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1

[Ankylosing Spondylitis].  

UK PubMed Central (United Kingdom)

Ankylosing Spondylitis (AS) is one of the rheumatoid diseases, however its clinical features are different. The diagnosis of AS and clinical features are shown, especially the diagnosis is very important. The new modified criteria for diagnosis is detailed here. In addition, the differential diagnosis is exhibited which is significantly useful for the diagnosis of AS. Recently As has been included in the group of seronegative spondylarthropathy (SPA). Now AS is thought to be the central position among SPA which has a lot of similar symptoms. The characteristic symptoms of SPA or AS are spinal, eye, skin, sytemic lesions and enthesopathy. These clinical features are also critical in the diagnosis of AS as well. Finally, what is the most important factor in AS? The answer is an early treatment by a correct diagnosis.

Mitsui H

2008-12-01

2

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

3

MRI appearances of inflammatory vertebral osteitis in early ankylosing spondylitis  

International Nuclear Information System (INIS)

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

2002-01-01

4

Genetics of ankylosing spondylitis.  

UK PubMed Central (United Kingdom)

Ankylosing spondylitis (AS) is a chronic inflammatory arthritis that affects the spine and sacroiliac joints. It causes significant disability and is associated with a number of other features including peripheral arthritis, anterior uveitis, psoriasis and inflammatory bowel disease (IBD). Significant progress has been made in the genetics of AS have in the last five years, leading to new treatments in trial, and major leaps in understanding of the aetiopathogenesis of the disease.

Robinson PC; Brown MA

2014-01-01

5

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

2001-01-01

6

[Spinal fractures in ankylosing spondylitis  

UK PubMed Central (United Kingdom)

In the final stage of ankylosing spondylitis the spine will be completely fixed. With loss of mobility the patients suffering of ankylosing spondylitis are susceptible to spinal fractures. Predominantly the fractures occur in the lower part of the cervical spine, caused often by minor trauma. High fatality is at a 30% rate seen as severe consequence of these fractures. Conservative and operative treatment may be used. Severe fracture dislocation and progressive neurological deficiencies are recommended to be stabilized operatively. To avoid trauma of the spine in patients with ankylosing spondylitis preventive measures seem to be possible and should be employed.

Bernd L; Bläsius K; Lukoschek M

1992-01-01

7

[Febrile form of ankylosing spondylitis  

UK PubMed Central (United Kingdom)

INTRODUCTION: Ankylosing spondylitis is a chronic inflammatory disorder that is rarely associated with severe systemic manifestations. EXEGESIS: We report the case of a 29-year-old man presenting with an atypical ankylosing spondylitis. The patient presented with a high spiking fever, a marked weight loss, and an unusual increase of acute phase response markers. Such features are rarely associated with ankylosing spondylitis and the review of the few similar reported cases in the literature showed that this presentation is usually associated with a severe disease course, and an asymmetrical joint involvement that is unresponsive to nonsteroidal anti-inflammatory agents. CONCLUSION: Clinicians should be aware of this unusual presentation of ankylosing spondylitis, which should be included in the list of aetiologies of fever of unknown origin, to avoid useless diagnostic procedures. The severity of the disease course may lead to the consideration of a more aggressive treatment strategy.

Arlet JB; Gentelle S; Grasland A; Pouchot J; Vinceneux P

2002-01-01

8

[Application of magnetic resonance diffusion weighted imaging in early ankylosing spondylitis].  

UK PubMed Central (United Kingdom)

OBJECTIVE: To evaluate the magnetic resonance diffusion-weighted imaging (DWI) in the detection of early ankylosing spondylitis and explore the manifestations of ankylosing spondylitis on whole body DWI (WB-DWI). METHODS: A total of 16 patients with early ankylosing spondylitis (AS) and 18 patients with low back pain (LBP) were recruited. Subchondral bone marrow apparent diffusion coefficient (ADC) in bilateral ilia and sacrum along sacroiliac joints were compared. An independent sample t-test (SPSS 16.0, SPSS, Chicago, III) was utilized to analyze the ADC value differences between groups. P < 0.05 denoted statistical significance. The mean ADC values of focal lesions in AS patients were also measured. Whole body diffusion weighted imaging was performed in additional 8 clinical confirmed AS patients and analyzed with the techniques of maximum intensity projection (MIP) and multiplanar reconstruction (MPR) in comparison with conventional MRI images to investigate the detectability of AS lesions with whole body DWI. RESULTS: Mean ADC values in 16 AS patients were (0.51 ± 0.13)×10(-3)mm(2)/s in ilia and (0.49 ± 0.17)×10(-3)mm(2)/s in sacrum. Mean ADC values in 18 LBP patients were (0.32 ± 0.06)×10(-3)mm(2)/s in ilia and (0.31 ± 0.08)×10(-3)mm(2)/s in sacrum. The ADC value in AS patients were statistically significantly greater than those in ilia and sacrum of LBP patients. Whole body DWI detected abnormalities in 8 AS patients within bilateral sacroiliac joints and other sites corresponding to the clinical symptoms of patients. The mean ADC values of focal lesions of this patient cohort were (1.31 ± 0.38)×10(-3)mm(2)/s in sacrum and (1.18 ± 0.27)×10(-3)mm(2)/s in ilia. CONCLUSION: Subchondral marrow ADC values along sacroiliac joints allow the differentiation of patients with early AS from LBP patients. In conjunctions with such post-processing techniques as MIP and MPR, WB-DWI allows a comprehensive assessment of AS patients to guide treatment, evaluate prognosis and follow therapeutic responses.

Ai F; Tian D; Zhang W; Li XM; Wu RP; Xie CM; Wu PH

2013-03-01

9

[Bf groups in ankylosing spondylitis  

UK PubMed Central (United Kingdom)

The phenotypes Bf were studied in 50 patients (42 men and 8 women) with definite ankylosing spondylitis and in certain of their relatives. The alleles BfF and BfS were most frequently encountered and the rare allele BfF1 in one case only. There may exist a preferential transmission of the haplotype HLA B27- Bf S. In 11 patients without B27 antigen, the distribution of the phenotypes was similar to that in a control group. It is probable that the locus Bf cannot be used as a preferential marker for ankylosing spondylitis.

Gaucher A; Raffoux C; Faure G; Netter P; Hauptmann G; Pourel J; Streiff F

1980-06-01

10

On diet in ankylosing spondylitis  

Digital Repository Infrastructure Vision for European Research (DRIVER)

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 fa...

Sundström, Björn

11

Ankylosing spondylitis and uveitis: overview.  

UK PubMed Central (United Kingdom)

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 difficult. 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.

Gouveia EB; Elmann D; Morales MS

2012-10-01

12

[Biologics in the early treatment of ankylosing spondylitis and related forms of spondyloarthritis].  

Science.gov (United States)

New pathogenetic insights have identified the key role of TNF-alpha in inflammatory rheumatic diseases and have revolutionized the therapy of spondyloarthritides. TNF-alpha-antagonists specifically inhibit the pro-inflammatory effects of TNF-alpha. Clinical studies with infliximab (Remicade), Etanercept (Enbrel) or Adalimumab (Humira) in ankylosing spondylitis or related diseases demonstrate superior efficacy to conventional drugs like non-steroidal antirheumatic drugs or traditional disease modifying antirheumatic drugs. PMID:18500471

Langer, Hans-Eckhard

2008-01-01

13

[Biologics in the early treatment of ankylosing spondylitis and related forms of spondyloarthritis].  

UK PubMed Central (United Kingdom)

New pathogenetic insights have identified the key role of TNF-alpha in inflammatory rheumatic diseases and have revolutionized the therapy of spondyloarthritides. TNF-alpha-antagonists specifically inhibit the pro-inflammatory effects of TNF-alpha. Clinical studies with infliximab (Remicade), Etanercept (Enbrel) or Adalimumab (Humira) in ankylosing spondylitis or related diseases demonstrate superior efficacy to conventional drugs like non-steroidal antirheumatic drugs or traditional disease modifying antirheumatic drugs.

Langer HE

2008-01-01

14

TNF antagonists for ankylosing spondylitis.  

UK PubMed Central (United Kingdom)

Up to 2 in 1,000 adults in the UK have ankylosing spondylitis. This chronic inflammatory disease causes pain and stiffness in the spine and sacroiliac and peripheral joints, and may also affect the eyes, heart and ungs. Characteristic features include ankylosis of the spine with a progressive loss of spinal mobility. Treatment with NSAIDs and physical therapy can provide symptomatic relief of pain and stiffness, but does not modify the course of the disease (e.g. slow or prevent ankylosis). In general, disease-modifying antirheumatic drugs (DMARDs), such as gold, methotrexate and sulfasalazine, have little or no effect in ankylosing spondylitis. [symbol: see text]Etanercept (Enbrel--Wyeth) and [symbol: see text]infliximab (Remicade--Schering-Plough), two drugs which block the inflammatory effect of tumour necrosis factor (TNF), are now licensed for the treatment of patients with severe ankylosing spondylitis whose symptoms have not responded adequately to conventional therapy. Here we review the place of these TNF antagonists in the management of such individuals.

2005-03-01

15

[Renal abnormalities in ankylosing spondylitis].  

UK PubMed Central (United Kingdom)

We will study the epidemiologic, clinical, biological, therapeutic, prognostic characteristics and predictive factors of development of nephropathy in ankylosing spondylitis patients. We retrospectively reviewed the medical record of 32 cases with renal involvement among 212 cases of ankylosing spondylitis followed in our service during the period spread out between 1978 and 2006. The renal involvement occurred in all patients a mean of 12 years after the clinical onset of the rheumatic disease. Thirty-two patients presented one or more signs of renal involvement: microscopic hematuria in 22 patients, proteinuria in 23 patients, nephrotic syndrome in 11 patients and decreased renal function in 24 patients (75%). Secondary renal amyloidosis (13 patients), which corresponds to a prevalence of 6,1% and tubulointerstitial nephropathy (7 patients) were the most common cause of renal involvement in ankylosing spondylitis followed by IgA nephropathy (4 patients). Seventeen patients evolved to the end stage renal disease after an average time of 29.8 ± 46 months. The average follow-up of the patients was 4,4 years. By comparing the 32 patients presenting a SPA and renal disease to 88 with SPA and without nephropathy, we detected the predictive factors of occurred of nephropathy: tobacco, intense inflammatory syndrome, sacroileite stage 3 or 4 and presence of column bamboo. The finding of 75% of the patients presented a renal failure at the time of the diagnosis of renal involvement suggests that evidence of renal abnormality involvement should be actively sought in this disease.

Samia B; Hazgui F; Abdelghani KB; Hamida FB; Goucha R; Hedri H; Taarit CB; Maiz HB; Kheder A

2012-07-01

16

[Renal abnormalities in ankylosing spondylitis].  

Science.gov (United States)

We will study the epidemiologic, clinical, biological, therapeutic, prognostic characteristics and predictive factors of development of nephropathy in ankylosing spondylitis patients. We retrospectively reviewed the medical record of 32 cases with renal involvement among 212 cases of ankylosing spondylitis followed in our service during the period spread out between 1978 and 2006. The renal involvement occurred in all patients a mean of 12 years after the clinical onset of the rheumatic disease. Thirty-two patients presented one or more signs of renal involvement: microscopic hematuria in 22 patients, proteinuria in 23 patients, nephrotic syndrome in 11 patients and decreased renal function in 24 patients (75%). Secondary renal amyloidosis (13 patients), which corresponds to a prevalence of 6,1% and tubulointerstitial nephropathy (7 patients) were the most common cause of renal involvement in ankylosing spondylitis followed by IgA nephropathy (4 patients). Seventeen patients evolved to the end stage renal disease after an average time of 29.8 ± 46 months. The average follow-up of the patients was 4,4 years. By comparing the 32 patients presenting a SPA and renal disease to 88 with SPA and without nephropathy, we detected the predictive factors of occurred of nephropathy: tobacco, intense inflammatory syndrome, sacroileite stage 3 or 4 and presence of column bamboo. The finding of 75% of the patients presented a renal failure at the time of the diagnosis of renal involvement suggests that evidence of renal abnormality involvement should be actively sought in this disease. PMID:22520483

Samia, Barbouch; Hazgui, Faiçal; Abdelghani, Khaoula Ben; Hamida, Fethi Ben; Goucha, Rym; Hedri, Hafedh; Taarit, Chokri Ben; Maiz, Hedi Ben; Kheder, Adel

2012-04-18

17

Validity of the Ankylosing Spondylitis Disease Activity Score (ASDAS) in patients with early spondyloarthritis from the Esperanza programme.  

