz; Bulent, Gogebakan; Servet, Akar; Zeynep, Eslik; Giray, Bozkaya; Nurullah, Akkoc.

169

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

Science.gov (United States)

To date, anti-tumor necrosis factor alfa (anti-TNF-?) 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 hepatitis B virus infection, congestive heart failure, demyelinating neurologic disorders, hematologic disorders like aplastic anemia and pancytopenia, vasculitis, immunogenicity, and exacerbation or induction of psoriasis are class effects of all the anti-TNF drugs, and have been seen in patients with ankylosing spondylitis. However, etanercept is less likely to induce reactivation of tuberculosis than the other anti-TNF drugs and it has been suggested that etanercept might be less immunogenic, especially in ankylosing spondylitis. Acute uveitis, Crohn's disease, and sarcoidosis are other adverse events that have been rarely associated with etanercept therapy in patients with ankylosing spondylitis. PMID:24101863

Senabre-Gallego, José Miguel; Santos-Ramírez, Carlos; Santos-Soler, Gregorio; Salas-Heredia, Esteban; Sánchez-Barrioluengo, Mabel; Barber, Xavier; Rosas, José

2013-01-01

170

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

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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-? may play an important role. Etanercept, a recombinant dimeric fusion protein consisting of a TNF-? 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.

Mehmet Tu?rul SEZER

2014-01-01

171

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

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Full Text Available Renal amyloidosis is a complication of ankylosing spondylitis. A possible pathogenetic role is due to TNF-?, 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-?, 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.

A. Gallo

2011-09-01

172

Radiation effects on the bone marrow of ankylosing spondylitis patients treated with radium 224  

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The clinical evaluation of patients treated in the German Democratic Republic for ankylosing spondylitis with radium 224 has been discussed in several previous publications (Laschner and Arnold, 1971; Arnod et al, 1980; Seyfarth, 1987). More recent work has concentrated on late effects produced by internal irradiation from the ?-particle-emitting radium 224, especially in relation to the induction of leukaemia and of bone tumours. Court-Brown and Doll (1957) drew attention to an apparent increase in the risk of leukaemia induction in ankylosing spondylitis patients with increasing numbers of radiation treatments. (author)

173

Cervix Cancer in a Patient With Ankylosing Spondylitis Using Etanercept: A Case Report  

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Full Text Available Tumor necrosis factor-alpha inhibitors (anti TNF-alpha are agents that increasingly used in the treatment of ankylosing spondylitis resistant to classical disease-modifying treatment and they provide better functional outcome. However, these agents have serious side effects. Their safety has been questioned by several published reports of increased risk for malignancies. In this study, we present a patient with ankylosing spondylitis who developed cervix cancer after receiving anti TNF-alpha therapy for 19 months. Turk J Phys Med Re­hab 2012;58:162-4.

P?nar Doruk

2012-06-01

174

Clinical study on effectiveness of leflunomide compared with sulfasalazine in treatment of ankylosing spondylitis  

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Objective: To evaluate the effectiveness and safety of leflunomide compared with sulfasalazine in treatment of ankylosing spondylitis. Methods: Sixty cases of ankylosing spondylitis were randomized into two groups:in 30 patients leflunomide was taken and in 30 patients were treated with sulfasalazine.The treatment lasted one year after discharge. The observation items included symptoms and sign, the bath ankylosing spondylitis disease activity index(BASDAI), the bath ankylosing spondytis function index (BASFI) and side effects have been used to assess the responsiveness of lefunomide and sulfasalazine therapy at study entry, three months, six months and twelve months after treatment. Results: In the third, sixth and twelfth months of follow-up, the lumbosacral portion pain, the time of lumbodorsal morning stiffness, the count of joint pain, BASDAI, BASFI, erythrocyte sedimentation rate (ESR), C-reaction protein (CRP) were all significantly lower than those on admission (P0.05). The incidence rates of gastrointestinal symptoms of leflunomide was less than those of sulfasalazine. Conclusion: The effectiveness of leflunomide was the same as those of sulfasalazine in treatment of ankylosing spondylitis. The adverse events of leflunomide are less than those of sulfasalazine. (authors)

175

The Relationship Between Bath Indexes and Osteoporosis in Male Patients with Axial Ankylosing Spondylitis  

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Full Text Available Objective: Osteoporosis is a common complication of patients with ankylosing spondylitis (AS. There is no avaible data for the indications of bone mineral density (BMD measurement related to osteoporosis diagnosis at AS patients. The aim of this study is to investigate the relationship between Bath indexes and BMD in patients with AS.Materials and Methods: 45 male AS patients (mean age: 46.96±13.58 years and 41 healthy male controls (mean age: 48.93±6.86 years were enrolled in the study. Patients with AS were evaluated with Bath Ankylosing Spondylitis Disease Activity Index (BASDAI, Bath Ankylosing Spondylitis Functional Index (BASFI, Bath Spondylitis Metrology Index (BASMI and Bath Ankylosing spondylitis Radiology Index (BASRI. The BMD of AS and control group patients were assessed at hip (femoral neck, Ward’s triangle and femur trochanter and lumbar area.Results: We have found a significant difference at the femoral ward triangle and lomber spine BMD and T scores in favour of AS patients (p<0.05. BASMI scores were negatively correlated with femoral neck and femoral ward triangle (p<0.05. BASDAI, BASFI scores were not correlated with BMD and T scores of any measured regions.Conclusion: We found that femur ward triangle may be appropriate to evaluate bone loss in patients with AS. BASMI score is a useful tool to determine BMD in patients with AS.

Nurullah Akkoc

2008-09-01

176

Leukocytoclastic vasculitis in a patient with ankylosing spondylitis.  

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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. PMID:24653851

Kobak, Senol; Yilmaz, Hatice; Karaarslan, Ahmet; Yalcin, Murat

2014-01-01

177

Multidetector Computed Tomography of Cervical Spine Fractures in Ankylosing Spondylitis  

International Nuclear Information System (INIS)

Purpose: To analyze multidetector computed tomography (MDCT) cervical spine findings in trauma patients with advanced ankylosing spondylitis (AS). Material and Methods: Using PACS, 2282 cervical spine MDCT examinations requested by emergency room physicians were found during a period of 3 years. Of these patients, 18 (16 M, aged 41-87, mean 57 years) had advanced AS. Primary imaging included radiography in 12 and MRI in 11 patients. Results: MDCT detected one facet joint subluxation and 31 fractures in 17 patients: 14 transverse fractures, 8 spinous process fractures, 2 Jefferson's fractures, 1 type I and 2 type II odontoid process fractures, and 1 each: atlanto-occipital joint fracture and C2 laminar fracture plus isolated transverse process and facet joint fractures. Radiographs detected 48% and MRI 60% of the fractures. MRI detected all transverse and odontoid fractures, demonstrating spinal cord abnormalities in 72%. Conclusion: MDCT is superior to plain radiographs or MRI, showing significantly more injuries and yielding more information on fracture morphology. MRI is valuable, however, in evaluating the spinal cord and soft-tissue injuries. Fractures in advanced AS often show an abnormal orientation and are frequently associated with spinal cord injuries. In these patients, for any suspected cervical spine injuries, MDCT is therefore the imaging modality of choice

178

ERAP1 in the pathogenesis of ankylosing spondylitis.  

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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

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

2014-12-01

179

Risk and effect of radium-224 therapy of ankylosing spondylitis  

International Nuclear Information System (INIS)

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)

180

Treatment of ankylosing spondylitis with [224Ra]-Radiumchloride  

International Nuclear Information System (INIS)

Ankylosing spondylitis (AS) is a chronic disease which in 30-50% of the patients leads to considerable episodes of pain, a remarkable reduction of quality of life and disablement. For treatment mostly nonsteroidal antiphlogistic drugs are used which are able to reduce pain in approximately 80% of the patients only. Those drugs however, have to be withdrawn in approximately 30% of the patients due to its known toxicity (mainly in the gastrointestinal tract). Basis medication (DMARDs) is helpful in a minority of AS patients only. Recently [224Ra]-Radiumchloride, which has been used previously between 1955 and 1990, has been made available again for treatment of AS. Whereas biokinetics, radiation exposure and the risk-profile of [224Ra]-Radiumchloride are documented well by experimental and clinical data, most of the historical studies about the efficacy of this radiopharmaceutical do not fulfill the requirements of modern therapy studies. Therefore as many patients as possible should be recruited for a prospective long-time Phase IV study. A close and well-coordinated cooperation between rheumatologists and nuclear medicine physicians is needed, when [224Ra]-Radiumchloride is used for treatment of AS. (orig.)

 
 
 
 
181

Multidetector Computed Tomography of Cervical Spine Fractures in Ankylosing Spondylitis  

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Purpose: To analyze multidetector computed tomography (MDCT) cervical spine findings in trauma patients with advanced ankylosing spondylitis (AS). Material and Methods: Using PACS, 2282 cervical spine MDCT examinations requested by emergency room physicians were found during a period of 3 years. Of these patients, 18 (16 M, aged 41-87, mean 57 years) had advanced AS. Primary imaging included radiography in 12 and MRI in 11 patients. Results: MDCT detected one facet joint subluxation and 31 fractures in 17 patients: 14 transverse fractures, 8 spinous process fractures, 2 Jefferson's fractures, 1 type I and 2 type II odontoid process fractures, and 1 each: atlanto-occipital joint fracture and C2 laminar fracture plus isolated transverse process and facet joint fractures. Radiographs detected 48% and MRI 60% of the fractures. MRI detected all transverse and odontoid fractures, demonstrating spinal cord abnormalities in 72%. Conclusion: MDCT is superior to plain radiographs or MRI, showing significantly more injuries and yielding more information on fracture morphology. MRI is valuable, however, in evaluating the spinal cord and soft-tissue injuries. Fractures in advanced AS often show an abnormal orientation and are frequently associated with spinal cord injuries. In these patients, for any suspected cervical spine injuries, MDCT is therefore the imaging modality of choice.

Koivikko, M.P.; Kiuru, M.J.; Koskinen, S.K. [Helsinki Univ. Central Hospital, Toeoeloe Trauma Center (Finland). Dept. of Radiology

2004-11-01

182

Preparation of 224Ra for therapy of ankylosing spondylitis  

International Nuclear Information System (INIS)

In the medical application of radium-224 for injection the radionuclidic purity of the product is a question of considerable importance. The contamination caused by the long-lived nuclides 226Ra, 228Ra, 227Ac, and 228Th must be limited to minimize their incorporation and the long-term skeletal dose received by the patients. The purification of the source material 228Th for manufacturing 224Ra and the extraction of 224Ra from 228Th are described. The actual trace amounts of the long-lived radioactive impurities in the injection solutions are compared with the maximum permissible body burdens recommended by ICRP. Buchler and Co. (since 1971 Amersham Buchler) is, as far as is known, the only producer of224Ra for injection. A total activity of 10 x 28 ? Ci of 224Ra for the therapy of ankylosing spondylitis is recommended. Taking this total activity, the injection of any long-lived radionuclide from 1967 through 1973 was less than 0.2% of its maximum permissible body burden. (author)

183

Health and Labour Questionnaire: Turkish Adaptation for Ankylosing Spondylitis  

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Full Text Available Objective: The purpose of this study was to perform a cross-cultural adaptation of the Health and Labour Questionnaire (HLQ into Turkish. Materials and Methods: The cross-cultural adaptation was conducted according to the International Society for Pharmacoeconomics and Outcomes Research guideline which consists the following ten steps respectively: Preparation, forward translation, reconciliation, back translation, back translation review, harmonization, cognitive debriefing (pilot testing, review of cognitive debriefing test results and finalization, proofreading and final report. The pilot testing was performed with 20 volunteers with ankylosing spondylitis.Results: The consensus version was prepared for pilot testing after the harmonization step. The translations generally found to be understandable to the participants. Some modifications and additional explanations for some terms in the questions 1, 2, 3, 15, 16 and 17 were required during the pilot testing. Furthermore, the response choices about the education system for the 3rd question of the appendix were adapted to the national system. Conclusion: The Turkish adaptation of the HLQ was performed successfully and found to be understandable to the pilot group and the expert group. It was considered that the Turkish version of the HLQ would encourage further researches about productivity loss related to many chronic health problems. Turk J Phys Med Re­hab 2012;58:204-11.

Engin Çakar

2012-09-01

184

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

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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-TNF?. We longitudinally enrolled in a multi-center study 214 AS patients, classified according to New York criteria, treated with anti-TNF? 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-TNF? 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-TNF? treatment.

F.M. Perrotta

2014-11-01

185

Chest Wall Motion during Speech Production in Patients with Advanced Ankylosing Spondylitis  

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Purpose: To test the hypothesis that ankylosing spondylitis (AS) alters the pattern of chest wall motion during speech production. Method: The pattern of chest wall motion during speech was measured with respiratory inductive plethysmography in 6 participants with advanced AS (5 men, 1 woman, age 45 plus or minus 8 years, Schober test 1.45 plus or…

Kalliakosta, Georgia; Mandros, Charalampos; Tzelepis, George E.

2007-01-01

186

Radiation effects on the bone marrow of ankylosing spondylitis patients treated with radium 224  

International Nuclear Information System (INIS)

Between 1951 and 1987 a total of 596 patients with ankylosing spondylitis were treated with radium 224 in the Karl-Marx University Orthopaedic Clinic at Leipzig. From this cohort 81 biopsies from a pelvic crest puncture were made in radium-224 treated patients and 39 in non-treated patients. This paper summarizes the bone marrow findings. (UK)

187

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

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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 syndesmophyte visible on a radiograph as compared to a vertebral corner with no CIL.

Pedersen, Susanne J; Chiowchanwisawakit, Praveena

2011-01-01

188

Multiple basal cell carcinomas in two cases of ankylosing spondylitis treated with X-ray therapy  

International Nuclear Information System (INIS)

Two case history summaries are presented in which multiple skin tumours were almost certainly induced by X radiation given for ankylosing spondylitis, one 39 years after X-ray treatment, the other 27 years after. Reasons for the apparent discrepancies in induction rates for radiation-induced skin cancer are discussed. (U.K.)

189

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

International Nuclear Information System (INIS)

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

190

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

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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).

Veidal, S S; Larsen, D V

2012-01-01

191

Disease activity assessment in ankylosing spondylitis in a Chinese cohort: BASDAI or ASDAS?  

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Recently, the Ankylosing Spondylitis Disease Activity Score (ASDAS), a new index, has been shown to be validated and highly discriminatory in assessing ankylosing spondylitis (AS) disease activity. This study is to evaluate the performance of ASDAS in a local Chinese cohort of AS in a cross-sectional setting and to compare it with the existing instrument, the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI). Consecutive patients with AS were recruited from a local rheumatology clinic. Data, including BASDAI, Bath Ankylosing Spondylitis Functional Index (BASFI), Visual Analogue Scale (VAS) for spinal pain, and patient and physician global assessments were gathered during clinic visit. Inflammatory markers, including erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), and high-sensitivity (hs)-CRP were collected. ASDAS was calculated accordingly. The discriminatory capacity of BASDAI and ASDAS was compared by: (1) standardized mean difference statistics, (2) R (2) in linear regressions, and (3) area under receiver operating characteristic curve (AUC) in logistic regression models. Both ASDAS and BASDAI showed satisfactory predictive value on disease activity with reference to patient and physician global assessment. R (2) in linear regression models ranged from 0.6-0.7. Both indices also demonstrated good discriminatory capacity as evidenced by a relatively high AUC (> 0.8) under the logistic regression models using either patient or physician global assessment score ?4 and local Chinese AS cohort. ASDAS performed better in subgroup with raised inflammatory markers. PMID:24981160

Au, Yuen Ling Elaine; Wong, Woon Sing Raymond; Mok, Mo Yin; Chung, Ho Yin; Chan, Eric; Lau, Chak Sing

2014-08-01

192

Delayed diagnosis of porphyria based on manifestations of systemic lupus erythematosus and ankylosing spondylitis.  

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In this case report, a patient with systemic lupus erythematosus and ankylosing spondylitis is presented, who was diagnosed with hereditary coproporphyria after 5 years of follow-up. Diagnostic difficulties and possible role of genetic background in the autoimmune response in patients with porphyria are briefly discussed. PMID:17048215

Korkmaz, Cengiz

2006-01-01

193

Instrumentos de avaliação em espondilite anquilosante / Outcome measures in ankylosing spondylitis  

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Full Text Available SciELO Brazil | Language: Portuguese Abstract in portuguese A espondilite anquilosante (EA) é uma doença inflamatória crônica caracterizada por acometimento predominante do esqueleto axial. Ocorre de forma insidiosa e é potencialmente debilitante, levando à redução na qualidade de vida dos indivíduos acometidos. A sua etiopatogenia ainda não está totalmente [...] esclarecida, dificultando estratégias no seu diagnóstico e manejo. O avanço da terapia com agentes biológicos veio reforçar discussões sobre a melhor forma de avaliação destes pacientes. Nesta revisão, discutimos os principais instrumentos utilizados para avaliar pacientes com EA e o consenso do grupo internacional (ASAS working group - Assessments in Ankylosing Spondylitis Working Group) determinado no OMERACT IV (Outcome Measures in Rheumatology). Abstract in english Ankylosing spondylitis is a chronic and progressive disease involving predominantly the axial skeleton. It is insidious and potentially debilitating, compromising the quality of life of patients suffering from the disease. The etiopathogenesis is still uncertain, which difficult strategies in its di [...] agnosis and treatment. Advances in biological therapies are reforcing discussions in the best way of managing the disease. In this paper, we revise the outcome instruments available for ankylosing spondylitis and the consensus from the ASAS working group (Assessments in Ankylosing Spondylitis Working Group) established at the OMERACT IV (Outcome Measures in Rheumatology).

Themis Mizerkowski, Torres; Rozana Mesquita, Ciconelli.

2006-06-01

194

Instrumentos de avaliação em espondilite anquilosante Outcome measures in ankylosing spondylitis  

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Full Text Available A espondilite anquilosante (EA é uma doença inflamatória crônica caracterizada por acometimento predominante do esqueleto axial. Ocorre de forma insidiosa e é potencialmente debilitante, levando à redução na qualidade de vida dos indivíduos acometidos. A sua etiopatogenia ainda não está totalmente esclarecida, dificultando estratégias no seu diagnóstico e manejo. O avanço da terapia com agentes biológicos veio reforçar discussões sobre a melhor forma de avaliação destes pacientes. Nesta revisão, discutimos os principais instrumentos utilizados para avaliar pacientes com EA e o consenso do grupo internacional (ASAS working group - Assessments in Ankylosing Spondylitis Working Group determinado no OMERACT IV (Outcome Measures in Rheumatology.Ankylosing spondylitis is a chronic and progressive disease involving predominantly the axial skeleton. It is insidious and potentially debilitating, compromising the quality of life of patients suffering from the disease. The etiopathogenesis is still uncertain, which difficult strategies in its diagnosis and treatment. Advances in biological therapies are reforcing discussions in the best way of managing the disease. In this paper, we revise the outcome instruments available for ankylosing spondylitis and the consensus from the ASAS working group (Assessments in Ankylosing Spondylitis Working Group established at the OMERACT IV (Outcome Measures in Rheumatology.

Themis Mizerkowski Torres

2006-06-01

195

Disease flare of ankylosing spondylitis presenting as reactive arthritis with seropositivity: a case report  

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Abstract Introduction Concurrent rheumatoid factor seropositivity is occasionally detected in ankylosing spondylitis and often causes confusion in clinical routine. Overlap between various seronegative arthritides is a known but uncommon association. Differentiation of spondyloarthropathy from rheumatoid arthritis is important, since the natural history, complications, treatments and prognosis of the two diseases differ significantly. Case presentation Here, we ...

Em, Manoj; Mk, Ragunathan

2012-01-01

196

Leukemia mortality after X-ray treatment for ankylosing spondylitis  

International Nuclear Information System (INIS)

Leukemia mortality has been studied in 14,767 adult ankylosing spondylitis patients diagnosed between 1935 and 1957 in the United Kingdom, of whom 13,914 patients received X-ray treatment. By 1 January 1992, there were 60 leukemia deaths among the irradiated patients, almost treble that expected from national rates. Among those irradiated, the ratio of observed to expected deaths for leukemia other than chronic lymphocytic leukemia was greatest in the period 1-5 years after the first treatment (ratio = 11.01, 95% confidence interval 5.26-20.98) and decreased to 1.87 (95% confidence interval 0.94-3.36) in the 25+ year period. There was no significant variation in this ratio with sex or age at first treatment. The ratio for chronic lymphocytic leukemia was slightly but not significantly raised (ratio=1.44, 95% confidence interval 0.62-2.79). Most irradiated patients received all their exposure within a year. Based on 1 in 15 random sample, the mean total marrow dose was 4.38 Gy. Doses were nonuniform, with heaviest doses to the lower spine. The risk for nonchronic lymphocytic leukemia was adequately described by a linear-exponential model that allowed for cell sterilization in heavily exposed parts of the marrow and time since exposure. Ten years after first exposure, the linear component of excess relative risk was 12.37 per Gy (95% confidence interval 2.25-52.07), and it was estimated that cell sterilization reduced the excess relative risk by 47% at 1 Gy (95% confide relative risk by 47% at 1 Gy (95% confidence interval 17%-79%). The average predicted relative risk in the period 1-25 years after exposure to a uniform dose of 1 Gy was 7.00. 20 refs., 2 figs., 8 tabs

197

Lung parenchymal changes in patients with ankylosing spondylitis  

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Full Text Available AIM: To assess lung parenchymal changes in ankylosing spondylitis (AS using high resolution computed tomography (HRCT. METHODS: We included 78 AS patients whose average age was 33.87 (18-56 years with a ratio of 53 males to 25 females who were followed up for 3.88 (1-22 years on average. Pneumonia and tuberculosis were excluded. In a detailed examination of lung HRCT findings, we investigated the presence of parenchymal micronodules, parenchymal bands, subpleural bands, interlobular and intralobular septal thickening, irregularity of interfaces, ground-glass opacity, consolidation, mosaic pattern, bronchial wall thickening, bronchial dilatation, tracheal dilatation, pleural thickening, emphysema, thoracic cage asymmetry, honeycomb appearance, structural distortion, apical fibrosis and other additional findings. RESULTS: In detailed HRCT evaluations, lung parenchymal changes were found in 46 (59% of all patients. We found parenchymal bands in 21 (27% cases, interlobular septal thickening in 9 (12%, emphysema in 9 (12%, apical fibrosis in 8 (10%, ground-glass opacities in 7 (9%, parenchymal micronodules in 5 (6%, irregularity in interfaces in 3 (4%, bronchial dilatation in 3 (4%, mosaic pattern in 2 (3%, pleural thickening in 2 (3%, consolidation in 1 (1%, bronchial wall thickening in 1 (1% and a subpleural band in 1 (1% case. Furthermore, we detected subsegmental atelectasis in 2 patients and a cavitary lesion in 1 patient. CONCLUSION: Our study had the highest number of AS cases of all previous studies in evaluating lung parenchymal changes. The rate of lung parenchymal changes was slightly lower than that reported in recent literature.

Zehra Isik Hasiloglu

2012-01-01

198

The impact of ankylosing spondylitis on audiovestibular functions.  

Science.gov (United States)

In this study, we aimed to evaluate the audiovestibular functions in the patients with ankylosing spondylitis (AS). This prospective study was performed in collaboration by the Otolaryngology and Rheumatology Departments of Bozok University School of Medicine between May 1, 2012, and January 1, 2013. We studied 80 subjects consisting of 40 AS patients (37 men and 3 women) in whom the diagnosis confirmed by the criteria of New York and 40 healthy controls (35 men and 5 women). All participants were evaluated by routine audiologic (including tympanometric evaluation, pure-tone audiograms, speech tests) and vestibular studies (including spontaneous nystagmus, gaze, optokinetic, saccadic movements, smooth pursuit, caloric test and Dix-Hallpike tests). The tympanometric values did not show a statistically significant difference between the AS group and the healthy subjects (p > 0.05). At low frequencies (250, 500, 1,000, and 2,000 Hz) pure-tone audiologic evaluations also proved statistically non-significant results at mean air conduction thresholds (ACT) and bone conduction thresholds (BCT) between the AS and control groups (p > 0.05). At high frequencies (4,000, 6,000, and 8,000 Hz), the ACTs and BCTs in AS group were lower than control group which was statistically significant (p nystagmus, gaze, optokinetic, canal paresis and saccadic movement tests between the two groups were statistically insignificant (p > 0.05). The comparison of smooth pursuit and Dix-Hallpike tests reached statistical significance (p central abnormalities in 7 patients (17.5 %), peripheral abnormalities in 16 patients (40 %), and mixed abnormalities in 3 patients (7.5 %). Our findings suggest a possible association between AS and audiovestibular system dysfunction. We assume that the hearing and vestibular disturbances in AS are more prevalent than previously recognized. PMID:24096816

Kapusuz Gencer, Zeliha; Özk?r??, Mahmut; Günayd?n, Ilhan; Saydam, Levent

2014-09-01

199

Logistic transmission modeling of HLA and ankylosing spondylitis  

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A nonparametric and general method of linkage analysis has been developed and used to evaluate histocompatibility (HLA) linkage to ankylosing spondylitis (AS) from the data of Berg & Moller. The conditional logistic function has been used to establish linkage by stepwise modelling of transmission from parent to progeny. Logistic transmission models have been explored to better understand the relationship of HLA to AS. The alleles at HLA-A and -B were determined in 38 families (32 monoplex and 6 multiplex). We have found that linkage is supported in this data over the random transmission of alleles at only HLA-B. Models constructed at HLA-B are powerful with, for example, coefficients for B27 of 1.9 (S.E. = 0.4) and B40 of 1.6 (S.E. = 0.8) contributing to a model with {chi}{sup 2} = 30 with 2 df and p < 3x10{sup -7}. No models are found supporting linkage at HLA-A and, therefore, the data at HLA-A does not add support for linkage beyond that present at HLA-B (e.g., {chi}{sup 2} for improvement < 1). These results establish that HLA-B is linked to AS. They further provide evidence that the gene responsible for AS is located nearer to HLA-B than it is to HLA-A. Also, the analysis shows that a number of HLA-B alleles may contribute to the risk of AS, beyond the B27 allele which has repeatedly been associated with AS.

