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1

Diagnosing early ankylosing spondylitis.  

Science.gov (United States)

Diagnosis of ankylosing spondylitis is still delayed by many years. Several efforts have been made in the past few years to shorten this delay. A new set of criteria for inflammatory back pain has performed better than previous sets. MRI has evolved to become the standard imaging modality for the detection of sacroiliitis during early disease, and it clearly outperforms quantitative scintigraphy, which was the standard screening test for many years. Promising new developments such as whole body MRI and ultrasound (sonography) for the detection of enthesitis or sacroiliitis deserve further evaluation. Serum antibodies directed against a 28-kD Drosophila antigen may provide additional diagnostic information. A recently proposed diagnostic algorithm in patients with suspected early ankylosing spondylitis may help physicians confidently diagnose patients before definite radiographic sacroiliitis is detectable. Finally, referral strategies for patients seen by primary care physicians seem to work well and are currently under further valuation. PMID:17915092

Song, In-Ho; Sieper, Joachim; Rudwaleit, Martin

2007-10-01

2

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

Hodler Juerg

2007-02-01

3

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.)

1979-01-01

4

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...

2007-01-01

5

Ankylosing spondylitis.  

Science.gov (United States)

Ankylosing spondylitis is an inflammatory disease involving entheses and joints, especially those in and around the spine. The most widespread involvement of the respiratory system by this disease occurs when this pathological process gives rise to chest wall pain, diminished chest wall movement and a dorsal stoop. As healing of the inflammatory process takes place, calcification occurs which leads to rigidity of these structures, with consequent loss of chest expansion which is exacerbated by the increasingly kyphotic spinal posture and intercostal muscle inefficiency. Fortunately diaphragmatic function is unimpaired and compensates well, so that there are only minor restrictive changes found in tests of respiratory function. Treatment is by mobilizing physiotherapy coupled with a home exercise programme encouraging mobility and improved cardiovascular fitness. As with many physical treatment methods, good quality controlled studies of efficacy are rare. The role of medication is to ease symptoms and hence enable exercise. Apical fibrobullous lung disease is found in a small proportion of AS patients. The initial changes are mainly fibrotic, with bullae becoming more important as the condition progresses. The disease may progress to major cavitation, which is prone to infection, especially with aspergillae. No methods exist which can either prevent the development of fibrobullous disease or halt its progression, although this may happen spontaneously. The main effects of therapy are aimed at the diagnosis and treatment of superinfection. Treatment of established aspergillosis, especially when aspergilloma formation has taken place, is unsatisfactory and carries substantial risks of morbidity and death. Non-apical pleural involvement, including pleural effusion, is very rare. The most common cause of breathlessness in AS patients is cardiac involvement by the disease. PMID:8519080

Haslock, I

1993-02-01

6

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 interstitial lung disease in early AS

2003-07-01

7

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

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

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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

9

Andersson Lesion in Ankylosing Spondylitis  

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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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Gait analysis in ankylosing spondylitis.  

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A study was conducted to compare the gait pattern of 12 patients with ankylosing spondylitis with axial disease only with that of 11 healthy controls using a telemeterised electrogoniometer gait analysis system. The reproducibility of the gait variables was found to be acceptable. Angles for movement at the hip and knee were less in patients with ankylosing spondylitis, but hip/knee angle ratios did not differ between the two groups. The stride length was shorter in the patients with ankylosi...

1992-01-01

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Chronic bronchiolitis in ankylosing spondylitis.  

Science.gov (United States)

The pleuro-pulmonary signs of ankylosing spondylitis are generally asymptomatic, typically represented by biapical lung fibrosis. To our knowledge, the severe bronchiolitis which is sometimes observed in other spondyloarthropathies has not been described in ankylosing spondylitis. We report two cases of severe chronic bronchiolitis in ankylosing spondylitis patients. Their clinical and radiological presentation were similar, characterized by progressive deterioration of stage III-IV dyspnea, non-reversible obstructive ventilatory defect, and CT scan showing air trapping with mosaic attenuation and ground-glass opacity in expiration. Lung biopsies confirmed the diagnosis of severe follicular bronchiolitis in one patient and constrictive bronchiolitis is suspected in the other. Only the patient with follicular bronchiolitis responded positively to treatment with low doses of macrolides. PMID:24284298

Marquette, David; Diot, Elisabeth; De Muret, Anne; Favelle, Olivier; Sonneville, Alain; Mammou, Saloua; Dumont, Pascal; Diot, Patrice; Marchand-Adam, Sylvain

2013-10-01

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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.)

1979-01-01

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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

2001-12-01

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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 clinically suspected ankylosing spondylitis or other joint diseases

1995-05-01

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[Diagnosis and approach in suspected ankylosing spondylitis].  

Science.gov (United States)

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

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

1991-05-21

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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

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On diet in ankylosing spondylitis  

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The aim of this thesis was to examine the role of diet in ankylosing spondylitis (AS). Patients were examined in: i) a postal questionnaire survey of dietary habits and gastrointestinal (GI) symptoms; ii) a study on biomarkers of diet and disease activity; iii) a comparison of cardiovascular risk factors with the general population using data from the Va?sterbotten Intervention Programme (VIP), and; iv) a 21-week omega-3 fatty acid supplementation study regarding the effects on disease activ...

Sundstro?m, Bjo?rn

2011-01-01

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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

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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.)

1987-01-01

20

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

 
 
 
 
21

Spinal instability in ankylosing spondylitis  

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Full Text Available 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. Materials and Methods: In a retrospective analysis of 16 cases of ankylosing spondylitis, treated surgically for unstable spinal lesions over a period of 12 years (1995-2007; 87.5% (n=14 patients had low energy (no obvious/trivial trauma while 12.5% (n=2 patients sustained high energy trauma. The most common presentation was pain associated with neurological deficit. The surgical indications included neurological deficit, chronic pain due to instability and progressive deformity. All patients were treated surgically with anterior surgery in 18.8% (n=3 patients, posterior in 56.2% (n=9 patients and combined approach in 25% (n=4 patients. Instrumented fusion was carried out in 87.5% (n=14 patients. Average surgical duration was 3.84 (Range 2-7.5 hours, blood loss 765.6 (± 472.5 ml and follow-up 54.5 (Range 18-54 months. The patients were evaluated for pain score, Frankel neurological grading, deformity progression and radiological fusion. One patient died of medical complications a week following surgery. Results: Intra-operative adverse events like dural tears and inadequate deformity correction occurred in 18.7% (n=3 patients (Cases 6, 7 and 8 which could be managed conservatively. There was a significant improvement in the Visual analogue score for pain from a pre-surgical median of 8 to post-surgical median of 2 (P=0.001, while the neurological status improved in 90% (n=9 patients among those with preoperative neurological deficit who could be followed-up (n =10. Frankel grading improved from C to E in 31.25% (n=5 patients, D to E in 12.5% (n=2 and B to D in 12.5% (n=2, while it remained unchanged in the remaining - E in 31.25% (n=5, B in 6.25% (n=1 and D in 6.25% (n=1. Fusion occurred in 11 (68.7% patients, while 12.5% (n=2 had pseudoarthrosis and 12.5% (n=2 patients had evidence of inadequate fusion. 68.7% (n=11 patients regained their pre-injury functional status, with no spine related complaints and 25% (n=4 patients had complaints like chronic back pain and deformity progression. In one patient (6.2% who died of medical complications a week following surgery, the neurological function remained unchanged (Frankel grade D. Persistent back pain attributed to inadequate fusion/ pseudoarthrosis could be managed conservatively in 12.5% (n=2 patients. Progression of deformity and pain secondary to pseudoarthrosis, requiring revision surgery was noted in one patient (6.2%. One patient (6.2% had no neurological recovery following the surgery and continued to have nonfunctional neurological status. Conclusion: In ankylosing spondylitis, the diagnosis of unstable spinal lesions needs high index of suspicion and extensive radiological evaluation Surgery is indicated if neurological deficit, two/three column injury, significant pain and progressive deformity are present. Long segment instrumentation and fusion is ideal.

Badve Siddharth

2010-01-01

22

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

23

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)

1989-01-01

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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)

2008-01-01

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Urolithiasis in ankylosing spondylitis: Correlation with Bath ankylosing spondylitis disease activity index (BASDAI), Bath ankylosing spondylitis functional index (BASFI) and Bath ankylosing spondylitis metrology index (BASMI)  

Science.gov (United States)

Background: Increased incidence of renal stone has been reported in ankylosing spondylitis (AS), but unlike some well-known renal involvements, they have not been fully studied. The aim of this study was to investigate the association of AS with urolithiasis and also the relation between urinary stone and severity markers. Methods: One hundred-sixty three AS patients were included in a cross-sectional study from Iranian AS association, Iran Rheumatology Center and Rheumatology Clinic of Shariati Hospital in Tehran. Prevalence of urolithiasis in AS patients was compared with results of a nationwide survey in Iran. Bath ankylosing spondylitis disease activity index (BASDAI), bath ankylosing spondylitis functional index (BASFI) and bath ankylosing spondylitis metrology index (BASMI) were determined for assessment of disease severity. Results: Urolithiasis was observed in 11.7% of AS patients versus 5.7% of normal population (p=0.001). After the elimination of corticosteroid effect, the prevalence of urolithiasis was still higher in AS patients than normal population but without maintaining significant difference. Significant higher values of BASFI, BASMI, BASDAI scores were observed in AS with urolithiasis than AS without urolithiasis. Conclusion: The results confirmed the association of AS with urolithiasis. However, this may be partly due to the effect of other factors such as corticosteroid. Moreover, urolithiais is accompanied with more severe diseases.

Fallahi, Sasan; Jamshidi, Ahmad Reza; Gharibdoost, Farhad; Mahmoud, Mahdi i; Paragomi, Pedram; Nicknam, Mohammad Hossein; Farhadi, Elham; Qorbani, Mostafa

2012-01-01

26

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

27

Rehabilitation techniques in ankylosing spondylitis management: a case report  

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Ankylosing spondylitis (AS) is a chronic inflammatory disorder of the musculoskeletal system. Progressive complaints of axial stiffness and restriction in movement may not be addressed by general medical practitioners. While AS has a progressive natural history, chiropractors may play a significant role in early detection, patient education, and management. Early diagnosis and therapy may help to minimize future pain and disability. Chiropractic treatment methods coupled with individualized a...

2003-01-01

28

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 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.)

2002-12-01

29

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

2009-03-01

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Polyclonal B cell activation in ankylosing spondylitis.  

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The peripheral blood lymphocyte response of patients with ankylosing spondylitis (AS) to several polyclonal B cell activators was investigated. No differences were found in the reactivity to pokeweed mitogen and protein A between patients and controls; in contrast, the peripheral blood lymphocyte response to Staphylococcus aureus strain Cowan I (SAC) was significantly higher in patients with AS than in controls. This responsiveness was not influenced either by the presence of the HLA-B27 anti...

1990-01-01

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Treatment of ankylosing spondylitis: focus on etanercept  

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Ankylosing spondylitis is a chronic inflammatory condition which preferentially affects the axial skeleton, often beginning in the sacroiliac joints. The etiology of the pathologic lesions of this condition including enthesitis, erosive articular changes, osteitis, and fibrous ankylosis, as well as changes which occur in the eye, gastrointestinal tract, cardiovascular system, and lungs is unknown; however, there is a strong association with HLA-B27, which indicates altered immunity. One of th...

Frech, Tracy

2007-01-01

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Foraminal Synovial Cyst Associated with Ankylosing Spondylitis  

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Ankylosing spondylitis (AS) is frequently associated with inflammatory lesions of the spine and continuous fatigue stress fractures; however, an association with an intraspinal synovial cyst has not been previously reported. A 55-year-old man with a five year history of AS who presented with back pain and a right radiculopathy was admitted to the hospital. Five years previously, he underwent a percutaneous vertebroplasty for an osteoporotic L1 compression fracture, and was diagnosed with AS a...

Kim, Heyun Sung; Ju, Chang Il; Kim, Seok Won

2011-01-01

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Surgical orodental implications in ankylosing spondylitis  

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Temporomandibular joint and the pelvic complex are bidirectionally related. Ankylosing spondylitis (AS) is a seronegative arthropathy with the key feature of bony fusion of lumbar vertebrae. A 39 year old known case of AS was presented to private office for left lower impacted third molar surgical removal. Previously, he was rejected to receive oral care for pulpectomy and extraction due to limited mouth opening. Prior to the surgery, lateral neck radiography was obtained to exclude any sublu...

2012-01-01

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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. PMID:21279185

Rezvani, Aylin; Ozaras, Nihal

2008-11-01

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Infertility improved by etanercept in ankylosing spondylitis  

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Full Text Available 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

2008-01-01

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Coexistence of Ankylosing Spondylitis and Klinefelter's Syndrome  

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Ankylosing spondylitis is a chronic inflammatory disease characterized by inflammatory lower back pain and morning stiffness and accompanied by spine and sacroiliac joint involvement. Klinefelter's syndrome is a genetic condition that only affects males. Affected males have an extra X chromosome. This paper reports a 30-years-old male on followup with the diagnosis of Klinefelters syndrome. The patient admitted with complaints of inflammatory lower back, and neck pain and morning stiffness an...

Kobak, S?enol; Yalc?in, Murat; Karadeniz, Muamer; Oncel, Guray

2013-01-01

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Surgical Management of Temporomandibular Joint Ankylosis in Ankylosing Spondylitis  

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Relatively few patients develop such severe degenerative temporomandibular joint (TMJ) disease that they require total joint replacement. Current indications include those conditions involving condylar bone loss such as degenerative (osteoarthritis) or inflammatory joint disease (ankylosing spondylitis, rheumatoid, and psoriatic). Ankylosis of the temporomandibular joint (TMJ) secondary to ankylosing spondylitis remains an under investigated entity. We aim to provide an overview of treatment ...

2011-01-01

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Neurological complications of ankylosing spondylitis: neurophysiological assessment.  

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Studies examined the neurological involvement of ankylosing spondylitis (AS) are limited. This study aimed to assess the frequency of myelopathy, radiculopathy and myopathy in AS correlating them to the clinical, radiological and laboratory parameters. Included were 24 patients with AS. Axial status was assessed using bath ankylosing spondylitis metrology index (BASMI). Patients underwent (a) standard cervical and lumbar spine and sacroiliac joint radiography, (b) somatosensory (SSEP) and magnetic motor (MEP) evoked potentials of upper and lower limbs, (c) electromyography (EMG) of trapezius and supraspinatus muscles. Patients' mean age and duration of illness were 36 and 5.99 years. Bath ankylosing spondylitis metrology index mean score was 4.6. Twenty-five percent (n = 6) of patients had neurological manifestations, 8.3% of them had myelopathy and 16.7% had radiculopathy. Ossification of the posterior (OPLL) and anterior (OALL) longitudinal ligaments were found in 8.3% (n = 2) and 4.2% (n = 1). About 70.8% (n = 17) had >or=1 neurophysiological test abnormalities. Twelve patients (50%) had SSEP abnormalities, seven had prolonged central conduction time (CCT) of median and/or ulnar nerves suggesting cervical myelopathy. Six had delayed peripheral or root latencies at Erb's or interpeak latency (Erb's-C5) suggesting radiculopathy. Motor evoked potentials was abnormal in 54% (n = 13). Twelve (50%) and five (20.8%) patients had abnormal MEP of upper limbs and lower limbs, respectively. About 50% (n = 12) had myopathic features of trapezius and supraspinatus muscles. Only 8.3% (n = 2) had neuropathic features. We concluded that subclinical neurological complications are frequent in AS compared to clinically manifest complications. Somatosensory evoked potential and MEP are useful to identify AS patients prone to develop neurological complications. PMID:19153738

Khedr, Eman M; Rashad, Sonia M; Hamed, Sherifa A; El-Zharaa, Fatma; Abdalla, Abdel Karim H

2009-07-01

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Management of ankylosing spondylitis with infliximab  

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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 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.)

1981-01-01

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Outcomes in ankylosing spondylitis: what makes the assessment of treatment effects in ankylosing spondylitis different?  

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There are four major challenges in the assessment of outcomes in patients with ankylosing spondylitis (AS) that are particularly relevant to the evaluation of new therapies. Firstly, measures of symptoms and impairment in AS are not specific for inflammatory processes, they also capture mechanical symptoms and fixed limitations. The non?specific nature of these measures may cause them to be less responsive and therefore less useful in determining treatment efficacy. Secondly, acute phase re...

Ward, M. M.

2006-01-01

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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

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Lessons learned from cervical pseudoarthrosis in ankylosing spondylitis  

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This case report illustrates three learning points about cervical fractures in ankylosing spondylitis, and it highlights the need to manage these patients with the neck initially stabilised in flexion. We describe a case of cervical pseudoarthrosis that is a rare occurrence after fracture of the cervical spine with ankylosing spondylitis. This went undetected until the development of myelopathic symptoms many months later. The neck was initially stabilised in flexion using tongs, and then slo...

Mountney, J.; Murphy, A. J.; Fowler, J. L.

2005-01-01

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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

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Lichen amyloidosis, ankylosing spondylitis and autoimmune thyroiditis: coincidence or association?  

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Primary localized cutaneous amyloidosis (PLCA) is characterized by the deposition of amyloid in a previously apparently normal skin with the absence of other systemic or cutaneous disorder. Although ankylosing spondylitis may be associated with secondary systemic amyloidosis, no reports have been found showing the association of this disease with PLCA. In addition, the association of PLCA with autoimmune thyroiditis has not been previously reported. We report a concomitant occurrence of lichen amyloidosis, ankylosing spondylitis and autoimmune thyroiditis in a caucasian woman. PMID:10972101

Apaydin, R; Bilen, N; Bayramgürler, D; Harova, G; Cetinarslan, B

2000-03-01

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Ankylosing Spondylitis in Iran; Late Diagnosis and Its Causes  

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Background: Ankylosing spondylitis (AS) is a chronic destructive and inflammatory disease of the axial skeleton manifested by back pain and progressive stiffness of the spine. Objectives: The aim of the present cross-sectional study was to evaluate and identify factors leading to delayed diagnosis of AS in Iranian patients. Patients and Methods: Sixty patients, (53 males, 7 females) with a diagnosis of AS according to the modified New York criteria were recruited. Diagnosis delay was defined as the interval between a patient’s first spondyloarthritic symptoms [inflammatory back pain (IBP), inflammatory arthritis, enthesopathy and uveitis] and a correct diagnosis of AS. Results: The average age of patients at diagnosis of AS was 36.4 ± 4.5 years and the average of delay in diagnosis was 6.2 ± 3.5 years. The most common diagnosis at the first visit was disc herniation (68.3%). Delay in diagnosis of Human Leukocyte Antigen (HLA-B27) positive and negative patients were 4.6 ± 2.2 years and 10.1 ± 3.2 years, respectively (P = 0.0001). Diagnosis delay in patients with morning stiffness and IBP were significantly shorter than that of patients without these symptoms (P = 0.0001 and P = 0.001, respectively). Patients with uveitis had the shortest diagnosis delay (P = 0.02). The Bath Ankylosing spondylitis disease activity index (BASDAI) was not significantly different in early ( 3years) diagnosis (3.3 ± 0.9 and 3.6 ± 0.7, respectively) (P = 0.18), but the Both ankylosing spondylitis functional index (BASFI) was significantly different between them (3.3 ± 1.0 and 4.1 ± 0.7 respectively) (P = 0.001). Conclusions: In this study, delay in diagnosis was similar to other studies. Educating physicians to careful history taking especially in the case of IBP, non-musculoskeletal symptoms such as uveitis and precise physical examination are important in early diagnosis.

Hajialilo, Mehrzad; Ghorbanihaghjo, Amir; Khabbazi, Alireza; Kolahi, Suosan; Rashtchizadeh, Nadereh

2014-01-01

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Socioeconomic impact of ankylosing spondylitis in Morocco.  

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The goal of this study was to determine the impact of ankylosing spondylitis (AS) on the socioeconomic well-being of Moroccan patients. One hundred (100) consecutive AS patients (71 men, 29 women) were included. The socioeconomic consequences were studied by measuring direct costs, indirect costs (consequences on work capacity), and intangible costs (social impact) of AS. The mean age at AS onset was 26.85 years +/- 11.71 (7-64). The mean disease duration of AS was 12.05 years +/- 8.32 (0.5-39). Financial difficulties due to AS were observed in 82% of the patients. In 28% of them, these conditions explained a bad observance to treatments. In 14% of the cases, they led children to leave school to support their handicapped parents. Work disability occurred in 22.9% of initially employed patients. Withdrawal from work was correlated to bad social conditions at work, higher scores of Bath ankylosing spondylitis functional index (BASFI), and absence of adherence to a social security system. Sexual problems were present in 64.2% of the patients and were correlated to higher scores of BASFI. There were also disturbances in housekeeping (65.8%) and in leisure time activities (72.2%). Patients received a financial and a psychological familial support in, respectively, 66 and 87% of the cases. Despite the great familial support, Moroccan AS patients suffer from important socioeconomic consequences because of the illness, the bad socioeconomic conditions, the insufficiency of state help, and the social security problems. PMID:17457657

Rkain, Hanan; Allali, Fadoua; Bentalha, Aziza; Lazrak, Noufissa; Abouqal, Redouane; Hajjaj-Hassouni, Najia

2007-12-01

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From rehabilitation to remission in ankylosing spondylitis  

Directory of Open Access Journals (Sweden)

Full Text Available During the past years, exercise and non-steroidal anti-inflammatory drugs (NSAIDs have been the mainstay of symptom control for Ankylosing Spondylitis (AS, a chronic, inflammatory rheumatic disease characterized by inflammatory back pain due to sacroiliitis and spondylitis. The ASsessment in AS (ASAS international working group has constructed evidence based recommendations to guide the physician in the management of AS (1. Among the major recommendations for the management of AS, the ASAS group stated that there is a level Ib evidence that NSAIDs improve spinal pain, peripheral joint pain, and function, but comparative studies (1 or population-based survey (2 of different NSAIDs/coxib have not demonstrated one preparation to be clearly better than the others. Wanders et al (3 showed that the clinical efficacy of continuous NSAIDs/coxib treatment for AS was similar to intermittent ‘‘on demand’’ use and they suggested that the continuous treatment with NSAIDs/coxib could slow the radiographic disease progression over 2 years...

A. Spadaro

2011-06-01

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Both Baseline Clinical Factors and Genetic Polymorphisms Influence the Development of Severe Functional Status in Ankylosing Spondylitis  

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Functional severity in ankylosing spondylitis (AS) patients is variable and difficult to predict early. The aim of our study was to assess whether a combination of baseline clinical factors and genetic markers may predict the development of severe functional status in AS. We performed a cross-sectional association study on AS patients included in the Spanish National Registry of Spondyloarthropathies—REGISPONSER. Bath Ankylosing Spondylitis Functional Index (BASFI) was standardized by adjus...

2012-01-01

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Spinal ankylosing spondylitis: a variant form of ankylosing spondylitis or a distinct disease entity?  

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In a population survey of ankylosing spondylitis (AS) seven subjects, six males and one female, had x-ray changes in the lumbar spine typical of AS but without concomitant roentgenological sacroiliitis. The overall prevalence of such cases in the population studied was 0.37%. Four out of these seven subjects carried the tissue antigen HLA-B27 (57%). The clinical and roentgenological features of these subjects are described and it is suggested that the x-ray findings represent a mild and varia...

Gran, J. T.; Husby, G.; Hordvik, M.

1985-01-01

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The genomics and genetics of ankylosing spondylitis  

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Full Text Available Tony J Kenna, Stuart I Davidson, Gethin P ThomasUniversity of Queensland Diamantina Institute, Brisbane, AustraliaAbstract: The spondyloarthropathies are a group of arthritides which specifically target the spine and pelvis with ankylosing spondylitis (AS being the most prevalent and debilitating of these conditions. Unique to AS is the progression to excessive uncontrolled bone formation following an initial inflammatory phase that can result in joint fusion and significant disability. Spondyloarthritis is estimated to affect 1%–2% of the population, twice as many as rheumatoid arthritis and thus constitutes a significant health problem. Currently AS pathogenesis is very poorly understood but recent large-scale genetics and gene expression profiling studies have identified some of the underlying mechanisms and pathways contributing to the disease. Genome-wide association studies have identified a number of candidate genes associated with AS sharing the same pathways which are now being targeted for therapeutic intervention. However, although such approaches can identify genes contributing to the disease process and are very informative as to disease aetiopathogenesis, they cannot profile the actual changes in gene/cell activity at any point in the disease process or possibly more importantly at specific sites. Such information is generated using expression profiling. A number of expression profiling studies have been undertaken in AS, looking at both circulating cells and tissues from affected joints. Although some common genes/pathways have been identified, overall the results to date have been somewhat disappointing due to differences in experimental design and tissue source as well as the low power of the studies. More recent better powered studies have shown some potential in developing gene expression profiling as a diagnostic tool in AS. True future success will rely on larger genetic and genomic studies and the combination of these datasets in eQTL studies requiring significant collaborative efforts. Such larger-scale approaches will also generate sufficient power to target specific disease stages and sites.Keywords: ankylosing spondylitis, genomewide association studies, gene expression, microarrays, spondylarthritis, inflammatory arthritis

Thomas GP

2011-12-01

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Evaluation of serum paraoxonase and arylesterase activities in ankylosing spondylitis patients  

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Full Text Available 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 study 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

2010-01-01

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Pain pressure threshold values in ankylosing spondylitis.  

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Rheumatic patients experience persistent and disabling pain. We aimed to investigate the pain pressure threshold (PPT) values in ankylosing spondylitis (AS) patients compared to rheumatoid arthritis (RA) patients and healthy subjects. The relationship between lumbar and thoracal Schober, chin-to-chest distance, occiput-to-wall distance, finger-to-floor distance, chest expansion, and pain scores were also evaluated in an AS group. Our study group consisted of 17 AS patients, 20 RA patients, and 21 healthy volunteers. Eighteen tender points accepted by the American College of Rheumatism (ACR) for fibromyalgia syndrome evaluation in 1990 and three control points were evaluated with Fischer's tissue compliance meter, which can also be used as an algometer. Fourteen paravertebral points were evaluated, and mean values of paravertebral myalgic scores were recorded in the AS group. Our data indicate that AS patients do not have lower PPT with respect to healthy individuals, whereas RA patients have significantly lower PPT. A significant correlation was obtained between finger-to-floor distance and paravertebral myalgic score for AS. We conclude that AS does not have a widespread pain nature as RA. PMID:12172953

Incel, Nurgül Arinci; Erdem, H Rana; Ozgocmen, Salih; Catal, Sema Atalay; Yorgancioglu, Z Rezan

2002-08-01

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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

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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.

2000-09-01

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Autoimmune thyroid disease in ankylosing spondylitis.  

Science.gov (United States)

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 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

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Effect of Pilates training on people with ankylosing spondylitis.  

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

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

2012-07-01

59

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

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Full Text Available 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, Autoimmunity

. Katsinelos P.

2007-03-01

60

Radiological changes of the symphysis in ankylosing spondylitis  

International Nuclear Information System (INIS)

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

2000-07-01

 
 
 
 
61

Economic Considerations of the Treatment of Ankylosing Spondylitis  

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Ankylosing spondylitis (AS)is associated with both significant direct and indirect costs,which vary by country, and have generally increased dramatically since the introduction of anti-TNF therapy. The cost-effectiveness of biologic agents is controversial, although cost-effectiveness studies need to consider the potential impact of anti-TNF treatments on work ability. Alternatives to reduce costs associated with biologics have been examined, including on-demand dosing and lower dose alternat...

Reveille, John D.; Ximenes, Antonio; Ward, Michael M.

2012-01-01

62

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

2004-05-01

63

MRI of the axial skeletal manifestations of ankylosing spondylitis  

Energy Technology Data Exchange (ETDEWEB)

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

64

Polyarthritis flare in patient with ankylosing spondylitis treated with infliximab  

Directory of Open Access Journals (Sweden)

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

65

Ankylosing spondylitis is associated with upper lobe lung fibrosis  

International Nuclear Information System (INIS)

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.)

1987-01-01

66

IgA-alpha 1 antitrypsin complexes in ankylosing spondylitis.  

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A study of 95 serum samples from 61 patients with ankylosing spondylitis (AS) showed that 21 patients (34%) had raised levels of IgA-alpha 1 antitrypsin complexes. These were associated with active disease as measured by a clinical index and also with erythrocyte sedimentation rate, C reactive protein, and serum IgA. In particular, an association was noted between 'extraspinal' manifestations of AS such as synovitis, uveitis, and active inflammatory properties of these complexes. It is sugges...

Struthers, G. R.; Lewin, I. V.; Stanworth, D. R.