UK PubMed Central (United Kingdom)

OBJECTIVES: To evaluate the validity of the Ankylosing Spondylitis Disease Activity Score (ASDAS) in early spondyloarthritis (SpA) in comparison with conventional clinical measures of disease activity. METHODS: Six hundred and seventy-six incident cases of early SpA from the Esperanza programme were included. Patients were categorised into high and low disease activity states based on patient and physician global assessment scores and on the physician's decision to start treatment with a disease-modifying antirheumatic drug or tumour necrosis factor blocker. The discriminant ability of ASDAS-C-reactive protein (CRP) and ASDAS-erythrocyte sedimentation rate (ESR) was tested using standardised mean differences between patients with high and low disease activity. Convergent validity was tested by Pearson correlation between ASDAS versions and other measures of disease activity. RESULTS: ASDAS-ESR and ASDAS-CRP showed good correlation with BASDAI (r=0.79 and 0.74, respectively). Both indices correlated well with the patient global assessment (r=0.70 in both indices) and moderately with the physician global score (r=0.46 and 0.47, respectively). CRP and ESR showed poor correlation with patient- and physician-derived measures. ASDAS performed similarly across the global SpA sample, ankylosing spondylitis (AS), non-radiographic axial SpA and peripheral SpA. CONCLUSIONS: ASDAS performed as a valid activity score even being slightly better than the Bath Ankylosing Spondylitis Disease Activity Index in its ability to discriminate between high and low disease activity in early SpA. ASDAS performed similarly in AS, early forms of SpA, non-radiographic axial SpA and peripheral SpA.

Fernández-Espartero C; de Miguel E; Loza E; Tomero E; Gobbo M; Descalzo MA; Collantes-Estévez E; Mulero J; Muñoz-Fernández S; Zarco P; Carmona L

2013-05-01

18

Adaptation of the Bath measures on disease activity and function in ankylosing spondylitis into Danish  

Digital Repository Infrastructure Vision for European Research (DRIVER)

  Udgivelsesdato: jan-feb , OBJECTIVE: Adaptation of the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), the Bath Ankylosing Spondylitis Global Score (BASG), and the Bath Ankylosing Spondylitis Functional Index (BASFI) for defining disease status in ankylosing spondylitis (AS) and related ...

Pedersen, Ole Birger; Hansen, G O; Svendsen, Anders Jørgen; Ejstrup, L; Junker, P

19

Spinal instability in ankylosing spondylitis  

Directory of Open Access Journals (Sweden)

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

2010-01-01

20

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

 
 
 
 
21

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

22

Medicament for treating ankylosing spondylitis  

UK PubMed Central (United Kingdom)

The invention discloses a medicament for treating ankylosing spondylitis, which comprises the following traditional Chinese medicine materials by weight portion: 90 portions of Radix Notoginseng, 60 portions of turtle shell, 10 portions of Chinese ephedra, 24 portions of cassia twig, 18 portions of rhizoma ligustici wallichii, 30 portions of ramulus mori, 30 portions of eucommia bark, 80 portions of rhizoma cibotii, 30 portions of Clematis chinensis, 100 portions of bone glue, 30 portions of luffa, 100 portions of raw hawthorn, 90 portions of elecampane and 10 portions of liquorice. The medicament has the advantages of no toxic or side effect, and difficult relapse after cure. The effective rate is 95%, and the cure rate is 82%.

BAOZHEN JIANG

23

ERAP1 and ankylosing spondylitis.  

UK PubMed Central (United Kingdom)

The strong genetic association of ERAP1 (endoplasmic reticulum aminopeptidase 1) with ankylosing spondylitis (AS), which is restricted to HLA-B27 positive cases, has profound pathogenetic implications. ERAP1 is involved in trimming peptides to optimal length for binding to HLA class 1 molecules, thereby not only affecting the stability and processing of HLA-B27 but also influencing the peptide repertoire presented to the immune system. This could have secondary effects on specific adaptive or autoimmune responses in AS. However, it appears increasingly likely that the pathogenic effect of ERAP1 may be mediated through effects on innate immunity, such as altering the interaction between HLA-B27 and immune receptors such as the killer immunoglobulin-like receptors (KIR) found on a range of innate immune cells or via the endoplasmic reticulum unfolded protein response. ERAP1 variants associated with reduced endopeptidase activity appear to be protective against AS, raising the possibility that ERAP1 inhibition could represent a future treatment strategy.

Keidel S; Chen L; Pointon J; Wordsworth P

2013-02-01

24

Secondary amyloidosis in ankylosing spondylitis.  

UK PubMed Central (United Kingdom)

We evaluated the frequency of secondary amyloidosis, associated clinical features, and outcomes in ankylosing spondylitis (AS) patients diagnosed in the last decade. The medical records of AS patients diagnosed at single academic medical center were reviewed for clinical evidence of amyloidosis. During routine follow-up, routine urinalysis was performed at each visit; patients with significant proteinuria underwent rectal biopsy. We diagnosed 8 clinically apparent amyloidosis patients (1.1 %) in our cohort of 730 AS patients (508 males, 222 females). Four patients undergoing hemodialysis were diagnosed secondary amyloidosis. Three patients had nephrotic syndrome and renal dysfunction and one patient had non-nephrotic proteinuria. When AS patients with amyloidosis were compared to AS controls, it was observed that the amyloidosis group was older, had longer disease duration, higher initial BASDAI scores, and ESR values, and more frequent peripheral arthritis (p < 0.05). Logistic regression analysis revealed that the initial BASDAI level was an independent predictor for the development of secondary amyloidosis (OR:2.36). Six patients were administered anti-TNF therapy. The clinical findings resolved in these. In 2 patients with nephrotic syndrome and renal dysfunction, in addition to clinical improvement, there was a decrement in proteinuria; renal function improved or remained stable. Anti-TNF therapy is safe and effective in patients with renal failure, and at an earlier stage, appears effective in improving renal function. The development of proteinuria in AS patients should occasion a search for underlying amyloidosis.

Dönmez S; Pamuk ÖN; Pamuk GE; Aydo?du E; Inman R

2013-07-01

25

Impaired gait in ankylosing spondylitis.  

UK PubMed Central (United Kingdom)

Ankylosing spondylitis (AS) is a chronic, inflammatory rheumatic disease. The spine becomes rigid from the occiput to the sacrum, leading to a stooped position. This study aims at evaluating AS subjects gait alterations. Twenty-four subjects were evaluated: 12 normal and 12 pathologic in stabilized anti-TNF-alpha treatment (mean age 49.42 (10.47), 25.44 (3.19) and mean body mass index 55.75 (3.19), 23.73 (2.7), respectively). Physical examination and gait analysis were performed. A motion capture system synchronized with two force plates was used. Three-dimensional kinematics and kinetics of trunk, pelvis, hip, knee and ankle were determined during gait. A trend towards reduction was found in gait velocity and stride length. Gait analysis results showed statistically significant alterations in the sagittal plane at each joint for AS patients (P < 0.049). Hip and knee joint extension moments showed a statistically significant reduction (P < 0.044). At the ankle joint, a decreased plantarflexion was assessed (P < 0.048) together with the absence of the heel rocker. Gait analysis, through gait alterations identification, allowed planning-specific rehabilitation intervention aimed to prevent patients' stiffness together with improve balance and avoid muscles' fatigue.

Del Din S; Carraro E; Sawacha Z; Guiotto A; Bonaldo L; Masiero S; Cobelli C

2011-07-01

26

Coexistence of Ankylosing Spondylitis and Klinefelter's Syndrome.  

Science.gov (United States)

Ankylosing spondylitis is a chronic inflammatory disease characterized by inflammatory lower back pain and morning stiffness and accompanied by spine and sacroiliac joint involvement. Klinefelter's syndrome is a genetic condition that only affects males. Affected males have an extra X chromosome. This paper reports a 30-years-old male on followup with the diagnosis of Klinefelters syndrome. The patient admitted with complaints of inflammatory lower back, and neck pain and morning stiffness and was diagnosed with ankylosing spondylitis. Nonsteroidal anti-inflammatory drug and salazopyrine treatment resulted in significant regression in his complaints. PMID:23762731

Kobak, Senol; Yalçin, Murat; Karadeniz, Muamer; Oncel, Guray

2013-05-21

27

Coexistence of Ankylosing Spondylitis and Klinefelter's Syndrome.  

UK PubMed Central (United Kingdom)

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

Kobak S; Yalçin M; Karadeniz M; Oncel G

2013-01-01

28

Coexistence of Ankylosing Spondylitis and Klinefelter's Syndrome  

Science.gov (United States)

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

Kobak, Senol; Yalcin, Murat; Karadeniz, Muamer; Oncel, Guray

2013-01-01

29

Sexual functions in ankylosing spondylitis.  

Science.gov (United States)

Ankylosing spondylitis (AS) is a chronic inflammatory disorder of the axial skeleton. In recent years, several authors reported an increased prevalence of sexual dysfunction among AS patients. We aimed to find out, whether the prevalence of erectile dysfunction among AS patients is different from age-matched healthy controls. Thirty-seven male patients with AS who were diagnosed according to the modified New York criteria and 67 normal healthy controls (NHC) were included in this study. Clinical characteristics of patients including age, disease duration and morning stiffness were noted. Disease activity was evaluated by using Bath AS disease activity index (BASDAI), functional statement was evaluated by using Bath AS functional index, and scores of spinal measurements were done by using Bath AS metrology index. Erectile function is evaluated using the International Index of Erectile Function (IIEF) scoring system. Health-related quality of life was assessed by short form 36. The mean age of the patients and controls were 42.8 + 10.8 and 43.6 + 5.9 years (P = 0.666). The prevalence of erectile dysfunction in AS patients and NHC were 35.1 and 26.9%, respectively (P = 0.335). There was no statistically significant difference between IIEF domain scores of AS patients and NHC except for the sexual desire domain (P = 0.014). Duration of morning stiffness and BASDAI was negatively correlated with sexual desire and overall satisfaction; however, they have no negative impact on erectile function, orgasmic function and intercourse satisfaction domains of IIEF. In this report, we showed that only the sexual desire domain of IIEF was significantly lower in AS patients. The prevalence of erectile dysfunction among AS patients is similar to NHC, which is a finding contrary to previous reports. AS patients do not suffer from erectile dysfunction, they rather have problems of satisfaction from the intercourse. PMID:20238218

Bal, Serpil; Bal, Kaan; Turan, Yasemin; Deniz, Gonca; Gürgan, Alev; Berkit, I??l Karata?; Sendur, Omer Faruk

2010-03-18

30

Sexual functions in ankylosing spondylitis.  

UK PubMed Central (United Kingdom)

Ankylosing spondylitis (AS) is a chronic inflammatory disorder of the axial skeleton. In recent years, several authors reported an increased prevalence of sexual dysfunction among AS patients. We aimed to find out, whether the prevalence of erectile dysfunction among AS patients is different from age-matched healthy controls. Thirty-seven male patients with AS who were diagnosed according to the modified New York criteria and 67 normal healthy controls (NHC) were included in this study. Clinical characteristics of patients including age, disease duration and morning stiffness were noted. Disease activity was evaluated by using Bath AS disease activity index (BASDAI), functional statement was evaluated by using Bath AS functional index, and scores of spinal measurements were done by using Bath AS metrology index. Erectile function is evaluated using the International Index of Erectile Function (IIEF) scoring system. Health-related quality of life was assessed by short form 36. The mean age of the patients and controls were 42.8 + 10.8 and 43.6 + 5.9 years (P = 0.666). The prevalence of erectile dysfunction in AS patients and NHC were 35.1 and 26.9%, respectively (P = 0.335). There was no statistically significant difference between IIEF domain scores of AS patients and NHC except for the sexual desire domain (P = 0.014). Duration of morning stiffness and BASDAI was negatively correlated with sexual desire and overall satisfaction; however, they have no negative impact on erectile function, orgasmic function and intercourse satisfaction domains of IIEF. In this report, we showed that only the sexual desire domain of IIEF was significantly lower in AS patients. The prevalence of erectile dysfunction among AS patients is similar to NHC, which is a finding contrary to previous reports. AS patients do not suffer from erectile dysfunction, they rather have problems of satisfaction from the intercourse.