Scofield, R.H.; Neas, B.R.; Harley, J.B. [Univ. of Oklahoma, Oklahoma City, OK (United States)

1994-09-01

200

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

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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-? 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 hepatitis B virus infection, congestive heart failure, demyelinating neurologic disorders, hematologic disorders like aplastic anemia and pancytopenia, vasculitis, immunogenicity, and exacerbation or induction of psoriasis are class effects of all the anti-TNF drugs, and have been seen in patients with ankylosing spondylitis. However, etanercept is less likely to induce reactivation of tuberculosis than the other anti-TNF drugs and it has been suggested that etanercept might be less immunogenic, especially in ankylosing spondylitis. Acute uveitis, Crohn’s disease, and sarcoidosis are other adverse events that have been rarely associated with etanercept therapy in patients with ankylosing spondylitis. Keywords: ankylosing spondylitis, etanercept, spondyloarthritis, efficacy, safety

Senabre-Gallego JM

2013-09-01

 
 
 
 
201

Biomarkers and cytokines of bone turnover: extensive evaluation in a cohort of patients with ankylosing spondylitis  

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Full Text Available Abstract Background Ankylosing spondylitis (AS is a chronic inflammatory disease of spine and sacroiliac joints; it is characterized by new bone formation, and the disease processes can be accompanied by osteoporosis. In the present study, we investigated changes in bone mineral density (BMD and in the levels of various bone turnover-related biomarkers and cytokines in a cohort of AS patients, with regard to clinical parameters, disease activity, and treatment regimen. Methods 55 AS patients and 33 healthy controls included in the study. Spinal mobility was assessed by the Bath Ankylosing Spondylitis Metrology Index (BASMI, and radiologic changes were scored by the Bath Ankylosing Spondylitis Radiologic Index (BASRI. Patients were also evaluated with the Bath Ankylosing Spondylitis Functional Index (BASFI and the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI. Bone mineral density (BMD assessed by dual energy X-ray absorptiometry. Various biomarkers and cytokines of bone turnover including osteoprotegerin (OPG, serum band 5 tartrate-resistant acid phosphatase (TRAP-5, soluble receptor activator of nuclear factor kappa-B ligand (sRANKL, secreted frizzled-related protein 1 (sFRP-1, Dickkopf-related protein 1 (DKK-1, and sclerostin were studied. Results The levels of TRAP-5, NTX, sRANKL, sclerostin, sFRP-1, DKK-1, and IFN?, were similar between the patients and controls (p?>?0.05, while BMD of femoral neck, and OPG levels were significantly lower in AS patients (p? Conclusions In this cross-sectional study we showed that OPG levels were significantly lower in AS patients compared to healthy subjects. On the other hand, the levels of wingless (Wnt signal pathway inhibitors seem not altered. Ectopic bone formation in AS may be related to dysfunction of these molecules at the cellular level.

Taylan Ali

2012-10-01

202

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

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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.

F.M. Perrotta

2013-07-01

203

Focal spinal abnormalities on bone scans in ankylosing spondylitis: a clue to the presence of fracture or pseudarthrosis  

International Nuclear Information System (INIS)

Four cases of ankylosing spondylitis are presented in which radionuclide bone studies indicated focal abnormalities of the spine. In three patients, the area of abnormal nuclide uptake corresponded to a site of pseudarthrosis, and in the fourth an acute fracture was present. As such focal lesions on bone scans are unusual in cases of chronic ankylosing spondylitis in which a complication is not apparent, their presence can be a useful finding

204

Cardiovascular risk in patients with ankylosing spondylitis: the role of systemic inflammation and endothelial dysfunction  

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Full Text Available Aim. To investigate the role of systemic inflammation and endothelial dysfunction as factors of cardiovascular risk in patients with ankylosing spondylitis.Material andMethods. 100 patients with ankylosing spondylitis were included into the study. Screening for arterial hypertension (HT and conventional cardiovascular risk factors (smoking, hyper- and dislipoproteinemia, body overweight, heredity and diabetes mellitus was performed in all patients. 10-year coronary disease risk (Framingham scale and 10-year risk of fatal cardiovascular event (SCORE scale was calculated. Additionally the follows cardiovascular risk factors were assessed: C-reactive protein level (CRP, fibrinogen level, platelet count, antithrombin III activity, plasma fibrinolytic activity, vonWillebrand factor (vWF activity, circulating endothelial cells (CEC count. Besides, endothelial functionwas evaluated by Doppler-ultrasonography of brachial artery in testswith reactive (endothelium-dependent or flow-mediated dilation and nitroglycerine (endotheliumindependent dilation hyperemia. 30 healthy patients were included into control group and were comparable with patients of studied group on sex and age.Results. 10-year coronary disease risk in patients with ankylosing spondylitis was significantly lower than this in patients of control group 4.0%(3,0; 7,5 vs 5.0%(3,0; 11,0,respectively (p<0,05. 10-year risk of fatal cardiovascular event in studied group was relatively low 1.0% (1.0; 2.0. However, analysis of the additional risk factors shown increased thrombogenic potential of blood, which was related to systemic inflammation activity: high platelets count, high fibrinogen activity, increased vWF activity, and decreased fibrinolytic activity. Moreover, signs of endothelial injury (increased level of CEC and vWF activity and endothelial dysfunction were found in patients with ankylosing spondylitis.Conclusion. Cardiovascular risk in patientswith ankylosing spondylitis estimated on the basis of conventional risk factors is not higher than this in general population. At the same time, these patients have signs of endothelial injure, dysfunction, and increased thrombogenic potential directly related to the systemic inflammation activity.We suppose these factors are responsible for the increased cardiovascular risk in patients with ankylosing spondylitis and, therefore, should be taken into account upon cardiovascular risk assessment.

D.A. Poddubnyy

2008-01-01

205

Enthesopathic erosive lesions of patella and tibial tuberosity in juvenile ankylosing spondylitis  

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The authors report the case of a 20-year-old joiner suffering from ankylosing spondylitis, with recurrent knee effusions from the age of 11 and radiological evidence of sacro-iliac involvement. The patient presented with pain and bone erosions localized to the sites of tendinous attachments in the upper pole of the left patella and in tibial tuberosities. On both sides an inflammation of deep infrapatellar bursa was observed on anatomical examination. These destructive lesions are considered as rare forms of the erosive enthesopathy which has been described in anlylosing spondylitis, particularly on spine and calcanum. They could be considered as highly localized forms of algodystrophy. (orig.)

206

Enthesopathic erosive lesions of patella and tibial tuberosity in juvenile ankylosing spondylitis  

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The authors report the case of a 20-year-old joiner suffering from ankylosing spondylitis, with recurrent knee effusions from the age of 11 and radiological evidence of sacro-iliac involvement. The patient presented with pain and bone erosions localized to the sites of tendinous attachments in the upper pole of the left patella and in tibial tuberosities. On both sides an inflammation of deep infrapatellar bursa was observed on anatomical examination. These destructive lesions are considered as rare forms of the erosive enthesopathy which has been described in anlylosing spondylitis, particularly on spine and calcanum. They could be considered as highly localized forms of algodystrophy.

Albert, J.; Lagier, R.

1983-11-01

207

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

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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

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

2013-03-01

208

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

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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....

Refik Oltulu; Hanife Yumak Erkoç; Günhal ?at?rtav; Mehmet Okka

2013-01-01

209

Characterization of patients with ankylosing spondylitis in hidrokinesitherapy - a multidimensional assessment  

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OBJECTIVES: Clinical, functional and working characterization of an Ankylosing Spondylitis (AS) group of patients that perform hydrotherapy regularly in a physical and rehabilitation department. Assessment of the benefit of hydrotherapy in symptom relief, function and consumption of analgesics and non-steroidal anti-inflammatory drugs (NSAIDs). MATERIAL AND METHODS: A transversal characterization of a group of patients with SA undergoing hydrotherapy was performed. Demographic, clini...

Janua?rio, F.; Almeida, J.; Serra, S.; Amaral, C.; Machado, P.; Rodrigues, La

2012-01-01

210

Fetuin-A is related to syndesmophytes in patients with ankylosing spondylitis: a case control study  

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OBJECTIVES: New bone formation is one of the hallmark characteristics of ankylosing spondylitis, which is thereby associated with syndesmophytes. Fetuin-A is a molecule that is abundantly found in calcified tissues and it shows high affinity for calcium phosphate minerals and related compounds. Considering the role of fetuin-A in the regulation of calcified matrix metabolism, we compared the fetuin-A levels in ankylosing spondylitis patients with syndesmophytes with those in patients without syndesmophytes and in healthy controls. We also studied other biomarkers that are thought to be related to syndesmophytes. METHODS: Ninety-four patients (49 patients without syndesmophytes, 67.3% male, 40.7±8.7 years; 45 patients with syndesmophytes, 71.1% M, 43.9±9.9 years) and 68 healthy controls (44.2±10.6 years and 70.6% male) were included in this study. Syndesmophytes were assessed on the lateral radiographs of the cervical and lumbar spine. The serum levels of fetuin-A, dickkopf-1, sclerostin, IL-6, high-sensitivity C-reactive protein and bone morphogenetic protein-7 were measured with an enzyme-linked immunosorbent assay. RESULTS: Patients with syndesmophytes had significantly higher levels of fetuin-A compared with patients without syndesmophytes and controls (1.16±0.13, 1.05±0.09 and 1.08±0.13 mg/ml, respectively). However, fetuin-A was not different between the patients without syndesmophytes and controls. Bone morphogenetic protein-7 was significantly lower; dickkopf-1 was significantly higher in patients with ankylosing spondylitis compared with controls. The sclerostin concentrations were not different between the groups. In regression analysis, fetuin-A was an independent, significant predictor of syndesmophytes. CONCLUSION: Our results suggest that fetuin-A may a role in the pathogenesis of bony proliferation in ankylosing spondylitis. PMID:25518021

Tuylu, Tugba; Sari, Ismail; Solmaz, Dilek; Kozaci, Didem Leyla; Akar, Servet; Gunay, Necati; Onen, Fatos; Akkoc, Nurullah

2014-01-01

211

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

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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 ...

Almeida Santos Jr, M.; Pietrovski, C. F.; Azevedo, V. F.

2011-01-01

212

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

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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 tr...

Eipe, Naveen; Fossey, Susan; Kingwell, Stephen P.

2013-01-01

213

Increased expression of carbonic anhydrase I in the synovium of patients with ankylosing spondylitis  

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Abstract Background One of the most distinctive features of ankylosing spondylitis (AS) is new bone formation and bone resorption at sites of chronic inflammation. Previous studies have indicated that the hyperplasia and inflammation of synovial tissues are significantly related to the pathogenic process of AS. The present study used a proteomic approach to identify novel AS-specific proteins by simultaneously comparing the expression profiles of synovial membranes from patie...

Cui Yazhou; Sun Shui; Yan Xinfeng; Zhao Yan; Han Jinxiang; Chang Xiaotian

2010-01-01

214

Double level Chance-type fractures of spine in ankylosing spondylitis.  

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Chance fractures are usually associated with seat belt injuries. Mechanism is always related to flexion-distraction at vertebral level. Double level Chance-type fractures have rarely been reported in published literature. We presented such a fracture at D10 and L3 level in a 38-year-old patient with ankylosing spondylitis. Management was done with posterior decompression and short segment fixation separately. PMID:25471435

Vargaonkar, Gauresh Shantaram; Singh, Varun Kumar; Kashyap, Abhishek; Kumar, Ramesh

2014-12-01

215

Pitfalls and complications in the treatment of cervical spine fractures in patients with ankylosing spondylitis  

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Abstract Patients with ankylosing spondylitis are at significant risk for sustaining cervical spine injuries following trauma predisposed by kyphosis, stiffness and osteoporotic bone quality of the spine. The risk of sustaining neurological deficits in this patient population is higher than average. The present review article provides an outline on the specific injury patterns in the cervical spine, diagnostic algorithms and specific treatment modalities dictated by the underlying d...

Tschoeke Sven K; Robinson Yohan; John Thilo; Stahel Philip F; Hasenboehler Erik; Fakler Johannes K; Heyde Christoph-E; Kayser Ralph

2008-01-01

216

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

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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 ...

Atkinson Mark D; Brophy Sinead; Siebert Stefan; Gravenor Mike B; Phillips Ceri; Ford David V; Jones Kerina H; Lyons Ronan A

2010-01-01

217

The effect of physical activity and motivation on function in ankylosing spondylitis: A cohort study  

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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....

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

2013-01-01

218

Splenic tuberculosis in a patient with ankylosing spondylitis treated with adalimumab  

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Full Text Available We present a rare case of splenic tuberculosis in a 42-year old man with long-standing ankylosing spondylitis treated with adalimumab. We review the association between antitumor necrosis factor therapy and splenic tuberculosis. Our case, like many other reported cases, illustrates that the index of suspicion of tuberculosis in patients treated with anti TNF therapies must be high and emphasizes that this rare infection may occur even with negative tuberculosis screening before the initiation of therapy.

M. Fernandes

2011-11-01

219

Reducing work disability in Ankylosing Spondylitis – development of a work instability scale for AS  

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Abstract Background The Work Instability Scale for Rheumatoid Arthritis (RA-WIS) is established and is used by physicians to identify patients at risk of job loss for rapid intervention. The study objective was to explore the concept of Work Instability (a mismatch between an individual's abilities and job demands) in Ankylosing Spondylitis (AS) and develop a Work Instability Scale specific to this population. Methods New items generated from qualitative intervi...

Helliwell Philip; Glyn, Smyth M.; Barkham Nick; Emery Paul; Gilworth Gill; Tennant Alan

2009-01-01

220

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

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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 r...

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

2013-01-01

 
 
 
 
221

Expansion of the lumbosacral spinal canal in neurofibromatosis and ankylosing spondylitis  

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Bony erosions of the lumbosacral spinal canal can be caused by tumors, meningoceles, meningeal or arachnoidal cysts and perineural cysts. The bony abnormalities may be visible on plain roentgenograms of the spine and on computed tomograms. Computerized tomography, particularly in conjunction with iohexol myelography, provides the most definitive anatomical study. Meningeal cysts are common in neurofibromatosis and are an uncommon accompaniment of ankylosing spondylitis. Both conditions can be differentiated by computerized tomography. 10 refs.; 4 figs

222

Biomechanical assessment of balance and posture in subjects with ankylosing spondylitis  

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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 anky...

Sawacha Zimi; Carraro Elena; Del Din Silvia; Guiotto Annamaria; Bonaldo Lara; Punzi Leonardo; Cobelli Claudio; Masiero Stefano

2012-01-01

223

The information needs of people living with ankylosing spondylitis: a questionnaire survey  

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Abstract Background Today, health care is patient-centred with patients more involved in medical decision making and taking an active role in managing their disease. It is important that patients are appropriately informed about their condition and that their health care needs are met. We examine the information utilisation, sources and needs of people with Ankylosing Spondylitis (AS). Methods Participants in an existing AS cohort study were asked to complete a ...

Cooksey Roxanne; Brophy Sinead; Husain Muhammad Jami; Irvine Elizabeth; Davies Helen; Siebert Stefan

2012-01-01

224

Whole-genome screening in ankylosing spondylitis: evidence of non-MHC genetic-susceptibility loci.  

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Ankylosing spondylitis (AS) is a common inflammatory arthritis predominantly affecting the axial skeleton. Susceptibility to the disease is thought to be oligogenic. To identify the genes involved, we have performed a genomewide scan in 185 families containing 255 affected sibling pairs. Two-point and multipoint nonparametric linkage analysis was performed. Regions were identified showing “suggestive” or stronger linkage with the disease on chromosomes 1p, 2q, 6p, 9q, 10q, 16q, and 19q. T...

Laval, Sh; Timms, A.; Edwards, S.; Bradbury, L.; Brophy, S.; Milicic, A.; Rubin, L.; Siminovitch, Ka; Weeks, DE; Calin, A.; Wordsworth, Bp; Brown, Ma

2001-01-01

225

Is there a relationship between endothelial nitric oxide synthase gene polymorphisms and ankylosing spondylitis?  

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OBJECTIVE: Nitric oxide is produced by endothelial nitric oxide synthase, and its production can be influenced by polymorphisms of the endothelial nitric oxide synthase gene. Because candidate genes responsible for susceptibility to ankylosing spondylitis are mostly unknown and available data suggest that there may be problems related to the nitric oxide pathway, such as endothelial dysfunction and increased asymmetric dimethylarginine, this study aimed to assess the association of common end...

Ismail Sari; Yusuf Ziya Igci; Gercek Can; Ali Taylan; Dilek Solmaz; Bulent Gogebakan; Servet Akar; Zeynep Eslik; Giray Bozkaya; Nurullah Akkoc

2013-01-01

226

Biomarkers and cytokines of bone turnover: extensive evaluation in a cohort of patients with ankylosing spondylitis  

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Abstract Background Ankylosing spondylitis (AS) is a chronic inflammatory disease of spine and sacroiliac joints; it is characterized by new bone formation, and the disease processes can be accompanied by osteoporosis. In the present study, we investigated changes in bone mineral density (BMD) and in the levels of various bone turnover-related biomarkers and cytokines in a cohort of AS patients, with regard to clinical parameters, disease activity, and treatment regimen. ...

Taylan Ali; Sari Ismail; Akinci Baris; Bilge Safak; Kozaci Didem; Akar Servet; Colak Ayfer; Yalcin Hulya; Gunay Necati; Akkoc Nurullah

2012-01-01

227

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

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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 ...

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

2006-01-01

228

Discovertebral (Andersson) lesions in severe ankylosing spondylitis: a study using MRI and conventional radiography  

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The objective of this study is to investigate the prevalence of Andersson lesions (AL) in ankylosing spondylitis (AS) patients who will start anti-tumor necrosis factor (TNF) treatment. Radiographs and magnetic resonance imaging (MRI) of the spine were performed before therapy with anti-TNF. ALs were defined as discovertebral endplate destructions on MRI, associated with bone marrow edema and fat replacement or sclerosis, a decreased signal on T1, enhancement after contrast administration (ga...

Vries, M. K.; Drumpt, A. S.; Royen, B. J.; Denderen, J. C.; Manoliu, R. A.; Horst-bruinsma, I. E.

2010-01-01

229

Exacerbation of Verruca Vulgaris Associated with Etanercept in A Case of Ankylosing Spondylitis  

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I have read with great interest the manuscript titled “Cervix Cancer in a Patient with Ankylosing Spondylitis Using Etanercept: A Case Report” authored by Doruk et al. (1) and would like to share my experience with regard to a patient develops severe exacerbation of verruca vulgaris under treatment with etanercept. Verruca vulgaris (common wart) is an infectious disease caused by human papilloma virus (HPV) that is an important risk factor for cervix cancer (2).A 20yearold male patient wa...

MahmutAlpayc?

2013-01-01

230

Therapy of ankylosing spondylitis with Leflunomide, Anakinra and Adalimumab - three open pilot studies  

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Background The therapeutic options for ankylosing spondylitis (AS), a chronic inflammatory rheumatic disease, are limited. The disease modifying antirheumatic drugs (DMARDs) leflunomide and anakinra were shown to be effective and safe for the therapy of rheumatoid arthritis (RA) and are potential therapeutic options for patients with AS. Because the TNF-alpha blockers etanercept and infliximab are very effective in treatment of AS, in the potential therapeutic effects of adalimumab should ...

Haibel, Hildrun

2010-01-01

231

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

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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. Th...

Moschos, M. M.; Gatzioufas, Z.; Margetis, I.

2010-01-01

232

Sister chromatid exchange analysis in the lymphocytes of patients with ankylosing spondylitis  

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OBJECTIVE—This study investigated whether any genomic change occurs in DNA level in ankylosing spondylitis (AS) by measuring sister chromatid exchange (SCE) frequency.?METHODS—SCE frequency was detected on metaphase chromosomes obtained from peripheral blood lymphocyte cultures in 15 patients diagnosed as having AS. SCE values were also obtained from 15 healthy subjects as a control group. SCE frequencies were detected from metaphases obtained from standard blood cultures by using bro...

Sonmez, S.

1997-01-01

233

HLA-DR4 in ankylosing spondylitis with different patterns of joint involvement.  

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Fifty patients with ankylosing spondylitis (AS) confined to the spine and sacroiliac joints were compared with 50 cases of AS complicated by various patterns of non-axial joint involvement. Radiological and clinical features were evaluated and HLA-DR4 typing was carried out. This antigen was found in 16% of 200 normal individuals in 18% of patients suffering from exclusively axial AS, and in 54% of patients with additional purely peripheral joint involvement (wrist, finger, ankle, toe). The p...

Miehle, W.; Schattenkirchner, M.; Albert, D.; Bunge, M.

1985-01-01

234

Cerebral magnetic resonance imaging in a patient with ankylosing spondylitis and multiple sclerosis-like syndrome  

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Clinical and cerebral magnetic resonance imaging (MRI) findings in a patient with ankylosing spondylitis (AS) and multiple sclerosis-like (MS-like) syndrome are reported. Cerebral MRI demonstrated multiple, MS-like, scattered foci of signal abnormality, one of which showed contrast enhancement. Lesion dissemination in ''space and time'' is a hallmark for diagnosis of MS, and its demonstration by enhanced cerebral MRI prompted suspicion of coexistence of MS and AS in our patient. (orig.)

235

Ankylosing spondylitis monocytes show upregulation of proteins involved in inflammation and the ubiquitin proteasome pathway.  

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OBJECTIVES: To determine if peripheral blood monocytes from patients with ankylosing spondylitis (AS) differed in protein expression compared to rheumatoid arthritis (RA) and healthy controls (HC). METHODS: Monocyte protein expression was characterised by 2D gel electrophoresis and by label-free quantitative expression profiling, using nano-ultra performance liquid chromatography coupled to electrospray ionisation mass spectrometry (ESI-MS(E), where (E) refers to low/high collision energy swi...

Wright, C.; Edelmann, M.; Digleria, K.; Kollnberger, S.; Kramer, H.; Mcgowan, S.; Mchugh, K.; Taylor, S.; Kessler, B.; Bowness, P.

2009-01-01

236

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

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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...

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

1984-01-01

237

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

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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 inflammati...

Huang, Han-qing; Zhu, Li-xin; Li, Liu-yang; Qian, Jun; Wang, Kun

2013-01-01

238

Possible role of enteric organisms in the pathogenesis of ankylosing spondylitis and other seronegative arthropathies.  

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One-hundred eighty-five clinical isolates of Salmonella sp., Shigella sp., Escherichia coli, and Campylobacter sp. were tested for their ability to absorb the lymphocytotoxic activity of an antiserum (anti-Klebsiella sp. K43) directed against a specific HLA-B27-associated cell surface determinant on the lymphocytes of patients with ankylosing spondylitis (AS). Seven of these isolates (three Salmonella sp., two Shigella sp., one E. coli, and one Campylobacter sp.) were found to cross-react wit...

Prendergast, J. K.; Sullivan, J. S.; Geczy, A.; Upfold, L. I.; Edmonds, J. P.; Bashir, H. V.; Reiss-levy, E.

1983-01-01

239

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

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Ankylosing spondylitis (ASp)is 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-mod...

Engin Bozkurt; Murat Akcay; Tahir Durmaz; Telat Keles; Nihal Akar Bayram; ?ükran Erten; Cenk Sari; Osman Kuloglu

2012-01-01

240

Adalimumab in ankylosing spondylitis: an evidence-based review of its place in therapy  

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Stephanie Hennigan, Christoph Ackermann, Arthur KavanaughCenter for Innovative Therapy, Division of Rheumatology, Allergy and Immunology, University of California, La Jolla, California, USAIntroduction: Ankylosing spondylitis (AS) is an idiopathic chronic inflammatory disease that has prominent effects on the spine and peripheral joints. In addition, extraarticular manifestations such as enthesitis and acute anterior uveitis may be clinically important. In recent years, the therapy of AS has ...

Stephanie Hennigan; Christoph Ackermann; Arthur Kavanaugh

2007-01-01

 
 
 
 
241

Fetuin-A is related to syndesmophytes in patients with ankylosing spondylitis: a case control study  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: English Abstract in english OBJECTIVES: New bone formation is one of the hallmark characteristics of ankylosing spondylitis, which is thereby associated with syndesmophytes. Fetuin-A is a molecule that is abundantly found in calcified tissues and it shows high affinity for calcium phosphate minerals and related compounds. Con [...] sidering the role of fetuin-A in the regulation of calcified matrix metabolism, we compared the fetuin-A levels in ankylosing spondylitis patients with syndesmophytes with those in patients without syndesmophytes and in healthy controls. We also studied other biomarkers that are thought to be related to syndesmophytes. METHODS: Ninety-four patients (49 patients without syndesmophytes, 67.3% male, 40.7±8.7 years; 45 patients with syndesmophytes, 71.1% M, 43.9±9.9 years) and 68 healthy controls (44.2±10.6 years and 70.6% male) were included in this study. Syndesmophytes were assessed on the lateral radiographs of the cervical and lumbar spine. The serum levels of fetuin-A, dickkopf-1, sclerostin, IL-6, high-sensitivity C-reactive protein and bone morphogenetic protein-7 were measured with an enzyme-linked immunosorbent assay. RESULTS: Patients with syndesmophytes had significantly higher levels of fetuin-A compared with patients without syndesmophytes and controls (1.16±0.13, 1.05±0.09 and 1.08±0.13 mg/ml, respectively). However, fetuin-A was not different between the patients without syndesmophytes and controls. Bone morphogenetic protein-7 was significantly lower; dickkopf-1 was significantly higher in patients with ankylosing spondylitis compared with controls. The sclerostin concentrations were not different between the groups. In regression analysis, fetuin-A was an independent, significant predictor of syndesmophytes. CONCLUSION: Our results suggest that fetuin-A may a role in the pathogenesis of bony proliferation in ankylosing spondylitis.

Tugba, Tuylu; Ismail, Sari; Dilek, Solmaz; Didem Leyla, Kozaci; Servet, Akar; Necati, Gunay; Fatos, Onen; Nurullah, Akkoc.

2014-12-01

242

Evidence of impaired cartilage/bone turnover in patients with active ankylosing spondylitis.  

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OBJECTIVES--To compare serum markers of bone formation with the urinary excretion of pyridinium crosslinks (PYR) as a possible measure of bone and cartilage degradation which would detect changes in bone metabolism in patients with ankylosing spondylitis (AS) and to relate them to influences of inflammatory disease activity, and to treatment. METHODS--In 62 patients with AS, serum osteocalcin, alkaline phosphatase (ALP), and skeletal ALP isoenzyme levels were evaluated concurrently in compari...

Marhoffer, W.; Stracke, H.; Masoud, I.; Scheja, M.; Graef, V.; Bolten, W.; Federlin, K.

1995-01-01

243

Computed tomographic demonstration of calcification of the ligamenta flava of the lumbosacral spine in ankylosing spondylitis.  

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An axial computed tomographic (CT) scan of the lumbosacral regions was performed in 65 patients. The patient population was divided into two groups. The first (control) group included 40 elderly patients without calcification of the ligamenta flava. The second group included 25 patients with ankylosing spondylitis. More than 90% of those in the second group showed calcified lumbosacral ligamenta flava. In two patients these calcifications produced spinal stenosis. The diagnostic and practical...

Avrahami, E.; Wigler, I.; Stern, D.; Caspi, D.; Yaron, M.

1988-01-01

244

IgA antibody response to klebsiella in ankylosing spondylitis measured by immunoblotting.  

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IgA antibodies to Klebsiella pneumoniae var oxytoca and Proteus mirabilis were measured in 66 patients with ankylosing spondylitis (AS) and 31 with rheumatoid arthritis (RA) and in 51 healthy control subjects, using an immunoblotting technique. The number of antigenic bands to klebsiella on nitrocellulose membrane was higher in 28 patients with active AS than in 38 patients with inactive AS, 31 patients with RA, and 51 healthy control subjects; comparatively smaller increases were found again...

Shodjai-moradi, F.; Ebringer, A.; Abuljadayel, I.

1992-01-01

245

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

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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. Becau...

Behrooz Nikbin; Mostafa Moin; Zahra Pourpak; Bita Ansaripour; Aref Amirkhani; Ahmad Reza Jamshidi; Farideh Khosravi; Mazdak Ganjalikhani Hakemi; Ali Akbar Amirzargar; Mahdi Mahmoudi; Mohamad Hossein Nicknam

2008-01-01

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

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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.

R. Pala

2011-09-01

247

Cauda equina syndrome associated with multiple lumbar arachnoid cysts in ankylosing spondylitis: improvement following surgical therapy.  

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A case of cauda equina syndrome with multiple lumbar arachnoid cysts complicating ankylosing spondylitis (AS) is described. The value of computerised tomography (CT) and magnetic resonance imaging (MRI) as a non-invasive means of establishing the diagnosis is emphasised. In contrast to previously reported cases the patient showed neurological improvement following surgical therapy. Surgery may be indicated in some patients, particularly when there is nerve root compression by the arachnoid cy...