1989-01-01

67

ASKyphoplan: a program for deformity planning in ankylosing spondylitis  

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A closing wedge osteotomy of the lumbar spine may be considered to correct posture and spinal balance in progressive thoracolumbar kyphotic deformity caused by ankylosing spondylitis (AS). Adequate deformity planning is essential for reliable prediction of the effect of surgical correction of the spine on the sagittal balance and horizontal gaze of the patient. The effect of a spinal osteotomy on the horizontal gaze is equal to the osteotomy angle. However, the effect of a spinal osteotomy on...

Royen, Barend J.; Scheerder, Famke J.; Jansen, Eric; Smit, Theo H.

2007-01-01

68

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

69

Higher prevalence of peripheral arthritis among ankylosing spondylitis patients.  

Science.gov (United States)

This study was performed to define the clinical spectrum and disease manifestations of ankylosing spondylitis (AS) in a referral hospital setting. We identified the differences in clinical manifestations according to the sex, the age at onset, the presence of peripheral arthritis and the presence of HLA B27. A total 412 patients (357 males, 55 females) were recruited. Eighty-seven percent were men and 155 out of 412 patients (35%) were juvenile-onset. HLA B27 was detected in 385 patients (93%). Peripheral joint involvement was noted in 287 of total AS cases (juvenile- onset ankylosing spondylitis (JOAS), 82%; adult-onset ankylosing spondylitis (AOAS), 61%), and was more common than those reported in other studies. A greater portion of patients with JOAS had peripheral arthritis and peripheral enthesitis than the patients with AOAS. The patients with peripheral arthritis showed a younger age at onset and an increased tendency of having enthesitis and trauma history. The natural history of Korean AS appears largely similar to those seen in Europe and North America, except a few differences. JOAS was quite common and AS was about nine times more common in men than in women. In addition, the HLA B27 antigen frequency was 93%, which is higher than those reported in other studies. PMID:12378021

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

2002-10-01

70

Ankylosing spondylitis in a military aviator: air medical considerations.  

Science.gov (United States)

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

71

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

72

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

73

MRI manifestations of lumbar active inflammation in ankylosing spondylitis  

International Nuclear Information System (INIS)

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

2008-06-01

74

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

International Nuclear Information System (INIS)

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

1994-05-01

75

Atividade sexual na espondilite anquilosante / Sexual activity in ankylosing spondylitis  

Scientific Electronic Library Online (English)

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.

76

Atividade sexual na espondilite anquilosante Sexual activity in ankylosing spondylitis  

Directory of Open Access Journals (Sweden)

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

77

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

1989-01-01

78

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

Directory of Open Access Journals (Sweden)

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

79

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

80

Higher prevalence of peripheral arthritis among ankylosing spondylitis patients.  

Digital Repository Infrastructure Vision for European Research (DRIVER)

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

Lee, Ji-hyun; Jun, Jae-bum; Jung, Sungsoo; Bae, Sang-cheol; Yoo, Dae-hyun; Kim, Think-you; Kim, Seong Yoon; Kim, Tae-hwan

2002-01-01

 
 
 
 
81

Ankylosing spondylitis in North India: a clinical and immunogenetic study.  

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Fifty-one North Indian patients with ankylosing spondylitis (AS) are described with mean age of onset 21.2 years and male to female ratio of 16:1. AS began with peripheral arthritis in 47%, low back pain in 41%, acute anterior uveitis in 10%, and heel pain in 2% of the patients. 76% of 51 patients had one of the extra-axial features of AS: peripheral arthritis (61%), heel pain (24%), anterior uveitis (22%), urethritis (12%), kidney disease (10%), mucosal ulcerations (6%), aortic incompetence ...

Prakash, S.; Mehra, N. K.; Bhargava, S.; Vaidya, M. C.; Malaviya, A. N.

1984-01-01

82

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

Scientific Electronic Library Online (English)

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.

83

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

1998-02-01

84

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

85

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

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To identify susceptibility loci for ankylosing spondylitis, we undertook a genome-wide association study in 2,053 unrelated ankylosing spondylitis cases among people of European descent and 5,140 ethnically matched controls, with replication in an independent cohort of 898 ankylosing spondylitis cases and 1,518 controls. Cases were genotyped with Illumina HumHap370 genotyping chips. In addition to strong association with the major histocompatibility complex (MHC; P rs11209026; P = 9.1 x 10(-14)) and ERAP1 (rs27434; P = 5.3 x 10(-12)). This study reports four genetic loci associated with ankylosing spondylitis risk and identifies a major role for the interleukin (IL)-23 and IL-1 cytokine pathways in disease susceptibility. PMID:20062062

Reveille, John D; Sims, Anne-Marie; Danoy, Patrick; Evans, David M; Leo, Paul; Pointon, Jennifer J; Jin, Rui; Zhou, Xiaodong; Bradbury, Linda A; Appleton, Louise H; Davis, John C; Diekman, Laura; Doan, Tracey; Dowling, Alison; Duan, Ran; Duncan, Emma L; Farrar, Claire; Hadler, Johanna; Harvey, David; Karaderi, Tugce; Mogg, Rebecca; Pomeroy, Emma; Pryce, Karena; Taylor, Jacqueline; Savage, Laurie; Deloukas, Panos; Kumanduri, Vasudev; Peltonen, Leena; Ring, Sue M; Whittaker, Pamela; Glazov, Evgeny; Thomas, Gethin P; Maksymowych, Walter P; Inman, Robert D; Ward, Michael M; Stone, Millicent A; Weisman, Michael H; Wordsworth, B Paul; Brown, Matthew A

2010-02-01

86

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

87

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

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

Wariaghli Ghizlane

2012-03-01

88

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

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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 functi...

Mustur Dušan; Vesovi?-Poti? Vladislava; Stanisavljevi? Dejana; Ille Tatjana; Ille Mihailo

2009-01-01

89

Prevalence of vertebral compression fractures due to osteoporosis in ankylosing spondylitis.  

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OBJECTIVE--To determine the prevalence of vertebral compression fractures due to osteoporosis in patients with ankylosing spondylitis. DESIGN--Prospective study of 111 consecutive patients; patients with vertebral compression fractures were entered into a case-control study. SETTING--Outpatient clinic at the centre for rheumatic diseases, Glasgow. PATIENTS--111 Consecutive patients with ankylosing spondylitis. Patients with compression fractures were matched for age and sex with two controls ...

Ralston, S. H.; Urquhart, G. D.; Brzeski, M.; Sturrock, R. D.

1990-01-01

90

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

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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

91

Assessment of Serum ADMA Levels and Aortic Elastic Properties in Patients with Ankylosing Spondylitis  

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Full Text Available Introduction: Ankylosing spondylitis is a chronic inflammatory disease which may be associated with cardiovascular complications. The aim of the study was to investigate aortic elastic properties and serum asymetric dimethylarginine (ADMA levels in patients with ankylosing spondylitis without any cardiac involvement.Patients and Methods: Fifty-five ankylosing spondylitis patients and 30 age/gender matched healthy subjects were enrolled into this study. Fasting glucose, serum lipids, C-reactive protein (CRP, erythrocyte sedimentation rate (ESR and ADMA were studied. Aortic strain, distensibility and stiffness index were calculated from aortic diameters measured by transthoracic echocardiography and simultaneous blood pressure measurements.Results: ESR and CRP were higher in patients group. Serum ADMA levels were also higher in ankylosing spondylitis than in controls (0.76 ± 0.19 vs. 0.55 ± 0.12, p< 0.001. In subgroup analysis, ADMA was significantly lower in anti-TNF-alfa treatment group than conventional treatment group (0.68 ± 0.15 vs. 0.87 ± 0.18, p< 0.001. Mean aortic strain and distensibility were lower and stiffness index was higher in ankylosing spondylitis group than controls. No correlation between ADMA and aortic elastic properties was observed. In ankylosing spondylitis group, a negative significant correlation was found between duration of ankylosing spondylitis and aortic strain and distensibility.Conclusion: Our study suggest that patients with ankylosing spondylitis without cardiac involvement, aortic elasticity was impaired and ADMA levels were increased, while there was no significant correlation between aortic elastic properties and ADMA levels.

Hasan Kaya

2013-08-01

92

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

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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.)

1993-01-01

93

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

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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

1995-10-01

94

A discrete event modelling framework for simulation of long-term outcomes of sequential treatment strategies for ankylosing spondylitis  

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Objective To develop a modelling framework which can simulate long-term quality of life, societal costs and cost-effectiveness as affected by sequential drug treatment strategies for ankylosing spondylitis (AS). Methods Discrete event simulation paradigm was selected for model development. Drug efficacy was modelled as changes in disease activity (Bath Ankylosing Spondylitis Disease Activity Index (BASDAI)) and functional status (Bath Ankylosing Spondylitis Functional Index (BASFI)), which w...

Tran-duy, A.; Boonen, A.; Laar, M. A. F. J.; Franke, A. C.; Severens, J. L.

2011-01-01

95

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) ...

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

2013-01-01

96

Ankylosing spondylitis and central core disease: case report  

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Full Text Available Ankylosing spondylitis (AS is an inflammatory disorder of unknown cause that primarily affects the axial skeleton. Neurological manifestations of AS are usually related to spinal deformities. Previous studies of the paraspinal muscles of AS patients showed muscle fiber atrophy, and core fibers. On the other hand, central core disease (CCD is a genetic condition that primarily involves the skeletal muscles, but can present articular deformities secondary to muscular weakness. We report the case of a 45-year-old man with clinical and radiological diagnosis of AS and proximal muscular weakness in the lower limbs. Needle electromyography showed myopathic features and nerve conduction study was normal. Muscle biopsy disclosed almost complete predominance of type-1 fibers, and fibers with central cores. This is the first report of AS and CCD. Whether central core myopathy is coincidental or a new association with AS is discussed.

Scola Rosana Herminia

2003-01-01

97

The outcome of ankylosing spondylitis: a study of 100 patients.  

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The outcome was studied in 100 patients with adult-onset primary ankylosing spondylitis (AS). After a mean disease duration of 16 yr, 51.5% of the patients were employed in full-time work. Cessation of work occurred at a mean disease duration of 15.6 yr, and was significantly associated with female sex, low levels of education, acute anterior uveitis, 'bamboo spine' and the co-existence of non-rheumatic diseases. Functional outcome was studied by analysing activities of daily living, and revealed similar findings in males and females. Most of the loss of function occurred during the first 10 yr of disease, and correlated significantly with the occurrence of peripheral arthritis, spinal X-ray changes of AS and development of 'bamboo spine'. After > 20 yr of disease, > 80% of the patients still complained of daily pain and stiffness, and > 60% reported daily use of drugs. PMID:9255111

Gran, J T; Skomsvoll, J F

1997-07-01

98

[Total hip replacement in patients with ankylosing spondylitis.].  

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The authors present their experience with total hip replacement in patients with ankylosing spondylitis. In the period of 1985-1997 they performed in total 66 total hip replacements in 41 patients. Of the total number of the used implants 24 were fully cemented (the average follow-up - 13 years), 3 were hybrid and 39 cementless (the average follow-up - 6 years). The results of total hip replacements were assessed on the basis of Harris score (HS). The outcomes of the two subgroups, i. e. cemented and cementless implants, were statistically evaluated and compared. The group of hybrid implants was not statistically evaluated due to a small size of the subgroup. In both evaluated groups of implants the results were very favourable (the average HS value in cemented: 86,2 in cementless: 86,4). The occurrence of periarticular ossifications was minimal in both groups. Of the post-operative complications we recorded one case of displacement of the implant which was solved by closed reduction under general anesthesia. Two cases required re-operation of the loosened cementless cup. There occurred no infect. On the basis of the evaluation of the average 13-year results of cemented implants the use of this type of total hip replacement in patients with M. Bechterev is recommended. The question remains whether the same positive values will be produced after the same time interval also by cementless implants as we still do not have results from a 10-year follow-up. Key words: ankylosing spondylitis, total hip replacement. PMID:20478223

Jezek, V; Vavrík, P; Popelka, S; Urbanová, Z

2000-01-01

99

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

100

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

 
 
 
 
101

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

Science.gov (United States)

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

102

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

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Full Text Available 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

2008-03-01

103

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

Science.gov (United States)

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.

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; F?rre, ?ystein; 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-Onate, Raphael; Romero-Sanchez, 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

104

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

Science.gov (United States)

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

2013-07-01

105

Marginal erosive discovertebral ''Romanus'' lesions in ankylosing spondylitis demonstrated by contrast enhanced Gd-DTPA magnetic resonance imaging  

International Nuclear Information System (INIS)

Objective. To assess the value of Gd-DTPA magnetic resonance (MR) imaging in the demonstration of marginal destructive discovertebral Romanus lesions in ankylosing spondylitis.Design and patients. A prospective study of Gd-DTPA MR imaging was performed in 39 patients with a clinical diagnosis of ankylosing spondylitis and typical Romanus lesions seen on radiographs of the thoracolumbar spine. MR morphological appearances and signal intensity changes at the discovertebral junctions were analysed and compared with the radiographic findings.Results. Ninety-nine discovertebral junctions with Romanus lesions showed low signal intensity on T1-weighted and high signal on T2-weighted and T1-weighted postcontrast images at the vertebral corners consistent with oedematous hyperaemic inflammatory tissue. There were nine discovertebral junctions with similar MR findings but normal radiographs. Fifty-three discovertebral junctions showed syndesmophyte formation with increased signal intensity on both T1- and T2-weighted images with no contrast enhancement. Sixty-five discovertebral junctions showed a mixture of radiographic features and varied high and low signal changes at the vertebral rim on MR imaging with rims of enhancement in the vertebral body following contrast administration.Conclusion. Gd-DTPA MR imaging demonstrates a variable signal pattern and degree of contrast enhancement which may reflect the evolutionary stages of discovertebral enthesitis in ankylosing spondylitis. MR imaging may identify early erosive changes in radiographically normal vertebra. The role of MR imaging needs further investigation. (orig.)

2000-01-01

106

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

107

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.

108

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)

1983-07-04

109

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

110

Visceral fat reflects disease activity in patients with ankylosing spondylitis.  

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Purpose: Response to infliximab treatment diminishes as body mass index (BMI) increases in patients with ankylosing spondylitis (AS). The purpose of the study was to determine if diminished response to infliximab treatment in patients with AS could be associated with increased visceral adipose tissue rather than increased BMI. Methods: Twenty six AS patients (21 males and five females) who fulfilled the modified New York criteria and who were currently receiving infliximab treatment were enrolled in the study. Pain was measured by the visual analogue scale (VAS). The disease activity and functional status were assessed by the Bath AS Disease Activity Index (BASDAI) and the Bath AS Functional Index (BASFI). The Bath AS Metrology Index (BASMI) was used to evaluate mobility restrictions. Weight and visceral body composition were measured without shoes in light indoor clothes using a bio-impedance meter. Results: There was a significant correlation between visceral adipose tissue amount and disease activity under infliximab treatment. In correlation analysis, visceral fat showed significant correlations between BASDAI (r=0.545, p=0.004) and VAS (r=0.458, p=0.019). Total body fat also showed a significant correlation with BASDAI (r=0.463, p=0.017). Conclusion: A significant correlation was found between visceral adipose tissue amount and disease activity in patients with AS. PMID:24895992

Aydin, Mesut; Aydin, Fatma; Yuksel, Murat; Yildiz, Abdulkadir; Polat, Nihat; Akil, Mehmet A; Bilik, Mehmet Z; Akyuz, Abdurrahman; Batmaz, Ibrahim; Alan, Sait

2014-01-01

111

Bone Mineral Density in Patients with Ankylosing Spondylitis  

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Full Text Available Objective: Patients with inflammatory arthritis are at risk for osteoporosis and bone fractures. Inflammation and immobility contribute to bone loss in patients with ankylosing spondylitis (AS. The aim of this study was to determine bone mineral density (BMD in patients with AS, and to compare the data of the AS patients with matched healthy controls. In addition, we sought to determine whether BMD values are related to disease activity in patients with AS or not. Patients and Methods: BMD measurements were performed with the use of Dual-Energy X-Ray Absorptiometry (DXA in 62 AS patients and 36 healthy controls. BMD was measured in spine L2-4 (anterior-posterior view and femoral neck by DXA. Results: The study showed that patients with AS have lower BMD values and t scores than healthy controls (p<0.001. Furthermore, total lomber BMD value negatively correlated with the length of disease duration in patients with AS (r=-0.322, p =0.01. Conclusion: We thought that evaluation and treatment of osteoporosis was helpful in especially late stages of AS.

Ahmet Demirkol

2008-06-01

112

Ankylosing spondylitis functional and activity indices in clinical practice  

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Background: Clinicians have at hand several indices to evaluate disease activity and functionality in ankylosing spondylitis (AS), in order to evaluate the prognostic and the treatment of AS patients. Objectives: to examine the relationship between functional and activity scores in AS; to note whether disease activity is associated with any clinical or laboratory variables. Methods: the study included AS patients, classified according to the revised New York criteria; data recorded: demographics, disease duration, type of articular involvement, HLA B27 presence, history of uveitis, calculation of BASFI, BASDAI and ASDASCRP, quantification of inflammation markers. Results: 50 AS patients; ASDASCRP correlated significantly (p < 0.001) with BASFI (r = 811), BASDAI (r = 0.810) and with erythrocyte sedimentation rate (ESR; r = 0.505); HLA B27 positive patients had a median BASDAI 5 times higher than HLA B27 negative patients (p = 0.033); compared with patients with strictly axial disease form, patients with axial and peripheral disease had a median ESR 3 times higher (p = 0.042) and a median BASDAI 2 times higher (p = 0.050). Conclusions: functional and activity AS indices are strongly correlated in assessing disease severity; inflammation and HLA B27 can predict the high value of these indices; axial and peripheral disease pattern is associated with higher disease activity.

Popescu, C; Trandafir, M; Badica, AM; Morar, F; Predeteanu, D

2014-01-01

113

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

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Full Text Available 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 disease in patients with ankylosing spondylitis. An emphasis is placed on the risks and complication patterns in the treatment of these rare, but challenging injuries.

Tschoeke Sven K

2008-06-01

114

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

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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 disease in patients with ankylosing spondylitis. An emphasis is placed on the risks and complication patterns in the treatment of these rare, but challenging injuries.

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

2008-01-01

115

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)

1988-10-03

116

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

117

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

118

Ankylosing spondylitis--experience with a self administered questionnaire: an analytical study.  

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A questionnaire drafted by the president of a self help group of patients suffering from ankylosing spondylitis (AS), the Danish Ankylosing Spondylitis Society (DASS), was completed by 179 of 184 (97%) consecutive patients with AS. The following results were found. The diagnosis of AS was delayed an average of 12.6 years for women and 9.5 years for men. No differences were found in age at onset of the disease. A comparison of juvenile and adult onset showed a higher incidence of initial perip...

Ringsdal, V. S.; Andreasen, J. J.

1989-01-01

119

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)

2008-03-01

120

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

 
 
 
 
121

Effects of balneotherapy on the reactants of acute inflammation phase in Ankylosing spondylitis  

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Introduction. Ankylosing spondylitis (AS) is a chronic inflammatory disease that affects sacroiliac joints, spinal column and peripheral joints. Beside medication therapy, physical and balneotherapy play an important role in its complex treatment. Objective. The aim of the research was to establish serum concentrations of C-reactive protein (CRP), ? 1-acid glycoprotein (? 1-AGP), ceruloplasmine (CP) and erythrocyte sedimentation rate (SE) before and after the balneotherapy in ankylosing spo...

Stamenkovi? Bojana; Stankovi? Aleksandra; Nedovi? Jovan; Stojanovi? Sonja; Dimi? Aleksandar; ?or?evi? Dragan; Bojanovi? Mila

2009-01-01

122

Regression of syndesmophyte after bone marrow transplantation for acute myeloid leukemia in a patient with ankylosing spondylitis: a case report  

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Full Text Available Abstract Introduction Disease progression of ankylosing spondylitis has been considered irreversible. However, we report a case of spontaneous regression of syndesmophyte development following allogeneic peripheral blood stem cell transplantation in a patient with acute myeloid leukemia, who was also diagnosed as having ankylosing spondylitis. To the best of our knowledge, this is the first case report presenting the partial radiologic regression of syndesmophytes. Case presentation A 39-year-old man with active ankylosing spondylitis achieved clinical remission and partial radiological regression of cervical spine syndesmophytes following a peripheral blood stem cell transplantation for acute myeloid leukemia. Our patient received an allogeneic peripheral blood stem cell transplantation following a pre-transplantation conditioning regimen of total body irradiation and cyclophosphamide. The donor was a human leukocyte antigen-matched 29-year-old man. Our patient has remained asymptomatic and has received no medication for ankylosing spondylitis for nearly three years. Conclusions Several explanations are proposed for the regression of syndesmophytes and clinical improvement in active ankylosing spondylitis observed in our patient, including changes in bone remodeling and immune reconstitution following stem cell transplantation, the effect of immunosuppressive agents, or fluctuation in the natural course of ankylosing spondylitis although further studies are required. The regression of syndesmophytes in ankylosing spondylitis in this case raises the possibility that stem cell transplantation might contribute to the development of a novel therapeutic strategy for treatment of the disease.

Yang Hae

2012-08-01

123

Leukemia mortality after X-ray treatment for ankylosing spondylitis  

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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% 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.

Weiss, H.A.; Darby, S.C. [Univ. of Oxford (United Kingdom); Fearn, T. [Univ. College London (United Kingdom)] [and others

1995-04-01

124

Lung parenchymal changes in patients with ankylosing spondylitis  

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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.

Hasiloglu, Zehra Isik; Havan, Nuri; Rezvani, Aylin; Sariyildiz, Mustafa Akif; Erdemli, Halil Eren; Karacan, Ilhan

2012-01-01

125

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% 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

1995-04-01

126

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

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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.)

1985-01-01

127

Breast cancer in a male with ankylosing spondylitis treated with TNFalpha antagonists.  

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A 72-year-old male with a 4-year history of TNFalpha antagonist therapy (infliximab and etanercept) for ankylosing spondylitis was diagnosed with breast cancer. He had a family history of breast cancer. The low incidence and considerable severity of breast cancer in males, genetic risk factors, and potential role for TNFalpha antagonist therapy are discussed. PMID:19457692

El Mansouri, Laila; Couchouron, Tifenn; Le Roux, Guillaume; Dugast, Catherine; Burtin, Françoise; Albert, Jean-David; Perdriger, Aleth; Hassouni, Najia Hajjaj; Chalès, Gérard

2009-07-01

128

Carotid Intima Media Thickness as a Marker of Atherosclerosis in Ankylosing Spondylitis  

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Aim. Increased cardiovascular morbidity and mortality have been observed in ankylosing spondylitis because of accelerated atherosclerosis. We measured carotid intima media thickness (CIMT) as a surrogate marker of atherosclerosis in this study. Methods. In this study 37 cases of AS and the same number of matched individuals were recruited. CIMT measurements were done using B-mode ultrasound. Disease activity was assessed using Bath ankylosing spondylitis disease activity index (BASDAI), Bath ankylosing spondylitis functional index (BASFI), and Bath ankylosing spondylitis metrological index (BASMI) scores and C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) levels. Results. Mean age of the study groups was 29.43?±?9.00 years. Average disease duration was 65.62?±?54.92 months. Twenty-eight (75.68%) of cases were HLA B-27 positive. A significantly increased CIMT was observed in cases as compared to control group (0.62?±?0.12 versus 0.54?±?0.04; P < 0.001). CIMT in the cases group positively correlated with age (r = 0.357;?P < 0.05), duration of disease (r = 0.549;?P < 0.01), and BASMI (r = 0.337;?P < 0.05) and negatively correlated with ESR (r = ?0.295;?P < 0.05). Conclusions. Patients of AS had a higher CIMT than those of the control group. CIMT correlated with disease chronicity.

Gupta, Naveen; Goyal, Laxmikant; Agrawal, Abhishek; Bhargava, Rajat; Agrawal, Arun

2014-01-01

129

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

130

Airway Management in Ankylosing Spondylitis with Intubating Laryngeal Mask Airway - A Case Report  

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Full Text Available Patients of Ankylosing Spondylitis (AS are difficult to intubate as a result of cervical spine rigidity; leading to inadequate extension of head and nonalignment of oral/pharyngeal and laryngeal planes. They are usually managed along the awake limb of difficult airway algorithm.

Dr. Veena Asthana / Dr. Sanjay Agrawal/ Dr. D K Singh/ Dr. J P Sharma

2006-07-01

131

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

132

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

133

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

Scientific Electronic Library Online (English)

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).

Torres, Themis Mizerkowski; Ciconelli, Rozana Mesquita.

134

The Impact of TNF-inhibitors on radiographic progression in Ankylosing Spondylitis  

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Introduction We studied the effect of Tumor Necrosis Factor-Alpha (TNF)-inhibitors on progressive spine damage in Ankylosing Spondylitis (AS) patients. Methods All AS patients (satisfying the modified New York criteria) prospectively followed and with at least two sets of spinal radiographs at a minimum gap of 1.5 years were included (n=334). Patients received clinical standard of care, which included non-steroidal anti-inflammatory drugs and TNF-inhibitors. Radiographic severity was assessed by the modified Stokes Ankylosing Spondylitis Spine Score (mSASSS). Patients with a rate of progression more than 1 mSASSS unit/year were considered progressors. Univariable and multivariable regression analyses were done. Propensity score matching (PSM) and sensitivity analysis were performed. A zero-inflated negative binomial (ZINB) model was used to analyze the effect of TNF-inhibitor on change in mSASSS with varying follow-up periods. Potential confounders like Bath AS Disease Activity Index (BASDAI), ESR, CRP, HLA-B27, gender, age of onset, smoking and baseline damage were included in the model. Results TNF-inhibitor treatment was associated with a 50% reduction in the odds of progression (OR: 0.52; CI: 0.30-0.88; p=0.02). Patients with a delay in starting therapy of more than 10 years were more likely to progress compared to those who started earlier (OR=2.4; 95% CI: 1.09-5.3; p=0.03). In the ZINB model TNF-inhibitor use significantly reduced progression when the gap between x-rays was more than 3.9 years. The protective effect of TNF-inhibitors was stronger after propensity score matching. Conclusions TNF-inhibitors appear to reduce radiographic progression in AS, especially with early initiation and longer duration of follow up.

Haroon, Nigil; Inman, Robert D.; Learch, Thomas J.; Weisman, Michael H.; Lee, MinJae; Rahbar, Mohammad H.; Ward, Michael M.; Reveille, John D; Gensler, Lianne S.

2014-01-01

135

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

136

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

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Full Text Available 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 report the case of a 47-year-old Sri Lankan man who had a long history of intermittent joint pains worsening following a recent episode of self-resolving non-bloody diarrhea. Subsequently, he developed a skin rash suggestive of keratoderma blenorrhagica and circinate balanitis. He had classical radiological evidence of ankylosing spondylosis (previously undiagnosed associated with human leukocyte antigen B27 antigen, but was positive for rheumatoid factor. Conclusions A disease flare of ankylosing spondylitis prompted by a minor diarrheal illness showing well documented features of reactive arthritis is remarkable. The prognostic implications of seropositivity in spondyloarthritis are discussed.

Manoj EM

2012-02-01

137

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

138

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

139

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

Science.gov (United States)

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

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

1982-10-01

140

Clinical and Radiographic Features of Adult-onset Ankylosing Spondylitis in Korean Patients: Comparisons between Males and Females  

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The objective of this study was to investigate clinical and radiographic features and gender differences in Korean patients with adult-onset ankylosing spondylitis. Multicenter cross-sectional studies were conducted in the rheumatology clinics of 13 Korean tertiary referral hospitals. All patients had a confirmed diagnosis of ankylosing spondylitis according to the modified New York criteria. Clinical, laboratory, and radiographic features were evaluated and disease activities were assessed u...

Jung, Young-ok; Kim, Inje; Kim, Suho; Suh, Chang-hee; Park, Han Jung; Park, Won; Kwon, Seoung Ryul; Jeong, Jae Cheon; Lee, Yun Jong; Ryu, Hee Jung; Park, Young Bae; Lee, Jisoo; Lee, You-hyun; Seo, Young Il; Chung, Won Tae

2010-01-01

 
 
 
 
141

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

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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

1981-01-01

142

Ankylosing spondylitis and psoriatic arthritis: clinical and economic consequences of the use of etanercept  

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Full Text Available Spondyloarthritis (SpA is the name for a family of inflammatory rheumatic disease that can affect the spine and joints, ligaments and tendons. Spondyloarthritis disease include ankylosing spondylitis, reactive arthritis, psoriatic arthritis, the spondylitis associated with the inflammatory bowel diseases and the undifferentiated spondyloarthritis. The most common treatments prescribed for spondyloarthritis are nonsteroidal anti-inflammatory drugs (NSAIDs given in combination with disease-modifying antirheumatic drugs (DMARDs. Due to a recently suggested role of the tumour necrosis factor (TNFa in the pathogenesis of SpA, new therapies specifically blocking TNFa have been investigated. Anti-TNF medications currently available on the Italian market are etanercept, infliximab and adalimumab. The aim of the present work was to furnish a clinical and pharmaco-economical profile of etanercept in treatment of psoriatic arthritis and ankylosing spondylitis based on a review of the published literature. Economical evaluations performed in several countries indicate that total treatment costs are lower with etanercept and adalimumab as compared to infliximab, mainly because of differences in the route of administration. Etanercept appears to be cost effective for the treatment of psoriatic arthritis and ankylosing spondylitis especially considering improved health related quality of life and lower medical costs due to superior efficacy of treatment.