Bal S; Bal K; Turan Y; Deniz G; Gürgan A; Berkit IK; Sendur OF

2011-07-01

31

[Radon within therapeutic strategies of ankylosing spondylitis].  

Science.gov (United States)

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. PMID:18500473

Herold, Manfred; Lind-Albrecht, Gudrun

2008-01-01

32

[Radon within therapeutic strategies of ankylosing spondylitis].  

UK PubMed Central (United Kingdom)

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.

Herold M; Lind-Albrecht G

2008-01-01

33

Radiation-induced leukemias in ankylosing spondylitis  

Energy Technology Data Exchange (ETDEWEB)

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

Toolis, F. (Royal Infirmary, Edinburgh, UK); Potter, B.; Allan, N.C.; Langlands, A.O.

1981-10-01

34

[HLA DRw in ankylosing spondylitis].  

UK PubMed Central (United Kingdom)

The association of ankylosing spondylarthritis with the B locus and more specifically with the B 27 antigen, is the closet known for any illness. The absence of linkage with the DRw antigens studied during this project, in 50 patients, can give rise to the hypothesis that spondylarthritis is associated with determinants situated on the B lymphocytes, linked to the HLA-B locus.

Gaucher A; Raffoux C; Netter P; Faure G; Pourel J; Streiff F

1978-05-01

35

Magnetic resonance imaging for ankylosing spondylitis  

International Nuclear Information System (INIS)

[en] 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.)[de] Die ankylosierende Spondylitis (AS) gilt als Prototyp der Spondylarthropathien, welche mit einer Praevalenz von 2% zu den haeufigsten rheumatischen Erkrankungen gerechnet werden. Die Spondylarthropathie umfasst die 5 Entitaeten AS, reaktive Arthritis, Psoriasis arthropathica, enteropathische Arthritis bei Morbus Crohn und Colitis ulcerosa und die undifferenzierte Spondylarthropathie. Bei 99% der Patienten mit AS sind die ersten pathologischen Befunde an den Sakroiliakalgelenken zu finden. Die zur Diagnose einer AS geforderten Roentgenbefunde treten erst mit einer Latenz von 5-9 Jahren nach Beginn der klinischen Symptome in Erscheinung. Mit Hilfe der MRT der Sakroiliakalgelenke lassen sich sowohl chronisch-entzuendliche Veraenderungen (Erosionen, Sklerosierungen, Knochenbruecken) als auch akut-entzuendliche Veraenderungen (Synovitiden, Kapsulitiden, Osteitiden) sicher nachweisen und bezueglich ihrer Chronizitaet und Akuitaet graduieren. Enthesitiden der Ligamenta interossea des Spatium retroarticulare gehoeren zum Bild der AS. Eine Spondylodiszitis (Andersson 1937) kann als entzuendliche und als nichtentzuendliche Form (transdiskaler Ermuedungsbruch) auftreten. Zur Ankylosierung fuehrende Entzuendungen der Facetten- und der kostospinalen Gelenke sind fuer die AS typisch. Veraenderungen der Wirbelkoerper finden sich als Spondylitis anterior (Romanus 1952), posterior und marginalis. Charakteristisch fuer alle Spondylarthropathien sind darueberhinaus asymmetrische Synovitiden an den grossen Gelenken vor allem der unteren Extremitaet (Gonarthritis, Coxitis, Tarsitis, periphere Oligoarthritis), die Fibroostitis rheumatica (pelvine Enthesitis, Calcaneopathia rheumatica) und die Peri- und Synchondritiden der Symphysis pubica und der Synchondrosis sternalis. Da sich bei der AS fruehe entzuendliche Veraenderungen an der Wirbelsaeule und an den extravertebralen Manifestationsorten in der MRT vor deren Auftreten im Roentgenbild nachweisen lassen und damit die diagnostische Luecke geschlossen werden konnte, empfiehlt sich bei neuen therapeutischen Optionen mit den sogenannten 'B

2002-01-01

36

Neurological complications of ankylosing spondylitis: neurophysiological assessment.  

Science.gov (United States)

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

2009-01-20

37

Neurological complications of ankylosing spondylitis: neurophysiological assessment.  

UK PubMed Central (United Kingdom)

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.

Khedr EM; Rashad SM; Hamed SA; El-Zharaa F; Abdalla AK

2009-07-01

38

Update on the treatment of ankylosing spondylitis  

Science.gov (United States)

Non-steroidal anti-inflammatory agents (NSAIDs) remain the mainstay of treatment for ankylosing spondylitis (AS) though one recent trial suggests that continuous as opposed to on-demand use may be superior in preventing progression of structural damage. One particular NSAID, which is a highly selective cyclo-oxygenase 2 inhibitor, etoricoxib, may be superior to standard NSAIDs for AS. Second-line agents typically used for rheumatoid arthritis appear to lack efficacy. Salazopyrin is only moderately effective in the subgroup of AS patients with concomitant peripheral arthritis and not in those with purely axial disease. A recent trial showed that there is no greater efficacy in patients presenting early in their disease course. Three anti-tumor necrosis factor alpha agents, infliximab, etanercept, and adalimumab, are now available for the treatment of AS, the latest being adalimumab. All possess similar clinical efficacy in phase III trials with response rates of about 60%. Imaging studies using magnetic resonance show substantial amelioration of inflammatory lesions in the spine and sacroiliac joints. There is as yet no evidence that any of these agents prevent progression of structural damage. One study that evaluated etanercept demonstrated no impact on damage progression. Increasing evidence points to the superiority of the two monoclonal antibodies, infliximab and adalimumab, over etanercept for the treatment of extra-articular manifestations typically seen in AS such as acute anterior uveitis and inflammatory bowel disease. All three agents can be used as monotherapy and concomitant methotrexate appears to offer no advantages although insufficient doses have been used to date. Future studies should target patients earlier in their disease course as well as those with adverse prognostic factors such as elevated serum metalloproteinase 3 levels and radiographic evidence of spinal ankylosis.

Maksymowych, Walter P

2007-01-01

39

Ankylosing Spondylitis and Postural Balance  

Directory of Open Access Journals (Sweden)

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

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

2008-01-01

40

[Functional abnormalities of complement in familial and sporadic ankylosing spondylitis  

UK PubMed Central (United Kingdom)

Levels of complement fractions of 12 patients with sporadic ankylosing Spondylitis and 6 patients with familial Ankylosing Spondylitis (N. Y. Criteria) were studied by an hemolytic and functional method (microhemolysis in plate. Cordis Lab. Miami, Fla. USA). Abnormal levels were found in 94% of them high levels of C1 and C2 (p 0.002), and C3 (p 0.05) C8 and C9 (p 0.001) deficiencies, mixed or isolated, correlated with the severity of the diseases. C9 deficiency belongs to familial Ankylosing Spondylitis. These functional deficiencies of serum complement can favor the colonization and persistence of germs, which could mediate in the genesis of Ankylosing Spondylitis.

Jiménez Balderas FJ; Rico Rosillo G; Bravo Gatica C; Mintz Spiro G

1989-01-01

 
 
 
 
41

Concomitance of Ankylosing Spondylitis and Multiple Sclerosis: A Case Report  

Directory of Open Access Journals (Sweden)

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

Nurettin TA?TEK?N; Kaan UZUNCA; Yahya ÇEL?K; Dilek KURTO?LU

2009-01-01

42

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

Directory of Open Access Journals (Sweden)

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

2010-01-01

43

Crohn's disease unmasked following etanercept treatment for ankylosing spondylitis.  

UK PubMed Central (United Kingdom)

We describe the case of a 45-year-old man with ankylosing spondylitis being treated with etanercept who presented with a 1 month history of abdominal pain. CT abdomen revealed an ileocaecal mass associated with an abscess, resulting in a laparotomy and right hemi-colectomy. Histology of the resected specimen showed the classical features of Crohn's disease. Etanercept was stopped and he was started on adalimumab. He is currently in clinical remission from both ankylosing spondylitis and Crohn's disease.

Jethwa H; Mann S

2013-01-01

44

Assessment of functional ability in younger and older patients with ankylosing spondylitis: performance of the bath ankylosing spondylitis functional index.  

UK PubMed Central (United Kingdom)

OBJECTIVE: To determine whether the Bath Ankylosing Spondylitis Functional Index (BASFI) is applicable in older patients with ankylosing spondylitis and whether it shows major differences between younger and older patients with ankylosing spondylitis. DESIGN: BASFI total scores and every BASFI item of 202 patients with ankylosing spondylitis aged >or=60 yr (group A) and 267 patients with ankylosing spondylitis aged ankylosing spondylitis.

Falkenbach A; Franke A; Van Tubergen A; Van Der Linden S

2002-06-01

45

Rehabilitation and surgical management of ankylosing spondylitis.  

Science.gov (United States)

Ankylosing spondylitis (AS) is a chronic inflammatory disease which, if untreated, may progress to severe damage of the spine with functional impairment, disability and poor quality of life. An increased mortality has been reported in AS patients compared to the general population. AS requires combined management (pharmacological and non-pharmacological) and advice by different health professionals. Even the pharmacological treatment in the last decade has dramatically changed the outcome, the severity of the disease might require a surgical approach for the hip involvement with total hip replacement, or the corrective spinal surgery. However, this surgery deserves some careful approaches since the complexity of the disease. Rehabilitation still represents a cornerstone of the global management of AS patients. The present review summarizes the state of art of surgical management of these two diseases. PMID:23949941

Lubrano, E; Astorri, D; Taddeo, M; Salzmann, A; Cesarano, E; Brunese, L; Giganti, M; Spadaro, A

2013-08-15

46

Temporomandibular joint involvement in ankylosing spondylitis.  

UK PubMed Central (United Kingdom)

Frequency of temporomandibular joint (TMJ) involvement in patients with ankylosing spondylitis (AS) has varied from 4% to 35%. It is more common in men and produces generalised stiffness in involved joints. Clinician should be suspicious of AS when a patient reports with painful restricted movements of joint, neck or back and with no trauma history. Conventional radiographic methods have allowed the demonstration of TMJ abnormalities in patients with AS, but CT is necessary to establish joint space relations and bony morphology. We describe a case of severe AS with TMJ involvement in a 40-year-old female patient and demonstrated TMJ changes on CT. A CT was able to demonstrate articular cartilage changes, disc- and joint abnormalities. Thus, if conventional radiographs in a symptomatic patient with rheumatic diseases are unable to demonstrate changes, CT can provide valuable additional information of the changes in the TMJ.

Arora P; Amarnath J; Ravindra SV; Rallan M

2013-01-01

47

[Special disco-vertebral forms of ankylosing spondylitis  

UK PubMed Central (United Kingdom)

In a retrospective study 10 cases (6 males, 4 females) of special disco-vertebral forms of ankylosing spondylitis were evaluated. In all cases radiographs showed bilateral sacroiliitis and destructive-sclerotic disco-vertebral lesions but hardly any syndesmophytes considered typical for ankylosing spondylitis. We found a rather striking diversity of morphologic changes caused by spondylodiscitis, polysegmental involvement, the simultaneous and successive appearance (in the cause of the disease) of shiny corner, as well as anterior spondylitis and spondylodiscitis. All cases had clinical and humoral signs of disease activity, and some even had extravertebral manifestations. Radiographs and clinical findings indicate that an inflammatory process causes the disco-vertebral lesions. The special forms of ankylosing spondylitis as described in this article are in accordance with the polymorphism frequently observed in this disease.

Prohaska E; Ellegast H; Petershofer H; Hawel R; Obererlacher J

1984-11-01

48

Membranous glomerulonephritis with the use of etanercept in ankylosing spondylitis.  