Shaw, P. J.; Allcutt, D. A.; Bates, D.; Crawford, P. J.

1990-01-01

248

Perfil gestacional na espondilite anquilosante / Pregnancy profile in ankylosing spondylitis  

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Full Text Available SciELO Brazil | Language: Portuguese Abstract in portuguese OBJETIVO: avaliar o perfil gestacional numa casuística de mulheres com espondilite anquilosante (EA) acompanhadas em um hospital universitário de referência. MÉTODOS: estudo retrospectivo avaliando 40 mulheres com EA, segundo os critérios modificados de New York, acompanhadas no Ambulatório de Espon [...] diloartropatias da FCM-UNICAMP no período entre 1990 e 2004. Foram avaliados os dados referentes ao número de gestações, partos e abortos, bem como o comportamento da doença durante a gestação naquelas pacientes que engravidaram após o início da EA. RESULTADOS: dentre as 40 mulheres avaliadas, 35 (87,5%) eram brancas e 27 (67,5%) eram HLA-B27 positivo, sendo que somente três (7,5%) referiam história familiar de EA. A média de idade de início foi de 29,9 anos e o tempo médio de doença foi de 15,5 anos. Nove pacientes (22,5%) nunca haviam engravidado, sendo que apenas uma paciente decidiu não engravidar por causa da EA. Trinta e uma pacientes apresentaram 83 gestações (média de 2,7 gestações/paciente), sendo sete após o início da doença. Ocorreram 71 partos e 12 abortos espontâneos (nenhum após o início da doença). Dentre as cinco pacientes que engravidaram após o início da EA, apenas uma apresentou piora da doença, associada ao comprometimento das coxofemorais. CONCLUSÕES: a análise do perfil gestacional da presente casuística indica que a fertilidade parece não ter sido afetada antes do início da EA e que a maioria das pacientes decide não engravidar após o início da doença. Abstract in english OBJECTIVE: To analyze the pregnancy profile in a group of female patients with ankylosing spondylitis (AS) followed at a referral university center. METHODS: Retrospective study analyzing 40 women with the diagnosis of AS according to the New York modified criteria followed at the Spondyloarthropath [...] ies Outpatient Clinic of the State University of Campinas in the period between 1990-2004. The number of pregnancies, deliveries and miscarriages was investigated, as well as the disease behavior during the pregnancy in those patients that got pregnant after AS onset. RESULTS: Among the 40 AS patients, 35 (87.5%) were Caucasians and 27 (67.5%) were HLA-B27 positive; 3 patients (7.5%) referred familial history of AS. The mean age of onset was 29.9 years old and the mean disease duration was 15.5 years. Nine patients (22.5%) never got pregnant; just one patient decided not to get pregnant because of AS. Thirty-one patients presented 83 pregnancies (an average of 2.7 pregnancies/patient), being seven after disease onset. There were 70 deliveries and 12 spontaneous miscarriages, but no miscarriages after AS onset. Among the 5 patients that got pregnant after disease onset, just 1 patient referred worsening of AS, related to hip involvement. CONCLUSIONS: In the present casuistic, fertility seemed not to be affected before disease onset and most patients decided not to get pregnant after AS onset.

Percival Degrava, Sampaio-Barros; Manoel Barros, Bértolo; Adil Muhib, Samara.

2005-06-01

249

Perfil gestacional na espondilite anquilosante Pregnancy profile in ankylosing spondylitis  

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Full Text Available OBJETIVO: avaliar o perfil gestacional numa casuística de mulheres com espondilite anquilosante (EA acompanhadas em um hospital universitário de referência. MÉTODOS: estudo retrospectivo avaliando 40 mulheres com EA, segundo os critérios modificados de New York, acompanhadas no Ambulatório de Espondiloartropatias da FCM-UNICAMP no período entre 1990 e 2004. Foram avaliados os dados referentes ao número de gestações, partos e abortos, bem como o comportamento da doença durante a gestação naquelas pacientes que engravidaram após o início da EA. RESULTADOS: dentre as 40 mulheres avaliadas, 35 (87,5% eram brancas e 27 (67,5% eram HLA-B27 positivo, sendo que somente três (7,5% referiam história familiar de EA. A média de idade de início foi de 29,9 anos e o tempo médio de doença foi de 15,5 anos. Nove pacientes (22,5% nunca haviam engravidado, sendo que apenas uma paciente decidiu não engravidar por causa da EA. Trinta e uma pacientes apresentaram 83 gestações (média de 2,7 gestações/paciente, sendo sete após o início da doença. Ocorreram 71 partos e 12 abortos espontâneos (nenhum após o início da doença. Dentre as cinco pacientes que engravidaram após o início da EA, apenas uma apresentou piora da doença, associada ao comprometimento das coxofemorais. CONCLUSÕES: a análise do perfil gestacional da presente casuística indica que a fertilidade parece não ter sido afetada antes do início da EA e que a maioria das pacientes decide não engravidar após o início da doença.OBJECTIVE: To analyze the pregnancy profile in a group of female patients with ankylosing spondylitis (AS followed at a referral university center. METHODS: Retrospective study analyzing 40 women with the diagnosis of AS according to the New York modified criteria followed at the Spondyloarthropathies Outpatient Clinic of the State University of Campinas in the period between 1990-2004. The number of pregnancies, deliveries and miscarriages was investigated, as well as the disease behavior during the pregnancy in those patients that got pregnant after AS onset. RESULTS: Among the 40 AS patients, 35 (87.5% were Caucasians and 27 (67.5% were HLA-B27 positive; 3 patients (7.5% referred familial history of AS. The mean age of onset was 29.9 years old and the mean disease duration was 15.5 years. Nine patients (22.5% never got pregnant; just one patient decided not to get pregnant because of AS. Thirty-one patients presented 83 pregnancies (an average of 2.7 pregnancies/patient, being seven after disease onset. There were 70 deliveries and 12 spontaneous miscarriages, but no miscarriages after AS onset. Among the 5 patients that got pregnant after disease onset, just 1 patient referred worsening of AS, related to hip involvement. CONCLUSIONS: In the present casuistic, fertility seemed not to be affected before disease onset and most patients decided not to get pregnant after AS onset.

Percival Degrava Sampaio-Barros

2005-06-01

250

Quantitative radio-isotope scanning of the sacroiliac joints in ankylosing spondylitis  

International Nuclear Information System (INIS)

A method for applying 99mTc-MDP for dynamic and static quantitative radioisotope scanning (QRS) of the sacroiliac joints (SI) in early progressive sacroiliitis in ankylosing spondylitis (AS) is described. In a prospective study, 2 groups of male AS patients were investigated, one with increased elevated erythrocytic sedimentation rate (ERS) (group A, n = 7) and one with normal ERS (group B, n = 8). In both groups an increased uptake of the radiotracer was found in the static part of the study versus a control group C (n = 9). An increased uptake versus group C was also found for group A in the dynamic part of the study (p = 0.01) while there was no significant difference dynamically between group B and C. The results of the dynamic study in group A indicate ERS to be a parameter of inflammatory activity in the SI joints. The study also seems to indicate QRS to be a valuable diagnostic method in early AS without definite radiographic changes in the SI joints. (orig.)

251

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

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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 spon...

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

2012-01-01

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Validation of the Italian versions of the Bath Ankylosing Spondylitis Functional Index (BASFI and the Dougados Functional Index (DFI in patients with ankylosing spondylitis  

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Full Text Available Objectives: The Bath Ankylosing Spondylitis Functional Index (BASFI and the Dougados Functional Index (DFI are the most commonly used instruments to measure functioning in ankylosing spondylitis (AS. The aim of this study was to translate, adapt and validate these instruments into the Italian language. Methods: The BASFI and DFI questionnaires were translated into Italian by two independent bilingual physicians who were familiar with the medical aspects of AS and by one professional translator. Two rheumatologists familiar with instrument validation, and who were aware of the purpose of the study, examined semantic, idiomatic and conceptual issues and produced by consensus unified versions of each instrument. English back-translations from the Italian were done by a professional translator unaware of the original version. Both English versions were compared, and where needed, modifications to the Italian versions were made. Results: A total of 95 patients were included: 77 males, age (mean±SD 47.9±9.3years, and disease duration 12.4±6.6 years, and 18 females, age 45.9±8.7 years, and disease duration 11.3±8.2 years. Reliability, measured in 23 patients participating a physiotherapy program, showed an acceptable one-week test-retest intraclass correlation coefficient (ICC - BASFI ICC: 0.91, 95% CI: 0,87-0.94 and DFI ICC: 0.86, 95% CI: 0.83-0.90. The internal consistency was 0.90 (Cronbach’s alpha for the BASFI and 0.87 for the DFI. For validity the functional indices were correlated with the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI, Bath Ankylosing Spondylitis Metrology Index (BASMI, Bath Ankylosing Spondylitis Patient Global Score (BAS-G, modified Health Assesment Questionnaire (HAQ-S, SF-36 physical component summary (SF-36 PCS, stiffness, pain, physician’s assessment of disease activity, Bath AS Radiology Index-total (BASRI-t, erythrocyte sedimentation rate (ESR, and C-reactive protein (CRP. The functional indices (BASFI and DFI were correlated with each other (p<0.0001 and with activity variables. There was no significant relationship between functional indices and BASRI-t and acute phase reactants. The receiver operating characteristic (ROC curve analysis indicated that the BASFI ranked superior compared to HAQ-S, (p = 0.019 and SF36 PCS (p = 0.002, but not respect to DFI (p = NS, in distinguishing between patients with high and low disease activity. Conclusions: The Italian versions of the BASFI and DFI showed adequate reliability and validity in patients with AS. Because of psychometric advantages, the BASFI may be preferred in clinical trial settings. However, sensitivity to changes due to drug therapy and/or rehabilitation remains to be determined.

W. Grassi

2011-09-01

253

Histopathologic evidence of sacroiliitis and bone scintigraphic imaging in ankylosing spondylitis  

International Nuclear Information System (INIS)

Objective: To evaluate the value of early diagnosis and to monitor the activity of ankylosing spondylitis (AS) by using bone scintigraphic imaging and histopathologic technology. Methods: Sixteen patients with As (31 sacroiliac joint of them were involved) were divided into 5 groups: 0 period, I period, II period, III period and IV period group according to the modified New York criteria of AS. SPECT was performed on whole body skeleton as well as on the sacroiliac joint to measure the radioactivity ratio of it. After 1 to 3 days, they underwent the centesis of the sacroiliac joint under CT guidance for the histopathologic work-up. Results: histopathologic evidence showed synovitis, enthesitis, intraarticular fibrous strands, new bone formation, and bony ankylosis in 30 sacroiliac joints of AS patients. The radioactivity ratio of sacroiliac joint/sacrum increased in 27 sacroiliac joints, and 16 AS patients were found with abnormalities in joints other than sacroiliac joint. Conclusion: Bone scintigraphic imaging is not only helpful to diagnosis of the AS in earlier stage, but also to monitoring of the activity of the disease

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Bloqueio cardíaco completo em espondilite anquilosante / Complete heart block in ankylosing spondylitis  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: Portuguese Abstract in portuguese A espondilite anquilosante é uma doença reumática crônica de homens jovens que afeta principalmente o esqueleto axial e está associada ao HLA-B27 em 90% dos casos. A incidência de envolvimento cardiovascular em casos de espondilite anquilosante varia entre 10%-30%; foram descritos distúrbios de cond [...] ução em 1%-9% dos pacientes com a doença. A maior parte do grupo acometido demonstra uma relação com doença de longa data. Este é o primeiro relato de bloqueio cardíaco completo em espondilite anquilosante precoce de nosso conhecimento. Abstract in english Ankylosing spondylitis (AS) is a chronic rheumatic disease of young men that affects mainly the axial skeleton and is associated with HLA-B27 in 90% of the cases. Incidence of cardiovascular involvement in AS ranges between 10%-30%; conduction disturbances have been described in 1%-9% of the patient [...] s with AS. The majority of the series show a relationship with longstanding disease. To our knowledge, this is the first report of complete heart block in early AS.

Juan Pablo, Restrepo; María Del Pilar, Molina.

2012-10-01

255

Assessment of the value of joint imaging in patients with ankylosing spondylitis  

International Nuclear Information System (INIS)

Objective: To assess the value of 99Tcm-human immunoglobulin G(HIgG) and 99Tcm-methylene diphosphonic acid (MDP) joint imaging in patients with ankylosing spondylitis (AS). Methods: Whole body imaging with 99Tcm-HIgG was performed on 21 patients with AS and 18 with rheumatoid arthritis (RA). Among them, 12 cases of AS were studied in comparison with 99Tcm-MDP. Results: 1) 20 of 21 cases of AS showed increased uptake of 99Tcm-HIgG in Art. sacro-iliac were negative. 3) The comparison between 99Tcm-HIgG and 99Tcm-MDP imaging demonstrated: abnormal sacro-iliac, and there were 32 surrounding joints with abnormal images in 44 clinically positive joints. The rate of coincidence was 75%. The image of the hand was normal in every patient. 2) All images of the hand were abnormal in RA, while images of Art. sacro-iliac images were found in 11 cases with 99Tcm-HIgG, while in 7 with 99Tcm-MDP. Among 31 clinically involved surrounding joints, 24 showed increased uptake of 99Tcm-HIgG, but only 16 were 99Tcm-MDP positive. Significant difference was found between the two modalities (P 99Tcm-HIgG joint imaging can more objectively detect inflammatory lesions of AS than 99Tcm-MDP. ItS than 99Tcm-MDP. It can also be helpful to the early diagnosis of AS

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Bloqueio cardíaco completo em espondilite anquilosante Complete heart block in ankylosing spondylitis  

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Full Text Available A espondilite anquilosante é uma doença reumática crônica de homens jovens que afeta principalmente o esqueleto axial e está associada ao HLA-B27 em 90% dos casos. A incidência de envolvimento cardiovascular em casos de espondilite anquilosante varia entre 10%-30%; foram descritos distúrbios de condução em 1%-9% dos pacientes com a doença. A maior parte do grupo acometido demonstra uma relação com doença de longa data. Este é o primeiro relato de bloqueio cardíaco completo em espondilite anquilosante precoce de nosso conhecimento.Ankylosing spondylitis (AS is a chronic rheumatic disease of young men that affects mainly the axial skeleton and is associated with HLA-B27 in 90% of the cases. Incidence of cardiovascular involvement in AS ranges between 10%-30%; conduction disturbances have been described in 1%-9% of the patients with AS. The majority of the series show a relationship with longstanding disease. To our knowledge, this is the first report of complete heart block in early AS.

Juan Pablo Restrepo

2012-10-01

257

Evaluation of the short-term efficacy of NSAIDs on patients with active ankylosing spondylitis in daily practice: a 3-month, longitudinal, observational study.  

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The objective of the study was to investigate the response rate to non-steroidal anti-inflammatory drugs (NSAIDs) and the clinical parameters that might predict this response in patients with active ankylosing spondylitis. This is a prospective, observational, 3-month study that was conducted in a single center. Ninety-five consecutive patients with active ankylosing spondylitis were included in the study. Full dose NSAIDs (indometacin 150 mg daily or acemetacin [corrected] 180 mg daily) were given to patients. Relevant clinical data of all patients' were recorded at the beginning and on three consecutive monthly visits. At the end of the study period, patients who respond to NSAIDs were determined. Demographic, clinical, and laboratory parameters that might influence the response to the NSAIDs were investigated. The response rate to the full-dose NSAIDs according to the ASAS20 in patients with active ankylosing spondylitis was found as 29.5%. Similarly, 20.0% of the patients were responders according to the ASAS40 criteria, whereas 5.6% of the patients responded according to the 5-out-of-6 criteria at week 12. Patients who responded to the treatment were found to be younger at the study entry (P = 0.001) and had shorter disease duration (P < 0.001). Due to the markedly lower rate of response to the NSAIDs in patients with active ankylosing spondylitis, early identification of those patients who does not respond to NSAIDs and subsequent decision regarding the institution of second-line treatments (anti-TNF) may be of great value in the prevention of irreversible changes that might develop in most of the patients. PMID:19466421

Cinar, Muhammet; Dinc, Ayhan; Simsek, Ismail; Erdem, Hakan; Koc, Bayram; Pay, Salih; Kilic, Selim

2010-01-01

258

Assessment of functional disability and quality of life in patients with ankylosing spondylitis  

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Full Text Available Introduction Ankylosing spondylitis is a chronic progressive autoimmune inflammatory disorder involving mainly the axial skeleton and larger peripheral joints that progressively limits spinal mobility and may lead to irreversible structural changes and consequently to impaired physical function and reduced quality of life. Objective The aim of this study was to assess functional disability and quality of life of patients with ankylosing spondylitis and determine the correlation between functional disability and quality of life. Methods The study enrolled 74 patients with ankylosing spondylitis (16 females and 58 males. The demographic data of the patients were collected. Functional disability was assessed with the Bath Ankylosing Functional Index (BASFI. Quality of life was assessed by the Short-Form 36 (SF-36 and the European Quality of Life Questionnaire (EuroQoL/EQ-5D. Results In our study, the mean age was 48.5±10.3 years. BASFI was negatively correlated with the SF-36 physical function subscale (p<0.001, physical role (p=0.002, bodily pain (p=0.003, general health (p<0.001, vitality (p=0.012 and mental health (p=0.010 subscale. There was a significantly inverse correlation between the BASFI score and the rating scale of EQ-5D (p=0.001. In the regression model, the BASFI score (p=0.000 showed an independent association with the physical function domain of SF-36. Conclusion In conclusion, the BASFI index was associated with physical function, physical role, bodily pain, general health, vitality and mental health domains of SF-36 and also with the rating scale of EQ-5D.

Mustur Dušan

2009-01-01

259

Expression of MHC class I dimers and ERAP1 in an ankylosing spondylitis patient cohort  

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The human leucocyte antigen HLA-B27 is strongly associated with ankylosing spondylitis, a form of seronegative inflammatory arthritis. In this study aspects related to several hypothesized mechanisms of disease pathogenesis have been investigated. Blood monocyte-derived dendritic cells (DC) from a small patient cohort of 29 patients with ankylosing spondylitis and one with reactive arthritis, were compared with DC from 34 healthy control subjects, of whom four were found to be HLA-B27 positive. The ability of HLA-B27 to form heavy-chain dimers reactive with monoclonal antibody HC10 was tested, along with the induction of endoplasmic reticulum (ER) stress, assessed by splicing xbp1 mRNA and immunoblotting of Immunoglobulin Binding Protein (BiP). Additionally, the protein expression levels of the ER resident aminopeptidase gene ERAP1 in patients with ankylosing spondylitis was also determined, following its recent identification as a novel disease-associated gene. No significant difference was noted in the global levels of HC10-reactive MHC class I dimers formed in either the patient or control DC populations. Stress on the ER, as determined by xbp1 mRNA splicing, was not detected but lower levels of BiP were observed in the DC from patients. Of further potential interest, in this patient cohort the expression of ERAP1 appeared to be higher in a number of patient DC samples when compared with controls, suggesting over-expression of ERAP1 as a mechanism promoting ankylosing spondylitic pathogenesis. PMID:21574996

Campbell, Elaine C; Fettke, Franziska; Bhat, Smita; Morley, Kenneth D; Powis, Simon J

2011-01-01

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Fluoroscopy-guided Intra-articular Sacroiliac Joint Steroid Injection for Sacroiliitis in Ankylosing Spondylitis: A Case Report.  

Science.gov (United States)

Sacroiliitis, a condition commonly seen in Ankylosing Spondylitis, is well known to be one of the main pain generators of low back pain, which may result in difficulty with walking. A 20-year old male with history of ankylosing spondylitis presented to the University Hospital of the West Indies, Physical Medicine and Rehabilitation clinic, with a two-year history of right buttock, low back and groin pain. Radiographic evaluation revealed increased sclerosis and erosive changes in bilateral sacroiliac joints, right greater than left. Right intra-articular sacroiliac joint steroid injection was administered under fluoroscopy guidance. Post-injection visual analogue pain scale (VAS) score with activity improved from 8 to 1 and Oswestry Disability Index improved from 40% moderate disability to 16% minimal disability. The patient's overall assessment was 95% perceived improvement in pain. This case report illustrates the effectiveness of intra-articular sacroiliac joint steroid injection in treating sacroiliitis in ankylosing spondylitis. PMID:25303203

Dawson, P Ua; Dewar, N A; Tulloch-Reid, D

2014-01-01

 
 
 
 
261

Finnish HLA studies confirm the increased risk conferred by HLA?B27 homozygosity in ankylosing spondylitis  

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OBJECTIVE: To determine the influence of HLA-B27 homozygosity and HLA-DRB1 alleles in the susceptibility to, and severity of, ankylosing spondylitis in a Finnish population. METHODS: 673 individuals from 261 families with ankylosing spondylitis were genotyped for HLA-DRB1 alleles and HLA-B27 heterozygosity/homozygosity. The frequencies of HLA-B27 homozygotes in probands from these families were compared with the expected number of HLA-B27 homozygotes in controls under Hardy-Weinberg equilibri...

Jaakkola, E.; Herzberg, I.; Laiho, K.; Barnardo, Mc; Pointon, Jj; Kauppi, M.; Kaarela, K.; Tuomilehto-wolf, E.; Tuomilehto, J.; Wordsworth, Bp; Brown, Ma

2005-01-01

262

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

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Full Text Available 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 literature. We report a new case in which we describe an outbreak of acute neutrophilic dermatosis revealing ankylosing spondylitis. Case presentation A 33-year-old Moroccan man presented with large-joint polyarthralgia, inflammatory pain in his buttocks and lower lumbar spine, fever and skin lesions. On examination, the patient had a low-grade fever, six tender but not swollen joints, limitation of motion of the lumbar spine, and painful erythematous maculopapules over his face, neck, and hands. Laboratory tests showed hyperleukocytosis, and elevated erythrocyte sedimentation rate and C-reactive protein. The immunological tests and infectious disease markers were negative. Investigations for an underlying neoplastic disease remained negative. Magnetic resonance imaging showed a bilateral sacroiliitis. Skin biopsy findings were consistent with Sweet’s syndrome. The diagnosis of Sweet’s syndrome associated with ankylosing spondylitis was established. Nonsteroid anti-inflammatory drugs were started and the patient showed rapid clinical and biological improvement. Conclusion Three observations of the association between Sweet’s syndrome and spondylarthropathy have been reported in the literature. The cause of this association remains unclear. Some hypotheses have been developed, but further studies are needed to confirm or refute them.

Mansouri Samia

2013-01-01

263

Adalimumab in ankylosing spondylitis: an evidence-based review of its place in therapy  

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Full Text Available Stephanie Hennigan, Christoph Ackermann, Arthur KavanaughCenter for Innovative Therapy, Division of Rheumatology, Allergy and Immunology, University of California, La Jolla, California, USAIntroduction: Ankylosing spondylitis (AS is an idiopathic chronic inflammatory disease that has prominent effects on the spine and peripheral joints. In addition, extraarticular manifestations such as enthesitis and acute anterior uveitis may be clinically important. In recent years, the therapy of AS has changed, largely due to the introduction of inhibitors of the proinflammatory cytokine tumor necrosis factor (TNF. Adalimumab, a human monoclonal antibody specifically for TNF, is the most recent of the TNF blocking agents that have been approved for the treatment of active, nonsteroidal antiinflammatory drug (NSAID-refractory patients with AS.Aims: To evaluate the evidence for the therapeutic value of adalimumab in ankylosing spondylitis.Evidence review: There is clear evidence that adalimumab, administered 40 mg subcutaneously every 2 weeks, substantially improves the signs and symptoms of NSAID-refractory, active AS when compared with placebo treatment. There is ample evidence that adalimumab causes significant improvements in physical health status and overall AS-specific, health-related quality of life and physical functioning, which consequently leads to better work productivity. There is substantial evidence that adalimumab improves spinal and sacroiliac joint inflammation in AS patients. Initial results from clinical trials suggest that there is no increased risk of serious infections or malignancies in adalimumab-treated patients with AS. The most common adverse events were injection-site reactions. Limited economic evidence suggests that adalimumab 40 mg may be cost effective when used according to current valid treatment guidelines. Place in therapy: Adalimumab is an effective treatment for patients with active AS.Key words: adalimumab, ankylosing spondylitis, TNF inhibitor, evidence, treatment

Stephanie Hennigan

2008-07-01

264

Lung Volume change after Pedicle Subtraction Osteotomy in Ankylosing Spondylitis Patients with Thoracolumbar Kyphosis.  

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Study Design. A retrospective clinical study.Objective. To investigate the lung volume change of ankylosing spondylitis patients with thoracolumbar kyphosis following the pedicle subtraction osteotomy procedure.Summary of Background Data. Most untreated ankylosing spondylitis patients result in thoracolumbar kyphosis with respiratory impairment. Restrictive pulmonary function is prevalent in these patients. The ideal evidence for restrictive pulmonary function impairment is to investigate the lung volume. A computed tomography based method can help to obtain accurate lung volume change during the osteotomy.Method. Twenty-eight AS patients with thoracolumbar kyphosis were included. All of these patients received pedicle subtraction osteotomy to correct their sagittal deformity. Pre and postoperative full-length radiographs and computed tomography scans were reviewed. The sagittal correction of the spine was measured. CT scans were used to estimate the pre and postoperative lung volume with software. The relationship between the sagittal correction and the lung volume change was investigated. All the patients were followed up for 2 years at least.Results. The PSO procedure was performed safely on each patient without serious complications. The average preoperative T1-S1 Cobb was 67.7°(42°? 88°) and the postoperative was 7.6°(-11°? 21°). T1-S1 Cobb change was 60.0° in average(PPSO osteotomy varied from T12 to L3. No relationship was found between the osteotomy location and the lung volume change.Conclusion. The PSO osteotomy effectively corrected the sagittal deformity of ankylosing spondylitis patients. Lung volume increased significantly following the osteotomy. PMID:25423303

Zhang, Guoying; Fu, Jun; Zhang, Yonggang; Zhang, Wei; Zhang, Xuesong; Wang, Zheng; Mao, Keya; Wang, Yan

2014-11-21

265

Espondilite anquilosante: investigação familiar de aspectos clínicos, imunogenéticos e radiológicos / Ankylosing spondylitis: familial investigation of clinical, immunogenetic and radiological aspects  

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Full Text Available SciELO Brazil | Language: Portuguese Abstract in portuguese OBJETIVO: avaliar familiares de primeiro grau de pacientes portadores de espondilite anquilosante (EA), em relação a alterações clínicas, imunogenéticas e radiológicas. MÉTODOS: foram avaliados 14 pacientes portadores de EA, acompanhados no Hospital das Clínicas da FMRP-USP e 30 familiares de primei [...] ro grau destes pacientes, pela história clínica e exame físico, tipificação do antígeno HLA-B27 (por microlinfocitotoxicidade e por citometria de fluxo), radiografia simples das articulações sacroilíacas e, em oito familiares, ressonância magnética (RM) da mesma região. RESULTADOS: observou-se que 47% (14/30) dos familiares apresentavam dor lombar com característica inflamatória crônica e 20% deles (6/30) apresentavam evidências radiológicas de sacroiliite bilateral. O diagnóstico de espondilite anquilosante (EA) foi confirmado em 10% dos familiares (3/30). O antígeno HLA-B27 estava presente em 60% dos familiares testados pela técnica de linfocitotoxicidade ou por citometria de fluxo. A RM não se mostrou superior à radiologia convencional na detecção precoce de alterações sacrilíacas. CONCLUSÕES: a avaliação de familiares de primeiro grau de pacientes portadores de EA pode revelar formas paucissintomáticas ou subclínicas da doença em uma proporção significativa de sujeitos. Abstract in english OBJECTIVE: to evaluate first-degree relatives of ankylosing spondylitis (AS) patients regarding to clinical, immunogenetic and radiological aspects. METHODS: fourteen patients with AS followed at the University Hospital of the Ribeirão Preto Medical School, University of São Paulo, Brazil (FMRP-USP) [...] and thirty first-degree relatives were evaluated by clinical history, physical examination, HLA-B27 typing (by lymphocytotoxicity and flow cytometry), plain radiography and magnetic resonance imaging (MRI) of sacroiliacal joints. RESULTS: we found that 47% (14/30) of the relatives presented low back pain with inflammatory characteristics, 20% (6/30) fulfilled displayed radiological features of bilateral sacroiliitis, and 10% (3/30) fulfilled the criteria for ankylosing spondylitis. Sixty percent of the relatives were HLA-B27 positive, verified either by lymphocytotoxicity or flow cytometry. MRI was not more sensitive than conventional radiography in the detection of early changes of sacroiliitis. CONCLUSIONS: the evaluation of first-degree relatives of patients with ankylosing spondylitis may reveal oligosymptomatic and subclinical forms of the disease in a significant proportion of subjects.