Viola Sacchi

2010-06-01

143

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

144

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.)

1983-11-01

145

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

146

Coexistence of Ankylosing Spondylitis and Hereditary Multiple Exostoses:Coincidence or Association  

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Coexisting ankylosing spondylitis and hereditary multiple exostoses have rarely been reported (three patients) previously. A 27-year-old man with hereditary multiple exostoses is presented as a fourth report. At the age of 15 years, the patient had multiple exostoses around the knee, ankle and shoulder joints. He was diagnosed with ankylosing spondylitis 3 years ago. The patient’s sister and his 3 brothers also have multiple exostoses without any family history of spondyloarthropathy or inflammatory arthritis. The aim of this report is to discuss an interesting coexistence of these two diseases. The increasing number of reported patients who have a coexistence of these two diseases might suggest that the association of these two diseases is stronger than a coincidence.

Rostamian, Abdolrahman; Mazoochy, Hamed; Movassaghi, Shafieh; Mortazavi, Seyed Mohammad Javad; Sadeghzadeh, Elham; Shahbazi, Fatemeh; Ghanaati, Hossein

2014-01-01

147

Juvenile Ankylosing Spondylitis and Juvenile Rheumatoid Arthritis: Differentiation on the Basis of Joint Involvement  

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Full Text Available Juvenile-onset Ankylosing Spondylitis (JAS, commonly present as an acute peripheral Arthritis, may be included in Juvenile Rheumatoid Arthritis (JRA patients. Distinction of the 2 diseases. On the basis of radiological findings, may last several years. Many investigations have tried to determine early clinical data of JAS and differentiate it from JRA. The present study aim to distinct early JAS findings and to compare them with JRA. During the previous 5 years 17 cases of JRA were diagnosed according to the American college of rheumatology criteria. In 4 to 12 oligoarticular JRA clinical features of JAS appeared according to the New York and European spondyloarthropathy study group (ESSG. Involvement of the knee and ankle joints was common in both diseases whereas involvement of the hip joint and enthesopathy occurred in all JAS patients but only in one JRA patient. Involvement of the joints of the upper extremities was seen in all JRA patients and only one JAS patient. Sacroiliac joint involvement was found only in JAS patients. So, one may conclude that involvement of the hip and sacroiliac joints, and occurrence of enthesopathy in an oligoarticular JRA patient, may be presenting signs of JAS, the recognition of which can lead to an early diagnosis of the disease.

B Heydari

1999-09-01

148

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.

149

Osteoporosis in ankylosing spondylitis - prevalence, risk factors and methods of assessment  

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Introduction: Osteoporosis can be a complication of ankylosing spondylitis (AS), but diagnosing spinal osteoporosis can be difficult since pathologic new bone formation interferes with the assessment of the bone mineral density (BMD). The aims of the current study were to investigate prevalence and risk factors for reduced BMD in a Swedish cohort of AS patients, and to examine how progressive ankylosis influences BMD with the use of dual-energy x-ray absorptiometry (DXA) of the lumbar spine i...

Klingberg, Eva; Lorentzon, Mattias; Mellstrom, Dan; Geijer, Mats; Gothlin, Jan; Hilme, Elisabet; Hedberg, Martin; Carlsten, Hans; Forsblad-d Elia, Helena

2012-01-01

150

Transpedicular wedge resection osteotomy for the treatment of a kyphotic Andersson lesion-complicating ankylosing spondylitis  

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Two cases with a long-standing thoracolumbar kyphosis due to ankylosing spondylitis are presented with a symptomatic localized destructive kyphotic lesion of the spine. Clinical and radiographic findings demonstrated a progressive vertebral and discovertebral kyphotic pseudarthrosis, known as an Andersson lesion, at the L1 and L1-2 level, respectively. Surgical correction and stabilization was performed by an extending transpedicular wedge resection osteotomy to restore spinal stability, to f...

2006-01-01

151

Cervical osteotomy for ankylosing spondylitis: an innovative variation on an existing technique  

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Ankylosing spondylitis can produce severe fixed flexion deformity in the cervical spine. This deformity may be so disabling that it interferes with forward vision, chewing, swallowing and skin care under the chin. The only treatment available is an extension osteotomy of the cervical spine. Existing techniques of cervical osteotomy may be associated with risk of neurological injury. We describe a variation on an existing technique, which provides a controlled method of reduction at the osteot...

Mehdian, S. M. H.; Freeman, B. J. C.; Licina, P.

1999-01-01

152

Retrograde intubation in a case of ankylosing spondylitis posted for correction of deformity of spine  

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Ankylosing spondylitis (AS) patients are most challenging. These patient present the most serious array of intubation and difficult airway imaginable, secondary to decrease or no cervical spine mobility, fixed flexion deformity of thoracolumbar spine and possible temporomandibular joint disease. Sound clinical judgment is critical for timing and selecting the method for airway intervention. The retrograde intubation technique is an important option when fiberoptic bronchoscope is not availabl...

Raval Chetankumar; Patel Heena; Patel Pranoti; Kharod Utpala

2010-01-01

153

The Interleukin 1 Gene Cluster Contains a Major Susceptibility Locus for Ankylosing Spondylitis  

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Ankylosing spondylitis (AS) is a common and highly heritable inflammatory arthropathy. Although the gene HLA-B27 is almost essential for the inheritance of the condition, it alone is not sufficient to explain the pattern of familial recurrence of the disease. We have previously demonstrated suggestive linkage of AS to chromosome 2q13, a region containing the interleukin 1 (IL-1) family gene cluster, which includes several strong candidates for involvement in the disease. In the current study,...

Timms, Ae; Crane, Am; Sims, Am; Cordell, HJ; Bradbury, La; Abbott, A.; Coyne, MR; Beynon, O.; Herzberg, I.; Duff, Gw; Calin, A.; Cardon, LR; Wordsworth, Bp; Brown, Ma

2004-01-01

154

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

155

Pregabalin for Opioid-Refractory Pain in a Patient with Ankylosing Spondylitis  

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Background. Ankylosing spondylitis (AS) is a systemic inflammatory disease with chronic back pain as the most common presenting symptom. We present a case of a male patient with AS reporting symptoms of severe low back pain, buttock pain, and limited spinal mobility. After chronic treatment with opioids, we administered pregabalin at a dose of 300?mg as an analgesic agent while opioids were discontinued. Findings. Pain symptoms improved progressively, and opioids were gradually discontinued...

Kontoangelos, Konstantinos A.; Kouzoupis, Anastasios V.; Ferentinos, Panagiotis P.; Xynos, Ioannis D.; Sipsas, Nikolaos V.; Papadimitriou, George N.

2013-01-01

156

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

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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 r...

2012-01-01

157

Somatic Serogroups, Capsular Types, and Species of Fecal Klebsiella in Patients with Ankylosing Spondylitis  

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The purpose of the present study was to find out whether patients with ankylosing spondylitis (AS) carry fecal Klebsiella strains that belong to serotypes or species specific for AS. Somatic serotypes (O groups), capsular (K) serotypes, and biochemically identified species were determined for fecal klebsiellae isolated from 187 AS patients and 195 control patients. The controls were patients with fibromyalgia or rheumatoid arthritis. The 638 isolates of Klebsiella that were obtained represent...

Toivanen, Paavo; Hansen, Dennis S.; Mestre, Francisca; Lehtonen, Leena; Vaahtovuo, Jussi; Vehma, Mari; Mo?tto?nen, Timo; Saario, Riitta; Luukkainen, Reijo; Nissila?, Martti

1999-01-01

158

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

2008-01-01

159

Coexistence of ankylosing spondylitis and rheumatoid arthritis in a female patient  

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Ankylosing spondylitis (AS) and rheumatoid arthritis (RA) are two distinguished representatives of inflammatory rheumatic diseases. The two diseases differ significantly in their etiology, pathology, clinical signs, and in the nature of articular manifestations. Their association has been a rarity in the literature. Here, authors describe a case of a 55-year-old female patient with AS associated with RA. Her spinal symptoms started in 1979, and the diagnosis of AS was established based on the...

Baksay B; Der A; Szekanecz Z; Szanto S; Kovacs A

2011-01-01

160

Circulating levels of sialic acid and glycosaminoglycans: a diagnostic test for ankylosing spondylitis.  

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The circulating levels of sialic acid (N-acetylneuraminic acid) and glycosaminoglycans (GAGs) were measured in 69 patients with spinal disorders of orthopaedic interest (ankylosing spondylitis 17, osteofluorosis 6, idiopathic backache 10, osteoarthrosis 16, osteoporosis 20). The serum GAG levels showed no statistically significant change from control values in the five disorders investigated in the present study. Although osteoporosis and osteoarthrosis showed a decrease in serum sialic acid ...

Susheela, A. K.; Das, T. K.; Khurana, J. S.; Jayaswal, A.; Dave, P. K.

1988-01-01

 
 
 
 
161

Posterior fixation of subaxial cervical spine fractures in patients with ankylosing spondylitis  

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Cervical spine fractures in patients with ankylosing spondylitis are serious and potentially lethal injuries with high complication rates. Treatment obstacles include long lever arms that generate large forces on any fixation device, osteoporosis, and, usually, kyphotic deformity. The Olerud Cervical Fixation System (OC), with cervical pedicle screws and rods, offers an opportunity to create a biomechanically stable posterior fixation in these complicated cases. The present study is a retrosp...

2005-01-01

162

Open label trial of anakinra in active ankylosing spondylitis over 24 weeks  

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Methods: Anakinra (100 mg) was given subcutaneously daily over 24 weeks to 20 NSAID refractory patients with ankylosing spondylitis. Thirteen completed the study. Clinical outcome assessments included disease activity, function, metrology, patients' and physicians' global assessment, peripheral joint assessment, quality of life, and C reactive protein. Dynamic magnetic resonance imaging (MRI) of sacroiliac joints or spine, using gadolinium DTPA as contrast agent, was done before treatment in ...

Haibel, H.; Rudwaleit, M.; Listing, J.; Sieper, J.

2005-01-01

163

Delayed presentation and diagnosis of cervical spine injuries in long-standing ankylosing spondylitis  

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Patients with ankylosing spondylitis (AS) are vulnerable to cervical spine fractures. Long-standing pain may mask the symptoms of the fracture. Radiological imaging of the cervical spine may fail to identify the fracture due to the distorted anatomy, ossified ligaments and artefacts leading to delay in diagnosis and increased risk of neurological complications. The objectives are to identify the incidence and risk factors for delay in presentation of cervical spine fractures in patients with ...

Anwar, Fahim; Al-khayer, A.; Joseph, G.; Fraser, M. H.; Jigajinni, M. V.; Allan, D. B.

2011-01-01

164

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

165

Surgery of the deformities in ankylosing spondylitis: Our experience of lumbar osteotomies in 31 patients  

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Corrective surgery for kyphotic deformities of the spine in ankylosing spondylitis is a major surgery. for rare indications. The authors report 31 lumbar osteotomies. The goal is to correct the deformity through a posterior limited approach and to minimise the neurological risks. The modifications developed by the authors for monosegmental closing wedge osteotomies are explained. The posterior resection is rhomboid shaped with a bilateral lamina removal. An osteotomy is performed in a forward...

Lazennec, J. Y.; Saillant, G.; Saidi, K.; Arafati, N.; Barabas, D.; Benazet, J. P.; Laville, C.; Roy-camille, R.; Ramare?, S.

1997-01-01

166

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

167

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

168

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

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Full Text Available Whether Behçet’s disease (BD is of the seronegative spondiloartropathy (SSpA group has been a subject of debate for many years. On the other hand, the number of reported cases of coexisting BD and a disease of SSpA group has increased. Here we presented a patient with ankylosing spondylitis (AS and BD to discuss the coexistence of these two diseases.

Umit Seckin

2008-06-01

169

Muscle activation patterns and gait biomechanics in patients with ankylosing spondylitis  

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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 ...

Filippis, L. G.; Balestrieri, A.; Furfari, P.; Caliri, A.; Africa, A.; Bagnato, G.

2011-01-01

170

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

171

Relation between chest expansion, pulmonary function, and exercise tolerance in patients with ankylosing spondylitis.  

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Thirty three patients with definite ankylosing spondylitis (AS) were examined to establish the relation between restriction of chest expansion, limitation of lung function, and working capacity or exercise tolerance. As in previous studies there was a significant association between chest expansion and lung vital capacity. There was also a significant association between vital capacity and exercise tolerance as measured by a subject's maximum oxygen capacity (VO2max). Both vital capacity and ...

Fisher, L. R.; Cawley, M. I.; Holgate, S. T.

1990-01-01

172

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.)

2001-12-01

173

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

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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 Health 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 patient...

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

2011-01-01

174

Thoracic spinal cord herniation in a patient with long-standing ankylosing spondylitis  

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The objective of this study was to describe an adult male patient with ankylosing spondylitis (AS) associated with thoracic spinal cord herniation (TSCH). TSCH is a scarce entity presented as a displacement of thoracic cord through an anterior or anterolateral dural defect. More importantly, the co-occurrence of AS and thoracic spinal cord herniation is exceptional. To date, only one case of SCH in association with AS has been reported in the literature. A 56-year-old male patient presented w...

Liu, Zhen; Wang, Wei-jun; Sun, Chao; Zhu, Zhe-zhang; Qiu, Yong

2011-01-01

175

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 <4 as cut off of high and low disease activity status, respectively. Although we could not demonstrate significant differences in the performance between them, subgroup analysis suggested better discriminatory ability of ASDAS in the high inflammatory marker subgroup. ASDAS and BASDAI showed similarly good performance in a cross-sectional setting in a 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

176

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

177

Ankylosing spondylitis: a difficult diagnosis in patients on long-term renal replacement therapy.  

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We report the case of a 48-year-old male, whose musculoskeletal manifestations, previously related to long-term renal replacement therapy (RRT), were diagnosed as ankylosing spondylitis when symptoms changed their pattern on daily hemodialysis (DHD). The patient started RRT in 1981; in 1985 he received a cadaver graft, which failed in 1987. Secondary hyperparathyroidism, amyloid geoids, bilateral carpal tunnel syndrome and high aluminium levels were present. Musculoskeletal pain, reported sin...

Segoloni, Giuseppe Paolo; Piccoli, Giorgina Barbara; Biancone, Luigi

2002-01-01

178

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

179

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

180

Long-term clinical investigation of patients with ankylosing spondylitis treated with /sup 224/Ra  

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Between 1952 and 1980 about 250 patients with ankylosing spondylitis were treated with /sup 224/Ra at the Orthopaedic University Hospital of Frankfurt/M. In 1970, 119 of them were examined and X-rayed as was another group of 40 patients in 1980. The results of those examined could be compared with a group of 40 patients treated without /sup 224/Ra. Patients with /sup 224/Ra demonstrated a long-lasting period of subjective improvement after the treatment, with reduced consumption of antirheumatoid and analgesic drugs, on the average. Blood examinations show inflammatory activities. Nevertheless, the ankylosing spondylitis proceeded. In the final stages of the disease, neither the clinical aspects nor the X-rays showed any specific changes. We observed no case of malignant bone tumor. Of the 169 examined patients, 22 had a total of 32 children after the treatment with /sup 224/Ra. Among these was a set of twins with cerebral palsy and diabetes insipidus renalis. In conclusion, /sup 224/Ra in ankylosing spondylitis is a recommended treatment without higher risk compared to the common therapy with drugs.

Schmitt, E. (Universitatsklinik Friedrichsheim, Frankfurt, West Germany); Ruckbeil, C.; Wick, R.R.

1983-01-01

 
 
 
 
181

Assessment of Pulmonary Changes in Patients with Ankylosing Spondylitis with High Resolution Computed Tomography  

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Full Text Available Objective: In this study, our aim was to investigate the pleural and parenchymal changes and their frequency in patients with ankylosing spondylitis using high resolution computed tomography.Patients and Methods: A total of 23 patients with the diagnosis of ankylosing spondylitis were included in the study. In all patients high resolution computed tomography of the lung was performed after maximum inspiration and expiration. Previous pulmonary findings of 11 cases were used for the analysis of the images.Results: Pulmonary changes were detected in 13 (57% of 23 patients using high resolution computed tomography. No parenchymal changes were detected in the remaining 10 patients. The most frequently detected finding was parenchymal nodules seen in 11 (48% patients. This was followed by parenchymal band formation in 9 (39% patients. In addition, mosaic pattern in 6 (26% patients, bronchiectasis in 5 (22% patients, emphysema, interlobular septal thickening, pleural thickening and/or ground glass opacity in 3 (13% patients, bronchial wall thickening in 2 (9% patients and honeycomb lung in 1 (4% patient, were detected.Conclusion: High resolution computed tomography of the lung is an effective method in demonstrating the pulmonary changes in patients with ankylosing spondylitis.

Hasan Dursun

2008-06-01

182

Evaluation of the effects of Global Postural Reeducation in patients with ankylosing spondylitis.  

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The objective of this study is to assess the effects of Global Postural Reeducation (GPR) in patients with ankylosing spondylitis and compare GPR with group conventional segmental self-stretching and breathing exercises. This is a controlled interventional study of 38 patients divided into 2 groups: a GPR group (n = 22) and a control group (n = 16). Both groups were treated for more than 4 months. With the GPR group patients, positions that stretched the shortened muscle chains were used. With the control group patients, conventional segmental self-stretching and breathing exercises were performed. The variables analyzed were pain intensity, morning stiffness, spine mobility, chest expansion, functional capacity (Health Assessment Questionnaire-Spondyloarthropathies-HAQ-S), quality of life (Medical Outcome Study Short Form 36 Healthy Survey-SF-36), and disease activity (Bath Ankylosing Spondylitis Disease Activity Index-BASDAI). Statistical analysis was used with a significance level of P mobility parameters, except finger-floor distance (P = 0.118), in chest expansion (P = 0.028), and in the physical aspect component of the SF-36 (P = 0.001). The results of this study showed that individual treatment with GPR (overall stretching) seems to have better clinical outcomes than group treatment with conventional segmental self-stretching and breathing exercises for patients with ankylosing spondylitis. PMID:21544639

Silva, Eliane Maria; Andrade, Sandra C; Vilar, Maria J

2012-07-01

183

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

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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.)

1992-01-01

184

A retrospective study of treating thoracolumbar spine fractures in ankylosing spondylitis.  

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Spinal fractures are commonly encountered in ankylosing spondylitis (AS) patients. This study compares the outcome of early surgical treatment with initial conservative treatment for thoracolumbar fractures in patients with AS. From 1996 to 2008, 28 patients with AS were treated either operatively or conservatively for thoracolumbar fractures; however, only 25 patients met the inclusion criteria with a minimum follow-up of 2 years. For surgically treated patients, posterior spinal instrumentation was performed using a transpedicle screw system. Nonsurgically treated patients wore a fracture brace. The demographic data, diagnosis, mechanism of injury, and neurological status were recorded, and fracture healing was assessed radiographically. The mean age was 54.2 ± 13.8 years (range 30-80 years). Six patients (Group A) received surgical intervention within 1 month. All of these fractures healed, and two of five patients showed neurologic improvement after surgery. Eight patients (Group B) had fractures that were missed. The delay in diagnosis resulted in pseudoarthrosis in all cases, and progressive neurologic deficits were identified in four cases. Eleven patients (Group C) received conservative treatment with bracing. Fracture union was achieved in three cases, and pseudoarthrosis occurred in eight cases. Operative treatment can achieve solid fusion and improve the neurological status, while conservative treatment may result in pseudoarthrosis and progressive neurologic deficit. The results suggest that AS patients with unstable spinal fractures should receive early surgical management to prevent further sequelae. PMID:24306166

Lu, Meng-Ling; Tsai, Tsung-Ting; Lai, Po-Liang; Fu, Tsai-Sheng; Niu, Chi-Chien; Chen, Lih-Huei; Chen, Wen-Jer

2014-07-01

185

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

186

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

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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.

187

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

188

Effect of anti-TNF treatment on sleep problems in ankylosing spondylitis.  

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Sleep disturbances and problems are increased in ankylosing spondylitis (AS). But much is not known in a quantitative way about sleep problems and effect of treatments on AS. This study is aimed first, to investigate sleep disturbances in AS and secondly, to evaluate the effects of anti-TNF treatment on SD in AS. One hundred seventy-one (Female/male: 90/81) AS patients fulfilling modified New York criteria and 86 (F/M: 56/30) age- and gender-matched controls without inflammatory diseases were included into the study. Demographic data and disease activity and treatments were recorded using The Bath Ankylosing Spondylitis Functional Index (BASFI) and The Bath Ankylosing Spondylitis Disease Activity Index (BASDAI). The Medical Outcomes Study (MOS) Sleep Questionnaire was used for evaluating sleep and problems of sleep. AS patients had higher sleep disturbance scale (SDS) and sleep problem index (SPI) II scores. Group A (patients using NSAID and/or DMARD, 53.2% of patients) had higher BASDAI and BASFI compared with Group B (Patients using anti-TNF treatments) (4.29 ± 2.38 vs. 2.46 ± 2.32, p < 0.001; 1.95 ± 2.15 vs. 0.93 ± 1.31, p < 0.001, respectively). Whereas Group A had higher scores of SDS, awaken short of breath or headache, somnolence, and SPI-II than controls, none of the sleep parameters were statistically different between patients on anti-TNF treatments and controls. BASDAI was positively correlated with SPI-I, SPI-II, SDS, and somnolence scale. AS patients had increased sleep problems and disturbances compared with controls. Anti-TNF agents improve significantly these problems. Sleep problems are significantly correlated with the disease activity. PMID:21448640

Karada?, Omer; Nakas, Dilek; Kalyoncu, Umut; Akdo?an, Ali; Kiraz, Sedat; Ertenli, Ihsan

2012-07-01

189

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

190

Effects of balneotherapy on the reactants of acute inflammation phase in Ankylosing spondylitis  

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Full Text Available Introduction. Ankylosing spondylitis (AS is a chronic inflammatory disease that affects sacroiliac joints, spinal column and peripheral joints. Beside medication therapy, physical and balneotherapy play an important role in its complex treatment. Objective. The aim of the research was to establish serum concentrations of C-reactive protein (CRP, ? 1-acid glycoprotein (? 1-AGP, ceruloplasmine (CP and erythrocyte sedimentation rate (SE before and after the balneotherapy in ankylosing spondylitis. Methods. The research included 50 AS patients according to the revised New York criteria, of mean age 43 years, who were treated for 14 days on the average at the Clinic for Rheumatology of the Institute 'Niška Banja'. All the patients received medications and balneotherapy (radioactive oligomineral baths, peloid, massage, kinesitherapy; the serum concentrations of CRP, ?1-AGP, CP and SE were measured before and after balneotherapy. Serum proteins were determined using original Nor Partigen plates Boehringer. Erythrocyte sedimentation rate was measured by Westergreen method. Balneotherapy was applied individually, intensively or mildly, depending on the AS stage and activity phase. Results. After dosed balneotherapy, a significant decrease in the concentrations of CP (p<0.05, ?1-AGP (p<0.01 and CRP (p<0.05 was registered in the serums of AS patients. ESR was not significantly reduced. Conclusion. The research proved that ? 1-acid glycoprotein, ceruloplasmine and C-reactive protein represent more sensitive inflammation markers as compared to erythrocyte sedimentation rate. The identification of acute phase reactants is important in the evaluation of dosed balneotherapy efficiency in the treatment of ankylosing spondylitis.

Stamenkovi? Bojana

2009-01-01

191

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

192

Evaluating the reliability of Persian version of ankylosing spondylitis quality of life (ASQoL) questionnaire and related clinical and demographic parameters in patients with ankylosing spondylitis.  

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Ankylosing spondylitis quality of life (ASQoL) is an instrument for assessing quality of life (QoL). The aims of this study were to assess the reliability of Persian version of ASQoL questionnaire and evaluation of QoL status and related factors in ankylosing spondylitis (AS). One hundred and sixty-three Iranian patients with AS who fulfilled modified New York criteria were enrolled. Patients were evaluated using questionnaires including demographic and clinical variables, Bath AS Disease Activity Index (BASDAI), Bath AS Functional Index (BASFI), fatigue, Bath AS Metrology Index, pain and ASQoL. Reliability and validity of Persian version of ASQoL were evaluated by test-re-test agreement, internal consistency and correlation with specific scales. Relationship of parameters with ASQoL was analyzed by multiple regression. Age, disease duration and ASQoL score (mean ± SD) were 37.74 ± 9.88, 14.49 ± 8.47 and 8.02 ± 5.28 years, respectively. Test-re-test reproducibility for ASQoL was good as assessed by intra-class correlation coefficient (ICC: 0.97, P < 0.001). Internal consistency was high (Cronbach's alpha: 0.91). Convergent validity was confirmed by correlation of ASQoL score with specific scales (BASFI, r = 0.74, BASDAI, r = 0.6, fatigue, r = 0.56, depression, r = 0.24, intermalleolar distance, r = -0.44 and educational level, r = -0.37). Persian version of ASQoL is a valid and reliable scale to assess QoL in AS. Function, fatigue, mood, hip mobility and education are the factors which should be noted to achieve the best QoL. PMID:24170319

Fallahi, Sasan; Jamshidi, Ahmad Reza; Bidad, Katayoon; Qorbani, Mostafa; Mahmoudi, Mahdi

2014-06-01

193

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

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

Yakup Tomak

2012-09-01

194

Juvenile idiopathic arthritis. Subgroup characteristics and comparisons between rheumatoid arthritis-like subgroups and ankylosing spondylitis-like subgroups.  

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In terms of adult-onset definitions, rheumatoid arthritis (RA) and ankylosing spondylitis (AS) are rarely diagnosed in children. Adult RA is in most aspects similar to seropositive polyarticular arthritis in children, but AS differs in its clinical presentation according to age at onset. In general, the nomenclature and classifications of arthritis in children encompass subgroups with specific signs or laboratory tests and pathogenic mechanisms that distinguish one clinical form from the other. While one of these subgroups corresponds to RA, the one related to AS usually includes children with undifferentiated SpA and not definite AS. Thus, comparisons of RA and AS in children actually correspond to comparisons of various forms of childhood arthritis, currently classified as juvenile idiopathic arthritis (JIA) and AS in its early undifferentiated form. In this paper, we review these to finally compare the two populations. PMID:19822060

Horneff, G; Burgos-Vargas, R

2009-01-01

195

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

196

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? Sala, Raimon; Ercilla Gonza?lez, M. Guadalupe; Branco?s Cunill, Ma Antonia; Cid Xutgla?, M. Cinta; Collado Cruz, Antonio; Rote?s Querol, J.

1987-01-01

197

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...

2008-01-01

198

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

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

1987-01-01

199

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

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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 dif...

Ahmet Inanir; Sevil Okan; Behcet Filiz

2013-01-01

200

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.)

1983-01-01

 
 
 
 
201

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 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)

2009-08-01

202

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

203

The "moustache" sign: Localized intervertebral disc fibrosis and panligamentous ossification in ankylosing spondylitis with kyphosis  

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Full Text Available Localized intervertebral disc and ligamentous ossification may precipitate neurological deficits at any time during the natural course of ankylosing spondylitis (AS. We report 2 patients with AS with "moustache? sign (localized intervertebral disc fibrosis and panligamentous ossification and neurological deficits. One patient had syndesmophytosis (with paraparesis secondary to thoracic spinal canal stenosis, and the other had "bamboo spine" above and below the involved level. A laminectomy in the former relieved paraparesis, and posterior element excision in both the patients relieved focal tenderness and pain; and both of them could lie supine following surgery.

Behari Sanjay

2010-12-01

204

Radon-therapy in ankylosing spondylitis reduces auto-antibody titers  

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Full Text Available Combined low-dose radon/hyperthermia therapy has been reported to improve pain and mobility in patients with rheumatic disorders. The key feature of inflammatory rheumatic diseases is the induction of autoimmune processes via the production of autoantibodies. As reducing the autoantibody level through administration of biologicals is described to correlate with delay of disease progression, we investigated the impact of combined low-dose radon/hyperthermia therapy on the serum levels of antibodies directed against cyclic citrullinated peptides in patients with ankylosing spondylitis. We found that levels of circulating anti-CCP antibodies is significantly reduced immediately after a 3 weeks of radon therapy regimen.

Angelika Moder

2011-11-01

205

Secretory IgA: immune defence pattern in ankylosing spondylitis and klebsiella.  