UK PubMed Central (United Kingdom)

OBJECTIVE: To report a case of membranous glomerulonephritis with the use of etanercept in a patient with ankylosing spondylitis. CASE SUMMARY: A 60-year-old female with severe ankylosing spondylitis and no history of renal disease was started on etanercept 50 mg subcutaneously once a week after standard treatment modalities failed. She had not been on any nephrotoxic drugs, including nonsteroidal antiinflammatory drugs, for over 1 year. After 2 months of etanercept therapy, the patient presented with anasarca, proteinuria, hypoalbuminemia, and normal serum creatinine. Renal biopsy showed features classic for membranous glomerulonephritis (MGN). Etanercept was discontinued, with resolution of anasarca and proteinuria over the following 3 months. DISCUSSION: Very few cases of MGN in patients with ankylosing spondylitis have been reported in the literature; additionally, MGN following etanercept therapy has not been described in patients with ankylosing spondylitis so far. The exact pathogenesis of etanercept-induced MGN in ankylosing spondylitis is not known. Tumor necrosis factor-? antagonists have been associated with the formation of autoantibodies and induction of lupus-like ailments in patients with rheumatoid arthritis. It is possible that a similar dysregulation of the immune system might have accounted for the development of MGN in this patient. The Naranjo probability scale showed that this patient's MGN was probably associated with etanercept therapy. CONCLUSIONS: In addition to the well-described serious adverse drug events, including serious infections, the use of etanercept in ankylosing spondylitis can be associated with the development of MGN. Health care providers, especially rheumatologists, should be aware of this potentially serious adverse drug reaction.

Kaushik P; Rahmani M; Ellison W

2011-12-01

49

Ankylosing spondylitis in sub-Saharan Africa.  

Science.gov (United States)

Ankylosing spondylitis (AS) represents a chronic inflammatory bone disease of the axial skeleton that manifests as chronic back pain and progressive stiffness of the spine. It characteristically affects young adults with a peak age of onset between 20-30 years. In contrast to Western Europe and North America, the disease is rare in Sub-Saharan Africa where the majority of the population is HLA-B27 negative. Even in some African populations where HLA-B27 is prevalent (for example, in Gambia and Senegal, where 3-6% of the general population has HLA-B27), the disease is also said to be rare. However, some other genetic markers may be involved in the causation of AS in the HLA-B27 negative population, and when it occurs in this subgroup of patients it has a similar manifestation with HLA-B27 negative white patients and these patients rarely develop anterior uveitis. The clinical presentation of the disease in Africa is generally milder; most affected individuals do not have a family history of AS, the patients are older at onset of the disease, and the majority of them lack extra-articular manifestations such as anterior uveitis compared with the situation in Western Europe and North America. In conclusion, AS in sub-Saharan Africa seems to represent a subgroup of the disease, which may open the window to a greater understanding of the pathophysiology of the condition. PMID:19581245

Belachew, D A; Sandu, N; Schaller, B; Guta, Z

2009-07-01

50

Body image in patients with ankylosing spondylitis.  

UK PubMed Central (United Kingdom)

OBJECTIVES: Physical disabilities generally cause disturbances in a patient's body image. The aim of the present study is to assess the prevalence of different aspects of body image disturbances (attractiveness /self-confidence, negative body judgement, accentuation of external appearance, worry about possible physical deficits, sexual problems and physical vitality) in patients with ankylosing spondylitis (AS) in the context of the severity of impairment, mood and pain intensity. METHODS: Fifty-six patients with AS and 48 healthy controls were investigated using a questionnaire for assessing one's body (1) and the body image questionnaire (2). Furthermore, in the AS patients' medical parameters including BASMI and BASFI, pain intensity and state of well-being were assessed. RESULTS: In comparison to the controls, the AS patients reported significantly more worries about possible physical deficits. The mildly impaired patients (including significantly more women) were even more insecure than the severely impaired patients. Furthermore the patients considered themselves as being less attractive. The AS patients reported better physical vitality than the controls. This result might be due to patients carrying out regular physical activity and performing exercises with therapeutic value. There were no differences between the groups concerning sexual problems. The total group of AS patients showed normal scores in the state of well-being and did not report pain intensity as being higher than what is expected in chronic pain patients in general. CONCLUSIONS: Rheumatologists should address problems in body image in patients with AS and in severe cases psychological therapy should be initiated.

Guenther V; Locher E; Falkenbach A; Gutweniger S; Kopp M; Pfaffenberger N; Stuerz K; Mur E

2010-05-01

51

Treatment of rheumatoid arthritis and ankylosing spondylitis.  

Science.gov (United States)

The treatment of the two most frequent inflammatory rheumatic diseases rheumatoid arthritis (RA) and ankylosing spondylitis (AS) has some similarities but in total more differences. Thus, therapy with non-steroidal anti-inflammatory agents (NSAIDs), conventional disease modifying anti-rheumatic drugs (DMARDs) and biologic agents has a different role in the management and different efficacy in AS and RA. This implies signs and symptoms, function, and structural damage. This is in part due to the different pathogenesis: (i) while the synovium is an important target in RA it is rather the bone in AS and (ii) while the pathology in RA is rather osteodestructive to cartilage and bone presenting with erosions, it is predominantly osteoproliferative in AS as indicated by syndesmophytes and ankylosis. Biologic agents targeting tumor necrosis factor (TNF-alpha) work clinically well in both diseases but, while they clearly inhibit structural damage in RA, they do not seem to have much influence on new bone formation in AS. DMARDs are efficacious in RA but less so in AS. NSAIDs are efficacious in both RA and AS, but they are considered first line of therapy in AS while they are rather adjunctive agents in RA. In AS, NSAIDs, potentially especially coxibs, may even prevent new bone formation due to their inhibitory effect on cyclooxygenase-2. PMID:19822062

Braun, J; Sieper, J

52

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.

2000-01-01

53

Do sex hormones play a role in ankylosing spondylitis?  

UK PubMed Central (United Kingdom)

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

Masi AT

1992-02-01

54

Differential diagnosis and management of ankylosing spondylitis masked as adhesive capsulitis: a resident's case problem.  

UK PubMed Central (United Kingdom)

STUDY DESIGN: Resident's case problem. BACKGROUND: Ankylosing spondylitis is a potentially debilitating seronegative spondyloarthropathy, with inflammatory low back pain as the most commonly reported symptom. In the absence of low back pain, identification of other diagnostic criteria or associated impairments and joint involvement, such as involvement of the hip or shoulder, may be beneficial. DIAGNOSIS: A 32-year-old man with right shoulder pain and decreased range of motion was referred with a diagnosis of adhesive capsulitis. He had been managed by multiple healthcare providers for 3 years before being referred to a physical therapist. Glenoid labral pathology was evident on prior magnetic resonance imaging, which had led to a persistent focus on the shoulder. The evaluation by the physical therapist revealed significant mobility deficits in the cervical, thoracic, and lumbar spine. Radiographs and laboratory tests were ordered and a referral was made to rheumatology after the initial physical therapy assessment. The diagnostic work-up confirmed the diagnosis of ankylosing spondylitis and led to multidisciplinary management of the disease. DISCUSSION: Low back pain is often the primary symptom of ankylosing spondylitis later in the disease process. Earlier indicators of ankylosing spondylitis, such as severely impaired mobility and spine stiffness, may help guide detection in the absence of spinal pain. In this case, an appropriate diagnosis led to improvement in the management strategy of what might have appeared to be unrelated shoulder pain. Early differential diagnosis is important, as emerging interventions show promise when used earlier in the disease process.

Jordan CL; Rhon DI

2012-10-01

55

Ankylosant spondylitis association and diffuse idiopathic skeletal hyperostosis (DISH)  

International Nuclear Information System (INIS)

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

2000-01-01

56

[Cardiovascular manifestations in ankylosing spondylitis. Concerning 210 cases].  

UK PubMed Central (United Kingdom)

BACKGROUND: To analyse and discuss cardiovascular manifestations of ankylosing spondylitis, evaluate the frequency and giving special attention to unusual forms. METHODS: We retrospectively reviewed the medical records of 21 cases with cardiovascular manifestations among 210 cases of ankylosing spondylitis seen over a 25 years period who met the Amor criteria. RESULTS: Cardiovascular complications were found in 21 patients (10%): 5 (2.40%) had aortic insufficiency, 2 (0.95%) had mitral insufficiency, 1 had mitral valve prolapse, 1 had pericarditis, 10 (4.7%) had atrioventricular block and 6 (2.8%) had bundle branch block. Takayasu's disease was diagnosed in one case. Cardiovascular involvement was common In patients longer disease duration. Peripheral arthritis was found in 33% and its prevalence did not differ in patients with or without cardiac involvement. CONCLUSION: Aortic insufficiency and conduction disturbances were the most common cause of cardiovascular involvement in ankylosing spondylitis. The funding of cardiovascular manifestations in 10% of our patients suggests that in this illness evidence of cardiac manifestations should be actively investigated in ankylosing spondylitis.

Ben Taarit Ch; Kaffel D; Ben Maiz H; Khedher A

2008-06-01

57

Diagnosing and managing spinal injury in patients with ankylosing spondylitis.  

UK PubMed Central (United Kingdom)

BACKGROUND: Individuals with ankylosing spondylitis are at an increased risk of vertebral fractures. These are often unstable, leading to primary and secondary neurological injury and conferring high levels of morbidity and mortality. Fractures in these patients can occur after minimal trauma and are easily missed, with potentially disastrous consequences. OBJECTIVES: To educate health professionals who may be involved in the initial assessment and management of ankylosing spondylitis patients with possible spinal injuries, despite not being spinal specialists. CASE REPORTS: We present three cases from our own hospital, which illustrate the pitfalls associated with traumatic spinal injury in ankylosing spondylitis. Case 1 shows why delayed presentation of spinal injury is common, as well as demonstrating the need for multiple imaging modalities in some patients. Case 2 is an example of primary neurological injury in this patient group, and case 3 highlights the risk of secondary neurological injury, as well as the effect of multiple comorbidities on patient outcomes. CONCLUSIONS: It is important that staff in the Emergency Department have an understanding of the extreme caution that is needed in the management of possible spinal injuries in patients with or suspected of having ankylosing spondylitis.

Waldman SK; Brown C; Lopez de Heredia L; Hughes RJ

2013-04-01

58

Ankylosing spondylitis of the craniovertebral junction: a single surgeon's experience.  

UK PubMed Central (United Kingdom)

OBJECT: The objective of this study was to describe a single surgeon's experience managing craniovertebral junction (CVJ) disease due to ankylosing spondylitis. METHODS: The authors undertook a retrospective review of the records of patients with CVJ disease due to ankylosing spondylitis who were evaluated and treated by the senior author. Charts were reviewed for symptoms and signs at presentation, radiography results, treatment, and outcome. In addition, some of the patients had pathology reports available for review. RESULTS: Eight patients with CVJ disease due to ankylosing spondylitis were identified who were evaluated by the senior author in the years 1990-2008. The most common presenting symptoms were neck pain (37.5%), cranial neuropathy (37.5%), and sensory disturbance (62.5%). On examination, the most common findings were limited cervical range of motion (37.5%), weakness (50%), and myelopathy (75%). Radiographic evaluation revealed atlantoaxial subluxation, retroodontoid pannus formation, basilar invagination, and bone erosion. Surgery was offered to all of the patients, 7 of whom underwent operations. In most cases, the treatment was transoral-transpalatopharyngeal decompression followed by occipitocervical fusion. One patient with a reducible lesion underwent dorsal fusion alone. Neurological outcomes were favorable overall. CONCLUSIONS: The incidence of CVJ disease in patients with ankylosing spondylitis varies among reports. These cases are rare in most neurosurgery clinics. It is important to recognize that patients with ankylosing spondylitis are at risk for CVJ disease, similar to patients with rheumatoid arthritis. Principles common to the management of other CVJ pathologies apply to these patients as well.

Albert GW; Menezes AH

2011-04-01

59

Hearing and cochlear function of patients with ankylosing spondylitis.  

Science.gov (United States)

Ankylosing spondylitis (AS) is a chronic systemic inflammatory disorder that primarily affects the spine and sacroiliac joints. Recent studies described audiovestibular impairment in AS patients. The aim of this study was to evaluate the hearing and function of the cochlear system in patients with AS. Thirty-seven AS patients and 20 healthy controls were evaluated prospectively. Otorhinolaryngologic examinations were performed in all patients together with pure tone audiometry, speech discrimination test, tympanometry, and distortion product otoacoustic emission (DPOE). Disease duration, Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) scores, and hematologic findings (CRP and ESR) were also collected. Pure tone audiometry findings of the patients and controls were significantly different in all frequencies (p 0.05). There was no correlation between disease duration, BASDAI scores, hematological findings, and audiometry findings (p > 0.05). This study demonstrated that there is an association between AS and hearing loss, but the cochlea is not the main source of hearing loss. PMID:22526477

Kahveci, Orhan Kemal; Demirdal, Umit Secil; Duran, Abidin; Altuntas, Ali; Kavuncu, Vural; Okur, Erdogan

2012-04-17

60

ERAP1 in ankylosing spondylitis: genetics, biology and pathogenetic role.  