Rejane Maria Rodrigues de Abreu, Vieira; Jorge, Elias Jr; Marcello Henrique Nogueira, Barbosa; Júlio César, Voltarelli.

2003-10-01

266

Espondilite anquilosante: investigação familiar de aspectos clínicos, imunogenéticos e radiológicos Ankylosing spondylitis: familial investigation of clinical, immunogenetic and radiological aspects  

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Full Text Available OBJETIVO: avaliar familiares de primeiro grau de pacientes portadores de espondilite anquilosante (EA, em relação a alterações clínicas, imunogenéticas e radiológicas. MÉTODOS: foram avaliados 14 pacientes portadores de EA, acompanhados no Hospital das Clínicas da FMRP-USP e 30 familiares de primeiro grau destes pacientes, pela história clínica e exame físico, tipificação do antígeno HLA-B27 (por microlinfocitotoxicidade e por citometria de fluxo, radiografia simples das articulações sacroilíacas e, em oito familiares, ressonância magnética (RM da mesma região. RESULTADOS: observou-se que 47% (14/30 dos familiares apresentavam dor lombar com característica inflamatória crônica e 20% deles (6/30 apresentavam evidências radiológicas de sacroiliite bilateral. O diagnóstico de espondilite anquilosante (EA foi confirmado em 10% dos familiares (3/30. O antígeno HLA-B27 estava presente em 60% dos familiares testados pela técnica de linfocitotoxicidade ou por citometria de fluxo. A RM não se mostrou superior à radiologia convencional na detecção precoce de alterações sacrilíacas. CONCLUSÕES: a avaliação de familiares de primeiro grau de pacientes portadores de EA pode revelar formas paucissintomáticas ou subclínicas da doença em uma proporção significativa de sujeitos.OBJECTIVE: to evaluate first-degree relatives of ankylosing spondylitis (AS patients regarding to clinical, immunogenetic and radiological aspects. METHODS: fourteen patients with AS followed at the University Hospital of the Ribeirão Preto Medical School, University of São Paulo, Brazil (FMRP-USP and thirty first-degree relatives were evaluated by clinical history, physical examination, HLA-B27 typing (by lymphocytotoxicity and flow cytometry, plain radiography and magnetic resonance imaging (MRI of sacroiliacal joints. RESULTS: we found that 47% (14/30 of the relatives presented low back pain with inflammatory characteristics, 20% (6/30 fulfilled displayed radiological features of bilateral sacroiliitis, and 10% (3/30 fulfilled the criteria for ankylosing spondylitis. Sixty percent of the relatives were HLA-B27 positive, verified either by lymphocytotoxicity or flow cytometry. MRI was not more sensitive than conventional radiography in the detection of early changes of sacroiliitis. CONCLUSIONS: the evaluation of first-degree relatives of patients with ankylosing spondylitis may reveal oligosymptomatic and subclinical forms of the disease in a significant proportion of subjects.

Rejane Maria Rodrigues de Abreu Vieira

2003-10-01

267

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

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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 caseons 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)

268

Vertebral hemangioma in the X-ray radiography of Andersson lesion in ankylosing spondylitis  

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The vertebral cavernous hemangioma is described as the number five cause in the etiology of the Andersson lesion (vertebral-discal destruction in ankylosing spondylitis). In one case of a completely stiffened spine, radiographs showed a vertebral hemangioma with a cockade-like appearance instead of the typical coarse-striated osseous structure. Histologic necropsy results were those of a cavernous vertebral hemangioma. The immobile rigid spine, that is, the pathologically disturbed function appears to have a strong influence on the form, structure and pathology. (orig.)

269

Therapeutic effect of 99Tc-MDP in the treatment of ankylosing spondylitis  

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Objective: To observe the therapeutic effect of 99Tc-methylene diphosphonic acid (MDP) in the treatment of ankylosing spondylitis (AS). Methods: 83 patients with AS were treated with 99Tc-MDP. Clinical manifestation, laboratory examination before and after treatment and side effect were observed. Results: The total effect of this treatment was 89%, and the effectiveness of relieving clinical symptom was significant, especially the morning stiffness and limitation of articulation function. No adverse effects was observed. Conclusion: The clinical effect of 99Tc-MDP is obvious, and it is safe and no significant adverse reaction. (authors)

270

Difficult intubation in a case of ankylosing spondylitis: a case report.  

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Full Text Available A case of severe ankylosing spondylitis involving the entire spine was to be operated for lumbar osteotomy. She had fixed rigidity of the cervical spine with minimal rotational movement, inability to lie down supine and severe restrictive lung disease with hypoxemia (pO2 = 65 mmHg. An awake intubation was performed and the patient was operated under general anaesthesia in the prone position. Intraoperative "wake-up" test was performed to judge whether extent of straightening was excessive. Postoperatively, she was electively ventilated and extubated uneventfully after 24 hours.

Kamarkar U

1998-04-01

271

Scintiscanning in ankylosing spondylitis: a clinical, radiological and quantitative radioisotopic study.  

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Twenty-six patients with ankylosing spondylitis and 10 control subjects had quantitative dorso-lumbar and sacroiliac scintigraphy performed using 99mtechnetium methylene diphosphonate. No difference was found in the mean uptakes of radionucleide at each vertebral level or in the sacroiliac joints between the diseases patients and controls. No correlation was found between radionucleide uptake and radiological score, pain and tenderness assessments. The large variation in quantiative measurements resulted in a large overlap between control and diseased patients and it is unlikely that scintigraphy will be of diagnostic value in the absence of improved methodology. PMID:522092

Spencer, D G; Adams, F G; Horton, P W; Buchanan, W W

1979-01-01

272

HLA class II antigens (DR, DQ LOCI) and peripheral arthritis in ankylosing spondylitis.  

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Fifty one patients with ankylosing spondylitis (AS) were typed for HLA-A, B, C, DR, and DQ antigens. The antigen frequencies were compared with those of a normal population and with a B27 positive control group. All but one of the patients with AS were HLA-B27 positive. A positive linkage disequilibrium between Cw1, Cw2, DR1, and the B27 antigen was observed. Patients with AS showed a significant increase in DQw2 antigen compared with the B27 positive control group. No differences in antigeni...

Sanmarti?, R.; Ercilla, M. G.; Branco?s, M. A.; Cid, M. C.; Collado, A.; Rote?s-querol, J.

1987-01-01

273

The Relationship Between Bath Indexes and Osteoporosis in Male Patients with Axial Ankylosing Spondylitis  

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Objective: Osteoporosis is a common complication of patients with ankylosing spondylitis (AS). There is no avaible data for the indications of bone mineral density (BMD) measurement related to osteoporosis diagnosis at AS patients. The aim of this study is to investigate the relationship between Bath indexes and BMD in patients with AS.Materials and Methods: 45 male AS patients (mean age: 46.96±13.58 years) and 41 healthy male controls (mean age: 48.93±6.86 years) were enrolled in the study...

Nurullah Akkoc; Servet Akar; Ismail Sari; Yesim Kiraz; Yesim Akkoc; Sibel Eyigor; Hale Karapolat

2008-01-01

274

Bone mineral density and vertebral compression fracture rates in ankylosing spondylitis.  

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OBJECTIVE--To examine the relationship between disease severity and bone density as well as vertebral fracture risk in patients with ankylosing spondylitis (AS). METHODS--Measurements were taken for bone mineral density (BMD) and vertebral fracture rates in 87 patients with AS. BMD was measured at the hip (femoral neck -FN), lumbar spine (L1-L4-LS) and for the whole body using a hologic-QDR-1000/W absorptiometer. An algorithm based on normal female ranges of vertebral heights was used to defi...

Donnelly, S.; Doyle, D. V.; Denton, A.; Rolfe, I.; Mccloskey, E. V.; Spector, T. D.

1994-01-01

275

Polysegmental lumbar posterior wedge osteotomies for correction of kyphosis in ankylosing spondylitis  

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Between 1984 and 1993 we treated 21 consecutive patients who had progressive thoracic kyphosis due to ankylosing spondylitis by polysegmental posterior lumbar wedge osteotomies. In 19 patients we used the Universal Spinal Instrumentation System and in the last 2 patients the H-frame. The average correction in 20 of 21 patients at follow-up was 25.6° (range 0°–52°), with a mean segmental correction of 9.5° and a mean loss of correction after operation of 10.7° (range 0°–36°). There ...

Royen, B. J.; Kleuver, M.; Slot, G. H.

1998-01-01

276

Ankylosing spondylitis-related secondary amyloidosis responded well to etanercept: a report of three patients.  

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Secondary (AA) amyloidosis is one of the most significant complications of ankylosing spondylitis (AS) that frequently leads to proteinuria and renal dysfunction. Anti-tumor necrosis factor alpha (anti-TNF) agents are promising in inducing clinical remission by suppressing systemic inflammation in AA amyloidosis. We report three cases with AS-related AA amyloidosis that responded well to etanercept therapy. Despite treatment with disease modifying anti-rheumatic drugs, all three patients had active AS, marked proteinuria, impaired renal function, and low serum albumin level. During 1-year treatment with etanercept, all patients experienced gradual improvement in all of these parameters. PMID:17611708

Kobak, Senol; Oksel, Fahrettin; Kabasakal, Yasemin; Doganavsargil, Eker

2007-12-01

277

Intestinal Behçet's disease appearing during treatment with adalimumab in a patient with ankylosing spondylitis.  

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Behçet's disease (BD) is a chronic inflammatory disease affecting multiple organ systems, such as the skin, joints, blood vessels, central nervous system, and gastrointestinal tract. Intestinal BD is characterized by intestinal ulcerations and gastrointestinal symptoms. The medical treatment of intestinal BD includes corticosteroids and immunosupressants. There have been several reports of tumor necrosis factor-? (TNF-?) blockers being successful in treatment of refractory intestinal BD. Here, we report on a patient who was diagnosed with intestinal BD despite treatment with the fully humanized TNF-? blocker (adalimumab) for underlying ankylosing spondylitis. This patient achieved clinical remission and complete mucosal healing through the addition of a steroid and azathioprine to the adalimumab regimen. PMID:23983446

Chung, Sook Hee; Park, Soo Jung; Hong, Sung Pil; Cheon, Jae Hee; Kim, Tae Il; Kim, Won Ho

2013-08-28

278

IgA serum levels and disease activity in ankylosing spondylitis: a prospective study.  

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We investigated the possible association between serum IgA, IgM, and IgG and disease activity in a longitudinal study of 48 weeks' duration in 38 male patients with active ankylosing spondylitis receiving regular treatment with either phenylbutazone or diflunisal. Throughout the study serum IgA levels correlated most frequently with chest expansion and lumbar flexion index, and patients with extensive radiological changes also had the highest serum IgA levels. Likewise, changes in IgA, but no...

Franssen, M. J.; Putte, L. B.; Gribnau, F. W.

1985-01-01

279

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

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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...

Na?tterkvist, Ylva

2012-01-01

280

Profiling of HLA-B Alleles for Association Studies with Ankylosing Spondylitis in the Chinese Population  

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Human leucocyte antigen (HLA) B*27 is a susceptibility allele to ankylosing spondylitis (AS). However, major AS-associated subtypes of HLA-B*27 and other HLA-B alleles vary in different ethnic populations. Herein, we examined HLA-B alleles in a total of 360 AS patients and 350 controls of Chinese Han ancestry. The HLA-B genotyping was performed with sequence-based typing (SBT) method. Six HLA-B*27 subtypes B*27:04, B*27:05, B*27:07, B*27:08, B*27:10 and B*27:15 were observed in the cohorts. H...

Yi, Lin; Wang, Jiucun; Guo, Xinjian; Espitia, Maribel G.; Chen, Enuo; Assassi, Shervin; Jin, Li; Zou, Hejian; Reveille, John D.; Zhou, Xiaodong

2013-01-01

 
 
 
 
281

Collagen-specific cytotoxic T lymphocyte responses in patients with ankylosing spondylitis and reactive arthritis.  

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Both ankylosing spondylitis (AS) and reactive arthritis (ReA) are strongly associated with HLA-B27 although the mechanism for this association is still unknown. Here we examine the hypothesis that B27-restricted, joint antigen-specific cytotoxic T lymphocytes (CTL) may be the driving force of AS and ReA. Type II and type XI procollagens (CII and CXI, respectively), expressed almost exclusively in the articular cartilage of the joints, were chosen as the possible targets of autoimmune CTL. Typ...

Gao, Xm; Wordsworth, P.; Mcmichael, A.

1994-01-01

282

Vasculitis and long standing ankylosing spondylitis in a patient with familial Mediterranean fever.  

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Coexistence of familial Mediterranean fever (FMF) and other inflammatory disorders has been frequently reported, but no specific underlying factor has been identified. We report a patient with FMF who is presented with long-standing ankylosing spondylitis (AS) and cutaneous leukocytoklastic vasculitis (LV) of the lower limbs. It is the first report on combination of FMF with AS and LV. The Mediterranean Fever (MEFV) gene mutation of heterozygote (R202Q/R726A) and HLA-B27 are detected in this case, and are believed to form genetic susceptibility to LV. PMID:25538787

Taylan, Ali; Yildiz, Yasar; Sari, Ismail; Ozkok, Guliz

2014-10-01

283

Cytotoxic T lymphocytes against disease-associated determinant(s) in ankylosing spondylitis  

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Cytotoxic T lymphocytes, induced by stimulating the PBMC of an HLA-B27+ normal individual (B27+, AS-) with the PBMC of an HLA-identical sibling suffering from ankylosing spondylitis (AS) (B27+, AS+), specifically lyse B27+, AS+ PBMC but not PBMC from HLA-27+ or B27-, AS- normal controls, or from HLA-B27- AS patients (B27-,AS+). CTL of similar specificity can also be raised by immunizing in vitro B27+,AS- cells with autologous cells modified by cross-reactive bacterial antigens. These results ...

1986-01-01

284

Anterior dural ectasia mimicking a lytic lesion in the posterior vertebral body in ankylosing spondylitis.  

Science.gov (United States)

Anterior dural ectasia is an extremely rare finding in ankylosing spondylitis (AS). The authors describe a unique case of AS in which the patient presented with cauda equina syndrome as well as an unusual imaging finding of erosion of the posterior aspect of the L-1 (predominantly) and L-2 vertebral bodies due to anterior dural ectasia. Symptomatic patients with long-standing AS should be monitored for the presence of dural ectasia, which can be anterior in location, as is demonstrated in the present case. PMID:21923238

Bele, Keerthiraj; Pendharkar, Hima Shriniwas; Venkat, Easwer; Gupta, Arun Kumar

2011-12-01

285

Cauda equina syndrome and dural ectasia: rare manifestations in chronic ankylosing spondylitis  

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Cauda equina syndrome (CES) is a rare manifestation in patients with long-standing ankylosing spondylitis (AS). We report a 57-year-old male patient with a 30-year history of AS who developed CES in the past 4 years. The CT and MRI examinations showed unique appearances of dural ectasia, multiple dorsal dural diverticula, erosion of the vertebral posterior elements, tethering of the conus medullaris to the dorsal aspect of the spinal canal and adhesion of the nerve roots of the cauda equina t...

Liu, C-c; Lin, Y-c; Lo, C-p; Chang, T-p

2011-01-01

286

Relation of microscopic haematuria in ankylosing spondylitis to circulating IgA containing immune complexes.  

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Ankylosing spondylitis (AS) is associated with IgA nephropathy. To study the pathogenetic mechanism of this association the presence of haematuria and circulating IgA containing immune complexes (IgA ICs) in 70 patients with AS was determined. In this retrospective study haematuria was present in 15 patients and 25 patients had IgA ICs. Circulating IgA ICs were shown in 9/15 (60%) of the patients with haematuria and in 16/55 (29%) of those without haematuria. These results suggest that IgA IC...

Peeters, A. J.; Den Wall Bake, A. W.; Dalsen, A. D.; Westedt, M. L.

1988-01-01

287

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

International Nuclear Information System (INIS)

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 ise 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

288

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

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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.

Engin Bozkurt

2012-01-01

289

A New Cardiac Autonomic Function Predictor (Heart Rate Turbulence in Patients with Ankylosing Spondylitis  

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Full Text Available Objective: Ankylosing spondylitis (AS is a chronic systemic disease. The risk of cardiovascular morbidity and mortality is high in patients with AS. Heart rate turbulence (HRT expresses ventriculophasic sinus arrhythmia and has been considered to reflect cardiac autonomic activity. It has been shown that HRT is an independent and powerful predictor of mortality. The aim of this study was to determine HRT changes in patients with AS in comparison with healthy controls. Materials and Methods: Thirty-seven patients with AS (28 men, 9 women; age: 42±2 years, range: 19-69 years according to the modified New York criteria and 37 age-and gender-matched healthy control subjects without obvious cardiovascular disease (mean age: 40±2 years, range: 23-68 years were included in this study. Mean duration of AS was 5±3 years (range: 1-20 years. All participants underwent 24-hour Holter ECG. HRT measurements, turbulence onset (TO and turbulence slope (TS were calculated with HRT View Version 0.60-0.1 software program. HRT was calculated in patients and healthy controls with at least one ventricular premature beat (VPB in their Holter recordings. TO is a measure of the early sinus acceleration and TS is the measure of the rate of sinus deceleration that follows the sinus acceleration after a VPB. Results: There were no significant differences in TO and TS between AS patients and control subjects (TO-AS: -0.0004±0.008, TO-Control: -0.118±0.006; TS-AS: 12.07±1.26, TS-Control: 10.39±1.26, respectively.Conclusion: Although cardiovascular manifestation (including increased morbidity and mortality of AS has been shown in various studies, HRT parameters, which determine the risk of sudden death, do not seem to be altered in this disease.

Ersel Onrat

2010-12-01

290

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

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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.

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

2003-02-01

291

Prevalence and clinical manifestations of ankylosing spondylitis in young Greek males.  

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Increased awareness and sensitivity of general physicians have increased the early diagnoses of seronegative arthritis in young patients, while new agents such as anti-TNF blockers have significantly changed the treatment of the disease. To investigate the prevalence, the clinical manifestations, and the ability for military service of young Greek males (18-30 years old) with ankylosing spondylitis (AS) in the pre-anti-TNF era. We retrospectively studied the AS cases recorded from 1989 to 1995 of the rheumatology department of the largest General Military Hospital in Greece; the diagnosis was based on the modified New York criteria for AS. A total of 285 AS cases were diagnosed among 357,184 young men. The overall prevalence of AS on December 1995 was estimated at 8.2 cases per 10,000 young men (95 % C.I. 7.2-9.2). All the patients had chronic back pain. Two hundred forty (84 %, 95 % C.I. 79-88 %) patients presented sacroiliitis of whom 163 (68 %, 95 % C.I. 62-73 %) were bilateral. Two hundred five patients (72 %, 95 % C.I. 66-77 %) had peripheral joint involvement. Thirty-one patients presented with anterior uveitis (11 %, 95 % C.I. 8-15 %). One patient had IgA nephropathy. None had gut involvement. HLA-B27 antigen was found in 257 patients (90 %, 95 % C.I. 86-93 %). Ninety-one patients (32 %, 95 % C.I. 27-38 %) had permanent discharge from the military service, while 128 (45 %, 95 % C.I. 39-51 %) were able for auxiliaries attendances. The prevalence of AS for the age group 18-30 years old in this young Greek men cohort was significantly lower than in other Caucasian European populations, and the clinical manifestations were considered as mild. PMID:24647983

Kassimos, D G; Vassilakos, J; Magiorkinis, G; Garyfallos, A

2014-09-01

292

Quantitative scintigraphy of the sacroiliac joints and spinal column in patients with probable form of ankylosing spondylitis  

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Quantitative scintigraphy with sup(99m)Tc-pyrophos--phate was performed in 103 patients with probable form of ankylosing spondylitis and in a control group of 104 healthy individuals. Sacroiliac and spino-sacral indexes were determined in the patients by comparing small zones of interest of the spinal column, sacroiliac joints and the sacrum. A total of 634 indexes were determined: 293 in patients with probable form of ankylosing spondylitis and 341 in the control group of normal individuals. Comparison of the sacroiliac and spino-sacral indexes in the two groups showed that these indexes were raised in patients with probable form of ankylosing spondylitis, in contrast to the control group. The difference was statistically significant with a high level of significance (p 10/sacrum and L4/sacrum. The difference between the C7/sacrum indexes in both groups of individuals had low significance level P=0.04. Repeated check up of patients with probable form of ankylosing spondylitis over a period of 2 to 5 years revealed that in the course of time the obligatory criteria for making a reliable diagnosis had been fulfilled in 15 patients. This is a proof of the high diagnostic value of quantitative scintigraphy of the sacroiliac joints and the spinal column. (authors)

293

Use of radium-224 in the treatment of ankylosing spondylitis and rheumatoid synovitis  

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In Nancy, France, repeated injections of 224Ra have been given to adult patients since 1964 for the treatment of ankylosing spondylitis and rheumatoid synovitis of the knee. In the case of ankylosing spondylitis 60 patients have received 224Ra intravenously. The time from first to last injection varied from 2 months to 2 years. The total injected activity varied from 560 to 1680 ?Ci 224Ra. The treatment had a positive result for 65% of the patients. Rheumatoid joints in 80 patients were treated with intra-articularly injected 224Ra. Repeated injections were given during a period of several months. The total activity injected varied from 28 to 616 ?Ci 224Ra. Complete remission of joint symptoms was obtained in 35% of the cases. 224Ra has now been abandoned in favour of yttrium-90 or erbium-169 for the treatment of rheumatoid joints. A subsequent review of 104 of these 140 total patients has shown that no bone sarcomas or soft tissue cancers were observed after a period varying from 1 to 10 years after 224Ra injection. (author)

294

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

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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 patients in daily practice. MATERIAL AND METHODs: The scientific committees from the ten participating countries selected nine clinical questions regarding diagnosis, monitoring and pharmacologic non-biologic treatment, and the Danish group chose 2 additional questions about non-pharmacologic treatment. Systematic literature searches were performed in Medline by 3 international and a Danish bibliographic fellow. Outcome data were extracted and processed by use of routine methods from clinical epidemiology and statistics. The evidence was presented to the Danish rheumatologists. The participants were divided into three groups, which each proposed recommendations. After a final plenary discussion, a voting session took place. Subsequently, agreement was obtained, and the strength of the recommendations was graded. RESULTS: The bibliographic fellows identified 2,709 relevant manuscripts and included 477 of these in the analysis. All 186 Danish rheumatologists were invited, and 26 (14,0%) participated in the meeting held in Copenhagen, December 2006. The individual recommendations were endorsed by 68-100% of the participants. CONCLUSION: Within the framework of the multinational 3e project, it was possible to develop Danish recommendations for AS patients by combining an evidence-based approach and the experience of clinical rheumatologists Udgivelsesdato: 2008/12/1

Pedersen, Susanne Juhl; Madsen, Ole Rintek

2008-01-01

295

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

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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 patients in daily practice. MATERIAL AND METHODs: The scientific committees from the ten participating countries selected nine clinical questions regarding diagnosis, monitoring and pharmacologic non-biologic treatment, and the Danish group chose 2 additional questions about non-pharmacologic treatment. Systematic literature searches were performed in Medline by 3 international and a Danish bibliographic fellow. Outcome data were extracted and processed by use of routine methods from clinical epidemiology and statistics. The evidence was presented to the Danish rheumatologists. The participants were divided into three groups, which each proposed recommendations. After a final plenary discussion, a voting session took place. Subsequently, agreement was obtained, and the strength of the recommendations was graded. RESULTS: The bibliographic fellows identified 2,709 relevant manuscripts and included 477 of these in the analysis. All 186 Danish rheumatologists were invited, and 26 (14,0%) participated in the meeting held in Copenhagen, December 2006. The individual recommendations were endorsed by 68-100% of the participants. CONCLUSION: Within the framework of the multinational 3e project, it was possible to develop Danish recommendations for AS patients by combining an evidence-based approach and the experience of clinical rheumatologists.

Pedersen, Susanne; Madsen, Ole

2008-01-01

296

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

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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

Refik Oltulu

2013-09-01

297

Exacerbation of Verruca Vulgaris Associated with Etanercept in A Case of Ankylosing Spondylitis  

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Full Text Available I have read with great interest the manuscript titled “Cervix Cancer in a Patient with Ankylosing Spondylitis Using Etanercept: A Case Report” authored by Doruk et al. (1 and would like to share my experience with regard to a patient develops severe exacerbation of verruca vulgaris under treatment with etanercept. Verruca vulgaris (common wart is an infectious disease caused by human papilloma virus (HPV that is an important risk factor for cervix cancer (2.A 20yearold male patient was diagnosed with ankylosing spondylitis (AS resistant to conventional therapy, three years ago. Treatment with subcutaneous etanercept (50 mg/week was initiated. The patient responded well to etanercept and this treatment was continued. When the patient last came to the outpatient clinic, he complained that he had numerous warts on his hands. The patient reported that, there was only one and small wart on his right hand before etanercept treatment. He had taken etanercept treatment for three years. During this period, the size and number of warts had increased. In the laboratory analyzes, routine biochemical, hematological, and urine tests were found to be within normal limits. Serology for HIV, hepatitis B and C viruses were negative. The chest Xray was evaluated as normal. The patient referred to a dermatologist for the evaluation of these skin lesions. He was diagnosed with verruca vulgaris, and etanercept treatment was discontinued.

MahmutAlpayc?

2013-05-01

298

A new look at the epidemiology of ankylosing spondylitis and related syndromes.  