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Saliva secretory IgA (sIgA), secretory component (SC); serum immunoglobulins (IgG, IgA, IgM), complement (C3, C4), C-reactive protein (CRP), and erythrocyte sedimentation rate (ESR) were performed in 32 patients with ankylosing spondylitis and 29 normal controls. They were investigated for carriage in the faeces of Klebsiella spp. on 3 occasions over the previous months. Throat swabs and urine were cultured at the same time as immunological estimations were done. 24-hour urine sIgA specimens ...

Calguneri, M.; Swinburne, L.; Shinebaum, R.; Cooke, E. M.; Wright, V.

1981-01-01

206

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

207

Increased levels of serum IgA as IgA1 monomers in ankylosing spondylitis.  

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The various subsets of serum IgA were determined in 43 patients with ankylosing spondylitis to investigate the putative mucosal origin of increased IgA concentrations in this disease. Total IgA was shown to be increased and weakly correlated with the erythrocyte sedimentation rate (ESR). In contrast, although the mean concentration (but not the median) of secretory IgA (SIgA) was slightly increased, no correlation was found with total IgA nor the ESR. Moreover, molecular sieving of nine serum...

Hocini, H.; Iscaki, S.; Benlahrache, C.; Vitalis, L.; Chevalier, X.; Larget-piet, B.; Bouvet, J. P.

1992-01-01

208

Phenotypic Study of Natural Killer Cell Subsets in Ankylosing Spondylitis Patients  

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It has been demonstrated that natural killer (NK) cells play a role in regulation of autoimmunity. They play a protective role in several rodent disease models. In this study we aimed to compare the immunophenotypic features of NK cells in Ankylosing Spondylitis (AS) with normal subjects with regard to CD56 and CD16 molecules. "nThis study was carried out on 30 AS patients and 33 normal volunteer donors. Peripheral Blood Mononuclear cells (PBMC) were tested by flow cytometry detecting the int...

Tahereh Mousavi; Hadi Poormoghim; Maziar Moradi; Nader Tajik; Farhad Shahsavar; Mahboobeh Soofi

2009-01-01

209

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

210

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

211

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

212

Cancer incidence among patients with ankylosing spondylitis in Sweden 1965–95: a population based cohort study  

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Background: Ankylosing spondylitis (AS) is a chronic inflammatory joint disease which may lead to extra-articular complications. The disease associated cancer risk has been poorly explored. Recently, tumour necrosis factor ? blockers have been found to be efficacious in AS, but their long term risk is unknown.

Feltelius, N.; Ekbom, A.; Blomqvist, P.

2003-01-01

213

Turkish Translation and Patient Evaluation of the ASAS/EULAR Recommendations-Patient Version for the Management of Ankylosing Spondylitis  

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Full Text Available Objective: The aim of this study was to evaluate the Turkish translation of the patient version of the Assessment in Spondyloarthritis International Society (ASAS and European League Against Rheumatism (EULAR recommendations for the management of ankylosing spondylitis (AS by the patients.Material and Methods: Twelve members of the Ankylosing Spondylitis Patient Society of Turkey participated in the study. All were patients suffering from AS and all items of the recommendations were evaluated for the exact Turkish wording, meaning and comprehensibility by Turkish AS patients. All items were discussed and scored by the patients. Results: The median age of the 12 patients (4 female and 8 male was 39.5 and disease duration was 11.5 years. The median Bath Ankylosing Spondylitis Disease Activity Index and Bath Ankylosing Spondylitis Functional Index were 4.0 and 3.42, respectively. Patients were agreed on each of the 10 items with a mean rate of >80%, and scored the overall recommendations with a mean score of 9.83±0.39. Conclusion: The patient version of the ASAS/EULAR recommendations for the management of AS has been successfully translated into Turkish and all of the patients reached an overall agreement on these recommendations. Treatment guidelines or recommendations that were composed using a medical language that could not be clearly understood by the patients should be translated into common vernacular in order to disseminate knowledge and maintain the patients’ participation.

Salih Özgöçmen

2009-12-01

214

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)

1983-01-01

215

Clinical and radiographic features of adult-onset ankylosing spondylitis in Korean patients: comparisons between males and females.  

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The objective of this study was to investigate clinical and radiographic features and gender differences in Korean patients with adult-onset ankylosing spondylitis. Multicenter cross-sectional studies were conducted in the rheumatology clinics of 13 Korean tertiary referral hospitals. All patients had a confirmed diagnosis of ankylosing spondylitis according to the modified New York criteria. Clinical, laboratory, and radiographic features were evaluated and disease activities were assessed using the Bath ankylosing spondylitis disease activity index. Five hundred and five patients were recruited. The male to female ratio was 6.1:1. Average age at symptom onset was 25.4+/-8.9 yr and average disease duration was 9.6+/-6.8 yr. Males manifested symptoms at a significantly earlier age. HLA-B27 was more frequently positive in males. Hips were more commonly affected in males, and knees in females. When spinal mobility was measured using tragus-to-wall distance and the modified Schober's test, females had significantly better results. Radiographic spinal changes, including bamboo spine and syndesmophytes, were more common in males after adjustment of confounding factors. In conclusion, we observed significant gender differences in radiographic spinal involvement as well as other clinical manifestations among Korea patients with adult-onset ankylosing spondylitis. These findings may influence the timing of the diagnosis and the choice of treatment. PMID:20357993

Jung, Young-Ok; Kim, Inje; Kim, Suho; Suh, Chang-Hee; Park, Han Jung; Park, Won; Kwon, Seoung Ryul; Jeong, Jae Cheon; Lee, Yun Jong; Ryu, Hee Jung; Park, Young Bae; Lee, Jisoo; Lee, You-Hyun; Seo, Young Il; Chung, Won Tae; Hong, Seung-Jae; Hong, Yeon-Sik; Baek, Han Joo; Choi, Hyo Jin; Kang, Hyo-Jong; Lee, Chan-Hee; Kim, Sang-Hyon; Kim, Hyun Ah

2010-04-01

216

Both Baseline Clinical Factors and Genetic Polymorphisms Influence the Development of Severe Functional Status in Ankylosing Spondylitis  

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Functional severity in ankylosing spondylitis (AS) patients is variable and difficult to predict early. The aim of our study was to assess whether a combination of baseline clinical factors and genetic markers may predict the development of severe functional status in AS. We performed a cross-sectional association study on AS patients included in the Spanish National Registry of Spondyloarthropathies—REGISPONSER. Bath Ankylosing Spondylitis Functional Index (BASFI) was standardized by adjusting for disease duration since the first symptoms (BASFI/t). We considered as severe functional status the values of BASFI/t in the top of the 60th (p60), 65th (p65), 70th (p70), and 75th (p75) percentile. We selected 384 single nucleotide polymorphisms (SNPs) distributed in 190 genes to be analyzed. The study cohort included 456 patients with mean age 50.8(±10.5) years and with mean disease duration since first symptoms 24.7 (±10.1) years. Older age at disease onset and neck pain at baseline showed statistical significant association with severe BASFI/t. Polymorphisms associated in the allele frequencies test with severe BASFI/t in all classifications were: rs2542151 (p60 [P?=?.04], p65 [P?=?.04], p70 [P?=?.001] and p75 [P?=?.001]) and rs2254441 (p60 [P?=?.004], p65 [P?=?.02], p70 [P?=?.01] and p75 [P<.001]).. Genotype association, after adjustment for covariates, found an association in three of the four patients' classifications for rs2542151 and in two of the classifications for rs2254441.Forward logistic regression did not identify any model with a good predictive power for severe functional development. In our study we identified clinical factors and 24 polymorphisms associated with development of severe functional status in AS patients. Validation of these results in other cohorts is required.

Schiotis, Ruxandra; Bartolome, Nerea; Sanchez, Alejandra; Szczypiorska, Magdalena; Sanz, Jesus; Cuende, Eduardo; Collantes Estevez, Eduardo; Martinez, Antonio; Tejedor, Diego; Artieda, Marta; Buzoianu, Anca; Mulero, Juan

2012-01-01

217

The serum levels of resistin in ankylosing spondylitis patients: a pilot study.  

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Resistin is a recently described adipokine which is a member of cysteine-rich secretory protein family. Although it has been primarily defined in human adipocytes, it has been identified that its level was higher in mononuclear leukocytes, macrophages, spleen, and bone marrow cells. Because ankylosing spondylitis is an inflammatory disease, it is suspected that upregulation of proinflammatory cytokines is effective in its immunopathogenesis. The aim of our study is to determine the serum resistin levels in patients with AS and to research the relationship with disease activity markers. A total of 30 patients with AS and 30 healthy controls were included in this study. Serum resistin concentrations, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), Bath AS Disease Activity Index (BASDAI) were evaluated. In results resistin levels in ankylosing spondylitis group were significantly higher than in control group. But, there was no correlation between resistin and ESR, CRP, BASDAI. In conclusion, higher serum resistin levels in patients with AS compared to healthy subjects give clues that resistin could have a role in the pathogenesis of AS. PMID:21140266

Kocabas, Hilal; Kocabas, Volkan; Buyukbas, Sad?k; Mel?koglu, Meltem Alkan; Sezer, Ilhan; Butun, Bulent

2012-03-01

218

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

DEFF Research Database (Denmark)

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

219

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

220

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

International Nuclear Information System (INIS)

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)

1978-07-01

 
 
 
 
221

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

DEFF Research Database (Denmark)

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

222

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 not in IgM and IgG, correlated with changes in a composite index of disease activity (IDA). Changes in erythrocyte sedimentation rate (ESR) showed a similar correlation with changes in IDA, whereas changes in serum IgA and ESR showed no consistent correlation, suggesting that both parameters reflect different aspects of disease. Serum IgA, ESR, and IDA values all decreased during regular drug treatment, suggesting a disease modifying effect of the non-steroidal anti-inflammatory drugs (NSAIDs) studied. Regular measurement of serum IgA may be useful in the assessment of disease activity of ankylosing spondylitis. PMID:4062389

Franssen, M J; van de Putte, L B; Gribnau, F W

1985-11-01

223

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

224

Evaluation of Clinical Findings, Quality of Life and Depression in Ankylosing Spondylitis Patients with MEFV Mutation  

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Full Text Available Objective: The aim of this study is to compare MEFV gene mutation carrier Ankylosing Spondylitis (AS patients with non-carrier AS patients with respect to clinical findings and quality of life (QOL measures.Materials and Methods: Fifty-five AS patients fulfilled the modified New York criteria were enrolled in the study. Patients were grouped as MEFV gene mutation negative patients (Group I and MEFV gene mutation positive patients (Group II. Visual analague scale (VAS was used to assess the activity pain and pain at rest. Disease activity and functional capacity of patients were evaluated by using Bath Ankylosing Spondylitis Disease Activity Index (BASDAI and Bath Ankylosing Spondylitis Functional Index (BASFI. QOL and depression was assessed by using Short Form 36 (SF-36 and Beck Depression Inventory (BDI respectively. Results: Thirty-two patients (28 males, 4 females were in group I and 23 patients (18 males, 5 females were in group II. VAS for pain at rest, VAS for acivity pain, BASDAI and BASFI scores of group II was significantly higher than those of group I (p<0.01. When two groups were compared for SF-36 subscales and BDI scores, except social function, all scores were significantly lower in group II . VAS for pain at rest, VAS for acivity pain, BASDAI scores, BASFI scores and duration of disease was significantly correlated with BDI scores and all SF-36 subscales (p<0.0001. The MEFV mutations determined in group II patients were E148Q in 8 patients, M694V in 8 patients, M680I in three patients, V726A in two patients, M694V/M680I in one patient, M694V/E148Q in one patient.Conclusion: In our study, we found that clinical findings and QOL are worse at MEFV gene mutation carrier AS patients. In conclusion we think that ?t is beneficial to diagnose these patients earlier, plan and maintain the treatment according to this condition. Turk J Phys Med Rehab 2008;54:148-51.

Dilek DURMU?

2008-12-01

225

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

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Full Text Available 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 (mean age: 47.5±10.8 years. Pulmonary status of the patients was assessed by spirometric measurements and radiographic methods (chest X-ray, high resolution computerized tomography [HRCT]; clinical status was assessed by Bath indexes (Bath Ankylosing Spondylitis Disease Activity Index [BASDAI], Bath Ankylosing Spondylitis Functional Index [BASFI], Bath Spondylitis Metrology Index [BASMI], Bath Ankylosing Spondylitis Radiology Index [BASRI]; quality of life was assessed by Nottingham Health Profile-1 (NHP and St. George Respiratory Questionnaire (SGRQ; and psychological symptoms were assessed by Beck Depression Scale (BDS. Results: Respiratory function tests were impaired in 15.4% of the patients (n: 3/1, restrictive/obstructive. HRCT revealed pathologic findings in 20.9% of the patients (n: 5. A negative correlation was detected between forced expiratory volume in 1 second (FEV1% and BASFI (r=-0.56, p0.05. Conclusion: Our study showed that pulmonary involvement may be observed among non-smoker AS patients with longer duration of disease; however, pulmonary involvement is not related with clinical status, quality of life or psychological symptoms.

Hale Karapolat

2009-12-01

226

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 "5"1Cr-release cytotoxicity assay, and possible reasons for the failure of others to confirm these observations, are briefly discussed

1986-01-01

227

Orthotic correction of postural unleveling in a patient with ankylosing spondylitis.  

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The authors describe the case of a patient with ankylosing spondylitis who was treated with orthotic devices for postural unleveling. The patient described specific pre-existing postural problems, both static and dynamic, that had been present for many years. A unilateral 9-mm gel heel lift was used, followed by custom-molded orthotic devices that incorporated the heel lift. The patient reported immediate resolution of these symptoms after orthotic treatment, as well as increased functionality and satisfaction in activities of daily living, which coincided with the leveling of his posture. The orthotic devices were used until the patient underwent total hip arthroplasty, at which point the orthotic treatment was discontinued. PMID:24481805

Lipton, James A; Mitchell, Lisa J

2014-02-01

228

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

229

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

230

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

231

Retrograde intubation in a case of ankylosing spondylitis posted for correction of deformity of spine  

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Full Text Available Ankylosing spondylitis (AS patients are most challenging. These patient present the most serious array of intubation and difficult airway imaginable, secondary to decrease or no cervical spine mobility, fixed flexion deformity of thoracolumbar spine and possible temporomandibular joint disease. Sound clinical judgment is critical for timing and selecting the method for airway intervention. The retrograde intubation technique is an important option when fiberoptic bronchoscope is not available, and other method is not applicable for gaining airway access for surgery in prone position. We report a case of AS with fixed flexion deformity of thoracic and thoracolumbar spine, fusion of posterior elements of cervical spine posted for lumbar spinal osteotomy with anticipated difficult intubation. An awake retrograde oral intubation with light sedation and local block is performed.

Raval Chetankumar

2010-01-01

232

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

233

Fifteen months' follow-up of intensive inpatient physiotherapy and exercise in ankylosing spondylitis.  

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Long-term effects of three or four-week inpatient physiotherapy and exercise courses were studied in 141 adult patients with ankylosing spondylitis (AS). Eight cervical and thoracolumbar range of motion (ROM) measurements and straight leg raise test, vital capacity (VC) and fitness index were measured at the beginning and end of an intensive course and 15 months later. All nine mobility measurements, vital capacity and fitness index were significantly improved after the course. Fifteen months later only chest expansion and vital capacity had significantly deteriorated from the baseline, while CR, FFD and fitness index were still significantly better. Disease duration did not influence treatment results. We conclude that it is possible by means of intensive rehabilitation courses to prevent for more than one year deterioration of spinal function and fitness in AS patients irrespective of disease duration. PMID:7586977

Viitanen, J V; Lehtinen, K; Suni, J; Kautiainen, H

1995-07-01

234

Relation between chest expansion, pulmonary function, and exercise tolerance in patients with ankylosing spondylitis.  

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Thirty three patients with definite ankylosing spondylitis (AS) were examined to establish the relation between restriction of chest expansion, limitation of lung function, and working capacity or exercise tolerance. As in previous studies there was a significant association between chest expansion and lung vital capacity. There was also a significant association between vital capacity and exercise tolerance as measured by a subject's maximum oxygen capacity (VO2max). Both vital capacity and VO2max were expressed as a percentage of predicted normal values using patients' height before disease. In this study chest expansion did not have a significant effect on exercise tolerance. The results suggested that patients who took a modest amount of exercise regularly could maintain a satisfactory work capacity despite very restricted spinal and chest wall mobility. It is recommended that greater emphasis should be given to encouraging patients with AS to maintain cardiorespiratory fitness as well as spinal mobility. PMID:2256739

Fisher, L R; Cawley, M I; Holgate, S T

1990-11-01

235

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

236

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

237

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

238

Efficacy evaluation of methotrexate in the treatment of ankylosing spondylitis using meta-analysis.  

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The aim of this study was to evaluate the efficacy of methotrexate (MTX) in the treatment of ankylosing spondylitis (AS). The literature on controlled clinical trials was searched from MEDLINE, EMBASE, OVID, and Cochrane Library databases up to November 2012. The quality of the studies included was evaluated publicly by two reviewers. A meta-analysis was conducted to the homogeneous studies using Cochrane systematic review. Three trials involving 116 patients compared treatment with MTX against placebo. No statistically significant differences (p < 0.05) were found in the primary outcome measures of withdrawal rate, bath ankylosing spondilitis active index (BASDAI), C-reactive protein (CRP), patient global assessment, and side effects such as nausea and vomiting. Two trials involving 142 patients compared treatment with MTX plus infliximab (IFX) against IFX alone in the effect of treatment of AS. No statistically significant differences (p < 0.05) were found in the primary outcome measures of ASAS20 and withdrawal rate. Thus, we should choose the right drugs based on the specific situation in clinical applications. Randomized controlled trials designed rationally and implemented strictly with multi-center, large sample size and enough follow-up time are needed in future research. PMID:24618070

Yang, Zibin; Zhao, Wei; Liu, Weihua; Lv, Qiao; Dong, Xiliang

2014-05-01

239

The natural history of juvenile-onset ankylosing spondylitis: a 24-year retrospective case-control study.  

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One hundred and thirty-five patients with juvenile-onset ankylosing spondylitis (JAS: less than 16 years at onset, mean 12.8 years) were compared to 135 adult-onset spondylitics (AAS: greater than 21 years at onset, mean 26.1 years), controlled for disease duration (24.5 and 23.5 years, respectively), to assess the outcome of juvenile-onset disease. Review was by postal questionnaire and health-assessment measures. The sex distribution was similar: 73% and 74% males, respectively. All parameters showed comparable outcome with the exception of the numbers in full-time employment (JAS 74%, AAS 56%; p less than 0.01) and total hip replacements (JAS 17%, AAS 4%; p less than 0.01). In conclusion: (a) the premature hip is particularly at risk in ankylosing spondylitis; (b) there are few differences between the outcome of JAS and AAS; (c) overall, JAS patients do well in adulthood. PMID:3365541

Calin, A; Elswood, J

1988-04-01

240

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

International Nuclear Information System (INIS)

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 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)

1977-01-01

 
 
 
 
241

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.

Samira Rostom

2013-01-01

242

Improvement in pain intensity, spine stiffness, and mobility during a controlled individualized physiotherapy program in ankylosing spondylitis  

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Physical therapy in ankylosing spondylitis (AS)is important for maintaining or improving mobility, fitness,functioning, and global health. It also plays a role in theprevention and management of structural deformities. Inthis study we assessed the functional status of AS patientsin relation to disease duration and activity. Furthermore, involunteering patients we analyzed the efficacy of a controlled,individualized physiotherapeutic program. Altogether,clinical data of 75 AS patients were ret...

Gyurcsik, Zsuzsanna Ne?methne?; Andra?s, Anita; Bodna?r, No?ra; Szekanecz, Zolta?n; Sza?nto?, Sa?ndor; Szekanecz Zoltán (1964-) (egyetemi tanár)

2011-01-01

243

Circulating inhibitor bound elastase in patients with ankylosing spondylitis and rheumatoid arthritis and the influence of sulphasalazine treatment.  

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The plasma concentration of granulocyte elastase in complex with alpha 1 proteinase inhibitor was determined in 42 patients with ankylosing spondylitis (AS) and 33 patients with rheumatoid arthritis (RA). Significantly raised levels of plasma elastase were found in patients with RA, whereas patients with AS had normal values. No correlation was seen between the elastase values and erythrocyte sedimentation rate (ESR), serum haptoglobin, immunoglobulins, or polymorphonuclear cell (PMN) count i...

Feltelius, N.; Ha?llgren, R.

1988-01-01

244

Cost-Effectiveness Evaluation of Etoricoxib versus Celecoxib and Nonselective NSAIDs in the Treatment of Ankylosing Spondylitis in Norway  

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Objectives. To evaluate the cost-effectiveness of etoricoxib (90?mg) relative to celecoxib (200/400?mg), and the nonselective NSAIDs naproxen (1000?mg) and diclofenac (150?mg) in the initial treatment of ankylosing spondylitis in Norway. Methods. A previously developed Markov state-transition model was used to estimate costs and benefits associated with initiating treatment with the different competing NSAIDs. Efficacy, gastrointestinal and cardiovascular safety, and resource use data...

Jansen, Jeroen P.; Taylor, Stephanie D.

2011-01-01

245

A multicenter, open-label, efficacy, pharmacokinetic, and safety study of adalimumab in Japanese patients with ankylosing spondylitis  

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We evaluated the efficacy, pharmacokinetics, and safety of adalimumab in Japanese patients with active ankylosing spondylitis (AS) who had an inadequate response to, or who were intolerant of, treatment with ?1 nonsteroidal anti-inflammatory drugs (NSAIDs). This phase 3, multicenter, open-label trial assessed the percentage of patients with a 20% response in the Assessment of SpondyloArthritis international society working group criteria (ASAS20) at week 12 as the primary endpoint. Secondar...

Kobayashi, Shigeto; Harigai, Masayoshi; Mozaffarian, Neelufar; Pangan, Aileen L.; Sharma, Shringi; Brown, L. Steven; Miyasaka, Nobuyuki

2012-01-01

246

Relationship between genotype for the cytochrome P450 CYP2D6 and susceptibility to ankylosing spondylitis and rheumatoid arthritis.  

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OBJECTIVES--To determine whether particular genotypes for the cytochrome P450 enzyme CYP2D6, a polymorphic enzyme, are associated with susceptibility to ankylosing spondylitis (AS) and rheumatoid arthritis (RA), or linked with any specific clinical or familial features of the two conditions. METHODS--CYP2D6 genotypes were determined in 54 patients with AS, 53 patients with RA, and 662 healthy controls. Leucocyte DNA was analysed for the presence of mutations by restriction fragment length pol...

1996-01-01

247

Usefulness of the WuScope to facilitate double-lumen endotracheal tube placement in a patient with ankylosing spondylitis.  

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Functional separation of the lungs may be accomplished by several methods. Patients with a stiff neck and limited mouth opening restrict options to a one-lung ventilation. We report the use of the WuScope video system, a new tool for facilitating double-lumen endotracheal tube placement for one-lung ventilation, in a patient who suffered from ankylosing spondylitis with a stiff, flexed neck and limited mouth opening for his recurrent spontaneous pneumothorax. PMID:21539765

Yu, Han-Dung; Ho, Angie C Y; Wu, Yi-Cheng; Lin, Ta-Sen

2011-01-01

248

Association of Variants at 1q32 and STAT3 with Ankylosing Spondylitis Suggests Genetic Overlap with Crohn's Disease  

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Ankylosing spondylitis (AS) is a common inflammatory arthritic condition. Overt inflammatory bowel disease (IBD) occurs in about 10% of AS patients, and in addition 70% of AS cases may have subclinical terminal ileitis. Spondyloarthritis is also common in IBD patients. We therefore tested Crohn's disease susceptibility genes for association with AS, aiming to identify pleiotropic genetic associations with both diseases. Genotyping was carried out using Sequenom and Applied Biosystems TaqMan a...

2010-01-01

249

Frequency of faecal Klebsiella aerogenes in patients with ankylosing spondylitis and controls with respect to individual features of the disease.  

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A study of 59 patients with definite ankylosing spondylitis and 41 comparable hospital outpatients with fractures has been undertaken to determine if the presence of faecal Klebsiella aerogenes is related to clinical activity of the spinal disease and its extraspinal features. The frequencies of fecal K. aerogenes were similar in both patients and controls and were not significantly related to spinal disease activity. Careful inquiry about antibiotic treatment, dietary habits, and hospitalisa...

Eastmond, C. J.; Willshaw, H. E.; Burgess, S. E.; Shinebaum, R.; Cooke, E. M.; Wright, V.

1980-01-01

250

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 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)

2011-09-01

251

Ankylosing Spondylitis  

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... is just one COX-2 inhibitor on the market: celecoxib. Gastroenterologist. A medical doctor who specializes in ... injuries and illnesses that affect movement. Also called rehabilitation physician or rehabilitation medicine specialist. Rheumatologist. A medical ...

252

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.

253

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 (fenh) and enhancement gradient (genh). 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 10-3 mm2/s, fenh from 1.85 to 0.60, and genh 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.)

2008-02-01

254

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. Detailed results of this further follow-up will be presented

1985-11-01

255

Relevant factors on the degree of anterior uveitis in patients with ankylosing spondylitis  

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Full Text Available AIM: To investigate the association between the degree of anterioruveitis and related factors including inflammatory markers as well as sacroiliac joint imaging in patients with ankylosing spondylitis(AS. METHODS: Anterior changes evaluated by slit lamp, erythrocyte sedimentation rate(ESR, C-reactive protein(CRPand magnetic resonance imaging of 55 cases with AS associateduveitis were retrospectively analyzed. A modified endotoxin-induced uveitis(EIUclinical standard was used for uveitis grading. SPARCC sacroiliac scoring was used to evaluate bone edema of sacroiliac joint. The correlation between the degree of uveitis and sacroiliitis was assessed.RESULTS: In the 55 patients with AS, EIU grading scored 2-10, and SPARCC index scored 0-22. Further analysis showed that the severity of uveitis was significantly correlated with ESR(r=0.869, Pr=0.485, Pr=0.237, P=0.081.CONCLUSION: Local autoimmunity of uveitis and sacroiliac joint inflammation with subsequent bone formation in AS might be mutually independent processes.

Guo-Xiang Song

2014-07-01

256

Pulmonary, renal and neurological comorbidities in patients with ankylosing spondylitis; implications for clinical practice.  

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Ankylosing spondylitis (AS) is associated with several comorbidities which contribute significantly to morbidity and mortality and add to the complexity of management. In addition to the well known extra-articular manifestations and increased cardiovascular risk, several pulmonary, renal, and neurological complications which have been associated with AS deserve equal attention. Whereas a clear link has been established for some manifestations, the evidence for other associations is less clear. Interstitial lung disease, apical fibrosis, secondary infection, and ventilatory restriction from reduced chest wall movement are well known pulmonary complications; more recently an association with sleep apnoea has been suggested. Renal amyloidosis and IgA nephropathy remain a treatment challenge which may respond to anti-TNF therapy. Atlanto axial subluxation and vertebral fractures can result in serious neurological complications and are notoriously difficult to diagnose unless a high level of suspicion is maintained. Despite several reports linking AS with demyelination a true link remains to be proved. This review discusses the prevalence, pathophysiology, and management of pulmonary, renal, and neurological complications, and implications for clinical practice. PMID:24925589

Mercieca, Cecilia; van der Horst-Bruinsma, Irene E; Borg, Andrew A

2014-08-01

257

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

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

Lopez-Mejias, Raquel; Miranda-Filloy, Jose A.; Ubilla, Begona; Carnero-Lopez, Beatriz; Blanco, Ricardo; Pina, Trinitario; Gonzalez-Juanatey, Carlos; Llorca, Javier; Gonzalez-Gay, Miguel A.

2014-01-01

258

Association of the MSX2 gene polymorphisms with ankylosing spondylitis in Japanese.  

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Several genes have been implicated in the etiology of ankylosing spondylitis (AS); however, the significance of these genes except HLA-B27 remains to be elucidated. In this study, we examined the association of AS with novel candidate genes and previously reported genes other than HLA-B27. We examined a total of 45 single nucleotide polymorphisms (SNPs) in 15 genes by a sequential screening. We first genotyped 170 Japanese AS patients and 896 controls for the SNPs (first screen). Then, we genotyped eight SNPs with P second screen). We checked the replication of the association of the most significant SNP by genotyping 219 Taiwanese AS patients and 185 controls. When the first and second screens were combined, four SNPs showed nominal significance of P A) in MSX2, a novel candidate gene, showed the most significant association (P = 0.0030). The association was not replicated in our Taiwanese population; however, there was the same trend with the Japanese population in the allelic frequency distribution of the SNP. In the genes previously reported to have association with AS, only one synonymous SNP, c.963T > G in ANKH, showed a marginal association in the Japanese population (P = 0.045). PMID:18299954

Furuichi, Tatsuya; Maeda, Koichi; Chou, Chung-Tei; Liu, Yu-Fen; Liu, Ting-Chun; Miyamoto, Yoshinari; Takahashi, Atsushi; Mori, Kanji; Ikari, Katsunori; Kamatani, Naoyuki; Kurosawa, Hisashi; Inoue, Hisashi; Tsai, Shih-Feng; Ikegawa, Shiro

2008-01-01

259

Interleukin-23 receptor genetic polymorphisms and ankylosing spondylitis susceptibility: a meta-analysis.  