UK PubMed Central (United Kingdom)

PURPOSE OF REVIEW: Endoplasmic reticulum aminopeptidase 1 (ERAP1) is an aminopeptidase of the endoplasmic reticulum involved in trimming of peptides to their optimal size for binding to major histocompatibility complex class I molecules. Natural ERAP1 polymorphism resulting in altered enzymatic activity is associated with ankylosing spondylitis, an inflammatory disorder very strongly linked to HLA-B27. RECENT FINDINGS: This review will summarize recent advances in the genetics of ERAP1 association with this disease, in the molecular basis of ERAP1 function and in the mechanism of functional interaction between ERAP1 and HLA-B27. SUMMARY: The findings suggest that the pathogenetic role of ERAP1 in ankylosing spondylitis is due to allotype-dependent alterations of the HLA-B27 peptidome that affect the immunologic and other features of HLA-B27.

Alvarez-Navarro C; López de Castro JA

2013-07-01

 
 
 
 
61

MRI and CT of ankylosing spondylitis with vertebral scalloping.  

Science.gov (United States)

Three cases of cauda equina syndrome in long-standing ankylosing spondylitis are reported. In all, vertebral scalloping and dural ectasia were confirmed by magnetic resonance imaging and computed tomography. MRI showed widening of the dural sac with signal intensity corresponding to cerebrospinal fluid. CT demonstrated asymmetrical lesions of the posterior elements of the lumbar spine. Myelography was not felt necessary to confirm the findings. PMID:3405419

Abelló, R; Rovira, M; Sanz, M P; Gili, J; Capdevila, A; Escalada, J; Peri, J

1988-01-01

62

Clinical feature and imaging findings of juvenile ankylosing spondylitis  

International Nuclear Information System (INIS)

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

2003-01-01

63

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

Directory of Open Access Journals (Sweden)

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; Mohd Asim Rasheed; D C Punera; Umesh K Bhadani

2011-01-01

64

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

2012-01-01

65

[Retrospective study on the treatment of ankylosing spondylitis with cervical spine fracture: 8 cases report].  

UK PubMed Central (United Kingdom)

OBJECTIVE: To discuss surgical procedures and curative effect of ankylosing spondylitis with cervical spine fracture. METHODS: From January 2003 to October 2011, 8 patients with ankylosing spondylitis with cervical spine fracture were respectively treated by surgical treatment (7 cases) and conservative treatment (1 case), 8 cases were male with an average of age 41 years old (ranged, 27 to 49). All patients were confirmed by CT and MRI,and 6 cases combined with spinal cord injury. One case was treated with skull-neck-thorax model, 7 cases were treated by surgery. The procedures included anterior approach (5 cases), posterior approach (1 case), and combined anteroposterior approach (1 case). Fracture fusion condition were evaluated according to CT at the final following up, improvement of spinal cord injury were assessed according to Frankel classification. RESULTS: Eight patients were followed up from 4 to 38 months with an average of 34 months. Seven cases obtained bone healing, 3 patients without spinal cord injury remained intact after operation, 5 patients with spinal cord injury improved at different degree after operation. Frankel classification of 7 patients were improved 1 degree, and 1 case delayed union for following up. CONCLUSION: Ankylosing spondylitis with cervical spine fracture is a special kind of trauma, which have a high rate of neurological deficits. Surgery should be performed as early as possible, and procedures were chosen depending on particular case.

Hong F; Ni JP

2013-06-01

66

Atividade sexual na espondilite anquilosante/ Sexual activity in ankylosing spondylitis  

Scientific Electronic Library Online (English)

Full Text Available 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 - BASDAI), funcionalidade (Bath Ankylosing Spondylitis Functional Index - BASFI) e atividade sexual (utilizando imagens de sete posições sexuais) 32 pacientes com diagnóstic (more) o 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 Ankylo (more) sing 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.

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

2012-12-01

67

[Pedicle subtraction osteotomy for correction of kyphosis in ankylosing spondylitis].  

UK PubMed Central (United Kingdom)

OBJECTIVE: To assess the effectiveness of single-level lumbar pedicle subtraction osteotomy for correction of kyphosis caused by ankylosing spondylitis. METHODS: Between July 2006 and July 2010, 45 consecutive patients with kyphosis caused by ankylosing spondylitis underwent single-level pedical subtraction osteotomy. There were 39 males and 6 females with an average age of 36.9 years (range, 21-59 years). The average disease duration was 18.6 years (range, 6-40 years). All patients had low back pain, fatigue, abnormal gaits, and disability of looking and lying horizontally. Radiological manifestations included sacroiliac joints fusion, bamboo spine, pelvic spin, and kyphosis. Cervical spine was involved in 30 patients; thoracolumbar spine was affected in 15 patients. RESULTS: Wound hydrops and dehiscence occurred in 1 case, and was cured after debridement; primary healing of incision was obtained in the other patients. Two patients had abdominal skin blisters, which were cured after magnesium sulfate wet packing. Forty-two patients were followed up 24-74 months (mean, 30 months). All osteotomy got solid fusion. The average bony fusion time was 6.8 months (range, 3-12 months). All patients could walk with brace and looked or lied horizontally postoperatively. The Scoliosis Research Society-22 Patient Questionnaire (SRS-22) score, T1-Sl kyphosis Cobb angle, L1-S1 lordosic Cobb angle, sagittal imbalance distance, and chin-brow vertical angle at 1 week and last follow-up were significantly improved when compared with those at preoperation (P < 0.05), but no significant difference was found between at 1 week and last follow-up (P > 0.05). CONCLUSION: Single-level pedicle subtraction osteotomy has satisfactory effectiveness for the correction of kyphosis caused by ankylosing spondylitis.

Xu H; Zhang Y; Mao K; Zhang X; Wang Z; Zheng G; Wang Y

2013-04-01

68

Ankylosing spondylitis clinical registries: principles, practices and possibilities.  

UK PubMed Central (United Kingdom)

The need for a rigorously developed longitudinal registry of patients with spondyloarthritis (SpA) is clear and urgent. Like randomized controlled trials, registries rely on a prospective, systematic protocol-driven approach to data acquisition to assess outcomes for a prescribed cohort of patients. Registries seek to capture large numbers of patients across large geographic zones and can serve as a valuable resource for patient advocacy, patient education and support, incidence and prevalence, and broad demographic profiles. Building on 3 existing registries--the Prospective Study of Outcomes in Ankylosing Spondylitis, the Program to Understand the Longterm Outcomes of Spondyloarthritis (PULSAR) and the University Health Network Spondyloarthritis Program--these registries and the Spondylitis Association of America propose to form a combined registry of North American SpA patients. The combined registry would, ideally, complement ongoing clinical goals and improve patient care.

Caplan L; Clegg DO; Inman RD

2013-06-01

69

Coexisting Ankylosing Spondylitis and Gouty Arthritis Case Report  

Directory of Open Access Journals (Sweden)

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

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

2011-01-01

70

Quantitative analysis of digitopalmar dermatoglyphics in men with ankylosing spondylitis.  

UK PubMed Central (United Kingdom)

Dermatoglyphic pattern analysis, one of the genetic methods, was used to determine digitopalmar ridge count in 40 men with ankylosing spondylitis. Twenty-two variables (ridge count on each of the ten fingers, their sum on five and ten fingers, four traits on each palm, i.e. ridge count between a-b, b-c and c-d triradii, and atd angles on the palms as well as their bilateral sum) were determined. The data thus obtained were compared with digitopalmar prints of 200 healthy men who served as a control group. A significant difference from the control group was found for six variables. The atd angle was reduced on both palms and consequentially in the overall sum. Ridge count was decreased between the b-c triradius on the left palm and increased on the third finger tip bilaterally. Accordingly, a polygenic system identical in some loci to the polygenic system predisposing to ankylosing spondylitis susceptibility might be found responsible for the dermatoglyphic pattern development. That means that they could used, and that is the aim of this study, in the evaluation of the relative risk in family members with positive disease history.

Cvjeticanin M; Jaji? Z; Jaji? I

2000-01-01

71

Nucleic acid detection kit for aided diagnosis of ankylosing spondylitis  

UK PubMed Central (United Kingdom)

The invention discloses a nucleic acid detection kit for aided diagnosis of ankylosing spondylitis. The detection kit comprises erythrocyte lysate, DNA extract, detection system polymerase chain reaction (PCR) reaction liquid A, internal reference system PCR reaction liquid B, Taq enzyme, a positive reference substance and a negative reference substance and is characterized in that: the detection system PCR reaction liquid A comprises PCR buffer solution, dNTP, Mg2+, upstream and downstream primers B27F/B27R for detection and a probe B27-Allglo, wherein B27F is GGGTCTCACA CCCTCCAGAAT B27R is CGGCGGTCCAGGAGCT B27-Allglo is MAR-TACCACC AGGACGCCTAG-MAR the internal reference system PCR reaction liquid B comprises PCR buffer solution, dNTP, Mg2+, upstream and downstream primers IPCF/IPCR for detection and a probe IPC-P, wherein IPCF is GAAGGTGAAGGTCG GAGTC IPCR is AGATGGTGATGGGATTTC and IPCP is FAM-CAAGCTTCCCGTT CTCAGCC-BHQ. The combination of real-time fluorescent PCR technology and Allglo probe is applied to HLA-B27 gene detection so as to detect an HLA-B27 gene subtype related to ankylosing spondylitis. The detection kit has the advantages of good specificity, high sensitivity and simple and rapid operation.

GUOWEI FANG; XINGZHONG GUO; YAO GUO; YUAN ZOU

72

Hearing and cochlear function of patients with ankylosing spondylitis.  

UK PubMed Central (United Kingdom)

Ankylosing spondylitis (AS) is a chronic systemic inflammatory disorder that primarily affects the spine and sacroiliac joints. Recent studies described audiovestibular impairment in AS patients. The aim of this study was to evaluate the hearing and function of the cochlear system in patients with AS. Thirty-seven AS patients and 20 healthy controls were evaluated prospectively. Otorhinolaryngologic examinations were performed in all patients together with pure tone audiometry, speech discrimination test, tympanometry, and distortion product otoacoustic emission (DPOE). Disease duration, Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) scores, and hematologic findings (CRP and ESR) were also collected. Pure tone audiometry findings of the patients and controls were significantly different in all frequencies (p < 0.01). Speech discrimination scores were also significantly different (p < 0.01). No significant difference was found between DPOE responses of the patients and controls (p > 0.05). There was no correlation between disease duration, BASDAI scores, hematological findings, and audiometry findings (p > 0.05). This study demonstrated that there is an association between AS and hearing loss, but the cochlea is not the main source of hearing loss.

Kahveci OK; Demirdal US; Duran A; Altuntas A; Kavuncu V; Okur E

2012-07-01

73

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

Digital Repository Infrastructure Vision for European Research (DRIVER)

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 eff...

Stephanie Hennigan; Christoph Ackermann; Arthur Kavanaugh

74

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

Digital Repository Infrastructure Vision for European Research (DRIVER)

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 tha...

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

75

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

Digital Repository Infrastructure Vision for European Research (DRIVER)

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 join...

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

76

Efficacy of anakinra in active ankylosing spondylitis: a clinical and magnetic resonance imaging study  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Objective: To determine the efficacy of anakinra, an interleukin 1 receptor antagonist in active ankylosing spondylitis (AS), and to investigate the effect of anakinra treatment on spinal enthesitis/osteitis using magnetic resonance imaging (MRI).

Tan, A; Marzo-Ortega, H; O'Connor, P; Fraser, A; Emery, P; McGonagle, D

77

Infliximab in combination with methotrexate in active ankylosing spondylitis: a clinical and imaging study  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Objective: To examine the efficacy and safety of infliximab combined with methotrexate compared with methotrexate alone in the treatment of ankylosing spondylitis (AS) using MRI and DXA to monitor its impact on bone.