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Among the rheumatic diseases, non so clearly illustrates the relations between host and environmental factors as the seronegative spondyloarthropathy group of disorders. The strongest association is with the histocompatibility antigen HLA-B27, which accounts for a striking susceptibility to these diseases and is present in over 90% of individuals with idiopathic ankylosing spondylitis. Next in importance appears to be a difference in sex penetrance with males predominating in all categories. The most dramatic sex relationship is with postvenereal Reiter's syndrome which has a male-to-female ratio of nearly 50:1. Another potent host factor is age, with increased predisposition to onset at puberty and young adulthood in HLA-B27-positive patients. Environmental or possibly infectious agent influence are most apparent in Reiter's syndrome, where the antecedent circumstances of venereal contact and bacillary dysentery are frequent precipitating events. Secondary forms of peripheral arthritis, radiographic sacroiliitis, and ankylosing spondylitis frequently occur in psoriasis and inflammatory bowel disease; in the case of peripheral arthritis, there is no or a significantly reduced association with HLA-B27 compared to AS or RS. Secondary factor seem to be contributing to spondyloarthropathy in these disorders. These iterrelations emphasize the powerful effects of host characteristics on the type of rheumatic disease syndrome acquired and provide superb opportunities for more precise understanding of disease pathogenesis and ultimate control through the integration of epidemiologic, clinical, and laboratory research. PMID:389516

Masi, A T; Medsger, T A

1979-09-01

299

Is magnetotherapy applied to bilateral hips effective in ankylosing spondylitis patients? A randomized, double-blind, controlled study.  

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This double-blind, randomized controlled study was conducted with the aim to investigate the effect of magnetic field therapy applied to the hip region on clinical and functional status in ankylosing spondylitis (AS) patients. Patients with AS (n = 66) who were diagnosed according to modified New York criteria were enrolled in this study. Patients were randomly divided in two groups. Participants were randomly assigned to receive magnetic field therapy (2 Hz) (n = 35), or placebo magnetic field therapy (n = 31) each hip region for 20 min. Patients in each group were given heat pack and short-wave treatments applied to bilateral hip regions. Both groups had articular range of motion and stretching exercises and strengthening exercises for surrounding muscles for the hip region as well as breathing and postural exercises by the same physical therapist. These treatment protocols were continued for a total of 15 sessions (1 session per day), and patients were examined by the same physician at months 1, 3 and 6. Visual analogue scale (VAS) pain, VAS fatigue, Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), Bath Ankylosing Spondylitis Functional Index (BASFI), Bath Ankylosing Spondylitis Metrologic Index (BASMI), DFI, Harris hip assessment index and Ankylosing Spondylitis Quality of Life scale (ASQOL) were obtained at the beginning of therapy and at month 1, month 3 and month 6 for each patient. There were no significant differences between groups in the VAS pain, VAS fatigue, morning stiffness, BASDAI, BASFI, BASMI, DFI, Harris hip assessment index and ASQoL at baseline, month 1, month 3 or month 6 (p > 0.05). Further randomized, double-blind controlled studies are needed in order to establish the evidence level for the efficacy of modalities with known analgesic and anti-inflammatory action such as magnetotherapy, particularly in rheumatic disorders associated with chronic pain. PMID:24399455

Turan, Yasemin; Bayraktar, Kevser; Kahvecioglu, Fatih; Tastaban, Engin; Aydin, Elif; Kurt Omurlu, Imran; Berkit, Isil Karatas

2014-03-01

300

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

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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

Tsui FW

2014-05-01

 
 
 
 
301

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

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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 detected also on magnetic resonance imaging (MRI) of the SIJ early in the disease course before they can be seen on radiography. The goals of this study were to assess the reproducibility of erosion and related features, namely, extended erosion (EE) and backfill (BF) of excavated erosion, in the SIJ using a standardized MRI methodology.

Weber, Ulrich; Pedersen, Susanne J

2012-01-01

302

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

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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...

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

1984-01-01

303

The natural history of ankylosing spondylitis in the 21st century  

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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.

C. Campana

2011-06-01

304

Health-related quality of life in patients with ankylosing spondylitis: a comprehensive review.  

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Ankylosing spondylitis (AS) is a complex systemic rheumatological disease which often causes severe disability and impaired quality of life (QoL). We searched the PubMed/MEDLINE electronic database for available literature on QoL and its predictors in patients with AS. Recent evidence indicates that AS patients have poorer QoL compared to the general population, but similar to that of patients with other rheumatological disorders. Disease activity is one of the most powerful predictors of QoL, however latest advances in pharmacological treatment (namely, anti-TNF-?) along with physical exercise can minimize the effects of AS on QoL. Psychological distress symptoms contribute to impaired QoL both directly and indirectly by influencing disease activity. The impact of other psychosocial variables, however, is less studied and more prospective investigations are necessary, which could eventually lead to the development of psychosocial interventions that are personalized to this patient population. PMID:25193010

Kotsis, Konstantinos; Voulgari, Paraskevi V; Drosos, Alexandros A; Carvalho, André F; Hyphantis, Thomas

2014-12-01

305

Blind confirmation in Leiden of Geczy factor on the cells of Dutch patients with ankylosing spondylitis  

International Nuclear Information System (INIS)

A follow-up blind study, of the ability of cross-reactive antisera to distinguish between the cells of Dutch patients with ankylosing spondylitis (AS) and normal controls, was performed in Leiden. Of the 45 cell samples tested, 29 were fresh peripheral blood mononuclear (PBM) cells while 15 were cryopreserved PBM. No false positives but one false negative was identified among the 45 samples, and the negative was confirmed after the recoded cryopreserved cells from this patient were retested. It is concluded that the cross-reactive antisera raised in Sydney give good discrimination between patients and normals. Factors affecting the success of the 51Cr-release cytotoxicity assay, and possible reasons for the failure of others to confirm these observations, are briefly discussed

306

Recent results of the follow-up of radium-224-treated ankylosing spondylitis patients  

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In this study 1473 ankylosing spondylitis patients were followed after treatment with 10-12 weekly injections of radium 224 of about 1MBq each injections( skeletal dose 0.56-0.67 Gy for a 70 kg man). 495 in the exposure group and 602 in the controls have died. By June 1988 (mean follow-up time 17 years), 3 cases of skeletal malignancies were observed in the exposure group versus one in the controls. Haematopoietic tissue disease among living and dead included bone marrow failure (10 in the exposed, seven in controls), and leukemias (7 versus 4). In the exposure group 3 of the leukemias were chronic myeloid and one acute lymphoblastic, and in the controls no chronic myeloid cases were found but 3 cases of lymphoblastic leukemia. Incidence of myeloproliferative disease is discussed compared with patients treated with other doses and dose rates. (author)

307

Iatrogenic Cervical Fracture in a Case with Ankylosing Spondylitis and Rehabilitation Practices  

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Full Text Available Ankylosing spondylitis (AS is a chronic inflammatory rheumatic disease that primarily affects the vertebral column and sacroiliac joints. The development of syndesmophytosis in AS leads up to a rigid and bamboo shape spine. Osteoporosis and a rigid spine may be potential risk factors for fractures due to minor traumas in this patient group. In this article, we present a case of iatrogenic C6-7 fracture and dislocation occurred while the patient was being positioned for magnetic resonance imaging study. Health care professionals should be aware of the increased risk of spine injury due to minor traumas in patients with AS. Turk J Phys Med Rehab 2010;56:88-90.

?lknur Tu?cu

2010-06-01

308

TNF-alpha blockade may improve autonomic dysfunction in ankylosing spondylitis  

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Full Text Available The incidence of autonomic neuropathy in ankylosing spondylitis (AS is well recognized. However, there are no studies demonstrating the therapeutic efficacy of TNF-alpha blockade in autonomic dysfunction of AS. We report here a case of a 36-year-old male of AS with high disease activity and autonomic symptoms, investigated for autonomic neuropathy. Non-invasive tests based on peripheral and cardiovascular autonomic neuropathy function were used for accurate assessment of autonomic neuropathy. The patient was treated with intravenous infusion of infliximab 5 mg/kg at weeks 0, 2, and 6.The 6 weeks therapy improved the disease activity, biomarkers of inflammation, and autonomic function. To the best of our knowledge, this is the first reported case of improvement in autonomic function associated with AS.

Inderjeet Verma

2014-09-01

309

Gastric outlet obstruction due to gastric amyloidosis mimicking malignancy in a patient with ankylosing spondylitis.  

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Amyloidosis is a group of disorders characterized by the extracellular accumulation of insoluble, fibrillar proteins in various organs and tissues. It is classified, on the basis of the identity of the precursor protein, as primary, secondary, or familial amyloidosis. Gastrointestinal amyloidosis usually presents as bleeding, ulceration, malabsorption, protein loss, and diarrhea. However, gastric amyloidosis with gastric outlet obstruction mimicking linitis plastica is rare. We report a case of gastrointestinal amyloidosis with gastric outlet obstruction in a patient with ankylosing spondylitis. The patient was indicated for subtotal gastrectomy because of the aggravation of obstructive symptoms, but refused the operation and was transferred to another hospital. Three months later, the patient died of aspiration pneumonia during medical treatment. PMID:24340260

Seon, Choon Sik; Park, Young Sook; Jung, Yu Min; Choi, Jeong Ho; Son, Byoung Kwan; Ahn, Sang Bong; Kim, Seong Hwan; Jo, Yun Ju

2013-11-01

310

Effects of icariin on cytokine-induced ankylosing spondylitis with fibroblastic osteogenesis and its molecular mechanism.  

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The aim of this study is to explore the effects of icariin on cytokine induced ankylosing spondylitis fibroblast osteogenesis type expression and its molecular mechanism. The normal fibroblasts were collected as normal control group, and the fibroblasts of hip joint capsule of AS patients were collected, which were respectively added in fetal bovine serum (group AS), fetal bovine serum and cytokines (BMP-2+TGF-beta 1) (group AS), and cell factor solution (icariin group), and observed of the osteogenic expression of fibroblast, to evaluate the impact of Icariin on it. The ALP activity, the content of collagen, osteocalcin content and cbfa1mRNA and OCmRNA of fibroblast of AS group increased compared to the normal control group and AS control group (P icariin can significantly inhibit the above changes (P Icariin can inhibit fibroblast further osteogenic differentiation through inhibiting the effect of cytokines on the fibroblast osteogenesis type markers and osteogenic gene expression and osteogenic differentiation. PMID:25674296

Jia, Chunrong; Liu, Hongxiao; Li, Min; Wu, Zhikui; Feng, Xinghua

2014-01-01

311

Intestinal Behçet’s disease appearing during treatment with adalimumab in a patient with ankylosing spondylitis  

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Full Text Available Behçet’s disease (BD is a chronic inflammatory disease affecting multiple organ systems, such as the skin, joints, blood vessels, central nervous system, and gastrointestinal tract. Intestinal BD is characterized by intestinal ulcerations and gastrointestinal symptoms. The medical treatment of intestinal BD includes corticosteroids and immunosupressants. There have been several reports of tumor necrosis factor-? (TNF-? blockers being successful in treatment of refractory intestinal BD. Here, we report on a patient who was diagnosed with intestinal BD despite treatment with the fully humanized TNF-? blocker (adalimumab for underlying ankylosing spondylitis. This patient achieved clinical remission and complete mucosal healing through the addition of a steroid and azathioprine to the adalimumab regimen.

Sook Hee Chung

2013-01-01

312

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

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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...

M. de Almeida Santos Jr

2011-06-01

313

Genética, HLA-B27 y espondilitis anquilosante: 40 años / Genetics of ankylosing spondylitis  

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Full Text Available SciELO Chile | Language: Spanish Abstract in spanish [...] Abstract in english Ankylosing spondylitis (AS) is a prototypical inflammatory disease of the locomotor system affecting axial skeleton. It is part of the general group of spondyloarthopathies (SpA). Its strong association with histocompatibility antigen HLA-B27 is known since 1973. However, HLA-B27 contribution to AS [...] genetic risk is approximately 16%. Therefore, other genes are necessarily involved in the pathogenesis of the disease. Genomic development and the possibility of making genome wide screening have contributed enormously to the study of the disease. In this paper, we describe the actual knowledge about AS genetic risk, which has contributed to understand the influence of HLA-B27 on the etiology and pathogenesis of the disease. We also intend to foresee how these findings will result in an improvement of patients’ quality of life.

Patricia, Castro-Santos; Miguel A, Gutiérrez; Roberto, Díaz-Peña.

1165-11-01

314

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

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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 differences were found between the matched pairs in response to heterogeneous klebsiella isolates, including K21. Our studies did not show impaired PBL transformation with klebsiella in AS and therefore do not support claims of antigenic cross-reactivity between klebsiella and HLA-B27. PMID:6332581

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

1984-08-01

315

Non-HLA genes in ankylosing spondylitis: what meta-analyses have shown?  

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HLA-B27 association with ankylosing spondylitis (AS) is one of the strongest ever reported in the literature. However, only a small proportion of 5-8% of HLA-B27 positive individuals of the general population develops the disease. In recent years, polymorphisms of many non-HLA genes were reported to be associated with AS. In this review, we summarise the current knowledge of non-HLA genetic factors contributing to AS susceptibility based on meta-analyses in order to overcome the limitations of individual genetic studies e.g. the small samples' sizes, the small samples' origin diversities, and the low statistical power of statistical analyses. PMID:25068597

Chatzikyriakidou, Anthoula; Voulgari, Paraskevi V; Drosos, Alexandros A

2014-01-01

316

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

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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.

Habiba Bouhamed Chaabouni

2011-05-01

317

Cauda equina syndrome and dural ectasia: rare manifestations in chronic ankylosing spondylitis.  

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Cauda equina syndrome (CES) is a rare manifestation in patients with long-standing ankylosing spondylitis (AS). We report a 57-year-old male patient with a 30-year history of AS who developed CES in the past 4 years. The CT and MRI examinations showed unique appearances of dural ectasia, multiple dorsal dural diverticula, erosion of the vertebral posterior elements, tethering of the conus medullaris to the dorsal aspect of the spinal canal and adhesion of the nerve roots of the cauda equina to the wall of the dural sac. A large dural defect was found at surgery. De-adhesion of the tethered conus medullaris was performed but without significant clinical improvement. The possible aetiologies of CES and dural ectasia in patients with chronic AS are discussed and the literature is reviewed. PMID:21606066

Liu, C-C; Lin, Y-C; Lo, C-P; Chang, T-P

2011-06-01

318

Dramatic efficacy of infliximab in cauda equina syndrome complicating ankylosing spondylitis.  

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Cauda equina syndrome is an uncommon complication of ankylosing spondylitis (AS) characterized by the slow and insidious development of severe neurologic impairment. Imaging studies usually show a wide lumbar canal with dural ectasia. No medical or surgical treatment has been proven effective. We managed the care of a 66-year-old man who had longstanding AS and clinical features of cauda equina syndrome, including anal incontinence and buttock hypoesthesia. Magnetic resonance imaging demonstrated no cause for these symptoms other than AS. The patient was treated with infliximab, a monoclonal antibody to tumor necrosis factor alpha that is used for the treatment of active AS. After 3 infliximab infusions, sphincter control and sensation were normal. The treatment was continued, and he was still doing well 1 year later. This is the first report of an effective treatment for cauda equina syndrome complicating AS. Our case report strongly supports an inflammatory mechanism to this condition. PMID:19479855

Cornec, Divi; Devauchelle Pensec, Valérie; Joulin, Sandrine Jousse; Saraux, Alain

2009-06-01

319

Increased frequency of circulating follicular helper T cells in patients with ankylosing spondylitis.  

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Abstract Objective. The relationship between circulating follicular helper T (Tfh) cells and ankylosing spondylitis (AS) remains unclear. The aims of our study were to measure the levels of circulating Tfh cells and several related parameters in patients with AS, and examine the correlation of these factors with disease activity. Methods. We designated CD4 + CXCR5 + ICOS+ T cells as circulating Tfh cells. The percentage of circulating Tfh cells was detected using flow cytometry. Plasma IL-21 and immunoglobulin (IgA, IgM, and IgG) levels were quantified using enzyme-linked immunosorbent assay in 60 AS patients and 60 healthy controls (HC). Results. The percentage of circulating Tfh cells was increased in AS patients compared with that in HC. As AS patients were divided into active and inactive groups, the percentage of circulating Tfh cells was significantly increased in active group compared with both inactive group and HC. Plasma IL-21 and immunoglobulin levels were elevated in AS patients, and the differences were significant except IgG. In addition, the percentage of circulating Tfh cells was positively correlated with Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), and plasma IL-21 levels were positively correlated with plasma immunoglobulin levels. But neither circulating Tfh cells nor BASDAI was significantly correlated with plasma IL-21 and immunoglobulin levels in AS patients, with the exception of significant correlation between BASDAI and plasma IgM levels in active AS patients. Conclusion. Our study has shown the increased percentage of circulating Tfh cells correlated with disease activity, and the high plasma IL-21 levels were associated with high plasma immunoglobulin levels in patients with AS, indicating that the circulating Tfh cells may be associated with the development of AS. PMID:24716597

Wu, Shanshan; Yang, Ting; Pan, Faming; Xia, Guo; Hu, Yanting; Liu, Li; Fan, Dazhi; Duan, Zhenhua; Ding, Ning; Xu, Shengqian; Cai, Guoqi; Wang, Li

2015-01-01

320

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

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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.

Han-qing HUANG

2013-07-01

 
 
 
 
321

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

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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.

Behrooz Nikbin

2008-05-01

322

Relationship Between Bone Mineral Density and Disease Activity in Patients with Ankylosing Spondylitis  

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Full Text Available Objective: This retrospective study was planned to determine the relationship between bone mineral density (BMD and clinical, radiological and laboratory parameters in patients with ankylosing spondylitis (AS. Materials and Methods: The study group consisted of 28 patients with a mean disease duration of 11.9±6.1 years. In addition to clinical and demographic variables, lumbar and femoral BMD were evaluated with dual energy X-ray absorbtiometry. Lumbar spine score (LSS and sacroiliac score (SIS were calculated by grading of standard radiographs. Erythrocyte sedimentation rate (ESR and C-reactive protein (CRP level were determined as laboratory parameters.Results: The rate of osteoporosis and osteopenia were 7.1% and 25% at the lumbar spine, and 14.2% and 17.8% at the femoral neck, respectively. LSS was significantly correlated with lumbar BMD (r=0.70, p<0.001, but not with femoral neck BMD (r=-0.11, p=0.55. SIS was negatively correlated with femoral neck BMD (r=-0.79, p<0.001, but not correlated with lumbar BMD (r=0.19, p=0.32. While lumbar BMD was positively correlated with disease duration (r=0.37, p=0.05, femoral neck BMD showed negative correlation with disease duration (r=-0.46, p=0.01. The evaluation of clinical paramaters and BMD showed that morning stiffness, spinal pain, ESR and CRP were not correlated with BMD. Only modified Schober’s test was related to BMD on both lumbar spine and femoral neck.Conclusion: Ankylosing spondylitis patients are at risk for developing osteoporosis. In advanced disease, the lumbar BMD is misleadingly high because of paravertebral calcification and ossification. Therefore, it is more rational to evaluate the BMD at the femoral neck.

Hasan Ulusoy

2010-03-01

323

Destructive dural ectasia of dorsal and lumbar spine with cauda equina syndrome in a patient with ankylosing spondylitis.  

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We present a patient with longstanding ankylosing spondylitis complicated with cauda equina syndrome. The patient suffered from increasing pain in the leg with reduced sensitivity and extremely cold feet associated with incontinence. Diagnostic workup revealed dural ectasia, arachnoiditis and a spinal inflammatory mass leading to extensive vertebral bone destruction. Of interest, this was not only found in the lumbar spine region (which is typical in cases of cauda equina syndrome associated with ankylosing spondylitis) but also in the lower cervical spine (C7) and upper dorsal spine. Moreover, the bone destructive phenotype of this complication of long-standing AS contrasts with the usual characteristics of new bone formation and ankylosis. As initial treatment with anti-inflammatory drugs was not sufficiently successful, infliximab therapy was started which resulted in manifest clinical improvement as chronic pain, incontinence and laboratory signs of inflammation progressively disappeared. PMID:21331306

Van Hoydonck, Marijke; de Vlam, Kurt; Westhovens, Rene; Luyten, Frank P; Lories, Rik J

2010-01-01

324

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

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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)

325

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

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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)

Smith, Peter G [London School of Hygiene and Tropical Medicine, Keppel Street, London WC1E 7HT (United Kingdom)

2007-12-15

326

Effect of Pulmonary Involvement on Bath Indexes, Quality of Life and Psychological Symptoms in Patients with Ankylosing Spondylitis  

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Objective: Pain and stiffness disturb the psychological status and quality of life in ankylosing spondylitis (AS) patients, which may be further deteriorated by pulmonary involvement. Therefore, detection of pulmonary involvement in AS patients is important. In this study, we aimed to detect pulmonary involvement in AS patients and to assess the effects of pulmonary involvement on Bath indexes, quality of life and psychological symptoms.Material and Methods: The study included 26 AS patients ...

Hale Karapolat; Funda Atamaz; Ye?im Akkoç; Alev Gürgün; Recep Sava?; Ye?im Kirazl?; Nurullah Akkoç

2009-01-01

327

The relation between disease activity, vitamin D levels and bone mineral density in men patients with ankylosing spondylitis  

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Full Text Available The aim of this study was to assess the vitamin D status in patients with ankylosing spondylitis (AS, and to investigate the relation between vitamin D levels, bone mineral density (BMD and disease activity in men with ankylosing spondylitis. Seventy patients with AS and 140 healthy individuals were included in the study. BMD of femur and lumbar spine was measured by DXA. Serum 25OH vitamin D, parathormone, serum calcium, C-reactive protein levels of all participants were also measured. The disease activity was evalu ated by Bath Ankylosing Spondylitis Disease Activity Index (BASDAI, and functional status by Bath Ankylosing Spondylitis Functional Index (BASFI. The mean 25(OHD level was 17.5+9.7 ng/mL in AS patients and 21.9+7.7 ng/mL in controls (P<0.001. In comparison with the control group, AS patients showed significantly higher CRP, and a significant reduction of vitamin D. In AS group, 62 patients (88.6% had Vitamin D deficiency, and 35 patients (50% were osteoporotic. Vitamin D was negatively correlated to BASDAI without any changes after adjustment for age, duration of disease, sunlight exposure, and total taking steroids (r=-0.32, P<0.001.We found a high incidence of vitamin D deficiency in our patients. Our study suggests that vitamin D deficiency in male AS may indirectly lead to osteoporosis by causing an increase in the inflammatory activity. Monitoring vitamin D levels would be useful in order to determine the patients under osteoporosis risk.

Ihsane Hmamouchi

2013-01-01

328

Ankylosing spondylitis is associated with an increased risk of vertebral and nonvertebral clinical fractures: a population-based cohort study.  

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The objective of this work was to study the associations between ankylosing spondylitis (AS) and clinical vertebral and nonvertebral fractures. Data from a large population-based public health database in Spain, Sistema d'Informació per al Desenvolupament de l'Investigació en Atenció Primària (SIDIAP), were used in this parallel cohort study. All participants registered in SIDIAP on January 1, 2006, were screened to identify those with a diagnosis of AS. Five age-matched, gender-matched, ...

Mun?oz-ortego, J.; Vestergaard, P.; Rubio, Jb; Wordsworth, P.; Judge, A.; Javaid, Mk; Arden, Nk; Cooper, C.; Di?ez-pe?rez, A.; Prieto-alhambra, D.

2014-01-01

329

Destructive Dural Ectasia of Dorsal and Lumbar Spine with Cauda Equina Syndrome in a Patient with Ankylosing Spondylitis  

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We present a patient with longstanding ankylosing spondylitis complicated with cauda equina syndrome. The patient suffered from increasing pain in the leg with reduced sensitivity and extremely cold feet associated with incontinence. Diagnostic workup revealed dural ectasia, arachnoiditis and a spinal inflammatory mass leading to extensive vertebral bone destruction. Of interest, this was not only found in the lumbar spine region (which is typical in cases of cauda equina syndrome associated ...

Hoydonck, Marijke; Vlam, Kurt; Westhovens, Rene; Luyten, Frank P.; Lories, Rik J.

2010-01-01

330

[Injuries of the cervical spine in patients with ankylosing spondylitis].  

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A brittle and rigid, osteoporotic and injury prone "bamboo" spine which develops as a result of transformation of the normal spine in the final stage of Bekhterev's disease contains normal neural elements. Unstable fractures occur frequently even after a minimal injury and the morbidity and mortality is significantly higher than in the group of routine injuries of the cervical, spine, in particular as a result of pulmonary complications. Diagnosis of the fracture based on simple X-ray pictures is difficult, CT examination is essential. The authors present an account on their experience with three patients. They draw attention to problems of skeletal traction when the spinal axis is altered by disease and to risks associated with semiconservative treatment. The authors therefore recommend traction with a minimal load and with subsequent early decompression and stabilization by a combined anterior and posterior approach in a single session. By this approach secondary affection of neural structures in unstable fractures can be prevented, and early rehabilitation with verticalization without restriction of respiratory excursions by an orthesis then significantly reduces the risk of pulmonary complications. PMID:11265347

Vaverka, M; Hrabálek, L

2001-01-01

331

Cancer mortality among patients with ankylosing spondylitis not given X-ray therapy  

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The causes of death among 1021 patients with ankylosing spondylitis not treated with X-rays (the 'untreated' group) have been compared with (i) those expected in a population of similar age and sex subject to the national mortality rates for England and Wales over the same period and (ii) those observed in 14000 similar patients given deep X-ray therapy (the 'treated' group). The untreated patients with spondylitis were enrolled in Great Britain and Northern Ireland during the period 1935 to 57 and have been followed up to 1965. The men in both treatment groups appear to have had spondylitis of similar severity, as judged from their death rates from various causes, but the 'untreated' women appear to have had a milder form of the disease. The number of deaths from cancer in the untreated group was not greater than that expected from national death rates, and there was no death from leukaemia. In the treated series the number of deaths from leukaemia was significantly raised (P = 0.03) when compared with that among patients not treated with X-rays. Deaths from cancers of sites classified as 'heavily irradiated' were also higher in the treated group though this difference was not statistically significant. Thus the excess leukaemia mortality in the treated patients, and possibly also the excess from other cancers, is likely to be associated with the X-ray treatment rather than with the disease process itself. Death rates from causes other than cancer were similar among uses other than cancer were similar among treated and untreated patients. It is likely that modern X-ray treatment with smaller fields and lower dosage will carry a smaller risk of induced malignancy. This risk must be balanced against the possible therapeutic advantages of radiation treatment, the extent of which can be determined only by controlled trials. (author)

332

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

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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 (?2=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 (?2=5.516, P0.05 ). When followed up for 6 months,the differences in the visual analogue scale(VAS) for hip of tvisual 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)

333

Comparison of radiography, computed tomography and magnetic resonance imaging in the detection of sacroiliitis accompanying ankylosing spondylitis  

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Objective. To compare magnetic resonance (MR) imaging, computed tomography (CT), and radiography in the detection of sacroiliitis accompanying ankylosing spondylitis (AS). Design and subjects. Nine volunteers and 24 patients were recruited. Radiography, CT, and MR imaging were completed within a 1-week period in 24 patients with AS. In precontrast MR examination, spin-echo T1, fast spin-echo T2, and gradient echo with rephasing T2* images were obtained without fat saturation using a 0.3-T imager for all volunteers and patients. Postcontrast MR examination was performed using the same precontrast SE T1 sequence for patients with AS. Results and conclusions. MR imaging directly showed the normal cartilage in all 16 sacroiliac joints of the 8 volunteers. In the 24 patients with AS, cartilage abnormalities were observed in 42 sacroiliac joints. More diagnoses of sacroiliitis were made using MR and CT imaging than using radiography (P<0.001). Therefore, low-field-strength MR can be useful in detecting early sacroiliitis in patients with AS. MR imaging was able to reveal early cartilage changes and bone marrow edema, which could not be found by either CT or radiography. (orig.) With 5 figs., 4 tabs., 36 refs.