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Up to now, many publications have evaluated the correlation between IL-23R polymorphisms and ankylosing spondylitis with conflicting results. We perform this meta-analysis to collect all the relevant studies up to date to further clarify the association of IL-23R polymorphisms with AS. Relevant published data were retrieved through Medline, PubMed, Embase, Web of Science, CNKI, Chinese BioMedical Literature Database on disc, and the statistical analysis was conducted using Stata 11.0. (1) A total of 11 literatures, including 13 population samples, were studied. (2) The allele A frequency of rs11209032 was higher in the AS group than in the controls (A vs. G: OR = 1.173, 95% CI = 1.107-1.243, P rs11209026 was lower in the AS group than in the controls. (5) No significant differences were found in allele frequency of rs10889677 polymorphism between cases and controls by random effects model. We concluded that the genetic susceptibility for AS is associated with the IL-23R gene polymorphisms. The protective SNPs include rs1343151, rs10489629, and rs11209026 while rs1004819 and rs11209032 may be the susceptibility SNPs. PMID:21253733

Duan, Zhenhua; Pan, Faming; Zeng, Zhen; Zhang, Tianchen; Wang, Sheng; Li, Guixing; Xu, Shengqian; Xu, Jianhua; Zhang, Li

2012-05-01

260

Comparison of Venous Thromboembolism after Total Hip Arthroplasty between Ankylosing Spondylitis and Osteoarthritis  

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Objective. Ankylosing spondylitis (AS), an inflammatory rheumatic disease, will gradually lead to severe hip joint dysfunction. Total hip arthroplasty is a useful method to improve patients' quality of life. The aim of this study was to compare the incidence and risk factors of deep vein thrombosis (DVT) between AS and hip osteoarthritis. Methods. In a retrospective study, a total of 149 subjects who underwent cementless THA were studied. Clinical data, biochemical data, and surgery-related data were measured between AS and OA groups. Results. The incidence of DVT in AS group was lower than that of OA group, although no significant difference was detected (P = 0.89). The patients of AS group were much younger (P < 0.0001) and thinner (P = 0.018) compared with those of OA group. AS patients had higher ejection fraction (EF) (P = 0.016), higher platelet counts (P < 0.0001), and lower hypertension rate (P = 0.0004). The values of APTT, PT, and INR in AS patients were higher than those in OA patients (all P < 0.0001). The values of D-dimer and APTT were both significantly higher in DVT subjects than those in non-DVT subjects. Conclusion. AS patients potentially had a lower incidence of DVT compared with OA patients.

Shi, Dongquan; Xu, Xingquan; Song, Kai; Xu, Zhihong; Dai, Jin; Chen, Dongyang; Jiang, Qing

2014-01-01

 
 
 
 
261

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. HLA-B*27:04:01 and -B*27:05:02 appeared significantly increased in AS patients, which indicated as two major susceptibility alleles to AS. Homozygous B*27 was observed only in AS patients. There are 30 HLA-B alleles identified in the studies. HLA-B*15, especially B*15:01:01:01, appeared as the major allele type in the Chinese controls. Some common HLA-B alleles such as HLA-B*15, B*13, B*46 and B*51 were significantly reduced in Chinese AS patients. In conclusion, the studies profiled the HLA-B alleles, and identified major susceptibility subtypes of B27 to AS in Han Chinese population

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

262

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

263

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 zygapophyseal joints from 8 patients with AS (age: 30 to 64, disease duration 7 to 33 years) undergoing spinal surgery with findings in MRI. For histopathological analysis, we quantified infiltrates of CD3+, CD4+ and CD8+ T cells as well as CD20+ B cells immunohistochemically. Bone marrow edema was evaluated in hematoxylin and eosin stained sections and quantified as the percentage of the bone marrow area involved. All patients with AS showed interstitial mononuclear cell infiltrates and various degrees of bone marrow edema (range from 10% to 60%) in histopathological analysis. However, in only three of eight patients histopathological inflammation and edema in the zygapophyseal joints correlated with bone marrow edema in zygapophyseal joints of the lumbar spine as detected by MRI. Interestingly, two of these patients showed the highest histological score for bone marrow edema (60%). This first study correlating histopathological changes in the spine of patients with AS with findings in MRI scans suggests that a substantial degree of bone marrow inflammation and edema is necessary to be detected by MRI. PMID:16925803

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

2006-01-01

264

Phenotypic Study of Natural Killer Cell Subsets in Ankylosing Spondylitis Patients  

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Full Text Available It has been demonstrated that natural killer (NK cells play a role in regulation of autoimmunity. They play a protective role in several rodent disease models. In this study we aimed to compare the immunophenotypic features of NK cells in Ankylosing Spondylitis (AS with normal subjects with regard to CD56 and CD16 molecules. "nThis study was carried out on 30 AS patients and 33 normal volunteer donors. Peripheral Blood Mononuclear cells (PBMC were tested by flow cytometry detecting the intensity of CD56 and CD16 surface molecules. The percentage of positive cells and their subsets were then calculated and statistically analyzed using SPSS software. A significant increase was found in CD56+ CD16+ (P? 0.009, and also in the subset of CD56 dim CD16+ (P? 0.02, but not in CD56 bright CD16+ (P=0.3 NK cells in AS patients compared to controls. We conclude that these results may indicate that NK and their subset ratios play a role in AS pathogenesis. Moreover, determination of NK subsets in combination with clinical features may be useful for AS diagnosis. However, further studies using large samples together with determination of relevant cytokines are recommended to verify the exact role of NK in AS disease.

Farhad Shahsavar

2009-07-01

265

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

266

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

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Full Text Available 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 Health 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

2011-01-01

267

Association between cytokines and methylation of SOCS-1 in serum of patients with ankylosing spondylitis.  

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In this study, we aim to determine the relationship between methylation level of an inflammatory-related gene, SOCS-1 in serum samples of patients with ankylosing spondylitis (AS) and their degree of inflammation as well as serum cytokine level. Quantitative real time methylation specific PCR was performed to examine the promoter methylation of SOCS-1 in serum samples of 43 HLA-B27+ AS patients and 6 B27+ healthy controls. Degree of inflammation was accessed by spondylopathy, sacroiliitis as well as acute phase reactant, erythrocyte sedimentation rate and C-reactive protein (CRP). Serum IL-6 and TNF-? level was determined by ELISA assay. SOCS-1 methylation can only be found in serums samples from patients but not normal control. Methylation of SOCS-1 significantly associated with severity of patient's spondylopathy (P < 0.005), sacroiliitis (P < 0.005) and acute phase reactant CRP (P = 0.0278). AS patients also exhibited higher serum IL-6 (P < 0.001) and TNF-? level (P < 0.001). Importantly, patients with high serum IL-6 or TNF-? level demonstrated a significantly higher SOCS-1 methylation (P < 0.001). In conclusion, this proof-of-principle study suggested that methylation of SOCS-1 can be detected in serum of HLA-B27+ AS patients but not in B27+ controls. The pathogenic potential of SOCS-1 methylation in AS deserves further investigation. PMID:24532142

Lai, Ning-Sheng; Chou, Jian-Liang; Chen, Gary C W; Liu, Su-Qin; Lu, Ming-Chi; Chan, Michael W Y

2014-06-01

268

Clinical Use of Chest Expansion Corrected for Age and Sex in Patients with Ankylosing Spondylitis  

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Full Text Available Objective: The aim of this study was to investigate if the chest expansion corrected by age and sex was appropriate for clinical practice or not and to evaluate the relation of chest expansion with pulmonary functions and disease severity in patients with ankylosing spondylitis (AS.Metarials and Methods: Eighty-two patients with AS and 42 healthy controls were included in the study. The patients were divided into two groups according to chest expansion corrected by age and sex: restricted and non-restricted groups. Additional to the clinical evaluation, the Bath AS Disease Activity Index (BASDAI, Bath AS Functional Index (BASFI, and Bath AS Metrology Index (BASMI were used to evaluate disease activity, functional impairment, and mobility, respectively.Results: Forced vital capacity and forced expiratory volume in the first second were significantly decreased in the restricted group when compared to the non-restricted and control groups. Pain, BASFI, and BASMI scores were significantly higher in the restricted group compared to the non-restricted one. Chest expansion was significantly correlated with clinical parameters and pulmonary function tests.Conclusion: Chest expansion measurement corrected for age and sex is appropriate for clinical practice and chest expansion is associated with pulmonary functions and disease severity. Turk J Phys Med Re­hab 2011;57:128-33.

Bekir Durmu?

2011-09-01

269

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

270

Associations of the PTPN22 and CTLA-4 genetic polymorphisms with Taiwanese ankylosing spondylitis.  

Science.gov (United States)

Ankylosing spondylitis (AS) is an autoimmune disease, and the imbalance of peripheral tolerance is involved in its pathogenesis. Importantly, the negative signal of activated T cells plays a crucial role in the balance of peripheral tolerance. It has been postulated that human protein tyrosine phosphatase nonreceptor 22 (PTPN22) and cytotoxic T-lymphocyte antigen-4 (CTLA-4) genes encode proteins that are actively involved in regulating T-cell activation. Therefore, we evaluated the effects of PTPN22 and CTLA-4 genotypes on the occurrence of AS. Genetic polymorphisms of PTPN22 -1123G/C and CTLA-4 +49A/G were identified by polymerase chain reaction for 391 AS patients and 391 healthy controls. Subjects with PTPN22 CC and GC genotypes had a greater risk of AS occurrence than those with PTPN22 GG genotype [relative risk = 1.39, 95 % confidence interval (95 % CI) 1.03-1.88]. Further, subjects with PTPN22 CC/CTLA-4 AA or PTPN22 GC/CTLA-4 AA genotypes had 1.90-fold (95 % CI 1.02-3.49) greater risk of AS development than those with other combinations of PTPN22 and CTLA-4 genotypes. Our findings indicated that PTPN22 -1123G/C and CTLA-4 +49A/G genetic polymorphisms have a combined effect on the development of AS. PMID:24212676

Huang, Chun-Huang; Wei, James Cheng-Chung; Chen, Chun-Chieh; Chuang, Chih-Shien; Chou, Chia-Hsuan; Lin, Yu-Jie; Wang, Ming-Fuu; Wong, Ruey-Hong

2014-05-01

271

Low doses of etanercept can be effective to maintain remission in ankylosing spondylitis patients.  

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We wanted to do a prospective open-label study to evaluate if ankylosing spondylitis (AS) patients in clinical remission with twice weekly etanercept (ETN) 25 mg therapy could be changed to weekly regimen or even to every other week regimen without increased dose for injection. Thirty-eight AS patients self-administered 25 mg of ETN (Wyett) subcutaneously. According to the protocol, patients who were in clinical partial remission with twice weekly ETN 25 mg at week 12 and 16 changed to a weekly regimen without a change of the dose. If clinical remission, despite the reduction of the dose, persists at week 24 and 28, patients changed to an every-other-week regimen, continuing with this administration schedule for the entire duration of the study if at week 36 and 46 clinical remission was maintained. At the end of the study, 18 patients (47 %) were still in remission, 4 (10 %) with a weekly regimen, and 14 (37 %) with an every-other-weekly regimen. Our study indicates that a consistent percentage of subjects with AS, treated with ETN 25 mg twice weekly, achieved clinical remission within the first 3 months of therapy, and also, a substantial percentage of these patients maintains the partial remission with an every other week regimen. PMID:24062201

De Stefano, Renato; Frati, Elena; De Quattro, Davide; Menza, Luana; Manganelli, Stefania

2014-05-01

272

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

International Nuclear Information System (INIS)

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)

1978-01-01

273

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

274

Adult-onset cyclic neutropenia responsive to cyclosporine therapy in a patient with ankylosing spondylitis.  

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A 45-year-old female with a long history of HLA-B27-positive ankylosing spondylitis and ulcerative colitis developed cyclic neutropenia. She was hospitalized for high fever during each of three consecutive episodes of absolute neutropenia. On the third hospitalization, granulocyte-colony-stimulating factor (G-CSF), 5 micrograms/kg/day, was given by subcutaneous injection and resulted in an increase of absolute neutrophil count from 0 to 2.2 x 10(9)/liter and an associated decrease of platelet count and hemoglobin as well as severe bone and joint pain predominantly in the middle and lower back and purulent diarrhea. The back pain necessitated discontinuation of the drug. Oral cyclosporine therapy was begun, and although the neutrophil count continued to oscillate, both the peaks and the nadirs were higher than previously, and symptoms of neutropenia subsided. We conclude that cyclosporine can be an effective treatment for cyclic neutropenia associated with autoimmunity since G-CSF may cause exacerbations of autoimmune disorders. PMID:7688178

Storek, J; Glaspy, J A; Grody, W W; Susi, E; Slater, E D

1993-06-01

275

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

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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

276

Correlations among enthesitis, clinical, radiographic and quality of life parameters in patients with ankylosing spondylitis.  

Science.gov (United States)

Abstract Objectives. To investigate the relationship between enthesitis and disease activity, functional status, fatigue, joint mobility, radiological damage, laboratory parameter and quality of life in patients with ankylosing spondylitis (AS). Methods. A total of 421 patients with AS (323 male and 98 female) who were included in the Turkish League Against Rheumatism Registry were enrolled in the study. The Bath AS Disease Activity Index (BASDAI), fatigue, the Bath AS Functional Index (BASFI), the Bath AS Metrology Index (BASMI), the Maastricht AS Enthesitis Score (MASES), AS quality of life (ASQoL), the Bath AS Radiology Index (BASRI) and erythrocyte sedimentation rate (ESR) were evaluated. Results. Enthesitis was detected in 27.3% of patients. There were positive correlations between MASES and BASDAI, BASFI and fatigue (p ESR. The mean MASES score was 1.1 ± 2.4. The most frequent regions of enthesopathies were right iliac crest, spinous process of L5 and proximal to the insertion of left achilles tendon, respectively. Conclusions. Enthesitis was found to be associated with higher disease activity, higher fatigue, worse functional status and lower disease duration. As enthesitis was correlated with BASDAI, we conclude that enthesitis can reflect the disease activity in patients with AS. PMID:24252034

Rezvani, Aylin; Bodur, Hatice; Ataman, Sebnem; Kaya, Taciser; Bu?dayc?, Derya Soy; Demir, Saliha Ero?lu; Koçyi?it, Hikmet; Altan, Lale; U?urlu, Hatice; K?rnap, Mehmet; Gür, Ali; Kozano?lu, Erkan; Ak?nc?, Ay?en; Tekeo?lu, Ibrahim; Sahin, Gün?ah; Bal, Ajda; Sivrio?lu, Konçuy; Yazgan, Pelin; Ayd?n, Gülümser; Hepgüler, Simin; Olmez, Ne?e; Sendur, Omer Faruk; Yener, Mahmut; Altay, Zühal; Ayhan, Figen; Durmu?, O?uz; Duruöz, Mehmet Tuncay; Günendi, Zafer; Nac?r, Bar??; Oken, Oznur; Tokta?, Hasan; Delialio?lu, Sibel Ünsal; Evcik, Deniz; Sertpoyraz, Filiz Meryem

2014-07-01

277

Thoracic spinal cord herniation in a patient with long-standing ankylosing spondylitis.  

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The objective of this study was to describe an adult male patient with ankylosing spondylitis (AS) associated with thoracic spinal cord herniation (TSCH). TSCH is a scarce entity presented as a displacement of thoracic cord through an anterior or anterolateral dural defect. More importantly, the co-occurrence of AS and thoracic spinal cord herniation is exceptional. To date, only one case of SCH in association with AS has been reported in the literature. A 56-year-old male patient presented with the progressive difficulty in walking and numbness of both lower limbs for the past 18 months. The patient was diagnosed as AS when he was 30 years old. Sagittal MRI of thoracic spine showed dural defect of the posterior aspect of T11 and 12 vertebral bodies. Axial T2-weighted MRI demonstrated that spinal cord was displaced ventrally and to the right. The diagnosis of TSCH with AS was established. The prognosis was explained to the patient. We recommended duraplasty for dural repair to the patient, but he refused surgery. The results demonstrated that TSCH associated with long-standing AS was very uncommon, and MRI is recommended to rule out SCH in the long-standing AS patients with neurologic symptoms. The SCH in AS might be caused by inflammation, and thoracolumbar hyperkyphosis results from AS might be associated with the development of SCH. PMID:20936535

Liu, Zhen; Wang, Wei-jun; Sun, Chao; Zhu, Zhe-zhang; Qiu, Yong

2011-07-01

278

Phenotype Difference between Familial and Sporadic Ankylosing Spondylitis in Korean Patients.  

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Clustered occurrences of ankylosing spondylitis (AS) in family have been noticed. We evaluated patients with AS confirmed by the modified New York criteria for familial history of AS (one or more first to third degree relatives). The clinical characteristics and the recurrence risks (number of AS patients/number of familial members) of the familial AS compared to sporadic AS were investigated. Out of a total of 204 AS patients, 38 patients (18.6%) reported that they had a familial history of AS. The recurrence risks in the familial AS patients for first, second and third degree family members were 14.5%, 5.2%, and 4.4% respectively. Erythrocyte sedimentation rate (ESR) (22.6±22.2 vs 35.4±34.4, P=0.029) and C-reactive protein (CRP) (1.24±1.7 vs 2.43±3.3, P=0.003) at diagnosis, body mass index (21.9±2.7 vs 23.7±3.3, P=0.002) and frequency of oligoarthritis (13.2% vs 33.7%, P=0.021) were significantly lower in the familial form. The presence of HLA-B27 (97.4% vs 83.1%, P=0.044) was significantly higher in familial AS. In conclusion, Korean familial AS patients show a lower frequency of oligoarthritis, lower BMI, lower ESR and CRP at diagnosis and higher presence of HLA-B27. PMID:24932078

Kim, Hye Won; Choe, Hye Rim; Lee, Su Bin; Chang, Won Ik; Chae, Hyun Jun; Moon, Jin Young; Kang, Jisue; Lee, Sungim; Song, Yeong Wook; Lee, Eun Young

2014-06-01

279

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)

2008-10-01

280

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

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

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

2011-01-01

 
 
 
 
281

Between adaptive and innate immunity: TLR4-mediated perforin production by CD28null T-helper cells in ankylosing spondylitis  

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CD3+CD4+CD28null and CD3+CD8+CD28null T cells are enriched in patients with immune-mediated diseases compared with healthy controls. This study shows that CD4+CD28null T cells express Toll-like receptors recognizing bacterial lipopolysaccharides in ankylosing spondylitis, psoriatic arthritis and rheumatoid arthritis. In ankylosing spondylitis, TLR4 (23.1 ± 21.9%) and, to a smaller extent, TLR2 (4.1 ± 5.8%) were expressed on CD4+CD28null T cells, whereas expression was negligible on CD4+CD28...

Raffeiner, Bernd; Dejaco, Christian; Duftner, Christina; Kullich, Werner; Goldberger, Christian; Vega, Sandra C.; Keller, Michael; Grubeck-loebenstein, Beatrix; Schirmer, Michael

2005-01-01

282

Tai Chi for Disease Activity and Flexibility in Patients with Ankylosing Spondylitis—A Controlled Clinical Trial  

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We investigated the effects of tai chi on disease activity, flexibility and depression in patients with ankylosing spondylitis (AS). We allocated 40 patients to either a tai chi treatment group or a no-treatment control group. The tai chi group performed 60 min of tai chi twice weekly for eight consecutive weeks and 8 weeks of home-based tai chi, after which the group showed significant improvement in disease activity and flexibility compared to the control group. All outcome measures were si...

Lee, Eun-nam; Kim, Young-hee; Chung, Won Tae; Lee, Myeong Soo

2008-01-01

283

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

284

CD8+ T-cell autoreactivity to an HLA-B27–restricted self-epitope correlates with ankylosing spondylitis  

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HLA-B27 is highly associated with ankylosing spondylitis (AS), but the mechanism is unknown. Among the HLA-B27 alleles, B*2709, which differs by one amino acid from the susceptible B*2705, is not associated with the disease. Here, we analyze the reactivity, in patients with AS and in healthy controls carrying the B*2709 or B*2705 alleles, to an EBV epitope derived from LMP2 (236-244) and to a sequence-related self-peptide from vasoactive intestinal peptide receptor 1 (VIP1R 400-408). We found...

Fiorillo, Maria T.; Maragno, Monica; Butler, Richard; Dupuis, Maria L.; Sorrentino, Rosa

2000-01-01

285

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.

286

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

287

HLA-B27 polymorphism in patients with juvenile and adult-onset ankylosing spondylitis in Southern China.  

Science.gov (United States)

Distribution of B27 subtypes in juvenile and adult-onset ankylosing spondylitis (JAS and AAS) in Southern China was studied. A total of 505 patients belonged to Han population were included (145 JAS and 360 AAS patients), and 1368 healthy individuals were included as controls. Human leukocyte antigen (HLA)-B27 typing was performed by Luminex liquid array combining polymerase chain reaction-sequence specific oligonucleotide probe (PCR-SSOP) and/or serological method. HLA-B27 subtyping was performed by polymerase chain reaction-sequence specific primer (PCR-SSP). The sequence-based typing was performed for the B*2715 samples to verify the PCR-SSP results. HLA-B27 was presented in 453 of 505 patients (89.7%), compared with 74 of 1368 controls (5.41%). B*2704 subtype in AS group was significantly higher than controls and B*2705 subtype significantly lower. B*2715 and B*2702 were found in 1.32% and 0.66% of the B27-positive patients but none in controls, and there was no significant difference between either of them and controls. B27-positive patients were 134 (92.4%) in JAS group and 319 (88.6%) in AAS group. There was no significant difference for B27 subtypes distribution between JAS (B*2704, 05, 15) and AAS (B*2704, 05, 15, 02) groups. The frequency of B*2715 in two groups was 3 (2.24%) and 3 (0.94%), respectively. The onset age of three JAS patients carrying B*2715 was 5, 9 and 13 years old, respectively. Our results suggested that B*2704 was the predominant subtype in AS patients in Southern China. B*2715 was observed in AS group only and slightly more in JAS than in AAS, and the patients carrying this allele tended to have early onset, B*2715 may be disease-association subtype. PMID:20196819

Mou, Y; Wu, Z; Gu, J; Liao, Z; Lin, Z; Wei, Q; Huang, J; Li, Q

2010-01-01

288

Assessment of quality of life and depression in spouses of patients with ankylosing spondylitis.  

Science.gov (United States)

The objective of this study is to investigate the quality of life and the rates of depression in spouses/partners of patients with AS compared with spouses/partners of healthy controls". Twenty-five persons with AS and their 25 spouses (21 women and 4 men) and 25 healthy controls were recruited consecutively. All the subjects completed 36-item Short Form Health Survey (SF-36) questionnaire forms and 17-item Hamilton Depression Rating Scale (HAM-D17). Mean age was 35 ± 6.47 years in spouse group (SG) and 36.26 ± 5.93 in control group (CG). In SG and CG, the SF-36 subscale scores were compared using Mann-Whitney U test. Social functioning, mental health, emotional role, and general health were significantly (P < 0.05) lower in SG compared with CG. The average score of social functioning was found to be 65.41 in spouses of patients compared with healthy controls (90.75). Depression scores were significantly (P < 0.001) higher in SG compared with CG. Among SF-36 subgroups in spouses, general health perception had a negatively significant correlation with depression scores (P < 0.05) and duration of ankylosing spondylitis (P < 0.05). A positively significant correlation has been identified between bodily pain and depression scores in spouses (P < 0.05). Therefore, female partners of male patients were found to be more depressive. Being a spouse of a patient with AS significantly interferes with quality of life and increases the depression frequency. PMID:22071688

Uludag, Murat; Unalan, Halil; Tuzun, Sans?n; Kocabasoglu, Nese; Aydin, Filiz Y?ld?z; Palamar, Deniz; Ozdemir, Samuray; Akarirmak, Ulku

2012-11-01

289

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

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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.)

2010-09-01

290

Is there a higher genetic load of susceptibility loci in familial ankylosing spondylitis?  

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Objective Several genetic risk variants for ankylosing spondylitis (AS) have been identified in genome wide association studies. Our objective was to examine whether familial AS cases have a higher genetic load of these susceptibility variants. Methods Overall, 502 AS patients were examined, consisting of 312 who had first-degree relatives (FDR) with AS (familial) and 190 who had no FDR with AS or spondyloarthritis (sporadic). All patients and affected FDRs fulfilled the modified New York Criteria for AS. The patients were recruited from two U.S. cohorts (NASC and PSOAS) and from the United Kingdom- Oxford cohort. The frequencies of AS susceptibility loci in IL23R, IL1R2, ANTRX2, ERAP1, two intergenic regions on chromosomes 2p15 and 21q22, and HLA-B27 status as determined by the tag SNP rs4349859 were compared between familial and sporadic cases. Association between SNPs and multiplex status was assessed by logistic regression controlling for sibship size. Results HLA-B27 was significantly more prevalent in familial than sporadic cases of AS (p=0.0001, OR: 4.44, CI: (2.06–9.55)). Furthermore, the AS risk allele at chromosome 21q22 intergenic region showed a trend towards higher frequency in the multiplex cases (p=0.08). The frequency of the other AS risk variants did not differ significantly between familial and sporadic cases, either individually or combined. Conclusions HLA-B27 is more prevalent in familial than sporadic cases of AS, demonstrating higher familial aggregation of AS in patients with HLA-B27 positivity. The frequency of the recently described non-MHC susceptibility loci is not markedly different between the sporadic and familial cases of AS.

Joshi, Reeti; Reveille, John D.; Brown, Matthew A.; Weisman, Michael H.; Ward, Michael M.; Gensler, Lianne S.; Wordsworth, B. Paul; Evans, David M.; Assassi, Shervin

2012-01-01

291

Therapy of ankylosing spondylitis. Part II: biological therapies in the spondyloarthritides.  

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Therapeutic options for patients with active and severe spondylarthritis (SpA) have been fairly limited in the past decades. There is now accumulating evidence that biological therapy with agents directed against tumour necrosis factor-alpha (TNF-alpha) is highly efficacious in the spondyloarthritides, especially in ankylosing spondylitis (AS) and psoriatic arthritis (PsA). The TNF blocking agents currently available, infliximab (Remicade), etanercept (Enbrel), and adalimumab (Humira), are approved for the treatment of rheumatoid arthritis (RA) in Europe and the USA. In contrast to rheumatoid arthritis (RA) disease-modifying anti-rheumatic drugs (DMARDs) have limited efficacy in SpA. No DMARDs are available for AS patients with active spinal disease. Thus, for AS patients whose condition is not sufficiently controlled with non-steroidal anti-inflammatory drugs (NSAIDs), therapy with TNF blockers may be considered as a first-line treatment. For infliximab, a dose of 3-5 mg/kg seems to be required, and intervals between 6 and 12 weeks are necessary to suppress disease activity continually. The standard dosage of etanercept is 2 x 25 mg subcutaneously (s.c.) per week. There are very few studies with adalimumab (standard dose in RA 20-40 mg s.c. every 1-2 weeks) in SpA. Infliximab and etanercept are now both approved for AS in Europe. There is some evidence that both agents also work in other SpA, especially in PsA. Withdrawal of long-term therapy in AS patients led to relapses of disease after several months. Less radiographic progression after 2 years of continuous treatment with infliximab compared to conventional therapy has been suggested in a small study. Serious adverse events on anti-TNF therapy have remained rare. However, severe infections, including tuberculosis, have been reported. These can be largely prevented by appropriate screening. The benefits of anti-TNF therapy in AS seem to outweigh these shortcomings. PMID:16134723

Braun, J; Baraliakos, X; Brandt, J; Sieper, J

2005-01-01

292

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

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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

293

Clinical characteristics and medical management of Iranian patients with ankylosing spondylitis.  

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Abstract Objectives. Ankylosing spondylitis (AS) is a chronic inflammatory rheumatic disease with variable clinical expression. Ethnic, racial and geographical factors have been associated with disease occurrence and expression. We intended to describe the clinical characteristics and assess the disease severity and treatment status in Iranian AS patients. Methods. A total of 320 AS patients were assessed for demographic variables, clinical manifestations, human leukocyte antigen (HLA) status, disease severity, functional capacities, quality of life and treatment status. Results. A gender ratio of 3.8:1, an average age onset of 27 ± 7.3 and a mean diagnostic delay of 8 years were observed. Eleven percent had juvenile onset AS. Positive family history was higher than that observed in most other countries. Enthesitis was a very common finding involving more than two-thirds of our patients. Uveitis was the leading extra-articular manifestation. We found an HLA-B27 prevalence of 73% and four HLA-B27 subtypes. Disease activity was high and the functional status was poor as indicated by mean Bath AS Disease Activity, Functional and Metrology indices. Quality of life was considerably impaired in our patients. We found a low percentage of patients on biological medications and a relatively higher percentage on disease modifying anti-rheumatic drugs and corticosteroids. Conclusions. Our results demonstrate a broad characterization of Iranian AS patients providing a better understanding of this disease. A national multicenter registry would enable larger- scale prospective studies to be carried out further evaluating the disease burden on patients and society. PMID:24251997

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

2014-05-01

294

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

295

Pattern of ankylosing spondylitis in an Iranian population of 98 patients.  