Marzo-Ortega, H; McGonagle, D; Jarrett, S; Haugeberg, G; Hensor, E; O'Connor, P; Tan, A; Conaghan, P; Greenstein, A; Emery, P

78

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

Directory of Open Access Journals (Sweden)

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; Allali Fadoua; Berrada Kenza; Idrissi Zineb; Hmamouchi Ihsane; Abouqal Redouane; Hajjaj-Hassouni Najia

2012-01-01

79

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

Energy Technology Data Exchange (ETDEWEB)

Ankylosing spondylitis (AS) is the prototypical form of the spondyloarthropathies, which at a prevalence of 2% is among the most frequent rheumatic diseases. Spondyloarthropathy comprises the following five disorders: AS, reactive arthritis, psoriatic arthritis, enteropathic arthritis in Crohn's disease, and ulcerosing colitis as well as undifferentiated spondyloarthropathy. In 99% of the patients with AS initial abnormal findings affect the sacroiliac joints. The radiographic changes required for diagnosing AS occur as late as 5-9 years after the onset of clinical symptoms. MRI of the sacroiliac joints reliably demonstrates both chronic inflammatory changes (erosions, sclerotic changes, bone bridges) and acute inflammatory changes (synovitis, capsulitis, osteitis) and allows for grading the chronicity and acuity of such changes. Enthesitis of the interosseous ligaments of the retroarticular space is a manifestation of AS. Spondylodiscitis (Andersson 1937) may occur as an inflammatory or non-inflammatory process (transdiscal fatigue fracture). Inflammations of the facet and costospinal joints developing into ankylosis are typical of AS. Changes of the vertebral bodies occur as anterior (Romanus 1952), posterior, and marginal spondylitis. All forms of spondyloarthropathies are furthermore characterized by asymmetrical synovitis of the large joints, particularly of the legs (gonarthritis, coxitis, tarsitis, peripheral oligoarthritis), rheumatic fibroosteitis (pelvic enthesitis, rheumatic calcaneopathy), and peri- and synchrondritis of the public symphisis and sternal synchondrosis. Since early inflammatory changes of the spinal column and of the extravertebral localizations in AS are demonstrated by MRI before they become apparent on radiographs, and thereby the diagnostic gap could be closed, the early use of MRI for diagnostic and follow-up is commendable, when new therapeutical options like the so-called 'biologicals' are employed. (orig.) [German] Die ankylosierende Spondylitis (AS) gilt als Prototyp der Spondylarthropathien, welche mit einer Praevalenz von 2% zu den haeufigsten rheumatischen Erkrankungen gerechnet werden. Die Spondylarthropathie umfasst die 5 Entitaeten AS, reaktive Arthritis, Psoriasis arthropathica, enteropathische Arthritis bei Morbus Crohn und Colitis ulcerosa und die undifferenzierte Spondylarthropathie. Bei 99% der Patienten mit AS sind die ersten pathologischen Befunde an den Sakroiliakalgelenken zu finden. Die zur Diagnose einer AS geforderten Roentgenbefunde treten erst mit einer Latenz von 5-9 Jahren nach Beginn der klinischen Symptome in Erscheinung. Mit Hilfe der MRT der Sakroiliakalgelenke lassen sich sowohl chronisch-entzuendliche Veraenderungen (Erosionen, Sklerosierungen, Knochenbruecken) als auch akut-entzuendliche Veraenderungen (Synovitiden, Kapsulitiden, Osteitiden) sicher nachweisen und bezueglich ihrer Chronizitaet und Akuitaet graduieren. Enthesitiden der Ligamenta interossea des Spatium retroarticulare gehoeren zum Bild der AS. Eine Spondylodiszitis (Andersson 1937) kann als entzuendliche und als nichtentzuendliche Form (transdiskaler Ermuedungsbruch) auftreten. Zur Ankylosierung fuehrende Entzuendungen der Facetten- und der kostospinalen Gelenke sind fuer die AS typisch. Veraenderungen der Wirbelkoerper finden sich als Spondylitis anterior (Romanus 1952), posterior und marginalis. Charakteristisch fuer alle Spondylarthropathien sind darueberhinaus asymmetrische Synovitiden an den grossen Gelenken vor allem der unteren Extremitaet (Gonarthritis, Coxitis, Tarsitis, periphere Oligoarthritis), die Fibroostitis rheumatica (pelvine Enthesitis, Calcaneopathia rheumatica) und die Peri- und Synchondritiden der Symphysis pubica und der Synchondrosis sternalis. Da sich bei der AS fruehe entzuendliche Veraenderungen an der Wirbelsaeule und an den extravertebralen Manifestationsorten in der MRT vor deren Auftreten im Roentgenbild nachweisen lassen und damit die diagnostische Luecke geschlossen werden konnte, empfiehlt sich bei neuen therapeutischen Optionen mit den sogenannt

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

2002-12-01

80

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

 
 
 
 
81

Bilateral deep infrapatellar bursitis associated with tibial tuberosity enthesopathy in a case of juvenile ankylosing spondylitis.  

Science.gov (United States)

A case of bilateral deep infrapatellar bursitis is reported in a 19-year-old man suffering from juvenile ankylosing spondylitis and surgically treated for bilateral tibial tuberosity enthesopathy. In addition to erosive non-specific bone remodelling the excised specimens showed, in the bursa, synovial layer hyperplasia with mild subintimal inflammatory cell infiltration, i.e. changes similar to those of synovitis in ankylosing spondylitis. The respective roles of the inflammatory "terrain" and of local shearing stress are discussed. PMID:4048762

Lagier, R; Albert, J

1985-01-01

82

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

UK PubMed Central (United Kingdom)

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

Joo KB; Lee S; Kang CN; Kim TH

2013-06-01

83

Systemic and mucosal antibodies to Klebsiella in patients with ankylosing spondylitis and Crohn's disease.  

Science.gov (United States)

Whole gut lavage fluid is a useful source of material for the study of intestinal immunity and inflammation in humans. Systemic and mucosal antibodies to Klebsiella pneumoniae were measured by enzyme linked immunosorbent assay (ELISA) in serum samples and whole gut lavage fluid from 14 patients with ankylosing spondylitis, 14 with Crohn's disease, and 16 immunologically normal controls. As the concentration of IgG in whole gut lavage fluid reflects disease activity in Crohn's disease, this approach was used to detect intestinal inflammation in patients with ankylosing spondylitis who also had disease activity and use of non-steroidal anti-inflammatory drugs (NSAIDs) recorded. Small intestinal permeability to cellobiose and mannitol was also studied. In serum samples, levels of IgA antibody to klebsiella were high in patients with Crohn's disease and in patients with active ankylosing spondylitis, and were significantly correlated with the erythrocyte sedimentation rate in patients with ankylosing spondylitis. Levels of IgG antibody to klebsiella were also high in patients with Crohn's disease. Studies of whole gut lavage fluid showed similar levels of IgA antibody to klebsiella in the three study groups, but levels of whole gut lavage fluid IgM and IgG antibodies to klebsiella were high in patients with Crohn's disease. Levels of IgG in whole gut lavage fluid were high in patients with Crohn's disease but in only one patient with ankylosing spondylitis, though the cellobiose/mannitol permeability ratio was abnormal in eight of 13 patients with ankylosing spondylitis. It is concluded that high levels of serum IgA antibody to klebsiella are not specific to ankylosing spondylitis, and that there is no evidence of an abnormal intestinal IgA antibody response to klebsiella in patients with ankylosing spondylitis.

O'Mahony, S; Anderson, N; Nuki, G; Ferguson, A

1992-01-01

84

Fatigue in ankylosing spondylitis: causes, consequences and self-management.  

UK PubMed Central (United Kingdom)

OBJECTIVES: To explore the perceived causes, consequences and management of fatigue in ankylosing spondylitis (AS). METHODS: In this single-cohort qualitative study, ten participants completed a seven-day diary and participated in a semi-structured interview exploring possible causes, consequences and self-management of fatigue. Interviews were recorded, transcribed and analysed using 'framework' analysis. Ethical approval was obtained. RESULTS: Three themes emerged: patterns and causes, consequences and management of fatigue. While patients' descriptions of fatigue were similar, the patterns and perceived causes of fatigue varied between individuals. Fatigue impacted on social life, relationships and work. Two approaches to fatigue management were observed: help and support from others and self-management, with four participants having sought medical help for fatigue. CONCLUSIONS: The study suggested that fatigue has a negative impact on quality of life in people with AS. Future practice should include a comprehensive fatigue assessment and the development of treatment programmes directed at enhancing self-management techniques.

Farren W; Goodacre L; Stigant M

2013-03-01

85

Tenoxicam compared with diclofenac in patients with ankylosing spondylitis.  

UK PubMed Central (United Kingdom)

A randomized study was performed on 24 patients with ankylosing spondylitis to compare the efficacy and tolerability of 20 mg tenoxicam daily with 50 mg diclofenac twice daily. There were 6 withdrawals from the group taking tenoxicam and 4 from the diclofenac group. Depression in 1 patient taking tenoxicam was the only significant adverse event. Both drugs were otherwise well tolerated. Tenoxicam and diclofenac were rated as good or excellent by 27% and 55% of patients, respectively. Global assessment, pain and duration of morning stiffness were improved with both drugs but this improvement was not statistically significant and there was no statistically significant difference between the two groups. This study confirms that tenoxicam is effective and well tolerated but larger numbers would be required to detect a small difference between groups.

Schwarzer AC; Cohen M; Arnold MH; Kelly D; McNaught P; Brooks PM

1990-01-01

86

Orbital cellulitis in a patient receiving infliximab for Ankylosing spondylitis.  

UK PubMed Central (United Kingdom)

PURPOSE: To describe a case of orbital cellulitis arising in a patient treated with an anti-TNFalpha agent. DESIGN: Single interventional case report. METHODS: A 42-year-old man developed severe unilateral orbital cellulitis while receiving infliximab (Remicade, Centocor) treatment for Ankylosing spondylitis (AS) as part of the open-label phase of a trial conducted at our tertiary referral center. Cultures grew Staphylococcus aureus. RESULTS: Infliximab treatment was stopped and the patient made a full recovery after receiving appropriate antibiotic therapy. Infliximab therapy was resumed after three weeks. CONCLUSIONS: Clinical vigilance is warranted when treating patients with anti-TNFalpha agents as these are associated with a diverse and growing number of ophthalmic complications. Resolved infection does not preclude the use of such agents.

Roos JC; Ostor AJ

2006-04-01

87

Subjective symptoms from the stomatognathic system in ankylosing spondylitis.  

UK PubMed Central (United Kingdom)

One hundred individuals with ankylosing spondylitis (AS) and 57 individuals a comparison group responded to a questionnaire concerning subjective symptoms from the stomatognathic system and general joint symptoms. It was concluded that the individuals with AS have more subjective symptoms from the stomatognathic system, especially difficulties in wide mouth opening, than the comparison group. Specific temporomandibular joint (TMJ) involvement in AS was difficult to determine but pain in the TMJ region, stiffness/tiredness in the jaws and with AS. TMJ involvement was also correlated to the severity and extension of the AS. In the comparison group awareness of parafunctions such as tooth-clenching and tooth-grinding were important subjective factors correlated to their symptoms from the stomatognathic system.

Wenneberg B; Kopp S

1982-01-01

88

Normal anti-Klebsiella lymphocytotoxicity in ankylosing spondylitis  

Energy Technology Data Exchange (ETDEWEB)

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

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

1986-03-01

89

Normal anti-Klebsiella lymphocytotoxicity in ankylosing spondylitis  

International Nuclear Information System (INIS)

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

1986-01-01

90

Use of simple analgesics in the treatment of ankylosing spondylitis.  

UK PubMed Central (United Kingdom)

The role played by simple analgesics in the treatment of ankylosing spondylitis (AS) is not clear. A questionnaire survey of AS patients and rheumatologists revealed that a majority (78%) of patients took NSAIDs and a substantial proportion (34%) took simple analgesics. A majority of rheumatologists (65%) considered simple analgesics worth prescribing for AS patients. Rheumatologists tended to prescribe NSAIDs more often initially than simple analgesics while the reverse was true for general practitioners. Over half the patients (57%) considered pain relief as their first priority for drug treatment. Other objectives such as prevention of deformities and relief of stiffness were less important. A sizeable proportion of patients (15%) bought over-the-counter drugs. Prescribing habits of doctors can be improved by listing over-the-counter drugs in the British National Formulary and Data Sheet Compendium.