Yu, Wei; Feng Feng; Yang Hongzen; Jiang Ming [Department of Radiology, Peking Union Medical College Hospital, Beijing (China); Dion, E.; Genant, H.K. [Department of Radiology, Musculoskeletal Section and Osteoporosis and Arthritis Research Group, University of California San Francisco, CA 94143-0628 (United States)

1998-06-01

334

Comparison of radiography, computed tomography and magnetic resonance imaging in the detection of sacroiliitis accompanying ankylosing spondylitis  

International Nuclear Information System (INIS)

Objective. To compare magnetic resonance (MR) imaging, computed tomography (CT), and radiography in the detection of sacroiliitis accompanying ankylosing spondylitis (AS). Design and subjects. Nine volunteers and 24 patients were recruited. Radiography, CT, and MR imaging were completed within a 1-week period in 24 patients with AS. In precontrast MR examination, spin-echo T1, fast spin-echo T2, and gradient echo with rephasing T2* images were obtained without fat saturation using a 0.3-T imager for all volunteers and patients. Postcontrast MR examination was performed using the same precontrast SE T1 sequence for patients with AS. Results and conclusions. MR imaging directly showed the normal cartilage in all 16 sacroiliac joints of the 8 volunteers. In the 24 patients with AS, cartilage abnormalities were observed in 42 sacroiliac joints. More diagnoses of sacroiliitis were made using MR and CT imaging than using radiography (P<0.001). Therefore, low-field-strength MR can be useful in detecting early sacroiliitis in patients with AS. MR imaging was able to reveal early cartilage changes and bone marrow edema, which could not be found by either CT or radiography. (orig.)

335

Treatment of ankylosing spondylitis with [{sup 224}Ra]-Radiumchloride; Therapie der Spondylitis ankylosans mit [{sup 224}Ra]-Radiumchlorid  

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Ankylosing spondylitis (AS) is a chronic disease which in 30-50% of the patients leads to considerable episodes of pain, a remarkable reduction of quality of life and disablement. For treatment mostly nonsteroidal antiphlogistic drugs are used which are able to reduce pain in approximately 80% of the patients only. Those drugs however, have to be withdrawn in approximately 30% of the patients due to its known toxicity (mainly in the gastrointestinal tract). Basis medication (DMARDs) is helpful in a minority of AS patients only. Recently [{sup 224}Ra]-Radiumchloride, which has been used previously between 1955 and 1990, has been made available again for treatment of AS. Whereas biokinetics, radiation exposure and the risk-profile of [{sup 224}Ra]-Radiumchloride are documented well by experimental and clinical data, most of the historical studies about the efficacy of this radiopharmaceutical do not fulfill the requirements of modern therapy studies. Therefore as many patients as possible should be recruited for a prospective long-time Phase IV study. A close and well-coordinated cooperation between rheumatologists and nuclear medicine physicians is needed, when [{sup 224}Ra]-Radiumchloride is used for treatment of AS. (orig.) [German] Die meist chronisch, oft auch in Schueben verlaufende Spondylitis ankylosans (AS) fuehrt bei 30-50% der Patienten zu betraechtlichen Schmerzen und einer nicht selten erheblichen Einschraenkung der Lebensqualitaet und Behinderung. Die am haeufigsten zur Therapie verwendeten nichtsteroidalen Antiphlogistika koennen nur bei etwa 80% der Patienten die Schmerzen lindern. Allerdings muessen diese Medikamente bei 20-30% der AS-Patienten wegen ihrer bekannten Toxizitaet - vor allem im Gastrointestinaltrakt - abgesetzt werden. Basistherapeutika (DMARDs) helfen bei der AS nur sehr begrenzt. Mit [{sup 224}Ra]-Radiumchlorid steht seit kurzem ein bereits in den Jahren 1945-1990 fuer die Behandlung der AS verwendetes Radiopharmakon wieder zur Verfuegung. Waehrend die Biokinetik, Strahlenexposition und das Risikoprofil von [{sup 224}Ra]-Radiumchlorid durch experimentelle und klinische Daten gut belegt sind, genuegen viele der aelteren Untersuchungen zur Wirksamkeit des Radiotherapeutikums nicht den Massstaeben, die heute an Therapiestudien zu legen sind. Aus diesem Grunde ist es wichtig, dass moeglichst viele Patienten in eine prospektive Langzeit-Anwendungsbeobachtungsstudie eingebracht werden. Bei der Anwendung von [{sup 224}Ra]-Radiumchlorid ist eine enge und gut aufeinander abgestimmete Kooperation zwischen Rheumatologen und Nuklearmedizinern erforderlich. (orig.)

Reiners, C. [Klinik und Poliklinik fuer Nuklearmedizin der Univ. Wuerzburg (Germany); Braun, J. [Rheumazentrum Ruhrgebiet Herne (Germany)

2001-07-01

336

MRI findings of sacroiliitis in ankylosing spondylitis: roles of MPGR and delayed post-contrast T1-weighted images  

International Nuclear Information System (INIS)

For early diagnosis of sacroiliitis in spondyloarthropathy, the MRI findings of sacroiliitis, roles of MPGR(multiplanar Gradient Recalled Acquisition in Steady State), and delayed post-contrast T1-weighted images were evaluated. Twenty six patients with seronegative spondyloarthropathy(Probable clinical diagnosis of ankylosing spondylitis) were grouped as either less than radiographic grade 1(group A) or more than grade 2(group B). The MRI findings of both sacroiliac joints were evaluated in every patient, and predominant sites were determined. The two groups were then compared. In 17 patients, the number of enhancing panni seen on early and delayed post-contrast T1-weighted images was counted and compared between the two groups. Panni were found in all cases, and in both groups, predominant patterns of involvement were the lower and iliac aspects of the sacroiliac joints in both groups; in group A, the synovial joints and punctate pannus were predominantly involved, and in group B, the ligamentous joints as well as the synovial joints and linear pannus. In group B, More periarticular fat accumulation than periarticular osteitis was found. For the evaluation of changes in joint space, MPGR images were superior to spin echo images. For the delineation of enhancing pannus less than radiographic grade I, delayed post-contrast images were statistically superior to those which were early post-contrast. MRI can detect early sacroiliitic change according to the predominant sitic change according to the predominant sites of involvement, and deslyed post-contrast images play a role in the diagnosis of early sacroiliitis. MPGR imaging is good for the evaluation of joint space change

337

MRI findings of sacroiliitis in ankylosing spondylitis: roles of MPGR and delayed post-contrast T1-weighted images  

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For early diagnosis of sacroiliitis in spondyloarthropathy, the MRI findings of sacroiliitis, roles of MPGR(multiplanar Gradient Recalled Acquisition in Steady State), and delayed post-contrast T1-weighted images were evaluated. Twenty six patients with seronegative spondyloarthropathy(Probable clinical diagnosis of ankylosing spondylitis) were grouped as either less than radiographic grade 1(group A) or more than grade 2(group B). The MRI findings of both sacroiliac joints were evaluated in every patient, and predominant sites were determined. The two groups were then compared. In 17 patients, the number of enhancing panni seen on early and delayed post-contrast T1-weighted images was counted and compared between the two groups. Panni were found in all cases, and in both groups, predominant patterns of involvement were the lower and iliac aspects of the sacroiliac joints in both groups; in group A, the synovial joints and punctate pannus were predominantly involved, and in group B, the ligamentous joints as well as the synovial joints and linear pannus. In group B, More periarticular fat accumulation than periarticular osteitis was found. For the evaluation of changes in joint space, MPGR images were superior to spin echo images. For the delineation of enhancing pannus less than radiographic grade I, delayed post-contrast images were statistically superior to those which were early post-contrast. MRI can detect early sacroiliitic change according to the predominant sites of involvement, and deslyed post-contrast images play a role in the diagnosis of early sacroiliitis. MPGR imaging is good for the evaluation of joint space change.

Jeon, Eui Yong; Joo, Kyung Bin; Koo, Ja Hong; Moon, Won Jin; Hahm, Chang Kok; Kim, Tae Hwan; Kim, Seong Yoon [Hanyang Univ. College of Medicine, Seoul (Korea, Republic of)

1997-10-01

338

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

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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.).

Dale, K.; Vinje, O.

339

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

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Court Brown and Doll identified over 14,000 patients with ankylosing spondylitis who had been treated with one or more courses of x-irradiation from 1935 to 1954 at one of 87 radiotherapy centers in Great Britain and Northern Ireland. The first reports from this study analyzed mortality among these patients from leukemia and other causes, particularly cancer, but these analyses included many patients who had been treated with x-rays for their spondylitis more than once. This complicated the interpretation of the late effects of the treatment on mortality, as it was not clear to what extent the subsequent treatments contributed to the excess of deaths that persisted for many years after the first treatment. Smith and Doll (1982) avoided this difficulty by examining the death rate from leukemia and other radiation-induced cancers at different times after a single course of treatment. A comparison of the mortality of this group with the mortality of Japanese atomic bomb survivors revealed good agreement between the two studies, thus increasing confidence in the belief that both studies are giving sensible estimates of the risk of cancer from high doses of radiation. The follow-up of those spondylitic patients who received a single course of treatment only has recently been extended until the end of 1982, that is, for an additional 13 years. A further 1406 patients are now known to have died, including an additional 335 deaths for which the certified cause is cancer. Deta which the certified cause is cancer. Detailed results of this further follow-up will be presented

340

Monitoring ankylosing spondylitis therapy by dynamic contrast-enhanced and diffusion-weighted magnetic resonance imaging  

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The effects of different therapies on enthesitis/osteitis in active ankylosing spondylitis (AS) were evaluated by magnetic resonance imaging (MRI). The aim was to assess the role of quantitative MRI in the evaluation of AS treatment efficacy. Thirty patients with active spondylitis or bilateral sacroilitis were selected and followed up for 1 year. Ten of the patients were treated only with non-steroidal anti-inflammatory drugs, 10 patients additionally received at baseline an intravenous pulse of glucocorticoids and 10 patients were treated with regular infusions of infliximab. Disease activity was measured according to clinical instruments and laboratory tests. For each patient, one selected inflamed lesion was followed from baseline through control visits quantitatively by diffusion-weighted imaging (DWI) measuring the apparent diffusion coefficient (ADC) and by dynamic contrast-enhanced imaging (DCEI) with evaluation of the enhancement factor (f{sub enh}) and enhancement gradient (g{sub enh}). Clinical and quantitative MRI parameters diminished significantly with regression of the inflammatory activity. The improvement in AS was most pronounced in patients treated with infliximab; after 12 months the ADC diminished from an average of 1.31 to 0.88 x 10{sup -3} mm{sup 2}/s, f{sub enh} from 1.85 to 0.60, and g{sub enh} from 3.09 to 1.40 %/s. Diffusion-weighted imaging and DCEI were shown to be effective in quantifying changes in inflammation in skeletal lesions during the treatment of AS, and could therefore be convenient for assessing treatment efficacy. To the best of our knowledge this is the first time DWI was used to evaluate the activity of skeletal inflammation in rheumatic diseases such as AS. (orig.)

Gaspersic, Natasa [University Medical Centre, Department of Rheumatology, Ljubljana (Slovenia); Sersa, Igor [Jozef Stefan Institute, Ljubljana (Slovenia); Jevtic, Vladimir [Medical Faculty, Department of Radiology, Ljubljana (Slovenia); Tomsic, Matija; Praprotnik, Sonja [University Medical Centre, Department of Rheumatology, Ljubljana (Slovenia)

2008-02-15

 
 
 
 
341

Optimisation of rheumatology assessments - the actual situation in axial spondyloarthritis including ankylosing spondylitis.  

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The spondyloarthritides (SpA) are currently differentiated into axial and peripheral SpA. Patients with axial SpA (axSpA) may be further classified into the classical form ankylosing spondylitis (AS) and non-radiographic axSpA (nr-axSpA). The SpA are genetically linked, and the subtypes including psoriatic arthritis (PsA) share characteristic clinical symptoms such as inflammatory back pain (IBP) and enthesitis. IMP can be due to sacroiliitis and spondylitis, enthesitis may occur with or without arthritis, and anterior uveitis, as well as other extraarticular manifestations such as psoriasis and chronic inflammatory bowel disease (IBD). In addition to clinical findings, imaging, mainly conventional radiography and magnetic resonance imaging (MRI), and laboratory results such as HLA B27 and CRP are important tools for classification and diagnosis of SpA. The Assessment of SpondyloArthritis international Society (ASAS), an international group of experts in the field of SpA since 1995, has published on assessments and outcome parameters in SpA. The publication of classification criteria for axSpA has now largely replaced the 1984 criteria for AS. However, the established cut-off between AS and nr-axSpA, 'definite' structural changes in the sacroiliac joints, has been recently debated because of limited reliability. Since imaging plays an important role in all criteria sets, the ASAS group has recently published definitions for inflammatory changes in the SIJ and the spine. The most important domains in AS are disease activity, function, spinal mobility, structural damage, and quality of life, some of which are discussed in this manuscript. For axSpA there are two major tools to assess disease activity, the BASDAI and the ASDAS, one for function, the BASFI, and several mobility measures including the BASMI. The AS Health Index (AS-HI) is introduced elsewhere in this supplement. PMID:25365096

Braun, J; Kiltz, U; Baraliakos, X; van der Heijde, D

2014-01-01

342

Evaluation of Postural Stability and Fall Risk in Patients with Ankylosing Spondylitis  

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Full Text Available Purpose: The purpose of this study is to evaluate the influences of Ankylosing spondylitis on postural balance and the risk of falls. Methods: A total of 73 sobjects were recruited for the study, including 36 with AS (17 men, 19 women and 37 healthy controls (19 men, 18 women. Patients were evaluated in terms of balance and risk of falls. Balance and risk of falls was assessed with the Biodex Stability System. Results: The mean age, gender and body mass index of the participants did not differ significantly between (p=0.308, p=0.724, p=0.766, respectively. When groups were evaluated in terms of postural stability indexes Overall Stability Index (OSI, Antero-Posteior Stability Index (APSI and Medio-Lateral Stability Index (MLSI had no statistically significant difference (p=0.190, p=0.437 ve p=0.144, respectively. Fall Risk Index (FRI evaluations showed that as patients? test scores were higher than control group (p=0.001. (Table 1. Conclusions: In this study, we present numerical data that suggests that AS are associated with risk of falling. [Cukurova Med J 2013; 38(1.000: 86-91

Ahmet Inanir

2013-02-01

343

Quantitative radio-isotope scanning in ankylosing spondylitis: a clinical, laboratory and computerised tomographic study  

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Quantitative sacroiliac and lumbar spine radio-isotope (Tc-99m MDP) scans were performed in 42 patients with ankylosing spondylitis, and repeated 12 months later in 25. Clinical and laboratory assessments as well as computerised tomographic (CT) scans of the sacroiliac joints (SIJ) and lateral lumbar spine x-rays, were performed. Bone (using the L3/4 area of the lumbar spine, sacrum, SIJ's and knee) to soft tissue (ST) ratios all correlated strongly with each other. Patients with high SIJ:ST ratios had significantly greater low-back stiffness (p<0.05). Change in serum IgA levels correlated negatively with change in bone: ST ratios. There was no relationship between bone: ST ratios and any other clinical or laboratory variables. The change in SIJ:ST ratios correlated positively with change in CT erosion score (p<0.05) and negatively with change in CT ankylosis score (p<0.05). (au) 24 refs., 2 figs., 1 tbl)

344

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

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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.

Ming Li

2012-10-01

345

Functionally distinct ERAP1 allotype combinations distinguish individuals with Ankylosing Spondylitis.  

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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

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

2014-12-01

346

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

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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. Paith 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.)

347

Level set based vertebra segmentation for the evaluation of Ankylosing Spondylitis  

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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.

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

2006-03-01

348

Gender differences in ankylosing spondylitis-associated cumulative healthcare utilization: a population-based cohort study  

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Full Text Available SciELO Brazil | Language: English Abstract in english BACKGROUND: Ankylosing spondylitis (AS) is one of the most common rheumatic diseases with gender differences in prevalence and clinical presentation. This study aimed to examine whether such gender differences are correlated with cumulative healthcare utilization in Taiwan. METHODS: The National Hea [...] lth Insurance Research Database supplied claim records of one million individuals from 1996 to 2007. Selected cases included patients aged >16 years. Certified rheumatologists diagnosed the patients in three or more visits and gave prescriptions for AS. Multivariate adjusted logistic regression analyses were used to calculate the influence of gender on cumulative healthcare utilization associated with AS. RESULTS: The study included 228 women and 636 men. After adjustment for potential confounding factors, men had more cumulative outpatient visits associated with AS (odds ratio, 1.59; 95% confidence interval, 1.13 -2.23; p = 0.008). Men also exhibited a trend for higher frequency of AS-related hospitalization (p = 0.054). CONCLUSION: Men are more likely to have high cumulative AS-associated healthcare utilization than women. Further investigation of the causal factors is warranted.

Hsin-Hua, Chen; Tzeng-Ji, Chen; Yi-Ming, Chen; Chiu, Ying-Ming; Der-Yuan, Chen.

349

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

International Nuclear Information System (INIS)

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)

350

Pseudoartrosis vertebral en la espondilitis anquilosante / Spinal pseudoarthrosis in ankylosing spondylitis  

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Full Text Available SciELO Spain | Language: Spanish Abstract in spanish La pseudoartrosis vertebral es una espondilodiscitis aséptica que aparece como complicación tardía de la espondilitis anquilosante. Dos pacientes presentaron este proceso de destrucción discovertebral después de una caída espontánea. Los dos asociaron manifestaciones neurológicas por compresión medu [...] lar, interviniéndose quirúrgicamente el primero. En el estudio de estas lesiones, las diferentes técnicas de imagen se complementan. Con radiología simple se puede identificar en algunos casos la afección discovertebral. La tomografía axial computerizada delimita mejor estas lesiones y revela la fractura del arco posterior. Por último, el estudio con resonancia magnética aporta sensibilidad para la detección precoz, descarta la existencia de partes blandas paravertebrales que puedan ser de otro origen e identifica la compresión del cordón medular. Abstract in english Spinal pseudoarthrosis is an uncommon complication in patients with advanced ankylosing spondylitis which consists in destruction of the discovertebral junction. Two cases of spinal pseudoarthrosis at the thoracolumbar level after a spontaneous fall are reported. Because of the neural arch involveme [...] nt and the spinal cord compression a stabilization was required. Different imaging techniques are complementaries in the study of this entity, conventional radiographs and computed tomography may depicte bone abnormalities, but magnetic resonance allows a correct evaluation of spinal cord and soft tissue involvement.

F. J., Manero Ruiz; M., Roca Espiau; J., Mota Martínez.

2002-09-01

351

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

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224Ra treatment of ankylosing spondylitis with 1 i.v. injection of 28 ?Ci 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 ? radiation of 224Ra and the antiphlogistic action of the ? and ? 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)

352

Incidence of tumours of the skeleton in 224Ra-treated ankylosing spondylitis patients  

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We are following 1426 ankylosing spondylitis (a.sp.) patients treated with 224Ra and 1556 control patients with a.sp. not treated with any form of ionizing radiation. The average follow-up time of the exposure group is 16 years and the average ?-dose to the skeleton is 65 rad, resulting from intravenous injection of 4.8?Ci/kg224Ra on average within a medium injection span of 12 weeks. Injections normally have been performed once a week, and in some cases also half-weekly with a correspondingly shorter injection span. Since 1970 three cases of malignant tumours in the skeleton have been observed in the exposure group in patients with skeletal ?-doses below 90 rad compared with 0.6 expected. (No bone tumour has occurred in the control group.) Two of the three cases observed were tumours of the bone marrow. The incidence of leukaemias in both exposure and control groups is discussed with respect to phenylbutazone treatment and ?-radiation from 224Ra. An effect of 224Ra on the bone marrow not yet detected in the Spiess series of patients treated with higher amounts of 224Ra cannot be excluded. (author)

353

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

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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.

Atkinson Mark D

2010-09-01

354

Attenuated insulin response and normal insulin sensitivity in lean patients with ankylosing spondylitis.  

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Chronic low-grade inflammation is associated with insulin resistance. The aim of this study was to determine insulin response to intravenous glucose load and insulin sensitivity in patients with ankylosing spondylitis (AS). Fourteen nonobese male patients with AS and 14 matched healthy controls underwent frequent-sampling intravenous glucose tolerance test (FSIVGTT). Insulin secretion and insulin sensitivity were calculated using the computer-minimal and homeostasis-model assessment 2 (HOMA2) models. Fasting glucose, insulin, cholesterol, high-density lipoprotein and low-density lipoprotein cholesterol, triglyceride levels, HOMA2, glucose effectiveness, insulin sensitivity and insulin response to FSIVGTT did not differ between patients and controls. Tumor necrosis factor-alpha and interleukin (IL)-6 concentrations tended to be higher in AS patients than in controls. Second-phase beta-cell responsiveness was 37% lower (p = 0.05) in AS patients than in controls. A negative correlation was found between the percentage of beta-cell secretion and IL-6 in all subjects (r = -0.54, p = 0.006). We found normal insulin sensitivity but attenuated glucose utilization in the second phase of FSIVGTT in AS patients. Our results indicate that elevated IL-6 levels may play a pathophysiological role in attenuating beta-cell responsiveness, which may explain the association between elevated IL-6 levels and increased risk for type 2 diabetes. PMID:16366418

Penesova, A; Rovensky, J; Zlnay, M; Dedik, L; Radikova, Z; Koska, J; Vigas, M; Imrich, R

2005-01-01

355

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

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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

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

2014-09-01

356

Individual characterization of stably expanded T cell clones in ankylosing spondylitis patients.  

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Ankylosing spondylitis (AS) is commonly characterized by clonal expansions of T cells. However, these clonal populations are poorly studied and their role in disease initiation and progression remains unclear. Here, we performed mass sequencing of TCR V beta libraries to search for the expanded T cell clones for two AS patients. A number of clones comprising more than 5% of the corresponding TCR V beta family were identified in both patients. For the first time, expanded clones were shown to be stably abundant in blood samples of AS patients for the prolonged period (1.5 and 2.5 years for two patients, correspondingly). These clones were individually characterized in respect to their differentiation status using fluorescent cell sorting with CD27, CD28, and CD45RA markers followed by quantitative identification of each clone within corresponding fraction using real time PCR analysis. Stable clones differed in phenotype and several were shown to belong to the proinflammatory CD27 - /CD28 - population. Their potentially cytotoxic status was confirmed by staining with perforin-specific antibodies. Search for the TCR V beta CRD3 sequences homologous to the identified clones revealed close matches with the previously reported T cell clones from AS and reactive arthritis patients, thus supporting their role in the disease and proposing consensus TCR V beta CDR3 motifs for AS. Interestingly, these motifs were also found to have homology with earlier reported virus-specific CDR3 variants, indicating that viral infections could play role in development of AS. PMID:19657773

Mamedov, I Z; Britanova, O V; Chkalina, A V; Staroverov, D B; Amosova, A L; Mishin, A S; Kurnikova, M A; Zvyagin, I V; Mutovina, Z Y; Gordeev, A V; Khaidukov, S V; Sharonov, G V; Shagin, D A; Chudakov, D M; Lebedev, Y B

2009-09-01

357

Association between Endoplasmic Reticulum Aminopeptidase-1 (ERAP-1 and Susceptibility to Ankylosing Spondylitis in Iran  

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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 candidategene 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.

Mona Oraei

2012-12-01

358

Prevalence and risk factors of low bone mineral density in juvenile onset ankylosing spondylitis.  

Science.gov (United States)

The objective of this study is to assess the prevalence and risk in patients with juvenile onset ankylosing spondylitis (JoAS) complicated with low bone mineral density (BMD). A total of 112 children and adolescents with JoAS were enrolled in the study. Bone mass was measured from the lumbar spine and the left proximal femur using dual-energy X-ray absorptiometry. According to the 2007 International Society of Clinical Densitometry definitions, a Z score of less than -2 was termed as "low BMD." Stepwise regression analysis was used to investigate associations between low BMD and disease-related factors including gender, age, weight, height, body mass index, disease duration, HLA-B27 antigen, grades of sacroiliitis, Bath AS Disease Activity Index (BASDAI), Bath AS Functional Index (BASFI), patient global assessment (PGA), spine pain, erythrocyte sedimentation rate (ESR), and C-reactive protein (CRP). Low BMD was found in 18 (16.1 %) cases in at least one of the two measured regions. Lumbar spine BMD had negative correlations with BASDAI, BASFI, spine pain, ESR, and CRP (P < 0.05). Hip BMD significantly negatively correlated with BASDAI and PGA (P < 0.05). In conclusion, patients with JoAS are likely to develop low BMD, which may be related to high disease activity. PMID:24854154

Bao, Jun; Chen, Yi; Bao, Yi-Xiao

2014-08-01

359

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

Energy Technology Data Exchange (ETDEWEB)

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 of observed cases is within the expected range (3 myeloid leukaemias vs. 2.9 cases exp.). Out of these 7 cases of acute myeloid leukaemia, 4 cases have been observed at doses comparable to those of the {sup 224}Ra treatment practised currently with the pharmaceutical SpondylAT registered (10 injections of 1 MBq each), in one case the {sup 224}Ra-dose was the 0.6fold, in another case 1.6fold, whereas in one case the total dose could not be verified exactly. Similar higher incidences of leukaemia have not been found in another group of patients treated with higher doses or dose rates of {sup 224}Ra, observed by Spiess and co-workers. However, the enhanced leukaemia incidence in our exposed group is in line with results from animal experiments in mice having been injected with bone seeking alpha-emitters given at low dose rates. (orig.)

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

360

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

International Nuclear Information System (INIS)

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 ?-emitter 224radium 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 ?Ci) of 224Ra each, given at weekly intervals. This resulted in a cumulative ?-dose of 0.56 to 0.67 Gy to the marrow-free skeleton (bone surface dose: ? 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 ? 26 yr in the exposed group or ? 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 16observation, 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 224Ra treatment practised currently with the pharmaceutical SpondylAT registered (10 injections of 1 MBq each), in one case the 224Ra-dose was the 0.6fold, in another case 1.6fold, whereas in one case the total dose could not be verified exactly. Similar higher incidences of leukaemia have not been found in another group of patients treated with higher doses or dose rates of 224Ra, observed by Spiess and co-workers. However, the enhanced leukaemia incidence in our exposed group is in line with results from animal experiments in mice having been injected with bone seeking alpha-emitters given at low dose rates. (orig.)

 
 
 
 
361

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

Directory of Open Access Journals (Sweden)

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.

Jindal Parul

2009-01-01

362

Family studies in Bechterew's syndrome (ankylosing spondylitis). II. Prevalences of symptoms and signs in relatives of HLAB27 negative probands.  

Science.gov (United States)

All available adult first-degree relatives of 9 probands with HLAB27 negative ankylosing spondylitis were examined. Completion rate was 90%. Prevalences of symptoms and signs and distributions of chest and spinal mobility are presented. No secondary case of Bechterew's syndrome was found among the relatives, compared with 10% among the relatives of HLAB27 positive probands (p = 0.05). We conclude from this study and that of relatives of HLAB27 positive probands, that a HLAB27 negative relative runs a low risk of contracting Bechterew's syndrome, irrespective of the HLAB27 status of the proband. PMID:6232703

Møller, P; Vinje, O; Dale, K; Berg, K; Kåss, E

1984-01-01

363

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

Digital Repository Infrastructure Vision for European Research (DRIVER)

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...