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The prevalence and pattern of ankylosing spondylitis (AS) can vary from country to country, according to genetic and environmental factors. This study aims to analyze the patterns of disease in a population of Iranian patients with AS. We performed a prospective study (2002-2007) analyzing 98 patients with diagnosis of AS according to the modified New York criteria. Selected patients underwent complete clinical (initial symptom, axial and peripheral involvement, heel enthesitis, extra-articular manifestations) and radiological (sacroiliac, lumbar, thoracic, and cervical spine) investigations, and these data were compared with sex, age at onset, and HLA-B27. There was predominance of men (71.4%), adult onset (>16 years, 90.8%), and positive HLA-B27 (73.4%). Family history of AS was noted in 14.3% of the patients. The predominant initial symptoms were inflammatory low back pain (44.2%). Radiological findings included syndesmophytes in 34.7% and "bamboo spine" in 16.3% of patients. Acute anterior uveitis was noted in 44.9% of patients. Male sex was associated with involvement of shoulder (P = 0.001). Female sex and juvenile-onset AS were associated with extra-articular involvement. Positive HLA-B27 was associated with hip involvement (P = 0.042) and adult-onset AS (P = 0.035). Analysis of the patterns of disease in this population of 98 southern Iranian patients with AS revealed that female sex and juvenile-onset AS were associated with extensive extra-axial involvement; and HLA-B27 was associated with hip involvement. PMID:19266255

Nazarinia, Mohammad Ali; Ghaffarpasand, Fariborz; Heiran, Hamid Reza; Habibagahi, Zahra

2009-01-01

296

Serum Adipokines and Adipose Tissue Distribution in Rheumatoid Arthritis and Ankylosing Spondylitis. A Comparative Study  

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

Toussirot, Eric; Grandclement, Emilie; Gaugler, Beatrice; Michel, Fabrice; Wendling, Daniel; Saas, Philippe; Dumoulin, Gilles

2013-01-01

297

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

298

Retraction: Psychometric characteristics of the ankylosing spondylitis quality of life questionnaire, short form 36 health survey, and functional assessment of chronic illness therapy-fatigue subscale  

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Retraction of Revicki DA, Rentz AM, Luo MP, Wong RL, Doward LC, McKenna SP: Psychometric characteristics of the ankylosing spondylitis quality of life questionnaire, short form 36 health survey, and functional assessment of chronic illness therapy-fatigue subscale. Health and Quality of Life Outcomes 2009, 7: 6.

Revicki, Dennis A.; Rentz, Anne M.; Luo, Michelle P.; Wong, Robert L.; Doward, Lynda C.; Mckenna, Stephen P.

2009-01-01

299

Retraction: Psychometric characteristics of the ankylosing spondylitis quality of life questionnaire, short form 36 health survey, and functional assessment of chronic illness therapy-fatigue subscale  

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Abstract Retraction of Revicki DA, Rentz AM, Luo MP, Wong RL, Doward LC, McKenna SP: Psychometric characteristics of the ankylosing spondylitis quality of life questionnaire, short form 36 health survey, and functional assessment of chronic illness therapy-fatigue subscale. Health and Quality of Life Outcomes 2009, 7: 6.

Revicki Dennis A; Rentz Anne M; Luo Michelle P; Wong Robert L; Doward Lynda C; McKenna Stephen P

2009-01-01

300

Retraction: Psychometric characteristics of the ankylosing spondylitis quality of life questionnaire, short form 36 health survey, and functional assessment of chronic illness therapy-fatigue subscale  

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Full Text Available Abstract Retraction of Revicki DA, Rentz AM, Luo MP, Wong RL, Doward LC, McKenna SP: Psychometric characteristics of the ankylosing spondylitis quality of life questionnaire, short form 36 health survey, and functional assessment of chronic illness therapy-fatigue subscale. Health and Quality of Life Outcomes 2009, 7: 6.

Wong Robert L

2009-04-01

 
 
 
 
301

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

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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

302

Description of the registry of patients with ankylosing spondylitis in Turkey: TRASD-IP.  

Science.gov (United States)

A web-based application patient follow-up program was developed to create a registry of patients with ankylosing spondylitis (AS) by the Turkiye Romatizma Arastirma Savas Dernegi (TRASD) AS Study Group. This study describes the methodological background and patient characteristics. The patient follow-up program is a web-based questionnaire, which contains sections on socio-demographic data, anamnesis, personal and family history, systemic and musculoskeletal examination, laboratory and imaging data and treatment. Between October 1, 2007 and February 28, 2009, 1,381 patients from 41 centers were included in the registry (1,038 males [75.2%]; mean age 39.5 ± 10.7 years). Mean disease duration was 12.1 ± 8.5 years, and mean time from initial symptom to diagnosis was 5 ± 6.8 years (median 2 years). HLA-B27 positivity was detected in 73.7% of 262 patients tested. Manifestations of extraarticular involvement were anterior uveitis (13.2%), psoriasis and other skin and mucous membrane lesions (6%) and inflammatory bowel disease (3.8%). The prevalence of peripheral arthritis was 11.2%. In 51.7% of patients, the Bath AS Disease Activity Index was ?4. But since our patients consisted of the ones with more severe disease who referred to the tertiary centers and needed a regular follow-up, they may not represent the general AS population. Disease-modifying anti-rheumatic drugs were being used by 41.9% of patients, with 16.4% using anti-TNF agents. TRASD-IP (Izlem Programi: Follow-up program) is the first AS registry in Turkey. Such databases are very useful and provide a basis for data collection from large numbers of subjects. TRASD-IP gives information on the clinical and demographic profiles of patients, and the efficacy and safety of anti-TNF drugs, examines the impact on quality of life, and provides real-life data that may be used in cost-effectiveness analyses. PMID:20711591

Bodur, Hatice; Ataman, Sebnem; Bu?dayc?, Derya Soy; Rezvani, Aylin; Nas, Kemal; Uzunca, Kaan; Emlakç?o?lu, Emel; Karatepe, Alt?nay Göksel; Durmu?, Bekir; Sezgin, Melek; Ayhan, Figen; Yazgan, Pelin; Duruöz, Tuncay; Yener, Mahmut; Gürgan, Alev; K?rnap, Mehmet; Cakar, Engin; Altan, Lale; Soydemir, Raikan; Capk?n, Erhan; Tekeo?lu, Ibrahim; Ayd?n, Gülümser; Günendi, Zafer; Nac?r, Bar??; Sall?, Ali; Oztürk, Cihat; Memi?, Asuman; Turan, Yasemin; Kozano?lu, Erkan; Sivrio?lu, Konçuy

2012-01-01

303

[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

304

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

305

Association of variants at 1q32 and STAT3 with ankylosing spondylitis suggests genetic overlap with Crohn's disease.  

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Ankylosing spondylitis (AS) is a common inflammatory arthritic condition. Overt inflammatory bowel disease (IBD) occurs in about 10% of AS patients, and in addition 70% of AS cases may have subclinical terminal ileitis. Spondyloarthritis is also common in IBD patients. We therefore tested Crohn's disease susceptibility genes for association with AS, aiming to identify pleiotropic genetic associations with both diseases. Genotyping was carried out using Sequenom and Applied Biosystems TaqMan and OpenArray technologies on 53 markers selected from 30 Crohn's disease associated genomic regions. We tested genotypes in a population of unrelated individual cases (n = 2,773) and controls (n = 2,215) of white European ancestry for association with AS. Statistical analysis was carried out using a Cochran-Armitage test for trend in PLINK. Strong association was detected at chr1q32 near KIF21B (rs11584383, P = 1.6 × 10(-10), odds ratio (OR)?= 0.74, 95% CI:0.68-0.82). Association with disease was also detected for 2 variants within STAT3 (rs6503695, P = 4.6 × 10(-4). OR = 0.86 (95% CI:0.79-0.93); rs744166, P = 2.6 × 10(-5), OR = 0.84 (95% CI:0.77-0.91)). Association was confirmed for IL23R (rs11465804, P = 1.2 × 10(-5), OR = 0.65 (95% CI:0.54-0.79)), and further associations were detected for IL12B (rs10045431, P = 5.2 × 10(-5), OR = 0.83 (95% CI:0.76-0.91)), CDKAL1 (rs6908425, P = 1.1 × 10(-4), OR = 0.82 (95% CI:0.74-0.91)), LRRK2/MUC19 (rs11175593, P = 9.9 × 10(-5), OR = 1.92 (95% CI: 1.38-2.67)), and chr13q14 (rs3764147, P =?5.9 × 10(-4), OR = 1.19 (95% CI: 1.08-1.31)). Excluding cases with clinical IBD did not significantly affect these findings. This study identifies chr1q32 and STAT3 as ankylosing spondylitis susceptibility loci. It also further confirms association for IL23R and detects suggestive association with another 4 loci. STAT3 is a key signaling molecule within the Th17 lymphocyte differentiation pathway and further enhances the case for a major role of this T-lymphocyte subset in ankylosing spondylitis. Finally these findings suggest common aetiopathogenic pathways for AS and Crohn's disease and further highlight the involvement of common risk variants across multiple diseases. PMID:21152001

Danoy, Patrick; Pryce, Karena; Hadler, Johanna; Bradbury, Linda A; Farrar, Claire; Pointon, Jennifer; Ward, Michael; Weisman, Michael; Reveille, John D; Wordsworth, B Paul; Stone, Millicent A; Maksymowych, Walter P; Rahman, Proton; Gladman, Dafna; Inman, Robert D; Brown, Matthew A

2010-01-01

306

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

307

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

308

The effect of etanercept on a case of amyloidosis secondary to ankylosing spondylitis: results of 2-year follow-up.  

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Secondary amyloidosis (type AA) is rarely encountered but can be a significant complication of ankylosing spondylitis (AS) and may lead to proteinuria and renal dysfunction. Anti-tumor necrosis factor-alpha (anti-TNF?) agents may be used to induce clinical remission by suppressing systemic inflammation in secondary amyloidosis. The patient described , with the diagnosis of AS, was diagnosed with secondary amyloidosis, despite treatment with disease modifying anti-rheumatic medication. He developed marked proteinuria, renal dysfunction and low levels of serum albumin. Diagnosis of amyloidosis was confirmed by renal biopsy. During a 2-year treatment period with etanercept, an anti-TNF? agent, a definite improvement was determined in all parameters. This case illustrates that in the treatment of secondary amyloidosis related to AS, etanercept, an anti-TNF ? agent, can be considered an effective therapeutic option. PMID:24435036

Yilmaz, Halim; Kocabas, Hilal; Erkin, Gulten

2013-01-01

309

Prologue: 2009 Joint Meeting of Spondyloarthritis Research and Therapy Network (SPARTAN) and International Genetics of Ankylosing Spondylitis (IGAS).  

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In July 2009, a 3-day conference was held in Houston, Texas, USA, by members of several groups: the Spondyloarthritis Research and Therapy Network (SPARTAN); the International Genetics of Ankylosing Spondylitis (IGAS); and interested members of the Pan American League of Associations of Rheumatology (PANLAR). The purpose of this meeting was to bring together physician scientists, clinicians, and educators from around the world who are working together to improve their understanding of spondyloarthritis (SpA). In addition to the annual educational and Fellows sessions for SPARTAN members, the conference included a one-day international meeting dedicated to the role of HLA-B27, along with a series of sessions that summarized advances among various collaborative groups and defined opportunities for future genetic initiatives. This supplement provides a review of the SPARTAN and IGAS meetings. PMID:21123332

Reveille, John D; Clegg, Daniel O

2010-12-01

310

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 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.

311

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

312

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

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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

313

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

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

Kiltz, U; Feldtkeller, E; Braun, J

2008-12-01

314

Long term mortality after a single treatment course with X-rays in patients treated for ankylosing spondylitis  

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Mortality to 1 January 1983 was studied in 14,106 ankylosing spondylitis patients after a single course of X-rays (1935-1954). For neoplasms other than leukaemia or colon cancer, mortality was 28% greater than the general population of England and Wales, proportional increase reaching a maximum 71% between 10.0 and 12.4 years post-irradiation. There was 7% mortality increase more than 25.0 years post-irradiation and only for oesophageal cancer was the relative risk significantly raised. Neither the relative risk, nor its post-irradiation temporal pattern, were greatly influenced by the patient's age. There was a threefold increase in leukaemia mortality, the relative risk highest between 2.5 and 4.9 years post-treatment, but not disappearing being nearly twice that of the general population more than 25 years post-treatment. There was evidence that acute myeloid, acute lymphatic and chronic myeloid leukaemia risks were increased, but no evidence of increase in chronic lymphatic leukaemia. The relative risk appeared greatest for acute myeloid leukaemia. Colon cancer mortality increased by 30%. Non-neoplastic conditions showed a 51% mortality increase, likely to be associated with the disease itself, and not confined to diseases associated with spondylitis.

Darby, S.C.; Doll, R.; Gill, S.K.; Smith, P.G.

1987-02-01

315

Long term mortality after a single treatment course with X-rays in patients treated for ankylosing spondylitis  

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Mortality to 1 January 1983 was studied in 14,106 ankylosing spondylitis patients after a single course of X-rays (1935-1954). For neoplasms other than leukaemia or colon cancer, mortality was 28% greater than the general population of England and Wales, proportional increase reaching a maximum 71% between 10.0 and 12.4 years post-irradiation. There was 7% mortality increase more than 25.0 years post-irradiation and only for oesophageal cancer was the relative risk significantly raised. Neither the relative risk, nor its post-irradiation temporal pattern, were greatly influenced by the patient's age. There was a threefold increase in leukaemia mortality, the relative risk highest between 2.5 and 4.9 years post-treatment, but not disappearing being nearly twice that of the general population more than 25 years post-treatment. There was evidence that acute myeloid, acute lymphatic and chronic myeloid leukaemia risks were increased, but no evidence of increase in chronic lymphatic leukaemia. The relative risk appeared greatest for acute myeloid leukaemia. Colon cancer mortality increased by 30%. Non-neoplastic conditions showed a 51% mortality increase, likely to be associated with the disease itself, and not confined to diseases associated with spondylitis. (UK)

1983-01-01

316

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  

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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 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. Abstract in english 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 o [...] f 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.

Samuel Katsuyuki, Shinjo; Roberta, Gonçalves; Sérgio, Kowalski; Célio Roberto, Gonçalves.

317

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  

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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

318

Concomitância de fibromialgia em pacientes com espondilite anquilosante / Occurrence of fibromyalgia in patients with ankylosing spondylitis  

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Full Text Available SciELO Brazil | Language: Portuguese Abstract in portuguese INTRODUÇÃO: A Espondilite Anquilosante (EA) é uma doença inflamatória crônica que acomete o esqueleto axial. Cursa com dor e incapacidade funcional. Para medir o impacto da EA na vida dos pacientes são utilizados questionários que avaliam a atividade da doença (BASDAI); a incapacidade funcional (BAS [...] FI); e a qualidade de vida (ASQoL). A Fibromialgia (FM) é uma das causas mais comuns de dor generalizada e pode coexistir com outras doenças; pode ser avaliada por meio do questionário de impacto da Fibromialgia (FIQ). Há poucos estudos demonstrando correlações entre FM e EA. O presente estudo obteve dados referentes ao perfil epidemiológico de pacientes com EA e FM e avaliou a prevalência de FM em portadores de EA. Avaliou-se a interferência da FM nos escores dos testes BASDAI, BASFI e ASQoL. PACIENTES E MÉTODO: Foram incluídos 71 pacientes portadores de EA diagnosticados de acordo com os critérios modificados de Nova York. Avaliação clínica, funcional e aplicação dos testes BASDAI, BASFI e ASQoL foram realizados. Os pacientes com diagnóstico de FM foram avaliados com o FIQ. RESULTADOS: Onze pacientes preencheram os critérios para FM, observando-se assim uma prevalência de 15% de FM entre os pacientes com EA, sendo mais frequente entre as mulheres (3,8:1). A idade de início da doença (EA) foi de 27,5 anos. O antígeno HLA-B27 foi positivo na grande maioria (80,4%). Comparando-se as médias dos testes BASDAI, BASFI e ASQoL, verificou-se que os valores são significativamente superiores (P Abstract in english INTRODUCTION: Ankylosing spondylitis (AS) is a chronic inflammatory disease that affects the axial skeletal system, causing pain and functional incapacity. To measure the impact of AS on patient's life, questionnaires are used to assess disease activity (BASDAI); functional incapacity (BASFI); and q [...] uality of life (ASQoL). Fibromyalgia (FM) is one of the most common causes of generalized pain and can coexist with other diseases; it can be assessed by the Fibromyalgia Impact Questionnaire (FIQ). Few studies have demonstrated correlations between FM and AS. The present study obtained data regarding the epidemiologic profile of patients with AS and FM and evaluated the prevalence of FM in patients with AS. The FM influence on BASDAI, BASFI and ASQoL test scores was assessed. PATIENTS AND METHOD: A total of 71 patients with AS, diagnosed according to the modified New York criteria, were studied. Clinical and functional assessment was performed and BASDAI, BASFI and ASQoL tests were applied. Patients with a diagnosis of FM were evaluated through the FIQ. RESULTS: Eleven patients met the criteria for FM; thus a FM prevalence of 15% was observed among the patients with AS. FM was more prevalent among women (3.8:1). Age at disease onset (AS) was 27.5 years. The HLA-B27 antigen was positive in most of them (80.4%). When comparing BASDAI, BASFI and ASQoL test means, it was observed that values are significantly higher (P

Valderilio Feijó, Azevedo; Eduardo dos Santos, Paiva; Lúcio Ricardo Hiurko, Felippe; Ranieri Amorim, Moreira.

319

Caracterização da uveíte na espondilite anquilosante / Characterization of uveitis in ankylosing spondylitis  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: Portuguese Abstract in portuguese OBJETIVO: analisar a apresentação clínica e a evolução da uveíte em uma população de 207 pacientes com espondilite anquilosante (EA). MÉTODOS: estudo retrospectivo (1988-2001) analisando 207 pacientes com o diagnóstico de EA segundo os critérios de Nova York modificados. Todos apresentavam investiga [...] ção clínica (envolvimento axial e periférico, entesopatias, manifestações extra-articulares) e radiológica (sacroilíaca, coluna lombar, dorsal e cervical) completas, além da pesquisa do HLA-B27 (com seus respectivos alelos, quando possível). Os dados foram comparados com a presença de uveíte durante o período de seguimento dos pacientes. RESULTADOS: trinta pacientes (14,5%) apresentaram 55 episódios de uveíte anterior aguda unilateral durante o seguimento ambulatorial. Vinte e sete pacientes encontravam-se em atividade articular da EA no momento da crise de uveíte, enquanto três pacientes encontravam-se inativos do ponto de vista articular. Um único paciente, em tratamento de tuberculose pulmonar, apresentou um episódio de uveíte posterior. Entre os pacientes com uveíte, houve predomínio de sexo masculino (82,6%), raça caucasóide (77,8%), início da EA na idade adulta (83,1%), HLA-B27 positivo (79,2%), sem história familiar de EA (84,5%). Houve associação estatística entre uveíte e idade de início juvenil (p = 0,0094) e entesopatias aquileana (p = 0,0003) e plantar (p = 0,0067). Nenhum paciente apresentou seqüela ocular grave da uveíte. Dezesseis pacientes fizeram uso de sulfassalazina (1,0 g/dia a 2,0 g/dia), por prazo mínimo de seis meses. CONCLUSÕES: a uveíte anterior aguda foi comum na evolução da EA nesta casuística, estando associada preferencialmente à EA de início juvenil e ao acometimento articular entesopático de membros inferiores. Abstract in english OBJECTIVE: To analyze the clinical picture and outcome of uveitis in a series of 207 patients with ankylosing spondylitis (AS). METHODS: Retrospective study (1988-2001) analyzing 207 patients with diagnosis of AS according to the modified New York criteria. All patients were submited to complete cli [...] nical (axial and peripheral involvement, heel enthesopathies, extra-articular manifestations) and radiological (sacroiliac, lumbar, dorsal and cervical spine) investigation, HLA-B27 evaluation (and respective alleles, whenever possible), were searched. These data were compared with the occurrence of uveitis during the follow-up of the AS patients. RESULTS: Thirty patients (14.5%) presented 55 episodes of acute unilateral anterior uveitis. Twenty seven patients had active articular disease at the moment of the uveitis crisis, while three patients were inactive. One patient, in treatment of lung tuberculosis, presented a single episode of posterior uveitis. Among the uveitis in AS patients, there was predominance of male sex (82.6%), Caucasoid race (77.8%), adult-onset AS (83.1%), positive HLA-B27 (79.2%) and absence of familial history of AS (84.5%). There was statistical association between uveitis and juvenile-onset AS (p = 0.0094) and achillean (p = 0.0003) and plantar (p = 0.0067) enthesopathies. No patient presented severe ophthalmologic sequelae of uveitis. Sulfasalazine (1 to 2 g, daily) was prescribed to 16 patients, for a minimum period of six months. CONCLUSIONS: Acute anterior uveitis was common in the follow-up of AS patients in this casuistic, associated to the juvenile-onset of the disease and to the enthesophatic involvement of the lower limbs.

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

320

Caracterização da uveíte na espondilite anquilosante Characterization of uveitis in ankylosing spondylitis  

Directory of Open Access Journals (Sweden)

Full Text Available OBJETIVO: analisar a apresentação clínica e a evolução da uveíte em uma população de 207 pacientes com espondilite anquilosante (EA. MÉTODOS: estudo retrospectivo (1988-2001 analisando 207 pacientes com o diagnóstico de EA segundo os critérios de Nova York modificados. Todos apresentavam investigação clínica (envolvimento axial e periférico, entesopatias, manifestações extra-articulares e radiológica (sacroilíaca, coluna lombar, dorsal e cervical completas, além da pesquisa do HLA-B27 (com seus respectivos alelos, quando possível. Os dados foram comparados com a presença de uveíte durante o período de seguimento dos pacientes. RESULTADOS: trinta pacientes (14,5% apresentaram 55 episódios de uveíte anterior aguda unilateral durante o seguimento ambulatorial. Vinte e sete pacientes encontravam-se em atividade articular da EA no momento da crise de uveíte, enquanto três pacientes encontravam-se inativos do ponto de vista articular. Um único paciente, em tratamento de tuberculose pulmonar, apresentou um episódio de uveíte posterior. Entre os pacientes com uveíte, houve predomínio de sexo masculino (82,6%, raça caucasóide (77,8%, início da EA na idade adulta (83,1%, HLA-B27 positivo (79,2%, sem história familiar de EA (84,5%. Houve associação estatística entre uveíte e idade de início juvenil (p = 0,0094 e entesopatias aquileana (p = 0,0003 e plantar (p = 0,0067. Nenhum paciente apresentou seqüela ocular grave da uveíte. Dezesseis pacientes fizeram uso de sulfassalazina (1,0 g/dia a 2,0 g/dia, por prazo mínimo de seis meses. CONCLUSÕES: a uveíte anterior aguda foi comum na evolução da EA nesta casuística, estando associada preferencialmente à EA de início juvenil e ao acometimento articular entesopático de membros inferiores.OBJECTIVE: To analyze the clinical picture and outcome of uveitis in a series of 207 patients with ankylosing spondylitis (AS. METHODS: Retrospective study (1988-2001 analyzing 207 patients with diagnosis of AS according to the modified New York criteria. All patients were submited to complete clinical (axial and peripheral involvement, heel enthesopathies, extra-articular manifestations and radiological (sacroiliac, lumbar, dorsal and cervical spine investigation, HLA-B27 evaluation (and respective alleles, whenever possible, were searched. These data were compared with the occurrence of uveitis during the follow-up of the AS patients. RESULTS: Thirty patients (14.5% presented 55 episodes of acute unilateral anterior uveitis. Twenty seven patients had active articular disease at the moment of the uveitis crisis, while three patients were inactive. One patient, in treatment of lung tuberculosis, presented a single episode of posterior uveitis. Among the uveitis in AS patients, there was predominance of male sex (82.6%, Caucasoid race (77.8%, adult-onset AS (83.1%, positive HLA-B27 (79.2% and absence of familial history of AS (84.5%. There was statistical association between uveitis and juvenile-onset AS (p = 0.0094 and achillean (p = 0.0003 and plantar (p = 0.0067 enthesopathies. No patient presented severe ophthalmologic sequelae of uveitis. Sulfasalazine (1 to 2 g, daily was prescribed to 16 patients, for a minimum period of six months. CONCLUSIONS: Acute anterior uveitis was common in the follow-up of AS patients in this casuistic, associated to the juvenile-onset of the disease and to the enthesophatic involvement of the lower limbs.

Percival Degrava Sampaio-Barros

2003-12-01

 
 
 
 
321

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

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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 act...

Revicki Dennis A; Rentz Anne M; Luo Michelle P; Wong Robert L

2011-01-01

322

Participation of antigens related to the psoriasis associated antigen, pso p27, in immune complex formation in patients with ankylosing spondylitis.  

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Analysis of five serum samples and three synovial fluids from patients with ankylosing spondylitis (AS) and five serum samples from healthy blood donors for the presence of antibodies cross reacting with the Fc part of rabbit IgG (rheumatoid factors (RFs] using an isotype specific, enzyme linked immunosorbent assay (ELISA) showed only insignificant amounts of free RFs, while IgG RFs were observed in alkaline dissociated circulating immune complexes (CICs). Only insignificant amounts of free a...

Rødahl, E.; Asbakk, K.; Iversen, O. J.

1988-01-01

323

Home-based exercise therapy in patients with ankylosing spondylitis: effects on pain, mobility, disease activity, quality of life, and respiratory functions.  

Science.gov (United States)

The home-based exercise therapy recommended to the patients with ankylosing spondylitis (AS) is a simply applicable and cheap method. The aim of this study was to investigate the effects of home-based exercise therapy on pain, mobility, function, disease activity, quality of life, and respiratory functions in patients with AS. Eighty patients diagnosed with AS according to the modified New York criteria were included in the study. Home-based exercise program including range of motion, stretching, strengthening, posture, and respiratory exercises was practically demonstrated by a physiotherapist. A training and exercise manual booklet was given to all patients. Patients following home-based exercise program five times a week at least 30 min per session (exercise group) for 3 months were compared with those exercising less than five times a week (control group). Visual analog scale pain (VASp) values at baseline were significantly higher in the exercise group. The exercise group showed improvements in VASp, tragus-wall distance, morning stiffness, finger-floor distance, modified Schober's test, chest expansion, the Bath Ankylosing Spondylitis Disease Activity Index, the Bath Ankylosing Spondylitis Functional Index, Ankylosing Spondylitis Quality of Life Questionnaire (ASQoL), forced expiratory volume in first second, and forced vital capacity at third month. There was significant difference in ASQoL scores between the two groups in favor of the exercise group at third month. Regular home-based exercise therapy should be a part of main therapy in patients with AS. Physicians should recommend that patients with AS do exercise at least five times a week at least 30 min per session. PMID:21656347

Aytekin, Ebru; Caglar, Nil Say?ner; Ozgonenel, Levent; Tutun, Sule; Demiryontar, Dilay Yilmaz; Demir, Saliha Eroglu

2012-01-01

324

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

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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. Paravertebral hematomas and non-combined fractures are accompanied by higher incidences of other complications. The female gender entails a higher mortality rate. (orig.)

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

2009-01-15

325

Infliximab, a TNF-? antagonist treatment in patients with ankylosing spondylitis: the impact on depression, anxiety and quality of life level.  