Pal B

1987-06-01

91

Ankylosing spondylitis and central core disease: case report  

Directory of Open Access Journals (Sweden)

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; Lin Kátia; Iwamoto Fábio Massaiti; Arruda Walter Oleschko; Werneck Lineu Cesar

2003-01-01

92

MR imaging features of foot involvement in ankylosing spondylitis  

Energy Technology Data Exchange (ETDEWEB)

Objective: To determine alterations of the soft tissue, tendon, cartilage, joint space, and bone of the foot using magnetic resonance (MR) imaging in ankylosing spondylitis (AS) patients. Materials and Method: Clinical and MR examination of the foot was performed in 23 AS patients (46 feet). Ten asymptomatic volunteers (20 feet) were studied on MR imaging, as a control group. MR imaging protocol included; T1-weighted spin-echo, T2-weighted fast-field echo (FFE) and fat-suppressed short tau inversion recovery (STIR) sequences in sagittal, sagittal oblique, and coronal planes using a head coil. Specifically, we examined: bone erosions, tendinitis (acute and chronic), para-articular enthesophyte, joint effusion, plantar fasciitis, joint space narrowing, soft tissue edema, bone marrow edema, enthesopathy in the Achilles tendon and plantar fascia attachment, subchondral signal intensity abnormalities (edema and sclerosis), tenosynovitis, retrocalcaneal bursitis, subchondral cysts, subchondral fissures, and bony ankylosis. Midfoot, hindfoot, and ankle were included in examined anatomic regions. Results: Clinical signs and symptoms (pain and swelling) due to foot involvement were present in 3 (13%) of the patients while frequency of involvement was 21 (91%) with MR imaging assessment. The MR imaging findings were bone erosions (65%), Achilles tendinitis (acute and chronic) (61%), para-articular enthesophyte (48%), joint effusion (43%), plantar fasciitis (40%), joint space narrowing (40%), subchondral sclerosis (35%), soft tissue edema (30%), bone marrow edema (30%), enthesopathy of the Achilles attachment (30%), subchondral edema (26%), enthesopathy in the plantar fascia attachment (22%), retrocalcaneal bursitis (22%), subchondral cysts (17%), subchondral fissures (17%), tendinitis and enthesopathy of the plantar ligament (13%), and bony ankylosis (9%). The most common involved anatomical region was the hindfoot (83%) following by midfoot (69% ) and ankle (22%). Conclusion: In our experience, MR imaging may detect inflammatory and/or erosive bone, soft tissue, cartilage, tendon, and joint abnormalities in AS patients, even if AS patients did not have clinical signs and symptoms of foot involvement. If these data prove to be confirmed in further MR studies, MR imaging may be of importance especially in early diagnosis of inflammatory changes in the foot.

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

2005-01-01

93

MR imaging features of foot involvement in ankylosing spondylitis  

International Nuclear Information System (INIS)

[en] Objective: To determine alterations of the soft tissue, tendon, cartilage, joint space, and bone of the foot using magnetic resonance (MR) imaging in ankylosing spondylitis (AS) patients. Materials and Method: Clinical and MR examination of the foot was performed in 23 AS patients (46 feet). Ten asymptomatic volunteers (20 feet) were studied on MR imaging, as a control group. MR imaging protocol included; T1-weighted spin-echo, T2-weighted fast-field echo (FFE) and fat-suppressed short tau inversion recovery (STIR) sequences in sagittal, sagittal oblique, and coronal planes using a head coil. Specifically, we examined: bone erosions, tendinitis (acute and chronic), para-articular enthesophyte, joint effusion, plantar fasciitis, joint space narrowing, soft tissue edema, bone marrow edema, enthesopathy in the Achilles tendon and plantar fascia attachment, subchondral signal intensity abnormalities (edema and sclerosis), tenosynovitis, retrocalcaneal bursitis, subchondral cysts, subchondral fissures, and bony ankylosis. Midfoot, hindfoot, and ankle were included in examined anatomic regions. Results: Clinical signs and symptoms (pain and swelling) due to foot involvement were present in 3 (13%) of the patients while frequency of involvement was 21 (91%) with MR imaging assessment. The MR imaging findings were bone erosions (65%), Achilles tendinitis (acute and chronic) (61%), para-articular enthesophyte (48%), joint effusion (43%), plantar fasciitis (40%), joint space narrowing (40%), subchondral sclerosis (35%), soft tissue edema (30%), bone marrow edema (30%), enthesopathy of the Achilles attachment (30%), subchondral edema (26%), enthesopathy in the plantar fascia attachment (22%), retrocalcaneal bursitis (22%), subchondral cysts (17%), subchondral fissures (17%), tendinitis and enthesopathy of the plantar ligament (13%), and bony ankylosis (9%). The most common involved anatomical region was the hindfoot (83%) following by midfoot (69% ) and ankle (22%). Conclusion: In our experience, MR imaging may detect inflammatory and/or erosive bone, soft tissue, cartilage, tendon, and joint abnormalities in AS patients, even if AS patients did not have clinical signs and symptoms of foot involvement. If these data prove to be confirmed in further MR studies, MR imaging may be of importance especially in early diagnosis of inflammatory changes in the foot

2005-01-01

94

MRI of cervical spine injuries complicating ankylosing spondylitis  

International Nuclear Information System (INIS)

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

2008-01-01

95

MRI of cervical spine injuries complicating ankylosing spondylitis  

Energy Technology Data Exchange (ETDEWEB)

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

96

Normative values for the Bath Ankylosing Spondylitis Functional Index in the general population compared with ankylosing spondylitis patients in Morocco.  

UK PubMed Central (United Kingdom)

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 < 0.001) respectively. The best cutoff of BASFI was 1.5 with a sensitivity of 86% and a specificity of 90%. In the age group of 18-29 years, the best cutoff of the BASFI was 0.9 with a sensitivity of 93% and a specificity of 94%. In the age group of 30-50 years, the best cutoff of the BASFI was 1.5 with a sensitivity of 84% and a specificity of 88%. For those over 50 years of age, the best cutoff of the BASFI was 2.5 with a sensitivity of 84% and a specificity of 97%. 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 G; Allali F; Berrada K; Idrissi Z; Hmamouchi I; Abouqal R; Hajjaj-Hassouni N

2012-01-01

97

Biomechanical assessment of balance and posture in subjects with ankylosing spondylitis  

Directory of Open Access Journals (Sweden)

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

2012-01-01

98

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

UK PubMed Central (United Kingdom)

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 A; Hadler J; Pointon JP; Robinson PC; Karaderi T; Leo P; Cremin K; Pryce K; Harris J; Lee S; Joo KB; Shim SC; Weisman M; Ward M; Zhou X; Garchon HJ; Chiocchia G; Nossent J; Lie BA; Førre Ø; Tuomilehto J; Laiho K; Jiang L; Liu Y; Wu X; Bradbury LA; Elewaut D; Burgos-Vargas R; Stebbings S; Appleton L; Farrah C; Lau J; Kenna TJ; Haroon N; Ferreira MA; Yang J; Mulero J; Fernandez-Sueiro JL; Gonzalez-Gay MA; Lopez-Larrea C; Deloukas P; Donnelly P; Bowness P; Gafney K; Gaston H; Gladman DD; Rahman P; Maksymowych WP; Xu H; Crusius JB; van der Horst-Bruinsma IE; Chou CT; Valle-Oñate R; Romero-Sánchez C; Hansen IM; Pimentel-Santos FM; Inman RD; Videm V; Martin J; Breban M; Reveille JD; Evans DM; Kim TH; Wordsworth BP; Brown MA

2013-07-01

99

Golimumab administered subcutaneously every 4 weeks in ankylosing spondylitis: 104-week results of the GO-RAISE study.  

UK PubMed Central (United Kingdom)

OBJECTIVE: To assess the efficacy and safety of golimumab over 104 weeks in patients with active ankylosing spondylitis. METHODS: At baseline, patients with active ankylosing spondylitis (n=356) were randomly assigned (1:1.8:1.8) to subcutaneous injections of placebo (group 1), golimumab 50 mg (group 2) or golimumab 100 mg (group 3) every 4 weeks. At week 16, patients in groups 1 and 2 with <20% improvement in total back pain and morning stiffness entered early escape to 50 or 100 mg, respectively. At week 24, patients still receiving placebo crossed over to golimumab 50 mg. Findings through week 24 were previously reported; those through week 104 are presented herein. RESULTS: At week 104, 38.5%, 60.1% and 71.4% of patients in groups 1, 2 and 3, respectively, had at least 20% improvement in the Assessment in SpondyloArthritis international Society response criteria (ASAS20); 38.5%, 55.8% and 54.3% had an ASAS40 response and 21.8%, 31.9% and 30.7% were in ASAS partial remission. Mean Bath Ankylosing Spondylitis Disease Activity Index and Bath Ankylosing Spondylitis Functional Index scores were <3 at week 104 for all the treatment regimens. Golimumab safety through week 104 was similar to that through week 24. CONCLUSION: Clinical response that was achieved by patients receiving golimumab through 24 weeks was sustained through 52 and 104 weeks. The golimumab safety profile appeared to be consistent with the known safety profile of tumour necrosis factor inhibitors.

Braun J; Deodhar A; Inman RD; van der Heijde D; Mack M; Xu S; Hsu B

2012-05-01

100

[Use of conventional and unconventional therapies among patients with ankylosing spondylitis  

UK PubMed Central (United Kingdom)

OBJECTIVE: A large share of rheumatism patients who are treated by rheumatologists use unconventional therapies additionally. What is the frequency in patients with ankylosing spondylitis who present for treatment at a radon spa? PATIENTS: 75 patients with ankylosing spondylitis presenting for treatment at the Gasteiner Heilstollen Hospital agreed to participate in the study (6 refused). DESIGN: In an open interview a research assistant asked the patients to name all interventions which they have used for the treatment of ankylosing spondylitis. RESULTS: Unconventional therapies (beside treatment at the Gasteiner Heilstollen) were used by 39 patients. Most frequently cited were acupuncture (15x), diet (8x), herbal therapy (7x), and homeopathy (6x). In total 40 different forms of unconventional therapies were mentioned. All patients claimed to have used at least two conventional therapies. CONCLUSION: Patients presenting for treatment at a radon spa claim to have used conventional therapies more frequently than unconventional forms of treatment.

Curda B; Luxl M; Glauninger P; Falkenbach A

2000-04-01

 
 
 
 
101

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

2013-01-01

102

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

UK PubMed Central (United Kingdom)

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.

Sari I; Igci YZ; Can G; Taylan A; Solmaz D; Gogebakan B; Akar S; Eslik Z; Bozkaya G; Akkoc N

2013-01-01

103

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.

Ozlem Altindag; Mehmet Karakoc; Neslihan Soran; Hasan Tabur; Ahmet Demirkol

2008-01-01

104

Sexual activity in Moroccan men with ankylosing spondylitis.  

UK PubMed Central (United Kingdom)

The aim of this study was to assess the perceived impact of ankylosing spondylitis (AS) on sexual activity within Moroccan men and to identify the associations with demographic, psychological status, quality of sleep, and disease-related variables. A total of 110 patients with a confirmed diagnosis of AS according to the modified New York classification criteria were invited to participate in the study. Patients completed a questionnaire, which also included questions relating to the impact of AS on their sexual function, socio-demographic and clinical characteristics. The patient sample comprised 110 men. The mean age of patients was 38.5 ± 12.6 years. Among the 110 patients, only 73 (67 %) have already had sexual activity. In this group of patients, 32 (44 %) were unsatisfied, 30 (41 %) reported erectile dysfunction, and 28 (38.4 %) had orgasmic trouble. Multivariate analysis showed that fatigue and sleep disturbance were independently associated with erectile dysfunction. This study suggests that AS in men seems to impact on sexual lives. Fatigue and sleep disturbance were independently associated with perceived problems with sexual activity.

Rostom S; Mengat M; Mawani N; Jinane H; Bahiri R; Hajjaj-Hassouni N

2013-06-01

105

Pulmonary function in ankylosing spondylitis: association with clinical variables.  