Garci?a-medel, Noel; Sanz-bravo, Alejandro; Nguyen, Dung; Galocha, Begon?a; Go?mez-molina, Patricia; Marti?n-esteban, Adria?n; Alvarez-navarro, Carlos; Castro, Jose? A. Lo?pez

2012-01-01

364

Targeted Delivery of an Antigenic Peptide to the Endoplasmic Reticulum: Application for Development of a Peptide Therapy for Ankylosing Spondylitis  

Digital Repository Infrastructure Vision for European Research (DRIVER)

The development of suitable methods to deliver peptides specifically to the endoplasmic reticulum (ER) can provide some potential therapeutic applications of such peptides. Ankylosing spondylitis (AS) is strongly associated with the expression of human leukocytic antigen-B27 (HLA-B27). HLA-B27 heavy chain (HC) has a propensity to fold slowly resulting in the accumulation of misfolded HLA-B27 HC in the ER, triggering the unfolded protein response, and forming a homodimer, (B27-HC)2. Natural ki...

Yu, Hui-chun; Lu, Ming-chi; Li, Chin; Huang, Hsien-lu; Huang, Kuang-yung; Liu, Su-qin; Lai, Ning-sheng; Huang, Hsien-bin

2013-01-01

365

HLA-B27 associated cross-reactive marker on the cells of New Zealand patients with ankylosing spondylitis.  

Digital Repository Infrastructure Vision for European Research (DRIVER)

We have previously shown that antibodies raised in rabbits to certain enteric bacteria will specifically lyse, in a 51Cr release assay, the peripheral blood lymphocytes (PBL) of 80% of HLA-B27 positive patients with ankylosing spondylitis (B27+ AS+) but not the PBL of HLA-B27 positive normal controls (B27+ AS-). Other laboratories have been unable to reproduce these findings. This study was designed to ascertain whether this lack of reproducibility was due to a peculiarity of our B27+ AS+ pat...

Mcguigan, L. E.; Geczy, A. F.; Prendergast, J. K.; Edmonds, J. P.; Hart, H. H.; Bashir, H. V.

1986-01-01

366

Ankylosing spondylitis, HLA-B27, and Klebsiella: a study of lymphocyte reactivity of anti-Klebsiella sera.  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Twenty three anti-Klebsiella antisera were tested for their cytotoxic activity and four for their binding capacity for peripheral blood lymphocytes (PBL) from patients with HLA-B27 positive ankylosing spondylitis (AS+B27+) and from B27 positive (AS-B27+) and B27 negative (AS-B27-) healthy individuals. None of the antisera showed specific activity against PBL from any particular group. The antisera tested included two anti-Klebsiella K43 sera provided by an Australian group, who have reported ...

Singh, B.; Milton, J. D.; Woodrow, J. C.

1986-01-01

367

Persistence of HLA-B27 cross-reactive bacteria in bowel flora of patients with ankylosing spondylitis.  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Previous studies have shown that antisera raised in rabbits to certain enteric bacteria (cross-reactive bacteria) are capable of specifically lysing in a 51chromium-release lymphocytotoxicity test the lymphocytes of HLA-B27-positive (B27+) patients with ankylosing spondylitis (AS). This study investigated the clinical relevance of this finding by ascertaining whether Escherichia coli isolated from the rectal swabs of 20 B27+ AS patients (B27+ AS+) and 46 controls (35 B27- AS- and 11 B27+ AS-)...

Prendergast, J. K.; Mcguigan, L. E.; Geczy, A. F.; Kwong, T. S.; Edmonds, J. P.

1984-01-01

368

Espondilite anquilosante e anestesia / Ankylosing spondylitis and anesthesia / Espondilitis anquilosante y anestesia  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: Portuguese Abstract in portuguese 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 mulheres correspondem somente à minoria de pacientes. Há pouca informação sobre a EA na literatura anestésica. O objetivo deste artigo foi revisar aspectos da EA de interesse para o anestesiologista, permitindo um adequado manuseio perioperatório. CONTEÚDO: Estão definidas as características da espondilite anquilosante quanto à clínica e a conduta anestésica. CONCLUSÕES: Os pacientes com doenças crônicas da coluna vertebral apresentam desafios específicos para o anestesiologista. O manuseio da via aérea e o acesso ao neuroeixo poderão ser difíceis. Preferência tem sido dada à anestesia geral, mesmo com via aérea difícil reconhecida, evitando-se a anestesia no neuroeixo. O grau de envolvimento da coluna cervical determinará o quanto poderá ser difícil a intubação traqueal. Cuidado especial deve ser tomado para evitar a manipulação excessiva da coluna cervical, que poderia levar ao trauma da medula espinhal. Abstract in spanish JUSTIFICATIVA Y OBJETIVOS: La espondilitis anquilosante (EA) es una enfermedad inflamatoria crónica de las articulaciones, incluida en el grupo de las espondiloartropatías soronegativas. La característica principal de esa enfermedad es la fusión ósea de la columna vertebral que conlleva a la pérdida [...] permanente de la flexibilidad del dorso y del cuello. Otras grandes articulaciones y tejidos conectivos podrán estar afectados por el proceso inflamatorio. La EA acomete principalmente a hombres entre los 20 y 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. Abstract in english 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 art [...] iculations 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 chall

Carlos Rogério Degrandi, Oliveira.

2007-04-01

369

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

Directory of Open Access Journals (Sweden)

Full Text Available 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 mulheres correspondem somente à minoria de pacientes. Há pouca informação sobre a EA na literatura anestésica. O objetivo deste artigo foi revisar aspectos da EA de interesse para o anestesiologista, permitindo um adequado manuseio perioperatório. CONTEÚDO: Estão definidas as características da espondilite anquilosante quanto à clínica e a conduta anestésica. CONCLUSÕES: Os pacientes com doenças crônicas da coluna vertebral apresentam desafios específicos para o anestesiologista. O manuseio da via aérea e o acesso ao neuroeixo poderão ser difíceis. Preferência tem sido dada à anestesia geral, mesmo com via aérea difícil reconhecida, evitando-se a anestesia no neuroeixo. O grau de envolvimento da coluna cervical determinará o quanto poderá ser difícil a intubação traqueal. Cuidado especial deve ser tomado para evitar a manipulação excessiva da coluna cervical, que poderia levar ao trauma da medula espinhal.JUSTIFICATIVA Y OBJETIVOS: La espondilitis anquilosante (EA es una enfermedad inflamatoria crónica de las articulaciones, incluida en el grupo de las espondiloartropatías soronegativas. La característica principal de esa enfermedad es la fusión ósea de la columna vertebral que conlleva a la pérdida permanente de la flexibilidad del dorso y del cuello. Otras grandes articulaciones y tejidos conectivos podrán estar afectados por el proceso inflamatorio. La EA acomete principalmente a hombres entre los 20 y 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. Handling of the airways and the access to the neuroaxis can be difficult. Most anesthesiologi

Carlos Rogério Degrandi Oliveira

2007-04-01

370

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

DEFF Research Database (Denmark)

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 the Ankylosing Spondylitis spine Magnetic Resonance Imaging-activity [ASspiMRI-a, grading activity (0-6) per vertebral unit in23 units]; the Berlin modification of the ASspiMRI-a; and the Spondyloarthritis Research Consortium of Canada (SPARCC) scoring system, which scores the 6 vertebral units 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 set of MRI, and inter-reader reliability was evaluated by smallest detectable change (SDC) and by intraclass correlation coefficients (ICC) for all readers together and for all possible reader pairs separately. Sensitivity to change was investigated by calculating Guyatt's effect size on change scores. 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 inter-reader ICC per method were between 0.49 and 0.77 for scoring activity status, and between 0.46 and 0.72 for scoring activity change. ICC for all possible reader pairs showed much more fluctuation per method, with lowest observed values of about 0.05 (very low agreement) and highest observed values over 0.90 (excellent agreement). In general, ICC for SPARCC were consistently higher than for other systems. Sensitivity to change differed per reader, and was more consistent with SPARCC than with the other methods, but was in general excellent for all 3 methods. Discrimination between groups (TNF-blocker vs placebo) assessed by Z-scores was good and comparable among methods. CONCLUSION: This experiment demonstrates the feasibility of multiple-reader MRI scoring exercises for method comparison, provides evidence for the feasibility, reliability, sensitivity to change, and discriminatory capacity of all 3 tested scoring systems to be used in assessing spinal activity on MRI in patients with AS in clinical trials. On the basis of these results it is not possible to prioritize one of the 3 methods. Udgivelsesdato: 2007-Apr

Lukas, Cédric; Braun, Jürgen

2007-01-01

371

Psychometric characteristics of the short form 36 health survey and functional assessment of chronic illness Therapy-Fatigue subscale for patients with ankylosing spondylitis  

Directory of Open Access Journals (Sweden)

Full Text Available Abstract Background We evaluated the psychometric characteristics of the Short Form 36 (SF-36 Health Survey and the Functional Assessment of Chronic Illness Therapy (FACIT-Fatigue subscale in patients with ankylosing spondylitis (AS. Methods We analyzed clinical and patient-reported outcome (PRO data collected during 12-week, double-blind, placebo-controlled periods of two randomized controlled trials comparing adalimumab and placebo for the treatment of active AS. The Bath Ankylosing Spondylitis Disease Activity Index, Bath Ankylosing Spondylitis Functional Index, and other clinical measures were collected during the clinical trial. We evaluated internal consistency/reliability, construct validity, and responsiveness to change for the SF-36 and FACIT-Fatigue. Results The SF-36 (Cronbach alpha, 0.74-0.92 and FACIT-Fatigue (Cronbach alpha, 0.82-0.86 both had good internal consistency/reliability. At baseline, SF-36 and FACIT-Fatigue scores correlated significantly with Ankylosing Spondylitis Quality of Life scores (r = -0.36 to -0.66 and r = -0.70, respectively; all p Conclusions The SF-36 is a reliable, valid, and responsive measure of health-related quality of life and the FACIT-Fatigue is a brief and psychometrically sound measure of the effects of fatigue on patients with AS. These PROs may be useful in evaluating effectiveness of new treatments for AS. Trial Registration ClinicalTrials.gov: NCT00085644 and NCT00195819

Luo Michelle P

2011-05-01

372

18F-Fluoride PET/CT for detection of sacroiliitis in ankylosing spondylitis  

International Nuclear Information System (INIS)

The aim of this study was to evaluate the performance of 18F-fluoride-PET/CT (PET/CT) for the diagnosis of sacroiliac joint (SIJ) arthritis in patients with active ankylosing spondylitis (AS). Included in the study were 15 patients with AS according to the modified New York criteria (AS group) and with active disease and 13 patients with mechanical low back pain (MLBP; control group) who were investigated with whole-body 18F-fluoride PET/CT. The ratio of the uptake in the SIJ and that in the sacrum (SIJ/S) was calculated for every joint. The mean SIJ/S ratio of 30 quantified joints in the AS group was 1.66 (range 1.10-3.07) with PET/CT, and the mean SIJ/S ratio of 26 quantified joints in the MLBP group was 1.12 (range 0.71-1.52). The area under the receiver operating characteristic curve for SIJ arthritis was 0.84. With plain radiography as a the gold standard and taking an SIJ/S ratio of >1.3 as the threshold, the sensitivity, specificity and accuracy on a per patient basis were 80%, 77% and 79%, respectively. On a per SIJ basis, the greatest sensitivity (94%) was found in grade 3 sacroiliitis (n = 16). Our results suggest that quantitative 18F-fluoride PET/CT may play a role in the diagnosis of sacroiliitis in active AS and is an alternative to conventional bone scintigraphy in times of molybdenum shortage. (orig.)

373

{sup 18}F-Fluoride PET/CT for detection of sacroiliitis in ankylosing spondylitis  

Energy Technology Data Exchange (ETDEWEB)

The aim of this study was to evaluate the performance of {sup 18}F-fluoride-PET/CT (PET/CT) for the diagnosis of sacroiliac joint (SIJ) arthritis in patients with active ankylosing spondylitis (AS). Included in the study were 15 patients with AS according to the modified New York criteria (AS group) and with active disease and 13 patients with mechanical low back pain (MLBP; control group) who were investigated with whole-body {sup 18}F-fluoride PET/CT. The ratio of the uptake in the SIJ and that in the sacrum (SIJ/S) was calculated for every joint. The mean SIJ/S ratio of 30 quantified joints in the AS group was 1.66 (range 1.10-3.07) with PET/CT, and the mean SIJ/S ratio of 26 quantified joints in the MLBP group was 1.12 (range 0.71-1.52). The area under the receiver operating characteristic curve for SIJ arthritis was 0.84. With plain radiography as a the gold standard and taking an SIJ/S ratio of >1.3 as the threshold, the sensitivity, specificity and accuracy on a per patient basis were 80%, 77% and 79%, respectively. On a per SIJ basis, the greatest sensitivity (94%) was found in grade 3 sacroiliitis (n = 16). Our results suggest that quantitative {sup 18}F-fluoride PET/CT may play a role in the diagnosis of sacroiliitis in active AS and is an alternative to conventional bone scintigraphy in times of molybdenum shortage. (orig.)

Strobel, Klaus [University Hospital, Department of Medical Radiology, Division of Nuclear Medicine, Zurich (Switzerland); Cantonal Hospital Lucerne, Nuclear Medicine, Lucerne (Switzerland); Fischer, Dorothee R.; Stumpe, Katrin D.M.; Schulthess, Gustav K. von [University Hospital, Department of Medical Radiology, Division of Nuclear Medicine, Zurich (Switzerland); Tamborrini, Giorgio; Kyburz, Diego; Michel, Beat A.; Ciurea, Adrian [University Hospital Zurich, Department of Rheumatology, Zurich (Switzerland); Hesselmann, Rolf G.X.; Johayem, A. [University Hospital Zurich, Radiopharmacy, Zurich (Switzerland)

2010-09-15

374

224Ra: Risk to bone and haematopoietic tissue in ankylosing spondylitis patients  

International Nuclear Information System (INIS)

This follow-up study includes 1501 adult patients, who received repeated intraveneous injections of 224Ra as a treatment for ankylosing spondylitis (a.sp), and a control group of 1557 a.sp. patients not treated with radioactive drugs or X-rays. The average total injected activity for the patients of the exposure group was 4.8 ?Ci of 224Ra per kg body weight; the resulting average skeletal dose of ?-rays has been 0.65 Gy. The mean duration of the 224Ra treatment was 12 weeks with the mode at 10 weeks. At present, the mean follow-up time in the group of exposed patients is 16 years, and three cases of malignant skeletal tumours have been observed in patients with ?-doses to the skeleton below 0.9 Gy (the lowest skeletal dose found to be associated with a bone tumour in the high dose group followed by Spiess and Mays). Based on general population statistics the expected number of bone tumours (ICD 170) was 0.4-0.7 . A recent risk estimate from data of Spiess and Mays suggests 5.8 radiation induced bone tumours for the present follow-up time. It is, furthermore, notable that 2 of the 3 observed skeletal tumours are tumours of the bone marrow; in the high dose group of Spiess and Mays there has been only 1 bone marrow tumour among 55 bone tumours. No malignant bone tumours have occurred, until now, in the control group. In the 224Ra-group and the control group there have been 6 and 5 leukaemias, respectively,. Among the 6 leukaemias, respectively,. Among the 6 leukaemias in the 224R group 3 were chronic myeloid leukaemias while among the 5 leukaemias in the control group there was no chronic myeloid leukaemia. (orig.)

375

HLA-B27 and its Associated Clinical and Biochemical Presentation among Ghanaians with Ankylosing Spondylitis  

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Full Text Available HLA-B27 is a genetic predisposition marker for the development of Ankylosing Spondylitis (AS. AS is uncommon in West-Africa, but due to environmental and lifestyle changes, its prevalence is said to be increasing. This study sought to determine the baseline prevalence of HLA-B27 among Ghanaians presenting with AS, find out their disease activity, clinical presentation, presence of extra-articular manifestations, inflammation and dyslipidemia. In a cross-sectional study, 65 AS subjects were recruited from the orthopaedic departments of two leading Teaching Hospitals and a private laboratory, medilab diagnostics with centres across the country. Fifty healthy blood donors were also recruited as control group. HLA-B27, BASDAI score, Lipid profile, TNF-? and ESR levels were estimated among them. Statistical comparisons were analyzed using the one way ANOVA followed by Bonferroni’s Multiple Comparison test. There were four HLA-B27 positives representing 4.6%, the mean BASDAI score was 44.7/100. 48 AS patients had Sacroiliitis in their X-ray reports. None had a family history or any extra-articular manifestations. AS subjects had higher (p-1 compared to 5.70±0.48 pg mL-1 of control whiles the ESR was 34.64±1.87 mm h-1 as compared to 9.23±0.91 mm h-1 of controls. AS patients had moderate disease activity with no extra articular manifestation and a prevalence of 4.6%. Dyslipidemia was prominent and that inflammation plays a pivotal role in the development of atherosclerosis.

Robert E. Quansah

2012-01-01

376

Muscle activation patterns and gait biomechanics in patients with ankylosing spondylitis  

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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.

A. Caliri

2011-09-01

377

Retrospective analysis of spinal trauma in patients with ankylosing spondylitis: a descriptive study in Indian population.  

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Objective:This study aims to understand the demographics, mode of trauma, hospital stay, complications, neurological improvement, mortality and expenditure incurred by Indian patients with spinal trauma and ankylosing spondylitis (AS).Methods:Retrospective analysis of the patient data admitted to a tertiary referral hospital from 2008 to 2013 with the diagnosis of AS and spinal trauma was carried out. The variables studied were demographics, mode of trauma, neurological status, neurological improvement, involved vertebral level, duration of hospital stay, comorbid factors, expenditure and complications during the stay.Results:Forty-six patients with diagnosis of AS with spine trauma were admitted over the last 5 years with a total of 52 fractures. All were male patients; 58.6% had injury because of trivial trauma and 78.2% patients presented with neurological injury. C5 C6, C6 C7, C7 D1 and D12 were the most common injured level. Fractures through intervertebral disc were most common in cervical spine. Of the patients, 52.7% had shown neurological improvement of at least grade 1(AIS). Mean expenditure of patient admitted with spinal cord injury (SCI) with AS is 7957 USD (United States dollar), which is around five times the per capita income in India (as per year 2013).Conclusion:Males with AS are much more prone to spinal fractures than females and its incidence may be higher than previously reported. Domestic falls are the most common mechanism of spinal trauma in this population. High velocity injuries are associated with complete SCI. The study reinforces the need for development of subsidized spinal care services for SCI management.Spinal Cord advance online publication, 16 Septrmbrt 2014; doi:10.1038/sc.2014.150. PMID:25224600

Mahajan, R; Chhabra, H S; Srivastava, A; Venkatesh, R; Kanagaraju, V; Kaul, R; Tandon, V; Nanda, A; Sangondimath, G; Patel, N

2014-09-16

378

Bone Mineral Density in Patients with Ankylosing Spondylitis: Incidence and Correlation with Demographic and Clinical Variables  

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Full Text Available Objective: To evaluate bone mineral density (BMD in patients with ankylosing spondylitis (AS and determine its correlation with the demographic and clinical characteristics of AS. Patients and Methods: Demographic, clinical and osteodensitometric data were evaluated in a cross-sectional study that included 136 patients with AS. Spine and hip BMD were measured by means of dual energy X-ray absorptiometry (DXA. Using the modified Schober’s test we assessed spine mobility. We examined the sacroiliac, anteroposterior and lateral dorso-lumbar spine radiographs in order to grade sacroiliitis and assess syndesmophytes. Disease activity was evaluated using C-reactive protein (CRP levels and erythrocyte sedimentation rate (ESR. Demographic data and BMD measurements were compared with those of 167 age- and sex-matched healthy controls. Results: Patients with AS had a significantly lower BMD at the spine, femoral neck, trochanter and total hip as compared to age-matched controls (all p<0.01. According to the WHO classification, osteoporosis was present in 20.6% of the AS patients at the lumbar spine and in 14.6% at the femoral neck. There were no significant differences in BMD when comparing men and women with AS, except for trochanter BMD that was lower in female patients. No correlations were found between disease activity markers (ESR, CRP and BMD. Femoral neck BMD was correlated with disease duration, Schober’s test and sacroiliitis grade. Conclusion: Patients with AS have a lower spine and hip BMD as compared to age- and sex-matched controls. Bone loss at the femoral neck is associated with disease duration and more severe AS.

Laura MUNTEAN

2009-12-01

379

The potential of selected South African plants with anti-Klebsiella activity for the treatment and prevention of Ankylosing spondylitis.  

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A wide variety of herbal remedies are used in traditional African medicine to treat inflammatory disorders, including some autoimmune diseases. Thirty-four extracts from 13 South African plant species traditionally used for the treatment of inflam mation were investigated for their ability to control a microbial trigger for ankylosing spondylitis (Klebsiella pneumoniae). Twenty-six of the extracts (76.5 %) inhibited the growth of K. pneumoniae. Methanol and water extracts of Ballota africana, Carpobrotus edulis leaves, Kigellia africana, Lippia javanica, Pelargonium fasiculata, Syzygium cordatum (including bark), Terminalia pruinoides and Terminalia sericea were effective K. pneumoniae inhibitors, with MIC values <1000 µg/ml. The roots of Tulbaghia violaceae and bark from Warburgia salutaris also demonstrated efficacy. The most potent extracts were examined by RP-HPLC and UV-Vis spectroscopy for the presence of resveratrol. Methanolic extracts of B. africana, C. edulis leaves, L. javanica, T. pruinoides and T. sericea, as well as aqueous B. africana, T. pruinoides and T. sericea extracts, displayed peaks with retention times and UV-Vis spectra consistent with the presence of resveratrol. Resveratrol was generally a minor component, indicating that resveratrol was not solely responsible for the anti-Klebsiella growth inhibitory properties. Plant extracts with K. pneumoniae inhibitory activity were either non-toxic, or of low toxicity in the Artemia (brine shrimp) nauplii bioassay. Their low toxicity and antibiotic bioactivity against K. pneumoniae indicate their potential for both preventing the onset of ankylosing spondylitis and minimising its symptoms once the disease is established. PMID:25412961

Cock, I E; van Vuuren, S F

2014-11-21

380

Capacidad funcional y factores asociados en pacientes con espondilitis anquilopoyética / Functional capacity and associated factors in patients with ankylosing spondylitis  

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Full Text Available SciELO Cuba | Language: Spanish Abstract in spanish Introducción: la limitación funcional y la discapacidad son las consecuencias fundamentales para los pacientes con espondilitis anquilopoyética, diversos factores han sido relacionados con la discapacidad y su repercusión en la calidad de vida de estos enfermos. Objetivo: evaluar la capacidad funcio [...] nal y determinar factores asociados en los pacientes con espondilitis anquilopoyética. Métodos: se realizó un estudio transversal, descriptivo que incluyó 80 pacientes de la Consulta de Protocolo de Espondiloartropatías atendidos de junio de 2007 a julio de 2009. Se obtuvieron datos demográficos, clínicos, radiológicos y de laboratorio. Se evaluó la capacidad funcional aplicando el índice Bath Ankylosing Spondylitis Functional Index (BASFI) y se determinaron las asociaciones existentes. Resultados: predominó el sexo masculino (66,3 %). La edad media fue 40,1 años. La edad de inicio de la enfermedad, mayor de 20 años (73,8 %), presentó mayor BASFI (p=0,01), la ocupación laboral mostró diferencia significativa (56,14 %, p=0,04). El tiempo de demora del diagnóstico mayor de 10 años resultó significativo (p=0,03). El segmento cervical, la sacroilitis y el Bath Ankylosing Spondylitis Activity Index (BASDAI) reflejaron incremento del BASFI, significación estadística (p=0,01), no así, los reactantes de fase aguda y el HLA-B27. Conclusiones: la capacidad funcional se asocia de forma significativa con la edad de inicio de la enfermedad, el tiempo de demora del diagnóstico, la afectación del segmento cervical, la ocupación laboral, la sacroilitis y la actividad de la enfermedad. Abstract in english Introducción: the functional limitation and the inability are the mayor consequences for patients presenting Ankylosing Spondylitis, Different factors have been related to inability and its repercussion in the quality of life of these patients. Objective: to assess the functional ability and to dete [...] rmine associated factors. Method: a cross-sectional and descriptive study was conducted including 80 patients from the Protocol Consultation of Spondylo-artropathies seen from June, 2007 to July, 2009. Demographic, clinical, radiological, and laboratory data were obtained. The functional ability was assessed applying BASFI rate (Bath Ankylosing Spondylitis Functional Index) and the existing associations were determined. Results: there was male sex predominance, (63.3 %). The mean age was 40,1 years. The disease onset period - older than 20 years old (73.8 %), had great BASFI (p=0 0.01); the occupation showed significant difference (56.14 %, p=0.04). The delay time from diagnosis, longer than 10 years, was significant (p=0.03). The cervical segment, sacroiliitis and BASDAI (Bath Ankylosing Spondylitis Activyt) showed a statistically significant BASFI increase (p=0.01), except the acute phase reactants and HLA-B27. Conclusions: the functional ability is significantly associated with the disease onset age, diagnosis delay time, involvement of cervical segment, occupation, sacroiliitis, and the disease activity.

Nelsa, Casas Figueredo; Jelsys, Vidal Rojas; Dionisio, Pérez Campos; Concepción, Castell Pérez; Ángela, Gutiérrez Rojas.

2014-03-01

 
 
 
 
381

Relationship Between Upper Extremity Muscle Strength and Functional Level and Mobility in Patients with Ankylosing Spondylitis  

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Full Text Available Objective: To assess muscle strength of upper extremity muscles in patients with ankylosing spondylitis (AS and analyze any association between muscle strength and mobility and functional level. Materials and Methods: 30 patients diagnosed as AS and 20 healthy controls were included into the study. Demographics such as age, gender, body mass index, disease duration, and physical activity level were recorded. Mobility parameters [occiput-wall (OWD, chin-sternum (CSD, finger-floor distances (FFD, modified Schober (MS, and chest expansion diameter (CED] were evaluated in both groups. Deltoid anterior, trapezius middle, rhomboid and biceps muscle strength were measured by manual upper extremity-trunk dynamometer. Bath AS Functional Index (BASFI and Bath AS Disease Activity Index (BASDAI were used to evaluate functional level. Groups were compared by Mann–Whitney U test. The relationship between muscle strength and mobilization parameters and functional level were analyzed by Spearman correlation coefficient. Results: Mean age of the patients was 34.8±9.1 and the mean disease duration was 8.4±8.3 years (9/21: female/male. The mean age of controls was 34.0±7.3 years (7/13: female/male. All assessed mobilization parameters except CSD and OWD and muscle strengths except rhomboid muscle were significantly lower in patients (p<0.05. In the patient group, biceps muscle strength was associated with MS (r=0.480, p=0.038, CED (r=0.472, p=0.011, and inversely with FFD (-0.628, p=0.000. Middle trapezius muscle strength was associated with MS (r=0.621, p=0.005 and inversely with FFD (r=-0.610, p=0.001. Anterior deltoid muscle strength was associated with MS (r=0.383, p=0.044, CED (r=0.513, p=0.005, and inversely with FFD (r=-0.645, p=0.000 and CSD (r=-0.498, p=0.008. Rhomboid muscle strength was associated with MS, CED (r=0.421, p=0.026, and inversely with FFD (r=-0.504, p=0.006. No correlation was found between measured muscle strength and BASFI and BASDAI scores. Conclusion: Upper extremity muscle strengths decrease in patients with AS. There is an association between upper extremity muscle strengths and mobility.