Science.gov (United States)

The objective of this study was to assess the effect of infliximab on depression, anxiety and quality of life in patients with active ankylosing spondylitis (AS). In this 6-week longitudinal study, 16 patients with AS were assessed. Active disease as defined by BASDAI ?4.0 was sought for inclusion. Infliximab was administered 5 mg/kg at 0, 2 weeks and 6 weeks. Collected data included age, sex and date of onset of rheumatologic disease. Activity of disease was measured using Bath Ankylosing Spondylitis Disease Activity Index (BASDAI). Biological activity was evaluated with erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP). ESR and CRP were assessed at baseline and day 42. The Hospital Anxiety and Depression scale (HADS), Beck Depression Inventory (BDI) and 36-item Short Form Health Survey (SF-36) were used to evaluate anxiety, depression and quality of life. BASDAI, SF-36, HADS and BDE were assessed prior to the initial infliximab dose and at 2nd, 14th and 42nd day. Seven (43.8%) AS patients had depression scores above the cut off value for both the HADS depression (HADS-D) and BDI and 4 (25 %) had high HADS anxiety scores at baseline. Significant time effect for BDI and HADS-D scores were observed. Although significantly lower BDI scores were found after first, second and third infusions of infliximab, compared to initial score, the significant decrease in HADS-D appeared after second and third infusions. A significant time effect for HADS-anxiety scores were found as well. All of the subscales of SF-36 improved significantly during the course, with an exception of role emotional, for which the difference approached to the significance. The change in BASDAI scores and CRP and ESR, in the treatment process, were not correlated with the change in depression and anxiety scores. Infliximab which is an anti-TNF-? drug, may be effective in the treatment of depression accompanying AS. Possible implications for the treatment of major depressive disorder were discussed, as well. PMID:21079965

Ertenli, I; Ozer, S; Kiraz, S; Apras, S B; Akdogan, A; Karadag, O; Calguneri, M; Kalyoncu, U

2012-02-01

326

Testing the effect of different electrotherapeutic procedures in the treatment of canine ankylosing spondylitis  

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This paper presents the results of studies on the effects of suppression of chronic pain by currents with low (TENS), medium (Intf) and high (MT) frequencies, in dogs with ankylosing spondilytis. Prior to imaging diagnostics the dogs were clinically observed, trias was estimated, as well as habitus, neurological signs and degree of pain. After a 10 day treatment it was clear that all three treatments resulted in a significant decrease of pain at rest, during activity or during palpation...

Krsti? Nikola; Lazarevi?-Macanovi? Mirjana; Proki? B.; Mustur D.; Stanisavljevi? Dejana

2010-01-01

327

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

International Nuclear Information System (INIS)

ulfilling 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.)

1985-01-01

328

Ankylosing Spondylitis Patients Commencing Biologic Therapy Have High Baseline Levels of Comorbidity: A Report from the Australian Rheumatology Association Database  

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Full Text Available Aims. To compare the baseline characteristics of a population-based cohort of patients with ankylosing spondylitis (AS commencing biological therapy to the reported characteristics of bDMARD randomised controlled trials (RCTs participants. Methods. Descriptive analysis of AS participants in the Australian Rheumatology Association Database (ARAD who were commencing bDMARD therapy. Results. Up to December 2008, 389 patients with AS were enrolled in ARAD. 354 (91.0% had taken bDMARDs at some time, and 198 (55.9% completed their entry questionnaire prior to or within 6 months of commencing bDMARDs. 131 (66.1% had at least one comorbid condition, and 24 (6.8% had a previous malignancy (15 nonmelanoma skin, 4 melanoma, 2 prostate, 1 breast, cervix, and bowel. Compared with RCT participants, ARAD participants were older, had longer disease duration and higher baseline disease activity. Conclusions. AS patients commencing bDMARDs in routine care are significantly different to RCT participants and have significant baseline comorbidities.

John Oldroyd

2009-01-01

329

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

International Nuclear Information System (INIS)

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

2009-09-01

330

Immunogenicity of anti-tumour necrosis factor therapy in Korean patients with rheumatoid arthritis and ankylosing spondylitis.  

Science.gov (United States)

The aim of this study was to investigate the prevalence of antidrug antibodies (ADAs) against tumour necrosis factor (TNF) inhibitors in patients with rheumatoid arthritis (RA) and ankylosing spondylitis (AS). ADAs were detected in 18 (9.8%) patients with RA and in 18 (10.2%) patients with AS of the 360 patients. Development of ADAs was significantly associated with treatment failure in RA patients (P=0.003). When classified by drugs, the prevalence of immunogenicity in descending order was 17 (28.8%) patients treated with infliximab, 17 (10.4%) with adalimumab, and 2 (1.4%) with etanercept. After adjustment for disease and duration of anti-TNF therapy, the odds ratio as a reference of adalimumab-treated patients was 9.159 (95% confidence interval [CI] 2.005-41.845) for infliximab and 0.280 (95% CI 0.128-0.611) for etanercept. The immunogenicity of anti-TNF therapy was highest in the infliximab-treated group and significantly lower in the etanercept-treated group. PMID:24752013

Jung, Seung Min; Kim, Hyun-Sook; Kim, Hae-Rim; Kim, Na Young; Lee, Jung-Hwa; Kim, Juryun; Kwok, Seung-Ki; Park, Kyung-Su; Park, Sung-Hwan; Kim, Ho-Youn; Ju, Ji Hyeon

2014-07-01

331

Improved precision of syndesmophyte measurement for the evaluation of ankylosing spondylitis using CT: a phantom and patient study  

Science.gov (United States)

Ankylosing spondylitis is a disease characterized by abnormal bone formation (syndesmophyte) at the margins of inter-vertebral disc spaces. Syndesmophyte growth is currently typically monitored by the visual inspection of radiographs. The limitations inherent to the modality (2D projection of a 3D object) and rater (qualitative human judgment) may compromise sensitivity. With newly available treatments, more precise measures of syndesmophytes are needed to determine whether treatment can slow rates of syndesmophyte growth. We previously presented a computer algorithm measuring syndesmophyte volumes and heights in the 3D space of CT scans. In this study, we present improvements to the original algorithm and evaluate the gain in precision as applied to an anthropomorphic vertebral phantom and patients. Each patient was scanned twice in one day, thus providing two syndesmophyte volume and height measures. The difference between those two measures (ideally zero) determines our algorithm's precision. The technical improvements to the algorithm decreased the mean volume difference (standard deviation) between scans from 3.01% (2.83%) to 1.31% (0.95%) and the mean height difference between scans from 3.16% (2.99%) to 1.56% (1.13%). The high precision of the improved algorithm holds promise for application to longitudinal clinical studies.

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

2012-07-01

332

Candidate's single-nucleotide polymorphism predictors of treatment nonresponse to the first anti-TNF inhibitor in ankylosing spondylitis.  

Science.gov (United States)

The objective of this study is to identify single-nucleotide polymorphisms (SNPs) predictors of treatment nonresponse to the first anti-TNF-alpha agent in ankylosing spondylitis (AS). Patients were classified as "nonresponders" if they failed to achieve improvement ?50 % of the initial BASDAI. We selected candidate SNPs previously reported, associated with susceptibility or pathogenesis of AS and with other spondylarthropaties (SpAs). The predictors of nonresponse were modeled with multiple logistic regression. The predictive power of the genetic model of nonresponse to treatment was tested with AUC-ROC. One hundred and twenty-one (121) AS patients fulfilled the inclusion criteria. Of the candidate SNPs tested for association with treatment effectiveness, five independent predictors were identified: rs917997, rs755622, rs1800896, rs3740691, and rs1061622. The genetic model of nonresponse to treatment had a predictive power of 0.77 (95 % CI 0.68-0.86). Our study identified several polymorphisms which could be the useful genetic biomarkers in predicting nonresponse to anti-TNF-alpha therapy. PMID:24337767

Schiotis, Ruxandra; Sánchez, Alejandra; Escudero, Alejandro; Bartolomé, Nerea; Szczypiorska, Magdalena; Font, Pilar; Martínez, Antonio; Tejedor, Diego; Artieda, Marta; Mulero, Juan; Buzoianu, Anca; Collantes-Estévez, Eduardo

2014-06-01

333

Improvement in pain intensity, spine stiffness, and mobility during a controlled individualized physiotherapy program in ankylosing spondylitis.  

Science.gov (United States)

Physical therapy in ankylosing spondylitis (AS) is important for maintaining or improving mobility, fitness, functioning, and global health. It also plays a role in the prevention and management of structural deformities. In this study we assessed the functional status of AS patients in relation to disease duration and activity. Furthermore, in volunteering patients we analyzed the efficacy of a controlled, individualized physiotherapeutic program. Altogether, clinical data of 75 AS patients were retrospectively analyzed. Anthropometrical data, duration since diagnosis and disease activity, pain intensity, tender points, sacroiliac joint involvement determined by X-ray, functional condition, and physical activity level were recorded. Subjective, functional, and physical tests were performed. Out of the 75 patients, 10 volunteered to undergo a complex physical exercise program twice a week for 3 months. The program included 1.5 h of general posture reeducation, manual mobilization of the spine, and pelvic-, upper-, and lower-extremity exercises, stretching with joint prevention strategies and functional exercises. In AS, pain intensity recorded on a 10-cm visual analog scale (VAS), BASFI, BASDAI, modified Schober index, chest expansion and occiput-to-wall distance values showed significant correlation with disease activity. The 3-month physical therapy improved several subjective and functional parameters, and markedly reduced pain intensity and spine stiffness. A complex, individualized physical therapy program may be useful and should be introduced to AS patients in order to maintain and increase spine mobility, preserve functional capacity, decrease the pain and stiffness. PMID:22198694

Gyurcsik, Zsuzsanna Némethné; András, Anita; Bodnár, Nóra; Szekanecz, Zoltán; Szántó, Sándor

2012-12-01

334

NT-proBNP levels may be influenced by inflammation in active ankylosing spondylitis receiving TNF blockers: a pilot study.  

Science.gov (United States)

N-terminal pro-brain natriuretic peptide (NT-proBNP) is a strong marker of cardiovascular disease with recent evidence that inflammation may also influence its levels; discrimination of this confounding variable is of particular interest in rheumatic diseases. Therefore, we evaluated NT-proBNP in ankylosing spondylitis (AS) patients pre- and post-TNF blocker to determine the possible association between NT-proBNP levels and inflammatory parameters. Forty-five consecutive AS patients without previous/current cardiovascular disease or systolic myocardial dysfunction, who were eligible to anti-TNF therapy, were prospectively enrolled. All patients received TNF blockers and they were evaluated for circulating NT-proBNP levels, clinical and laboratory parameters of disease activity, traditional cardiovascular risk factors, and conventional and tissue Doppler imaging echocardiography at baseline (BL) and 6 months after (6M) treatment. At BL, all patients had active AS, NT-proBNP levels had a median of 36 (20-72)?pg/mL and 11 % were high in spite of no systolic alteration. Multiple linear regression analysis revealed that this peptide, at BL, was independently correlated with erythrocyte sedimentation rate (ESR) (p?active AS patients with no other evidence of cardiovascular disease. The short-term reduction of NT-proBNP levels in these patients receiving anti-TNF therapy appears to reflect an improvement in inflammatory status. PMID:23381669

Moraes, Julio C B; Ribeiro, Ana C M; Saad, Carla G S; Lianza, Alessandro C; Silva, Clovis A; Bonfá, Eloísa

2013-06-01

335

IgM, IgG, and IgA synthesis in vitro in persons suffering from yersinia arthritis and in patients with ankylosing spondylitis.  

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In ankylosing spondylitis (AS) and in yersinia arthritis the main findings in serum immunoglobulin (Ig) studies have been raised IgA in AS and a high anti-yersinia IgA and IgG response and the persistence of IgA class antibodies in yersinia arthritis. In order to study predisposition to high IgA response in AS and yersinia arthritis we measured the in-vitro Ig production in patients with AS and in persons who have once had yersinia arthritis, and we compared it with the Ig production in perso...

Vuento, R.; Eskola, J.; Leino, R.; Koskimies, S.; Viander, M.

1984-01-01

336

Low T cell production of TNF? and IFN? in ankylosing spondylitis: its relation to HLA-B27 and influence of the TNF-308 gene polymorphism  

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

2001-01-01

337

Contribution of KIR3DL1/3DS1 to ankylosing spondylitis in human leukocyte antigen-B27 Caucasian populations  

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Killer cell immunoglobulin-like receptors (KIRs) and human leukocyte antigen (HLA) loci are both highly polymorphic, and some HLA class I molecules bind and trigger cell-surface receptors specified by KIR genes. We examined whether the combination of KIR3DS1/3DL1 genes in concert with HLA-B27 genotypes is associated with susceptibility to ankylosing spondylitis (AS). Two HLA-B27-positive Caucasian populations were selected, one from Spain (71 patients and 105 controls) and another from the Az...

Lopez-larrea, Carlos; Blanco-gelaz, Miguel Angel; Torre-alonso, Juan Carlos; Armas, Jacome Bruges; Suarez-alvarez, Beatriz; Pruneda, Laura; Couto, Ana Rita; Gonzalez, Segundo; Lopez-va?zquez, Antonio; Martinez-borra, Jesus

2006-01-01

338

Infliximab Dose Reduction Sustains the Clinical Treatment Effect in Active HLAB27 Positive Ankylosing Spondylitis: A Two-Year Pilot Study  

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The rationale of the study was to evaluate the efficacy of infliximab (IFX) treatment in patients with ankylosing spondylitis (AS) and to determine whether IFX dose reduction and interval extension sustains the treatment effect. Nineteen patients were included and treated with IFX 5mg/kg every 6 weeks for 56 weeks. All patients concomitantly received MTX with median dose 7.5mg/weekly. During the second year, the IFX dose was reduced to 3mg/kg every 8 weeks. Eighteen patients completed the 1-y...

Xf Rck, Boel M.; Rille Pullerits; Mats Geijer; Tomas Bremell; Helena Forsblad-d'Elia

2013-01-01

339

IgA1 and IgA2 subclass antibodies against Klebsiella pneumoniae in the sera of patients with peripheral and axial types of ankylosing spondylitis.  

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OBJECTIVE--To study further the Klebsiella specific serum antibody response in patients with axial and peripheral types of ankylosing spondylitis (AS). METHODS--IgA1 and IgA2 subclass antibodies to Klebsiella pneumoniae were measured by enzyme linked immunosorbent assay in the sera of 171 patients with axial or peripheral type AS, and in sera of 100 healthy controls. The effect of 26 weeks of sulphasalazine treatment on the antibody levels in the two types of AS was also analysed. RESULTS--K ...

Ma?ki-ikola, O.; Nissila?, M.; Lehtinen, K.; Leirisalo-repo, M.; Granfors, K.

1995-01-01

340

Variáveis relacionadas com perda da produtividade no trabalho em pacientes com espondilite anquilosante / Variables related to work productivity loss in patients with ankylosing spondylitis  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: Portuguese Abstract in portuguese A perda da produtividade no trabalho, como resultado da espondilite anquilosante, tem se tornado tema de interesse dado o seu impacto socioeconômico. Além das limitações físicas, outras variáveis parecem interferir na produtividade desses pacientes que muitas vezes são aposentados precocemente do me [...] rcado de trabalho. Assim, esse manuscrito de revisão buscou identificar artigos publicados na língua inglesa no período de janeiro de 2001 a dezembro de 2011 que discutissem essas variáveis por meio de estudos realizados com pacientes adultos com diagnóstico de espondilite anquilosante, de ambos os gêneros e que usaram instrumentos padronizados para a avaliação da atividade da doença e da capacidade produtiva no trabalho. Foram identificados 33 artigos atendendo aos critérios de inclusão e observou-se que a perda de produtividade no trabalho em pacientes com espondilite anquilosante é influenciada por variáveis demográficas, emocionais, socioculturais e ocupacionais e hábitos de vida. Compreender esses possíveis fatores de risco pode colaborar para a elaboração de estratégias preventivas para a manutenção de pacientes com espondilite anquilosante no mercado de trabalho. Abstract in english The work productivity loss due to ankylosing spondylitis (AS) has become subject of interest because of its socioeconomic impact. In addition to physical limitations, other variables seem to affect the productivity of those patients, who often withdraw early from the labor force. This review was aim [...] ed at identifying articles published in English, from January 2001 to December 2011, which assessed those variables in adult patients of both sexes diagnosed with AS, using standardized instruments to measure disease activity and work productivity. Thirty-three articles meeting the inclusion criteria were identified. The work productivity loss of patients with AS proved to be influenced by demographics, emotional, social, cultural, and occupational factors, and lifestyle. Understanding those potential risk factors may contribute to the development of preventive strategies to maintain patients with AS participating in the labor force.

Frauendorf, Renata; Pinheiro, Marcelo de Medeiros; Ciconelli, Rozana Mesquita.

 
 
 
 
341

Ankylosing spondylitis: lateral approach to spinal anaesthesia for lower limb surgery.  

Science.gov (United States)

We describe three patients with long-standing ankyolsing spondylitis (AS) who underwent lower limb joint surgery under spinal anaesthesia. At preoperative assessment, it was considered that intubation of the trachea was likely to be difficult or impossible and previous general anaesthesia was associated with increased morbidity. Midline approach spinal anaesthesia failed but the lateral approach was successful. Spinal anaesthesia was induced using a 24 gauge Sprotte (Pajunk) needle with 3.5 ml heavy bupivacaine 0.5% at the L3-4 interspace with the patients in the sitting position. This resulted in adequate sensory blockade for the surgical procedure. None of the patients required airway interventions but equipment and aids to secure airway were available. PMID:7889588

Kumar, C M; Mehta, M

1995-01-01

342

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

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

Wafa Hamdi

2012-11-01

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Leishmaniose tegumentar em paciente com espondilite anquilosante utilizando adalimumabe / Cutaneous leishmaniasis in a patient with ankylosing spondylitis using adalimumab  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: Portuguese Abstract in portuguese A leishmaniose é uma antropozoonose causada por espécies de Leishmania e pode apresentar-se de diversas formas clínicas, dependendo da interação parasita-hospedeiro. O fator de necrose tumoral-α (TNF-α) é uma citocina essencial para o controle de infecções, especialmente contra parasitas intracelu [...] lares como a Leishmania. A terapia anti-TNF-α tem importante papel no tratamento de doenças reumáticas, mas o uso desses antagonistas está relacionado ao aumento de infecções. Relatamos o primeiro caso de leishmaniose cutânea no Brasil em uma paciente portadora de espondilite anquilosante em uso de adalimumabe e metotrexato. Acreditamos que neste caso não houve relação entre o uso de anti-TNF-α e a leishmaniose cutânea, pois a doença estava limitada a apenas uma úlcera, que cicatrizou completamente após o tratamento. Mais estudos, entretanto, são necessários para entender melhor a possível associação entre agentes anti-TNF-α e leishmaniose. Abstract in english Leishmaniasis is an anthropozoonosis caused by species of Leishmania and can have different clinical presentations, depending on the parasite-host relationship. Tumor necrosis factor-α (TNF-α) is a cytokine essential to infection control, especially against intracellular parasites such as Leishman [...] ia. Anti-TNF-α strategies have had a marked impact on the treatment of rheumatic diseases, but the clinical use of those antagonists has been accompanied by an increased report of infections. We report the first case of cutaneous leishmaniasis in a patient with ankylosing spondylitis treated with adalimumab and methotrexate in Brazil. We believe that, in this case, there was no association between the anti-TNF-α treatment and cutaneous leishmaniasis, because the disease was limited to only one ulcer that healed completely after treatment. More studies, however, are necessary to better understand the possible relationship between anti-TNF-α agents and leishmaniasis.

Gomes, Kirla Wagner Poti; Benevides, André Nunes; Vieira, Francisco José Fernandes; Burlamaqui, Maggy Poti de Morais; Vieira, Marcos de Almeida e Pontes; Fontenelle, Lysiane Maria Adeodato Ramos.

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Parallel analysis of cancer mortality among atomic bomb survivors and patients with ankylosing spondylitis given X-ray therapy  

International Nuclear Information System (INIS)

Radiation-induced cancer mortality rates among atomic bomb survivors with doses of at least 100 rad and patients with ankylosing spondylitis given X-ray therapy have been compared for the first time. The estimated average mean bone marrow dose for the spondylitics is more than twice that for atomic bomb survivors, and yet spondylitics experienced only half the risk of radiation-induced leukemia of atomic bomb survivors. For sites that were heavily irradiated in the spondylitics, provisional estimates indicate comparable doses in the two studies, and similar levels of cancer risk were observed. For these sites, when information from the studies was combined, there were statistically significant excesses for cancers of the esophagus, stomach, lung, and ovaries, multiple myeloma, other lymphomas, and tumors of the spinal cord and nerves. Very high relative risks (RR's) for tumors of the spinal cord and nerves were observed in both studies. For sites that were lightly irradiated in the spondylitics, in addition to previously documented sites, there was a statistically significant excess of cancers of the liver and gallbladder among atomic bomb survivors. A previous subdivision of cancer sites into radiosensitive and other tissues was not supported by the atomic bomb survivor data. Changes in the rates of radiation-induced cancers with age at exposure and time since exposure were studied and compared with the use of generalized linear modeling of the RR's and also by examination of the excess mortality rates. The level of agreement between the two studies was high; provided it is accepted that the reduced level of leukemia risk in the spondylitics is due to cell sterilization, no inconsistencies were found

1985-01-01

345

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

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

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

2014-05-01

346

A Functional Variant of PTPN22 Confers Risk for Vogt-Koyanagi-Harada Syndrome but Not for Ankylosing Spondylitis  

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Background Protein tyrosine phosphatase non-receptor 22 (PTPN22) is a key negative regulator of T lymphocytes and has emerged as an important candidate susceptibility factor for a number of immune-related diseases. This study aimed to examine the predisposition of PTPN22 SNPs to Vogt-Koyanagi-Harada (VKH) syndrome and acute anterior uveitis (AAU) associated with ankylosing spondylitis (AS). Methods A total of 1005 VKH syndrome, 302 AAU+AS+ patients and 2010 normal controls among the Chinese Han population were enrolled in the study. Genotyping, PTPN22 expression, cell proliferation, cytokine production and cell activation were examined by PCR-RFLP, Real-time PCR, CCK8, ELISA and Flow cytometry. Results The results showed significantly increased frequencies of the rs2488457 CC genotype and C allele but a decreased frequency of the GG genotype in VKH syndrome patients (PBonferroni correction (Pc)?=?3.47×10?7, OR?=?1.54; Pc?=?3.83×10?8, OR?=?1.40; Pc?=?6.35×10?4, OR?=?0.62; respectively). No significant association of the tested SNPs with AAU+AS+ patients was observed. Functional studies showed a decreased PTPN22 expression, impaired cell proliferation and lower production of IL-10 in rs2488457 CC cases compared to GG cases (Pc?=?0.009, Pc?=?0.015 and Pc?=?0.048 respectively). No significant association was observed concerning T cell activation and rs2488457 genotype. Conclusions The study showed that a functional variant of PTPN22 confers risk for VKH syndrome but not for AAU+AS+ in a Chinese Han population, which may be due to a modulation of the PTPN22 expression, PBMC proliferation and IL-10 production.

Hou, Shengping; Du, Liping; Yu, Hongsong; Cao, Qingfeng; Zhou, Yan; Liao, Dan; Kijlstra, Aize; Yang, Peizeng

2014-01-01

347

Ankylosing spondylitis in Danish and Norwegian twins: occurrence and the relative importance of genetic vs. environmental effectors in disease causation  

DEFF Research Database (Denmark)

OBJECTIVE: To estimate the influence of genetic effects in the aetiology and pathogenesis of ankylosing spondylitis (AS). METHODS: The study comprised one Norwegian and two Danish nationwide twin surveys. In 1994 and 2002, respectively, 37,388 and 46,331 Danish twin individuals were asked by questionnaire if they had AS. Similarly, in 1998, 12,718 Norwegian twins were asked if they had AS using a questionnaire phrased according to the Danish survey. Twins reporting AS were categorized according to the modified New York criteria. RESULTS: A total of 113 twin individuals reported AS, of whom 81 (72.3%) participated in validation of the diagnosis. After validation, 39 probands were diagnosed with AS. Subsequent invitation of co-twins resulted in 27 complete pairs. The point prevalence and the annual incidence of AS was 0.1% and 3/100,000 person-years (pyr) among the Danish twins. The positive predictive value of self-reported AS was 49.3%. Probandwise concordance rates on AS were (2/5) 40% in monozygotic (MZ) and (1/23) 4% in dizygotic (DZ) twins [difference 35% (95% CI 2.9-72.8), p = 0.26]. Heredity analysis including previously published and the present HLA-B27-positive twin pairs indicated that additive genetic effects account for 94% (95% CI 0.56-0.99) of the variance in the causation of AS. CONCLUSION: Self-reported AS needs careful validation. The occurrence of AS in a Danish twin population was 0.1% and accords well with previous studies on singletons in hospital settings. The present study adds to previous evidence of a major genetic effect in the pathogenesis of AS.

Pedersen, O B; Svendsen, Anders Jørgen

2008-01-01

348

Increased Risk of Ischemic Stroke in Young Patients with Ankylosing Spondylitis: A Population-Based Longitudinal Follow-Up Study  

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Background Prospective data on the association between ischemic stroke and ankylosing spondylitis (AS) in the young are sparse. The purpose of this population-based, age- and sex-matched longitudinal follow-up study was to investigate the risk of developing ischemic stroke in young patients with AS. Methods A total of 4562 patients aged 18- to 45-year-old with at least two ambulatory visits in 2001 with a principal diagnosis of AS were enrolled in the AS group. The non-AS group consisted of 22810 age- and sex-matched, randomly sampled subjects without AS. The two-year ischemic stroke-free survival rate for each group were calculated using the Kaplan-Meier method. Cox proportional hazards regression analysis was used to estimate the hazard ratio of ischemic stroke after adjusting for demographic and clinical covariates. Results During follow-up, 21 patients in the AS group and 53 in the non-AS group developed ischemic stroke. The ischemic stroke-free survival rate over the 2 year follow-up was lower in the AS group than the non-AS group (p?=?0.0021). The crude hazard ratio of ischemic stroke for the AS group was 1.98 (95% CI, 1.20–3.29; p?=?0.0079) and the adjusted hazard ratio after controlling for demographic and comorbid medical disorders was 1.93 (95% CI, 1.16–3.20; p?=?0.0110). Conclusion Our study showed an increased risk of developing ischemic stroke in young patients with AS.

Lin, Chia-Wei; Huang, Ya-Ping; Chiu, Yueh-Hsia; Ho, Yu-Tsun; Pan, Shin-Liang

2014-01-01

349

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

Science.gov (United States)

The aim of this study was to assess the role of HLA-B*27 and it's subtypes in determining severity and clinical manifestations of ankylosing spondylitis (AS).A total of 163 AS patients were assessed for clinical manifestations and severity using structured questionnaires. HLA-B*27 screening and B*27 sub-typing were performed by PCR.One hundred twenty two patients (74.8%) were B*27 positive. The male to female ratio, peripheral arthritis, steroid use, intense dorsal kyphosis and decrease of cervical slope had a significantly higher frequency in B*27 positive patients compared to B*27 negative ones (p=0.01, 0.001, 0.01, 0.04 and 0.04, respectively). However, the age of diagnosis was significantly lower in B*27 positive patients (p=0.005). Trend in uveitis and some severity markers including: BASMI and ASQoL were toward higher values in B*27 positive group with no significant difference. After controlling confounding variables, significant relationship was found only between B*27 and BASMI (p=0.01). B*27 subtypes in patients were included B*2705: 48.4%, B*2702: 42.6%, B*2704: 5.7% and B*2707: 3.3%. No significant differences were seen for severity markers and clinical manifestations between subtypes; although trend toward lower values of severity markers, less intense dorsal kyphosis and less decrease of cervical slope were observed in B*2704 and B*2707 versus other polymorphisms.Clinical features and severity of AS is influenced by HLA-B*27. Trend toward higher severity markers in B*2705 and B*2702 versus other polymorphisms might be subject of interest for evaluation in other ethnicities with concentration to other novel susceptibility genes co-inherited in each B*27 subtype. PMID:23996708

Fallahi, Sasan; Mahmoudi, Mahdi; Nicknam, Mohammad Hossein; Gharibdoost, Farhad; Farhadi, Elham; Saei, Azad; Nourijelyani, Keramat; Ahmadzadeh, Nooshin; Jamshidi, Ahmad Reza

2013-12-01

350

Are clinical measures influenced by various ethnic origins in Iranian patients with ankylosing spondylitis?A pilot study.  

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Background: Ankylosing spondylitis (AS) may manifest with heterogeneous patterns according to ethnic origins. The purpose of this study was to describe the influence of various Iranian ethnic origins on clinical measures in patients with AS. Methods: 0ne hundred sixty-three AS patients diagnosed by modified New York 1984 criteria were enrolled consecutively. The patients were classified into Fars, Turk, Kord, Lor and other ethnic origins. Several clinical measures were described and compared between the ethnic origins. Results: The highest and the lowest finger to floor distance was observed for Fars ethnicity (20.4±14.8) and other ethnicities (5.9±8.1), respectively (P=0.04). The frequency of severe decrease in cervical slope was significantly different between various ethnicities (P=0.025). The most and the least frequency of severe decrease in cervical slope was observed in Fars patients (61.3%) and other ethnicities (20%), respectively. The frequency of severe thoracic kyphosis was significantly dissimilar between various ethnicities (P=0.006). The most and the least frequency of severe increase in thoracic kyphosis was observed in Fars (68.8%) and Lor patients (25%), respectively. A significant relationship was seen only between other ethnicities and finger to floor distance, lateral lumbar flexion, chest expansion and BASDAI (P<0.05). Conclusion: Clinical expression variations in AS disease might be influenced by various Iranian ethnic origins. A larger sample size with other Iranian ethnicities (Baluch, Arab, etc) is required to clear the definite relationship between Iranian ethnicities and clinical expression. PMID:24778778

Fallahi, Sasan; Jamshidi, Ahmad Reza; Mahmoudi, Mahdi; Qorbani, Mostafa

2014-01-01

351

Ankylosing spondylitis and central core disease: case report / Espondilite anquilosante e doença do core central: relato de caso  

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Full Text Available SciELO Brazil | Language: English Abstract in portuguese A espondilite anquilosante (EA) é desordem inflamatória de causa desconhecida que afeta primariamente o esqueleto axial. Estudos prévios dos músculos para-espinhais em pacientes acometidos de EA demonstraram atrofia de fibras musculares e fibras com core central. Por outro lado, a doença do core cen [...] tral (DCC) é condição genética que envolve primariamente a musculatura esquelética, podendo acarretar deformidades articulares devido a fraqueza muscular. Relatamos o caso de um paciente de 45 anos com diagnóstico clínico e radiológico de espondilite anquilosante e fraqueza muscular proximal nos membros inferiores. A eletromiografia de agulha mostrou padrão miopático e a biópsia muscular evidenciou predominância quase total de fibras tipo 1 e fibras com cores, compatível com DCC. Este é o primeiro relato de EA e DCC. Discutimos se a EA é apenas coincidência ou uma nova associação com a DCC. Abstract in english Ankylosing spondylitis (AS) is an inflammatory disorder of unknown cause that primarily affects the axial skeleton. Neurological manifestations of AS are usually related to spinal deformities. Previous studies of the paraspinal muscles of AS patients showed muscle fiber atrophy, and core fibers. On [...] the other hand, central core disease (CCD) is a genetic condition that primarily involves the skeletal muscles, but can present articular deformities secondary to muscular weakness. We report the case of a 45-year-old man with clinical and radiological diagnosis of AS and proximal muscular weakness in the lower limbs. Needle electromyography showed myopathic features and nerve conduction study was normal. Muscle biopsy disclosed almost complete predominance of type-1 fibers, and fibers with central cores. This is the first report of AS and CCD. Whether central core myopathy is coincidental or a new association with AS is discussed.

Rosana Herminia, Scola; Kátia, Lin; Fábio Massaiti, Iwamoto; Walter Oleschko, Arruda; Lineu Cesar, Werneck.

352

B lymphocyte involvement in ankylosing spondylitis: the heavy chain variable segment gene repertoire of B lymphocytes from germinal center-like foci in the synovial membrane indicates antigen selection  

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The synovial membrane (SM) of affected joints in ankylosing spondylitis (AS) is infiltrated by germinal center-like aggregates (foci) of lymphocytes similar to rheumatoid arthritis (RA). We characterized the rearranged heavy chain variable segment (VH) genes in the SM for gene usage and the mutational pattern to elucidate the B lymphocyte involvement in AS.

Voswinkel, Jan; Weisgerber, Kerstin; Pfreundschuh, Michael; Gause, Angela

2001-01-01

353

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

DEFF Research Database (Denmark)

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

Glintborg, Bente; Ã?stergaard, Mikkel

2010-01-01

354

Grupos educacionais para pacientes com espondilite anquilosante: revisão sistemática / Educational groups for ankylosing spondylitis patients: systematic review  

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, que acomete as articulações sacroilíacas, em graus variáveis a coluna vertebral e, em menor extensão as articulações periféricas. Dentre as formas de tratamento não medicamentoso, os grupos educacionais tê [...] m sido recomendados como importante coadjuvante no tratamento da doença. O objetivo deste estudo foi rever na literatura as evidências científicas sobre grupos educacionais para pacientes com EA. MÉTODO: A revisão foi realizada nas Bases de dados LILACS, Medline, Web of Science e PEDro. Os termos para busca sistemática foram extraídos dos Descritores em Ciências da Saúde (DeCS). RESULTADOS: Foram localizados nove artigos científicos no período de 1990 a 2012. Na seleção e análise dos estudos foram utilizados critérios de inclusão e exclusão, incluído artigos científicos que abordassem principalmente os grupos educacionais como forma de tratamento para os pacientes com EA. CONCLUSÃO: A literatura a respeito dos grupos educacionais como coadjuvante no tratamento desses pacientes é escassa. Futuros estudos mostrando os formatos dos grupos, duração, quantidade e conteúdos das aulas devem ser realizados, bem como a avaliação de sua efetividade. Abstract in english BACKGROUND AND OBJECTIVES: Ankylosing spondylitis (AS) is a chronic inflammatory disease affecting sacroiliac joints, the spine in different degrees and in lesser extension peripheral joints. Among non-pharmacological treatments, educational groups have been recommended as major coadjuvants to treat [...] this disease. This study aimed at reviewing the literature on scientific evidences of educational groups for AS patients. METHOD: The following databases were reviewed: LILACS, Medline, Web of Science and PEDro. Words for systematic search were extracted from Health Sciences Keywords (HSC). RESULTS: Nine scientific articles were found between 1990 and 2012. Inclusion and exclusion criteria were used to select and analyze studies, including scientific articles especially addressing educational groups as treatment approaches for AS patients. CONCLUSION: Literature on educational groups as coadjuvant to treat such patients is scarce. Further studies are needed to show group formats, number and content of classes, in addition to evaluating their effectiveness.

Marcelo Cardoso de, Souza; Aline, Orlandi; Anamaria, Jones; Fábio, Jennings; Elisabeth, Biruel.

355

Equilíbrio estático e dinâmico no indivíduo com espondilite anquilosante: revisão da literatura / Static and dynamic balance in subjects with ankylosing spondylitis: literature review  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: Portuguese Abstract in portuguese Com o objetivo de analisar as alterações musculoesqueléticas dos indivíduos com espondilite anquilosante (EA) e suas repercussões sobre o controle postural, realizou-se uma revisão bibliográfica nas bases de dados da BIREME e EBSCO HOTS e no site Pubmed com as palavras-chave: "ankylosing spondylitis [...] ", "postural balance" e "posture". Foram selecionados artigos envolvendo seres humanos e que analisavam o controle postural e a biomecânica dos indivíduos com EA, nos idiomas inglês e português, publicados no período entre 1999 e 2010. Do total de artigos encontrados, apenas quatro preencheram os requisitos. Desses, três compararam os resultados de pacientes com EA com os dados obtidos de indivíduos saudáveis, e um analisou apenas indivíduos com EA. Nenhum artigo continha o mesmo método de análise postural. Para avaliação do equilíbrio foram utilizadas a Escala de Equilíbrio de Berg, a Plataforma de Força e a Magnometria. Os principais desvios posturais encontrados foram aumento da cifose torácica e flexão do quadril, que levam a uma anteriorização do centro de gravidade corporal, apresentando flexão do joelho e plantiflexão do tornozelo como compensação para manter o equilíbrio. Apenas um autor encontrou piora do equilíbrio funcional nos sujeitos com EA. Todos os métodos de avaliação utilizados foram considerados capazes de mensurar o equilíbrio, não havendo uma escala específica para pacientes com EA. Abstract in english To analyze the musculoskeletal changes of individuals with ankylosing spondylitis (AS) and their repercussions on postural control, a literature review was carried out in the BIREME and EBSCO HOTS databases and Pubmed site with the following keywords: "ankylosing spondylitis", "postural balance", an [...] d "posture". Articles involving human beings, assessing the postural control and balance of individuals with AS, written in English or Portuguese and published between 1999 and 2010, were selected. Of the total number of articles found, only four met the requirements. Of those, three compared the outcomes of patients with AS with data obtained from healthy individuals, and one article assessed individuals with AS. No article used the same method of postural analysis. To assess balance, Berg Balance Scale, Force Plate, and Magnometry were used. The major postural deviations found were increased thoracic kyphosis and hip flexion, which lead to a forward displacement of the body's center of gravity, with knee flexion and ankle plantar flexion as compensation to control balance. Only one author reported worsening of functional balance in subjects with AS. All assessment methods used were considered capable of measuring balance, and no specific scale for patients with AS exists.

Pompeu, José Eduardo; Romano, Renata Sorroche Lourenço; Pompeu, Sandra Maria Alvarenga Anti; Lima, Sônia Maria Anti Loduca.

356

Equilíbrio estático e dinâmico no indivíduo com espondilite anquilosante: revisão da literatura Static and dynamic balance in subjects with ankylosing spondylitis: literature review  

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Full Text Available Com o objetivo de analisar as alterações musculoesqueléticas dos indivíduos com espondilite anquilosante (EA e suas repercussões sobre o controle postural, realizou-se uma revisão bibliográfica nas bases de dados da BIREME e EBSCO HOTS e no site Pubmed com as palavras-chave: "ankylosing spondylitis", "postural balance" e "posture". Foram selecionados artigos envolvendo seres humanos e que analisavam o controle postural e a biomecânica dos indivíduos com EA, nos idiomas inglês e português, publicados no período entre 1999 e 2010. Do total de artigos encontrados, apenas quatro preencheram os requisitos. Desses, três compararam os resultados de pacientes com EA com os dados obtidos de indivíduos saudáveis, e um analisou apenas indivíduos com EA. Nenhum artigo continha o mesmo método de análise postural. Para avaliação do equilíbrio foram utilizadas a Escala de Equilíbrio de Berg, a Plataforma de Força e a Magnometria. Os principais desvios posturais encontrados foram aumento da cifose torácica e flexão do quadril, que levam a uma anteriorização do centro de gravidade corporal, apresentando flexão do joelho e plantiflexão do tornozelo como compensação para manter o equilíbrio. Apenas um autor encontrou piora do equilíbrio funcional nos sujeitos com EA. Todos os métodos de avaliação utilizados foram considerados capazes de mensurar o equilíbrio, não havendo uma escala específica para pacientes com EA.To analyze the musculoskeletal changes of individuals with ankylosing spondylitis (AS and their repercussions on postural control, a literature review was carried out in the BIREME and EBSCO HOTS databases and Pubmed site with the following keywords: "ankylosing spondylitis", "postural balance", and "posture". Articles involving human beings, assessing the postural control and balance of individuals with AS, written in English or Portuguese and published between 1999 and 2010, were selected. Of the total number of articles found, only four met the requirements. Of those, three compared the outcomes of patients with AS with data obtained from healthy individuals, and one article assessed individuals with AS. No article used the same method of postural analysis. To assess balance, Berg Balance Scale, Force Plate, and Magnometry were used. The major postural deviations found were increased thoracic kyphosis and hip flexion, which lead to a forward displacement of the body's center of gravity, with knee flexion and ankle plantar flexion as compensation to control balance. Only one author reported worsening of functional balance in subjects with AS. All assessment methods used were considered capable of measuring balance, and no specific scale for patients with AS exists.

José Eduardo Pompeu

2012-06-01

357

Adhesive arachnoiditis causing cauda equina syndrome in ankylosing spondylitis: CT and MRI demonstration of dural calcification and a dorsal dural diverticulum  

International Nuclear Information System (INIS)

We present the radiological features of a 42-years-old man with long-standing inactive ankylosing spondylitis (AS), demonstrating that arachnoiditis is a cause of a cauda equina syndrome (CES) in this disease. CT showed a dorsal arachnoid diverticulum causing scalloped erosion of the laminae, and punctate and curvilinear dural calcification. MRI revealed adhesion and convergence of the cauda equina dorsally into the arachnoid pouch, causing the dural sca to appear empty canal. To the best of our knowledge, dural calcification on CT is a new finding in AS, which may be related to the CES. Our findings support the hyopthesis that chronic adhesive arachnoiditis with subsequent loss of meningeal elasticity may be the main cause of CES in AS. (orig.)

1999-07-01

358

Investigation of two novel biochemical markers of inflammation, matrix metalloproteinase and cathepsin generated fragments of C-reactive protein, in patients with ankylosing spondylitis  

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Ankylosing spondylitis (AS) is a chronic inflammation of the spine and the sacroiliac joints. Current markers of inflammation, such as C-reactive protein (CRP), are reflecting the production of an acute phase reactant rather than tissue specific inflammation, but the use of CRP as a diagnostic and prognostic marker for AS has not provided the sought accuracy and specificity. We hypothesized that local enzymatic activity in the disease-affected tissue, which is associated with extensive tissue turnover may, by cleavage, modify the CRP produced in the liver. These cleavage products may provide additional information on systemic inflammation as compared to that of full-length CRP. We investigated whether these CRP degradation products would provide additional diagnostic value in AS patients compared to full-length CRP.

Skjøt-Arkil, Helene; Schett, Georg

2012-01-01

359

Estimates of radiation doses in tissue and organs and risk of excess cancer in the single-course radiotherapy patients treated for ankylosing spondylitis in England and Wales  

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Available data on patients with ankylosing spondylitis who received a single treatment course with X-rays were reviewed in a previous study to estimate radiation doses in tissues and organs giving rise to excess leukemias and cancers of heavily irradiated sites. These estimates are discussed and it is concluded that they are extremely crude being based on very limited data and on a number of assumptions. It is probable that they are accurate to within a factor of 2. The accuracy of these estimates is severely limited by the inadequacy of information on doses absorbed by the tissues at risk in the irradiated patients. Thus work to obtain these data is under way; only when they are available can more precise estimates of risk of cancer induction by radiation in man be obtained. (U.K.)

1982-06-11

360

Effects and Safety of Allogenic Mesenchymal Stem Cells Intravenous Infusion in Active Ankylosing Spondylitis Patients Who Failed NSAIDs: A 20 Week Clinical Trial.  

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Objective: To evaluate the feasibility, safety, and efficacy of intravenous infusion of allogenic mesenchymal stem cells (MSCs) in ankylosing spondylitis (AS) patients who are refractory to or could not tolerate the side effects of nonsteroidal anti-inflammatory drugs (NSAIDs). Method: AS patients enrolled in this study received 4 intravenous infusions (IVI) of MSCs on days 0,7,14, and 21. The percentage of ASAS20 responders (the primary endpoint) at the 4th week and the mean ASAS20 response duration (the secondary endpoint) were used to assess treatment response to MSC infusion and duration of the therapeutic effects. Ankylosing Spondylitis Disease Activity Score Containing C-reactive Protein (ASDAS-CRP) and other pre-established evaluation indices were also adopted to evaluate the clinical effects. Magnetic resonance imaging (MRI) was performed to detect changes of bone marrow edema in the spine. The safety of this treatment was also evaluated. Results: Thirty-one patients were included, and the percentage of ASAS20 responders reached 77.4% at the 4th week and the mean ASAS20 response duration was 7.1 weeks. The mean ASDAS-CRP score decreased from 3.6±0.6 to 2.4±0.5 at the 4th week, and then increased to 3.2±0.8 at the 20th week. The average total inflammation extent (TIE) detected by MRI decreased from 533,482.5 at baseline to 480,692.3 at the 4th week (p>0.05) and 400,547.2 at the 20th week (p<0.05). No adverse effects were noted. Conclusion: Intravenous infusion of MSCs is a feasible, safe, and promising treatment for patients with AS. PMID:23711393

Wang, Peng; Li, Yuxi; Huang, Lin; Yang, Jiewen; Yang, Rui; Deng, Wen; Liang, Biling; Dai, Lie; Meng, Qingqi; Gao, Liangbin; Chen, Xiaodong; Shen, Jun; Tang, Yong; Zhang, Xin; Hou, Jingyi; Ye, Jichao; Chen, Keng; Cai, Zhaopeng; Wu, Yanfeng; Shen, Huiyong

2013-05-22

 
 
 
 
361

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

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

Fabrizio Cantini

2009-12-01

362

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

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The Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), the Bath Ankylosing Spondylitis Function Index (BASFI) and the Bath Ankylosing Spondylitis Global Score (BAS-G) (ranges 0-10) have gained widespread in use as self-reported measures of disease activity, functional impairment and overall well-being in patients with ankylosing spondylitis and other spondyloarthropathies (SpA). In Denmark, BASDAI, BASFI and BAS-G are systematically used to monitor treatment response in patients treated with tumour necrosis factor (TNF) inhibitors. The purpose of the present study was to examine the reproducibility of the indices in anti-TNF-treated SpA patients already familiar with the use of the indices. Testing was performed twice on two different days (median interval 7 days, range 4-10 days) under standardised conditions in 26 out-clinic patients (median age 39 years, range 22-56 years). Limits of agreement were calculated as the 95% likely range for the difference between paired scores. Test-retest results were significantly intercorrelated with r (s) = 0.90 for BASDAI, 0.92 for BASFI and 0.74 for BAS-G. Limits of agreement for BASDAI, BASFI and BAS-G were +/-1.8, +/-1.4 and +/-3.2, respectively. Reproducibility as expressed as the mean of individual standard deviations was significantly poorer for BAS-G than for BASDAI and BASFI (p <0.01). Internal consistency reliability and construct validity of BASDAI and BASFI were acceptable. In conclusion, in a sample of anti-TNF-treated patients experienced with the use of BASDAI, BASFI and BAS-G, random measurement errors of the scores were not negligible. The finding should be considered when monitoring anti-TNF treatment in daily clinical practice.

Madsen, Ole R; Rytter, Anne

2010-01-01

363

Surface electromyography assessment of muscle activation patterns while sitting down in young healthy women and patients with ankylosing spondylitis [Povrchové elektromyografické hodnocení svalové aktivity ve zkoušce posazení u zdravých mladých žen a u pacient? s ankylozující spondylitidou  

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BACKGROUND: Muscle activation patterns depend on many factors. Surface electromyography (SEMG) can reveal these patterns in subjects of different ages and health states. We studied patterns of muscle activation in two groups of subjects - healthy young women (as a control group) and patients with ankylosing spondylitis. OBJECTIVE: The aim of this study was to register and compare muscle activation patterns while sitting down in these two groups in four situat...

Amr Mohamed Zaki Zaatar; Jaroslav Opavský; Petr Uhlí?

2011-01-01

364

MR imaging - guided corticosteroid-infiltration of the sacroiliac joints: pain therapy of sacroiliitis in patients with ankylosing spondylitis; Magnetresonanzgesteuerte Kortikosteroid-Infiltration der Sakroiliakalgelenke: Schmerztherapie der Sakroiliitis bei Patienten mit Spondylitis ankylosans  

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Purpose: To evaluate the efficacy and specific properties of MR imaging-guided corticosteroid infiltration of the sacroiliac (SI) joints in the treatment of therapy-refractory sacroiliitis in patients with ankylosing spondylitis. Materials and Methods: In this study, 26 patients were prospectively included. Inclusion criteria were AS with therapy refractory acute sacroiliitis and inflammatory back pain {>=} 6 months. The intervention was performed using an open low-field MR-scanner. Inflammatory back pain was assessed on a visual analog scale (VAS). Success of the therapy was defined as an absolute reduction of the VAS score {<=} 5, a relative reduction of the VAS score {>=} 35% and persisting improvement {>=} 2 months. The grade of sacroiliitis was documented using high-field MR imaging. Variables were compared using McNemar test and Wilcoxon test. The mean remission time was calculated using a Kaplan-Meier analysis. A p-value < 0.05 was considered statistically significant. Results: The intervention was technically successfully performed in all patients. Following MR imaging-guided corticosteroid infiltration of the SI joints, the VAS score improved from 8 (5-10) points to 4.5 (0-8) points(-44%) in all patients (n=26), which was statistically significant (p<0.001). Of 26 patients, 22 (85%) fulfilled the predefined criteria for successful therapy. This group had a statistically significant (p<0.01) improvement of the VAS score from 8 (6-10) to 3 (0-5) (-63%). Improvement was seen after 7 (1-30) days. There was a marked reduction of the subchondral bone marrow edema (-38%). The mean remission time was 12 (4-18) months. Conclusion: MR imaging-guided corticosteroid infiltration of the SI joints proved to be an effective therapy of inflammatory back pain in patients with therapy refractory AS. With the ability of multiplanar imaging, precise localization of the bone marrow edema and the lack of ionizing radiation, interventional MR imaging currently represents the superior method for the treatment of the predominantly young patient group presenting with ankylosing spondylitis. Owing to short intervention times, open MR-scanners are ideally suited for MR imaging-guided infiltration of the SI joints. (orig.)

Fritz, J.; Koenig, C.W.; Clasen, S.; Claussen, C.D.; Pereira, P.L. [Radiologische Klinik, Abt. fuer Radiologische Diagnostik, Eberhard-Karls-Univ. Tuebingen (Germany); Guenaydin, I.; Koetter, I. [Medizinische Klinik und Poliklinik II, Rheumaambulanz, Eberhard-Karls-Univ. Tuebingen (Germany); Kastler, B. [Univ. de Franche Comte, CHU Minjoz, Besancon (France)

2005-04-01

365

Variants of the IL23R gene are associated with ankylosing spondylitis but not with Sjögren syndrome in Hungarian population samples.  

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Recently, associations were found between several autoimmune diseases and functional variants of interleukin-23 receptor (IL23R) gene; here, we studied the possible association of nine polymorphisms of IL23R with ankylosing spondylitis (AS) and with Sjögren syndrome (SS). In our study, we genotyped groups of patients with AS (n = 206), SS (n = 156) and healthy controls (n = 235) for rs11805303, rs10889677, rs1004819, rs2201841, rs11209032, rs11209026, rs10489629, rs7517847 and rs7530511 variants using PCR-RFLP methods. We observed significant increase in the carriage of the T allele of rs11805303 and the A allele of rs1004189 in the AS group compared with the controls. For the rs10889677 variant, the prevalence of the AA genotype and for the rs2201841, the CC genotype showed a more than two-fold increase in the AS group compared with the controls. By contrast, the GA heterozygous genotype of rs11209026 variant showed a significant decrease in AS patients compared with controls. Haplotype analysis revealed association of four IL23R haplotypes with AS. There was no difference in the distribution of any of the examined IL23R variants between controls and SS patients. In conclusion, we confirmed the susceptibility or protective associations of IL23R polymorphisms with AS in a Hungarian population and first demonstrated the involvement of the rs11805303 intronic single nucleotide polymorphisms, which was tested so far only for other autoimmune diseases. PMID:19522770

Sáfrány, E; Pazár, B; Csöngei, V; Járomi, L; Polgár, N; Sipeky, C; Horváth, I F; Zeher, M; Poór, G; Melegh, B

2009-07-01

366

[Clinical, radiographic and biologic particularities of ankylosing spondylitis in Tunisian patients according to the presence or the absence of the HLA B27 and its sub-types].  

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To assess the clinical, radiographic and biologic particularities of ankylosing spondylitis (AS) in Tunisian patients according to HLA B27 and its sub-types statute. This was a case-control study that included 100 patients (85 males/15 females) with AS according to the modified New York criteria. Demographic, clinical, AS specific indexes, radiographic and biologic parameters were determined. HLA-B and B27 subtypes typing of all subjects were performed by PCR-SSP. Patients mean age was 38.4 years +/- 12.6 HLA-B27 was found in 62% of patients. The comparison of B27 positive and B27 negative patients revealed a correlation of B27 with age, male gender, family history of spondylarthropathies, age at disease onset, acute onset of the disease, inaugural spinal involvement, uveitis, bilateral and destructive hip arthritis as well as a high score of mSASSS. The most frequent sub-types of HLA B27 were B*2702 (49.2%) and B*2705 (36.3%). No significant difference of the clinical presentation of the disease or severity factors was found among these patients. This study confirmed the contribution of the HLA B27 to the determination of the clinical presentation of AS. The variability of factors linked to B27 may be explained by the polygenic model of the disease. PMID:22984764

Hamdi, W; Kaffel, D; Ghannouchi, M M; Laadhar, L; Makni, S; Kchir, M Montacer

2012-01-01

367

Ankylosing Spondylitis and Rheumatoid Arthritis: Serum Levels of TNF-? and Its Soluble Receptors during the Course of Therapy with Etanercept and Infliximab  

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The effects of the TNF-? blockers infliximab or etanercept on the levels of TNF-?, TNF-receptor 1 (TNF-R1), and TNF-receptor 2 (TNF-R2), as well as the levels of the inflammation markers CRP and IL-6, were measured in ankylosing spondylitis (AS) and rheumatoid arthritis (RA) patients receiving treatment with either compound. We found that RA patients tend to have higher levels of TNF-? than both healthy individuals and AS patients prior to treatment (P < 0.05). We measured greatly increased levels of TNF-? in both the AS and RA etanercept patient groups during the course of treatment, while in the infliximab treated patients, the amount of TNF-? measured remained unchanged. Elevated TNF-? in the etanercept treated patients does not appear to be a significant risk factor for the spontaneous development of further autoimmune diseases in our study group. Increased levels of TNF-R1 were determined in both AS (P < 0.05) and RA (P < 0.001) patients when compared to healthy controls. In AS patients, the levels of TNF-R1 dropped significantly when treated with either infliximab (P < 0.01) or etanercept (P < 0.001). In contrast, the levels of this receptor remained unchanged in RA patients treated with either compound.

2014-01-01

368

Medidas de avaliação clínica em pacientes com espondilite anquilosante: revisão da literatura Measures of clinical assessment in patients with ankylosing spondylitis: review of literature  

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Full Text Available A espondilite anquilosante (EA é uma doença inflamatória osteoarticular crônica e sistêmica de etiologia desconhecida. Dependendo de sua atividade e gravidade, a EA altera a qualidade de vida do paciente, acarretando diferentes graus de incapacidade física, social, econômica e/ou psicológica. Consequentemente, torna-se difícil quantificar e mensurar a doença, baseando-se apenas em um parâmetro clínico ou laboratorial. Desde o início da década de 90, têm sido descritos diversos instrumentos para avaliar atividade da doença, comprometimento funcional, grau de lesão estrutural, evolução do paciente e qualidade de vida apresentados pelos pacientes com EA. Apresentamos uma revisão desses diferentes instrumentos de avaliação clínica.The ankylosing spondylitis (AS is a systemic and chronic inflammatory osteoarticular disease of unknown etiology. Depending of its activity and gravity, the AS modifies patient’s quality of life, leading to different levels of physical, social, economic and/or physicological incapacity. Consequently, it is difficulty to quantify and assess the disease, basing only on clinical or laboratorial parameters. Since the beginning of 90’s various instruments to verify the different problems showed by patients with AS have been described, contributing to quantify the disease. We present a review of these different instruments of clinical measurement.

Samuel Katsuyuki Shinjo

2006-10-01

369

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

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OBJECTIVE: To determine whether a vertebral corner that demonstrates an active corner inflammatory lesion (CIL) on magnetic resonance imaging (MRI) in patients with ankylosing spondylitis (AS) is more likely to evolve into a de novo syndesmophyte visible on plain radiography than is a vertebral corner that demonstrates no active inflammation on MRI. METHODS: MRI scans and plain radiographs were obtained for 29 patients recruited into randomized placebo-controlled trials of anti-tumor necrosis factor alpha (anti-TNFalpha) therapy. MRI was conducted at baseline, 12 or 24 weeks (n = 29), and 2 years (n = 22), while radiography was conducted at baseline and 2 years. A persistent CIL was defined as a CIL that was found on all available scans. A resolved CIL was defined as having completely disappeared on either the second or third scan. A validation cohort consisted of 41 AS patients followed up prospectively. Anonymized MRIs were assessed independently by 3 readers who were blinded with regard to radiographic findings. RESULTS: New syndesmophytes developed significantly more frequently in vertebral corners with inflammation (20%) than in those without inflammation (5.1%) seen on baseline MRI (P

Maksymowych, Walter P; Chiowchanwisawakit, Praveena

2008-01-01

370

Clinical response, drug survival and predictors thereof in 432 ankylosing spondylitis patients after switching tumour necrosis factor α inhibitor therapy : results from the Danish nationwide DANBIO registry  

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OBJECTIVE: To investigate frequencies and reasons for switching, treatment responses and drug survival in patients with ankylosing spondylitis (AS) switching tumour-necrosis-factor-α inhibitor (TNFi) treatment in routine clinical care. METHODS: AS patients were identified in the Danish nationwide DANBIO registry. Disease activity, treatment responses (50% or 20 mm reduction in Bath AS Disease Activity Index (BASDAI)), duration and rates of drug survival and predictors thereof were studied in patients receiving �2 different biological drugs. RESULTS: Of 1436 AS patients starting TNFi treatment, 432 patients (30%) switched to a second and 137 (10%) to a third biological drug. Compared with non-switchers, switchers were more frequently women (33%/22%), had shorter disease duration (3 years/5 years) and higher BASDAI (62(52-76) mm/56(43-69) mm (median(interquartile-range))), Bath AS Functional Index (BASFI) (54(39-71) mm/47(31-65) mm) and visual-analogue-scale (VAS) global, pain and fatigue scores when they started the first TNFi (all p

Glintborg, Bente; Ã?stergaard, Mikkel

2013-01-01