Duygu Geler Külcü

2009-06-01

382

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

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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 content. Acceptance and circulation of the German patient version should be evaluated in the near future. PMID:19214540

Kiltz, U; Feldtkeller, E; Braun, J

2010-03-01

383

Effect of aquatic exercise on ankylosing spondylitis: a randomized controlled trial.  

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Ankylosing spondylitis (AS) is a chronic systemic inflammatory disease that affects mainly the axial skeleton and causes significant pain and disability. Aquatic (water-based) exercise may have a beneficial effect in various musculoskeletal conditions. The aim of this study was to compare the effectiveness of aquatic exercise interventions with land-based exercises (home-based exercise) in the treatment of AS. Patients with AS were randomly assigned to receive either home-based exercise or aquatic exercise treatment protocol. Home-based exercise program was demonstrated by a physiotherapist on one occasion and then, exercise manual booklet was given to all patients in this group. Aquatic exercise program consisted of 20 sessions, 5× per week for 4 weeks in a swimming pool at 32-33 °C. All the patients in both groups were assessed for pain, spinal mobility, disease activity, disability, and quality of life. Evaluations were performed before treatment (week 0) and after treatment (week 4 and week 12). The baseline and mean values of the percentage changes calculated for both groups were compared using independent sample t test. Paired t test was used for comparison of pre- and posttreatment values within groups. A total of 69 patients with AS were included in this study. We observed significant improvements for all parameters [pain score (VAS) visual analog scale, lumbar flexion/extension, modified Schober test, chest expansion, bath AS functional index, bath AS metrology index, bath AS disease activity index, and short form-36 (SF-36)] in both groups after treatment at week 4 and week 12 (p < 0.05). Comparison of the percentage changes of parameters both at week 4 and week 12 relative to pretreatment values showed that improvement in VAS (p < 0.001) and bodily pain (p < 0.001), general health (p < 0.001), vitality (p < 0.001), social functioning (p < 0.001), role limitations due to emotional problems (p < 0.001), and general mental health (p < 0.001) subparts of SF-36 were better in aquatic exercise group. It is concluded that a water-based exercises produced better improvement in pain score and quality of life of the patients with AS compared with home-based exercise. PMID:24626605

Dundar, U; Solak, O; Toktas, H; Demirdal, U S; Subasi, V; Kavuncu, V; Evcik, D

2014-11-01

384

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

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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 1 and group 2 was 22 ± 1 months and 21 ± 1.6 months, respectively.Conclusion: Remission of ankylosing spondylitis is possible in at least 50% of patients treated with etanercept 50 mg weekly. After halving of the etanercept dose, remission is maintained in a high percentage of patients during long-term follow-up, with important economic implications.Keywords: ankylosing spondylitis, anti-tumor necrosis factor, etanercept, remission, dose reduction

Nannini C

2013-01-01

385

Espondilitis anquilosante primaria: patrones clínicos en pacientes cubanos / Primary ankylosing spondylitis: clinical patterns in Cuban patients  

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Full Text Available SciELO Cuba | Language: Spanish Abstract in spanish Se estudiaron retrospectivamente 70 pacientes con diagnóstico de espondilitis anquilosante (EA) primaria, según los criterios de Nueva York modificados, para investigar sus patrones clínicos en pacientes cubanos. Los datos demográficos, clínicos y radiológicos fueron comparados según sexo, raza, eda [...] d de inicio de la EA y status del antígeno HLA-B27. Se encontró predominio de pacientes del sexo masculino (80,0 %), de raza caucásica (82,9 %), de inicio de la EA en la adultez (90,0 %), y positivos de HLA-B27 (90,0 %). Los antecedentes familiares de EA se registraron en 17,1 % de los pacientes. La afectación axial pura se observó en 4,3 %; la entesopatía, en 81,4 %; y la artritis periférica, en 58,6 %. La uveítis anterior aguda fue la manifestación extraarticular más frecuente (17,1 %). El sexo masculino se asoció con insuficiencia aórtica y el femenino, con fibromialgia (p = 0,11); también el sexo se asoció con la ubicación de los pacientes, mientras los hombres procedieron del medio urbano, las mujeres lo hicieron del medio rural (p = 0,001). La raza no caucásica, a diferencia de la caucásica, fue sometida al reemplazo total de cadera (p = 0,027). Los pacientes con EA de inicio juvenil presentaron con mayor frecuencia artritis periférica (p = 0,019), y necesitaron reemplazo total de cadera (p = 0,003). Los pacientes positivos de HLA-B27 presentaron con mayor frecuencia, sacroileítis bilateral grados 3 y 4 (p = 0,009), dolor bajo de espalda (p = 0,023), entesopatía (p = 0,006), y un tiempo de duración más largo de la EA que los pacientes negativos para este alelo (8,1 y 3,6 años, p = 0,021). Se concluyó que el sexo marcó diferencias en las manifestaciones extraarticulares de la EA, la raza caucásica y la no caucásica presentaron manifestaciones clínicas similares, el inicio juvenil de la EA se caracterizó por la artritis periférica, y la presencia del HLA-B27 se asoció a manifestaciones axiales y entesopatía. Abstract in english 70 patients with diagnosis of primary ankylosing spondylitis, according to the modified criteria of New York, were retrospectively studied aimed at investigating its clinical patterns in Cuban patients. The demographic, clinical and radiological data were compared by sex , race, age at the onset of [...] AS, and status of the HLA-B27 antigen. There was a predominance of males (80.0 %), of individuals of the Caucasian race (82.90 %), of onset of the ankylosing spondylitis at adulthood (90.0 %), and of positive HLA-B27 (90.0 %). The familiy histories of AS were registered in 17.1 % of the patients. The pure axial affection was observed in 4.3 %, enthesopathy in 81.4 %, and peripheral arthritis in 58.6 %. The anterior severe uveitis was the most frequent extraarticular manifestation (17.1 %). The male sex was associated with aortic failure and the female sex with fibromyalgia (p=0.11). Sex was also associated with the location of the patients. Males came from urban areas, and females from rural areas (p=0.001). The non-Caucasian race differently from the Caucasian, was subjected to total hip replacement (p=0.027). Those patients with AS of juvenile onset presented peripheral arthirits more frequently (p=0.019), and needed total hip replacement (p =0.003). Bilateral grade 3 and 4 sacro-illitis (p = 0,009), low back pain (p=0.023), and enthesopathy were more common in the patients positive for HLA-B27 than in the patients negative for this allele. The time of duration of AS was also longer (8.1 y 3.6 years, p=0.021). It was concluded that the male sex marked differences in the extraarticular manifestations of AS, the Caucasian and the non-Caucasian races presented similar clinical manifestations, the juvenile onset of AS was characterized by peripheral arthritis, and that the presence of HLA-B27 antigen was associated with axial manifestations and enthesopathy.

Elena, Kokuina; Araceli, Chico; Miguel, Estévez; Flora, Calzadilla; Ángela, Gutiérrez.

2007-03-01

386

Espondilitis anquilosante primaria: patrones clínicos en pacientes cubanos Primary ankylosing spondylitis: clinical patterns in Cuban patients  

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Full Text Available Se estudiaron retrospectivamente 70 pacientes con diagnóstico de espondilitis anquilosante (EA primaria, según los criterios de Nueva York modificados, para investigar sus patrones clínicos en pacientes cubanos. Los datos demográficos, clínicos y radiológicos fueron comparados según sexo, raza, edad de inicio de la EA y status del antígeno HLA-B27. Se encontró predominio de pacientes del sexo masculino (80,0 %, de raza caucásica (82,9 %, de inicio de la EA en la adultez (90,0 %, y positivos de HLA-B27 (90,0 %. Los antecedentes familiares de EA se registraron en 17,1 % de los pacientes. La afectación axial pura se observó en 4,3 %; la entesopatía, en 81,4 %; y la artritis periférica, en 58,6 %. La uveítis anterior aguda fue la manifestación extraarticular más frecuente (17,1 %. El sexo masculino se asoció con insuficiencia aórtica y el femenino, con fibromialgia (p = 0,11; también el sexo se asoció con la ubicación de los pacientes, mientras los hombres procedieron del medio urbano, las mujeres lo hicieron del medio rural (p = 0,001. La raza no caucásica, a diferencia de la caucásica, fue sometida al reemplazo total de cadera (p = 0,027. Los pacientes con EA de inicio juvenil presentaron con mayor frecuencia artritis periférica (p = 0,019, y necesitaron reemplazo total de cadera (p = 0,003. Los pacientes positivos de HLA-B27 presentaron con mayor frecuencia, sacroileítis bilateral grados 3 y 4 (p = 0,009, dolor bajo de espalda (p = 0,023, entesopatía (p = 0,006, y un tiempo de duración más largo de la EA que los pacientes negativos para este alelo (8,1 y 3,6 años, p = 0,021. Se concluyó que el sexo marcó diferencias en las manifestaciones extraarticulares de la EA, la raza caucásica y la no caucásica presentaron manifestaciones clínicas similares, el inicio juvenil de la EA se caracterizó por la artritis periférica, y la presencia del HLA-B27 se asoció a manifestaciones axiales y entesopatía.70 patients with diagnosis of primary ankylosing spondylitis, according to the modified criteria of New York, were retrospectively studied aimed at investigating its clinical patterns in Cuban patients. The demographic, clinical and radiological data were compared by sex , race, age at the onset of AS, and status of the HLA-B27 antigen. There was a predominance of males (80.0 %, of individuals of the Caucasian race (82.90 %, of onset of the ankylosing spondylitis at adulthood (90.0 %, and of positive HLA-B27 (90.0 %. The familiy histories of AS were registered in 17.1 % of the patients. The pure axial affection was observed in 4.3 %, enthesopathy in 81.4 %, and peripheral arthritis in 58.6 %. The anterior severe uveitis was the most frequent extraarticular manifestation (17.1 %. The male sex was associated with aortic failure and the female sex with fibromyalgia (p=0.11. Sex was also associated with the location of the patients. Males came from urban areas, and females from rural areas (p=0.001. The non-Caucasian race differently from the Caucasian, was subjected to total hip replacement (p=0.027. Those patients with AS of juvenile onset presented peripheral arthirits more frequently (p=0.019, and needed total hip replacement (p =0.003. Bilateral grade 3 and 4 sacro-illitis (p = 0,009, low back pain (p=0.023, and enthesopathy were more common in the patients positive for HLA-B27 than in the patients negative for this allele. The time of duration of AS was also longer (8.1 y 3.6 years, p=0.021. It was concluded that the male sex marked differences in the extraarticular manifestations of AS, the Caucasian and the non-Caucasian races presented similar clinical manifestations, the juvenile onset of AS was characterized by peripheral arthritis, and that the presence of HLA-B27 antigen was associated with axial manifestations and enthesopathy.

Elena Kokuina

2007-03-01

387

Estimated radiation doses to different organs among patients treated for ankylosing spondylitis with a single course of X rays  

International Nuclear Information System (INIS)

A follow-up study of over 14000 patients treated with a single course of X rays for ankylosing spondylitis demonstrated substantial excess risk of developing cancer. Previously the excess risk of leukaemia has been related to the estimated mean radiation dose to active bone marrow but detailed estimates were not made of the radiation doses to other organs. Data extracted from the original treatment records of a random sample of one in 15 patients have been used to make dose estimates, using Monte Carlo methods, for 30 specific organs or body regions and 12 bone marrow sites. Estimates of mean and median organ doses, standard deviations and ranges have been tabulated. Detailed distributions are presented for six organs (lung, bronchi, stomach, oesophagus, active bone marrow and total body). Comparison with the earlier bone marrow estimates and more recent theoretical estimates shows good agreement. (author)

388

Criptosporidiose em paciente com espondilite anquilosante usando adalimumabe Cryptosporidiosis in a patient with ankylosing spondylitis treated with adalimumab  

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Full Text Available A criptosporidiose é uma doença parasitária causada pelo protozoário Cryptosporidium sp. Observou-se um aumento no número de diagnósticos realizados nos últimos vinte anos, principalmente em pacientes que apresentam imunodeficiências como a síndrome da imunodeficiência humana adquirida e as imunodeficiências induzidas como em pacientes transplantados e nos que necessitam realizar hemodiálise frequentemente. Relata-se o caso de um jovem com espondilite anquilosante que, usando adalimumabe, apresentou diarreia devido à criptosporidiose.Cryptosporidiosis is a parasitic disease caused by a protozoan called Cryptosporidium sp. An increased number of diagnoses were made in the last 20 years, especially in patients with immunodeficiency like the acquired human immunodeficiency syndrome and induced immunodeficiency, such as in transplant patients and those who need frequent hemodialysis, has been observed. We report the case of a young patient with ankylosing spondylitis treated with adalimumab who developed chronic diarrhea secondary to cryptosporidiosis

Fernando Augusto Chiuchetta

2010-06-01

389

Criptosporidiose em paciente com espondilite anquilosante usando adalimumabe / Cryptosporidiosis in a patient with ankylosing spondylitis treated with adalimumab  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: Portuguese Abstract in portuguese A criptosporidiose é uma doença parasitária causada pelo protozoário Cryptosporidium sp. Observou-se um aumento no número de diagnósticos realizados nos últimos vinte anos, principalmente em pacientes que apresentam imunodeficiências como a síndrome da imunodeficiência humana adquirida e as imunodef [...] iciências induzidas como em pacientes transplantados e nos que necessitam realizar hemodiálise frequentemente. Relata-se o caso de um jovem com espondilite anquilosante que, usando adalimumabe, apresentou diarreia devido à criptosporidiose. Abstract in english Cryptosporidiosis is a parasitic disease caused by a protozoan called Cryptosporidium sp. An increased number of diagnoses were made in the last 20 years, especially in patients with immunodeficiency like the acquired human immunodeficiency syndrome and induced immunodeficiency, such as in transplan [...] t patients and those who need frequent hemodialysis, has been observed. We report the case of a young patient with ankylosing spondylitis treated with adalimumab who developed chronic diarrhea secondary to cryptosporidiosis

Fernando Augusto, Chiuchetta.

2010-06-01

390

[Radiologic changes in the costovertebral and costotransverse joints and functional changes in the thoracic spine in ankylosing spondylitis].  

Science.gov (United States)

Radiological, morphological and functional changes of the thoracic spine together with costovertebral and costotransversal joint involvement were studied in patients with ankylosing spondylitis. While radiological changes were found in all patients, in 74% they were of inflammatory origin. Radiological abnormalities were more prominent in patients with a more severe clinical course and a relatively short duration of the disease. As many as 95% of patients exhibited functional impairment of the thoracic spine. No significant difference was observed between the duration of disease and functional impairment of the thoracic spine (t = 1.4, P > 0.05) but there was a highly significant correlation between radiological changes and functional impairment of the thoracic spine (r = 0.577, P < 0.001). PMID:1366139

Jelci?, A; Jaji?, I; Fürst, Z

1992-01-01

391

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

DEFF Research Database (Denmark)

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 spine MRI score for activity (ASspiMRI-a), the Berlin method (a modification of the ASspiMRI-a), and the Spondyloarthritis Research Consortium of Canada Magnetic Resonance Imaging Index for Assessment of Spinal Inflammation in AS (SPARCC). All 3 methods were judged to be similar with respect to responsiveness and discrimination, although the differences in between-reader intraclass correlation coefficients (ICC) were judged to be relevant (the SPARCC method provided consistently higher ICC). The Berlin and SPARCC methods were preferred most frequently. The development of a new method combining the best elements of all methods is an additional possibility.

van der Heijde, Désirée; Landewé, Robert

2007-01-01

392

Association between copy number variations of HLA-DQA1 and ankylosing spondylitis in the Chinese Han population.  

Science.gov (United States)

Ankylosing spondylitis (AS) is a chronic inflammatory disease with complex genetic traits. Multiple sequence variations have been associated with AS, but explained only a proportion of heritability. The studies herein aimed to explore potential associations between genomic copy number (CN) variation (CNV) and AS in Han Chinese. Five AS patients were examined with the high-density comparative genomic hybridization microarrays in the first screen test for AS-associated CNVs. A total of 533 AS patients and 792 unrelated controls were examined in confirmation studies with the AccuCopy assays. A significant association was observed between the CNV of HLA-DQA1 and that of AS. Compared with controls, AS patients showed an aberrant CN, and a significantly increased number of patients had more than two copies of HLA-DQA1. Therefore, the CNV of HLA-DQA1 may have an important role in susceptibility to AS in the Han Chinese population. PMID:24048351

Wang, J; Yang, Y; Guo, S; Chen, Y; Yang, C; Ji, H; Song, X; Zhang, F; Jiang, Z; Ma, Y; Li, Y; Du, A; Jin, L; Reveille, J D; Zou, H; Zhou, X

2013-12-01

393

Occurrence of ankylosing spondylitis and multiple sclerosis-like syndrome in a HLA-B27 positive patient.  

Science.gov (United States)

Occurrence of multiple sclerosis (MS) in patients with ankylosing spondylitis (AS) has been reported in isolated cases. We describe a white 33-year-old male with a definite familial HLAB27 positive AS and MS-like syndrome. The patient developed acute onset of gait difficulty, postural unsteadiness, dysarthria and right side weakness that resolved within 1 month; after 6 months he presented right-sided face sensory loss, disappeared after 2 weeks. Brain and cervical MRI was performed twice and showed disseminated lesions in space (multiple foci of increased signal intensity in the periventricular white matter, in the corpus callosum, in the hypothalamus, in the brainstem and in the cervical spinal cord) and in time (a new enhancing lesion >3 months after the onset of the clinical event). Visual evoked potentials were markedly altered. Cerebrospinal fluid examination was negative for intrathecal production of oligoclonal bands. Differential diagnosis was considered and other pathologies were excluded. PMID:19444380

Mignarri, Andrea; Dotti, Maria Teresa; Battisti, Carla; Vallone, Ignazio; Federico, Antonio

2009-08-01

394

Family studies in Bechterew's syndrome (ankylosing spondylitis). I. Prevalences of symptoms and signs in relatives of HLAB27 positive probands.  

Science.gov (United States)

All available adult first-degree relatives of 66 patients with HLAB27 positive ankylosing spondylitis were examined clinically and radiographically and their white blood cells were HLA typed. Ten per cent of all relatives and 20% of HLAB27 positive relatives had Bechterew's syndrome. An additional 10% had minimal radiographical changes in the sacro-iliac joints, or peripheral arthropathy. Sixteen out of 19 persons who had minimal radiographical changes in the sacro-iliac joints were HLAB27 positive. Backache was common (25% or more) in any group of relatives, and did not discriminate well between relatives with or without Bechterew's syndrome. Spine or chest stiffness should prompt examination for Bechterew's syndrome, but is an inadequate diagnostic criterion for the syndrome. Typing for HLAB27 is probably the best prognostic test, although most HLAB27 positive persons did not exhibit any objective sign of disease. Repeated radiographical examination of HLAB27 negative persons should be avoided. PMID:6232702

Møller, P; Vinje, O; Dale, K; Berg, K; Kåss, E

1984-01-01

395

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

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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-? (TNF-? inhibitors represented a significant advance in the management of rheumatoid arthritis (RA and other chronic inflammatory diseases. Although three TNF-? 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-? 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-? 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-? 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, golimumab has the potential advantage of once monthly subcutaneous administration and the possibility of both subcutaneous and intravenous administration.Keywords: golimumab, TNF-? inhibitors, rheumatoid arthritis, psoriatic arthritis, ankylosing spondylitis

Jonathan Kay

2009-07-01

396

[Welfare as the goal of the analgesic pharmacotherapy accompanying biological treatment in patients with rheumatoid arthritis and ankylosing spondylitis].  

Science.gov (United States)

Therapy of chronic rheumatic diseases, such as rheumatoid arthritis (RA) and ankylosing spondylitis (AS) needs a comprehensive approach to the patient, based on the control of pain and improvement in overall condition, which affects the quality-of-life. This requires optimizing the treatment with non-steroidal anti-inflammatory drugs (NSAIDs) or analgesics and control of adverse drug reactions. The aim of the study was to evaluate the efficacy and safety of pain pharmacotherapy in patients with rheumatoid arthritis and ankylosing spondylitis treated as the basic pharmacotherapy-biological drugs, the analysis of awareness of pharmacovigilance and evaluation of analgesic treatment costs. Material and methods. Examined group consisted of 102 people with RA or AS received biological therapy. Test method was questionnaire with closed and open questions. Results. 86.2% of respondents used a pain medication (41%--an ad hoc basis, but 23%--at least once a day), while 79.4%--NSAIDs (33%--an ad hoc basis and 17%--at least once a day). In 85.3% of those not observed adverse effects of pain pharmacotherapy. 5 persons declared abdominal pain. Most of the patients complied with the recommendations of the doctor in the pain treatment. For the third respondents the cost of pharmacotherapy of pain was monthly 1-10 zl, but 6% of patients paying for drugs from 50-60 and above 60 zl monthly. Conclusions. Biological treatment in RA and AS is effective but requires additional analgesic therapy. Adverse effects seen during pharmacological treatment of chronic pain in rheumatic diseases are, in practice sporadic. Therapeutic patient education with chronic diseases is proper. Costs borne by the patient's pain relief in this group are not too high. PMID:25546988

Tomasiewicz, Beata; Hurkacz, Magdalena; Jarzibowski, Jaros?aw; Wiela-Hoje?ska, Anna

2014-11-01

397

OA01.04. Management of ankylosing spondylitis through ayurvedic medicine along with agnikarma- A case study  

Science.gov (United States)

Purpose: To specify the role of Ayurvedic medicine along with Agni karma in treatment of Ankylosing spondylitis, a chronic inflammatory arthritis and auto immune disease with a strong genetic predisposition Method: In present case study of AS with +ve HLAB27 and LDH (lactate dehydrogenase) 624.1U/L(normal range 230460U/L)with radiological abnormalities at the sight of L.S. spine AP and Lt. are symptoms of mild lumbar spondylosis with right sacro-iliac arthritis. The patient was having Vata and Kapha dominant symptoms like Amavata so he was subjected to therapy which performs removal of Ama and detoxification of toxins from the body followed by ruksh virechan with swadista virechan churna 5 gm in every 4 days once in night and Nadi sweda with dashmool kwath for 7days there after agni karma in every 15 days periodically along with hypothetical herbomineral combination up to 6 months as patient follows. Result: After 4 months of regular treatment all other typical features related to disease like amajeerna, shoola etc were also improved. In lab reports, HLAB27 became negative and LDH returned to normal range up to 294U/L. In radiological reports the fusion of vertebral column was also reversed as showed in AP view of X-ray imaging. This particular case has proved the importance of Ayurvedic medicine and Agni karma in AS. Conclusion: Ayurvedic intervention was found to be efficacious in management of Ankylosing spondylitis. Further studies are needed to establish efficacy on the basis of rigorous parameters.

Tamrakar, Anupam; Sonkar, Ramsukh; Chandrakar, Vijaya Lakshmi; Tamrakar, Er. Anuraj

2012-01-01

398

Brazilian-portuguese version and applicability questionnaire of the mobility index for ankylosing spondyliti Versão em língua portuguesa do Brasil e a reprodutibilidade do questionário de índice de mobilidade para espondilite anquilosante  

Directory of Open Access Journals (Sweden)

Full Text Available PURPOSE: To translate and adapt the Bath Ankylosing Spondylitis Methodology Index (BASMI - a metrological measurement for the assessment of patients with ankylosing spondylitis to Brazilian-Portuguese and to analyze the applicability of the questionnaire. METHODS: The Brazilian-Portuguese version of the Bath Ankylosing Spondylitis Methodology Index was achieved through a translation and back-translation process. This new Bath Ankylosing Spondylitis Methodology Index version was administered to 25 consecutive patients with ankylosing spondylitis who met the 1984 New York criteria for ankylosing spondylitis and were followed in the Soronegative Spondyloarthropathy Unit of the Rheumatology Division, São Paulo University Medical School, from May to November 2005. In order to evaluate the applicability of the questionnaire, it was administered to patients by 2 separate observers, A and B (Rheumatologists, enabling inter-observer test analysis. After 2 weeks, the second interview was administered to the same patients by observer A only to analyze the intra-observer test. All interviews were conducted in the morning. The Pearson coefficient correlation was used to evaluate applicability. RESULTS: There was no conflict stemming from translation and re-translation of Bath Ankylosing Spondylitis Methodology Index questionnaire, and cross-cultural adaptation proved unnecessary. All components had statistically significant coefficients for intra- and inter-observational applicability, with scores ranging from 0.85 to 1.00 and 0.80 to 0.94, respectively. DISCUSSION: The Brazilian-Portuguese version of the Bath Ankylosing Spondylitis Methodology Index proved to be an applicable instrument for analyzing the mobility index of Brazilian patients with ankylosing spondylitis.OBJETIVO: Traduzir e adaptar para a língua portuguesa do Brasil o Bath Ankylosing Spondylitis of Metrodology Index (BASMI - instrumento de mensuração metrológica de pacientes com espondilite anquilosante - além de avaliar a reprodutibilidade deste questionário. MÉTODOS: O Bath Ankylosing Spondylitis of Metrodology Index em versão língua portuguesa do Brasil foi obtida após processo de tradução e retro-tradução. Essa nova versão foi aplicada em 25 pacientes consecutivos com espondilite anquilosante, que preenchiam os critérios modificados de Nova Iorque de 1984 e que estavam em acompanhamento na Unidade de Espondiloartropatia Soronegativa do Serviço de Reumatologia da Faculdade de Medicina de Universidade de São Paulo, de maio a novembro de 2005. Para avaliar a reprodutibilidade, o questionário foi aplicado aos pacientes por dois observadores fixos e independentes: A e B (Reumatologistas, no mesmo dia, para avaliar teste interobservador. Após 14 dias, o observador A reaplicou o questionário aos mesmos pacientes para avaliação de teste intra-observador. Todas as entrevistas foram feitas no período de manhã. O coeficiente de correlação de Pearson foi usado para avaliação da reprodutibilidade. RESULTADOS: Não houve conflito quanto a tradução e re-tradução do questionário Bath Ankylosing Spondylitis of Metrodology Index. Também não houve a necessidade de adaptação cultural. Todos os componentes do Bath Ankylosing Spondylitis of Metrodology Index apresentaram coeficiente estatisticamente significante para reprodutibilidade intra e interobservadores, com escores, respectivamente, variando entre 0,85 a 1,00, e 0,80 a 0,94. DISCUSSÃO: O Bath Ankylosing Spondylitis of Metrodology Index, versão para a língua portuguesa do Brasil, mostrou-se ser um instrumento reprodutível para ser utilizado na avaliação do índice de mobilidade de pacientes brasileiros com espondilite anquilosante.

Samuel Katsuyuki Shinjo

2007-01-01

399

Brazilian-portuguese version and applicability questionnaire of the mobility index for ankylosing spondyliti / Versão em língua portuguesa do Brasil e a reprodutibilidade do questionário de índice de mobilidade para espondilite anquilosante  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: English Abstract in portuguese OBJETIVO: Traduzir e adaptar para a língua portuguesa do Brasil o Bath Ankylosing Spondylitis of Metrodology Index (BASMI) - instrumento de mensuração metrológica de pacientes com espondilite anquilosante - além de avaliar a reprodutibilidade deste questionário. MÉTODOS: O Bath Ankylosing Spondyliti [...] s of Metrodology Index em versão língua portuguesa do Brasil foi obtida após processo de tradução e retro-tradução. Essa nova versão foi aplicada em 25 pacientes consecutivos com espondilite anquilosante, que preenchiam os critérios modificados de Nova Iorque de 1984 e que estavam em acompanhamento na Unidade de Espondiloartropatia Soronegativa do Serviço de Reumatologia da Faculdade de Medicina de U