UK PubMed Central (United Kingdom)

To evaluate the association between pulmonary function and clinical variables in ankylosing spondylitis (AS) and to compare the pulmonary function of patients with AS with that of healthy controls, 61 AS patients and 74 healthy controls were included. In AS, we assessed clinical disease indices (BASDAI, BASFI, BASG), morning stiffness, number of hypersensitive entheses, metrology measures, 6-min walking test, acute phase reactants, radiological presence of "bamboo spine," and severity of radiological involvement in sacroiliac and vertebral joints. AS and healthy controls had similar age and gender. All the parameters of pulmonary function were significantly diminished in AS than in healthy controls (p < 0.001), with a higher proportion of restrictive pattern (57.4 vs. 5.4 %). In AS, pulmonary function correlated negatively with BASDAI, BASFI, BASG, morning stiffness, number of hypersensitive entheses, occiput-wall distance, and ESR, and positively with 6-min walking test. There was no association between pulmonary function with radiological stage of vertebral joints and sacroiliac joints, "bamboo spine," disease duration, or chest expansion. A higher frequency of AS patients had a decreased pulmonary function and results of the 6-min walking test. These abnormalities in AS were more related with disease activity than with mobility limitation.

Brambila-Tapia AJ; Rocha-Muñoz AD; Gonzalez-Lopez L; Vázquez-Del-Mercado M; Salazar-Páramo M; Dávalos-Rodríguez IP; De la Cerda-Trujillo L; Diaz-Toscano ML; Hernandez-Cuervo P; Diaz-Rizo V; Sanchez-Mosco D; Vazquez-Jimenez JC; Cardona-Muñoz EG; Gamez-Nava JI

2013-09-01

106

Serum prolidase activity in ankylosing spondylitis and rheumatoid arthritis.  

UK PubMed Central (United Kingdom)

The aim of the present study was to emphasize the collagen turnover in 2 of the most common chronic inflammatory rheumatic diseases by evaluating serum prolidase activity (SPA) in ankylosing spondylitis (AS) and rheumatoid arthritis (RA). 30 patients who met the modified New York Criteria for the classification of AS, 29 patients who met the 2010 Rheumatoid Arthritis Classification Criteria for the classification of RA, and 31 healthy controls were enrolled in the study. Serum samples of the patients and the controls were collected and SPA was measured by a spectrophotometric method. The comparison of the SPA in these 3 groups was statistically examined. In both patient groups, the SPA was lower than in the control group. SPA in patients with AS was statistically significantly lower than in the control and RA groups (P < 0.001/P = 0.002). No statistically significant difference was found between the RA and the control groups (P = 0.891). In conclusion, lower SPA is presumably associated with decreased collagen turnover and fibrosis, leading to decreased physical functions in both chronic inflammatory musculoskeletal diseases.

Uçar D; Em S; Bozkurt M; Oktayoglu P; Yüksel HK; Caglayan M; Gezer O; Nas K

2013-01-01

107

Update on biologic therapies in ankylosing spondylitis: a literature review.  

UK PubMed Central (United Kingdom)

AIM: The present paper aims to review the recent advances in diagnosis and management of ankylosing spondylitis (AS). METHOD: Medline and abstracts submitted to the recent European League Against Rheumatism (EULAR) congress were searched to obtain quality-controlled information on the management of AS. RESULTS: The use of magnetic resonance imaging (MRI) allows the diagnosis of AS to be made in the pre-radiographic stage. The Assessment in Spondylarthritis International Society recommendations for the management of AS have been modified so that patients with non-radiographic spondyloarthritis (SpA) can now be considered for biological therapy. The 'older' anti-tumour necrosis factor (TNF) continued to be effective in longer-term studies. Studies with longer duration of follow-up have shown that some patients with pre-radiographic SpA entered into prolonged drug-free remission. It is likely that in the foreseeable future, more AS patients will be treated with biological therapies at an earlier stage of the disease. New biologic therapies, golimumab and secukinumab, are looking promising in improving the signs and symptoms of AS, at least in the short-term. CONCLUSION: Longer-term studies of AS patients treated with infliximab, etanercept and adalimumab continued to show a good clinical response. There is a need for more long-term studies to examine the longitudinal efficacy of golimumab and secukinumab in AS.

Goh L; Samanta A

2012-10-01

108

Health and Labour Questionnaire: Turkish Adaptation for Ankylosing Spondylitis  

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

Engin Çakar; Emel Özcan; Ekin ?lke ?EN; O?uz Durmu?; Ay?e Karan; Mehmet Zeki K?ralp

2012-01-01

109

The impact of ankylosing spondylitis on female sexual functions.  

Science.gov (United States)

The aim of this study was to explore the impact of ankylosing spondylitis (AS) and the disease-related variables, psychological status and the quality of life on the female patients' sexual function measured according to the Female Sexual Function Index (FSFI). Thirty-seven sexually active female AS patients and 33 healthy controls were enroled in this study. Their demographic data were evaluated and the generalised pain in patients with AS was assessed according to the visual analogue scale (0-100?mm). Laboratory tests were conducted in order to measure the C-reactive protein (CRP) and erythrocyte sedimentation rates (ESR) of the patients. In comparison to the healthy control group, patients with AS had significantly lower scores in each of the five domains of the FSFI except for the pain domain (P<0.05). The disease activity, functional status, quality of life, radiological score and CRP levels were negatively correlated with the FSFI (P<0.05). No significant correlation was observed with the disease duration, smoking status, depression, anxiety, pain and ESR when the total scores and the scores from the domains of the FSFI were compared. The sexual function is impaired in female patients with AS. This impairment in the sexual function is especially related to the functional status and disease activity among the clinical and laboratory parameters. PMID:23303332

Sariyildiz, M A; Batmaz, I; Inanir, A; Dilek, B; Bozkurt, M; Bez, Y; Karakoç, M; Cevik, R

2013-01-10

110

The impact of ankylosing spondylitis on female sexual functions.  

UK PubMed Central (United Kingdom)

The aim of this study was to explore the impact of ankylosing spondylitis (AS) and the disease-related variables, psychological status and the quality of life on the female patients' sexual function measured according to the Female Sexual Function Index (FSFI). Thirty-seven sexually active female AS patients and 33 healthy controls were enroled in this study. Their demographic data were evaluated and the generalised pain in patients with AS was assessed according to the visual analogue scale (0-100?mm). Laboratory tests were conducted in order to measure the C-reactive protein (CRP) and erythrocyte sedimentation rates (ESR) of the patients. In comparison to the healthy control group, patients with AS had significantly lower scores in each of the five domains of the FSFI except for the pain domain (P<0.05). The disease activity, functional status, quality of life, radiological score and CRP levels were negatively correlated with the FSFI (P<0.05). No significant correlation was observed with the disease duration, smoking status, depression, anxiety, pain and ESR when the total scores and the scores from the domains of the FSFI were compared. The sexual function is impaired in female patients with AS. This impairment in the sexual function is especially related to the functional status and disease activity among the clinical and laboratory parameters.

Sariyildiz MA; Batmaz I; Inanir A; Dilek B; Bozkurt M; Bez Y; Karakoç M; Cevik R

2013-05-01

111

Multidetector Computed Tomography of Cervical Spine Fractures in Ankylosing Spondylitis  

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

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

2004-11-01

112

Multidetector Computed Tomography of Cervical Spine Fractures in Ankylosing Spondylitis  

International Nuclear Information System (INIS)

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

2004-01-01

113

Evaluation of the Iranian versions of the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), the Bath Ankylosing Spondylitis Functional Index (BASFI) and the Patient Acceptable Symptom State (PASS) in patients with ankylosing spondylitis.  

UK PubMed Central (United Kingdom)

The Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) and the Bath Ankylosing Spondylitis Functional Index (BASFI) are widely used instruments in assessment of patients suffering from ankylosing spondylitis (AS). The Patient Acceptable Symptom State (PASS) is regarded as a target for patients' well-being. The aim of this study was to translate and adapt BASDAI, BASFI and PASS into the Iranian official language, Farsi, and evaluate their reliability and validity. Ninety patients with AS were included in this study. The questionnaires were translated into Farsi and back translated into English, modified until the final versions were approved with minor adaptations and the VAS was changed to numerical rating scales from 0 to 10. Forty-eight-hour test-retest agreement showed good reliability: interclass correlation coefficient (ICC) for BASDAI was 0.93 (CI at 95%, 0.90-0.95), for BASFI was 0.96 (CI at 95%, 0.94-0.97) and for PASS was 0.87 (CI at 95%, 0.79-0.92). Chronbach's alpha was 0.95, 0.96 and 0.87 for BASDAI, BASFI and PASS, respectively. BASDAI showed a significant correlation with patient global disease activity index, nocturnal back pain, total back pain, number of swollen joints, number of enthesites, morning stiffness, Bath Ankylosing Spondylitis Global Score (BAS-G), BASFI and BASMI. A significant correlation was also found between BASFI and occiput-to-wall distance, mentum-to-sternum distance, chest expansion, finger-to-floor distance, number of swollen joints, number of enthesites, nocturnal back pain, total back pain, BAS-G, BASDAI and BASMI. Patients who answered "no" to PASS (found their condition unsatisfactory) reported significantly increased pain scores, patient global disease activity scores, BAS-G, BASDAI and BASFI scores. The results showed that the Iranian versions of BASDAI, BASFI and PASS are adequately reliable and valid in patients with AS.

Bidad K; Fallahi S; Mahmoudi M; Jamshidi A; Farhadi E; Meysamie A; Nicknam MH

2012-11-01

114

Evaluation of the Iranian versions of the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), the Bath Ankylosing Spondylitis Functional Index (BASFI) and the Patient Acceptable Symptom State (PASS) in patients with ankylosing spondylitis.  

Science.gov (United States)

The Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) and the Bath Ankylosing Spondylitis Functional Index (BASFI) are widely used instruments in assessment of patients suffering from ankylosing spondylitis (AS). The Patient Acceptable Symptom State (PASS) is regarded as a target for patients' well-being. The aim of this study was to translate and adapt BASDAI, BASFI and PASS into the Iranian official language, Farsi, and evaluate their reliability and validity. Ninety patients with AS were included in this study. The questionnaires were translated into Farsi and back translated into English, modified until the final versions were approved with minor adaptations and the VAS was changed to numerical rating scales from 0 to 10. Forty-eight-hour test-retest agreement showed good reliability: interclass correlation coefficient (ICC) for BASDAI was 0.93 (CI at 95%, 0.90-0.95), for BASFI was 0.96 (CI at 95%, 0.94-0.97) and for PASS was 0.87 (CI at 95%, 0.79-0.92). Chronbach's alpha was 0.95, 0.96 and 0.87 for BASDAI, BASFI and PASS, respectively. BASDAI showed a significant correlation with patient global disease activity index, nocturnal back pain, total back pain, number of swollen joints, number of enthesites, morning stiffness, Bath Ankylosing Spondylitis Global Score (BAS-G), BASFI and BASMI. A significant correlation was also found between BASFI and occiput-to-wall distance, mentum-to-sternum distance, chest expansion, finger-to-floor distance, number of swollen joints, number of enthesites, nocturnal back pain, total back pain, BAS-G, BASDAI and BASMI. Patients who answered "no" to PASS (found their condition unsatisfactory) reported significantly increased pain scores, patient global disease activity scores, BAS-G, BASDAI and BASFI scores. The results showed that the Iranian versions of BASDAI, BASFI and PASS are adequately reliable and valid in patients with AS. PMID:22101612

Bidad, Katayoon; Fallahi, Sasan; Mahmoudi, Mahdi; Jamshidi, Ahmadreza; Farhadi, Elham; Meysamie, Alipasha; Nicknam, Mohammad Hossein

2011-11-20

115

Seasonal disease activity and serum vitamin D levels in rheumatoid arthritis, ankylosing spondylitis and osteoarthritis.  

UK PubMed Central (United Kingdom)

BACKGROUND: Vitamin D is a steroid hormone that plays essential roles in calcium and phosphorus metabolism, bone formation and mineralization homeostasis, also has a role in the maintenance of immune-homeostasis. OBJECTIVE: We aimed to investigate seasonal serum vitamin D levels and seasonal disease activity in patients with Rheumatoid Arthritis, Ankylosing Spondylitis, and Osteoarthritis. METHODS: Seventy-one Rheumatoid Arthritis patients, 72 Ankylosing Spondylitis patients, 74 knee Osteoarthritis patients and 70 healthy controls were recruited for the study. Bi-seasonal measurements of serum 25(OH)D vitamin were checked in either in July or August or September for summertime and either in December or January or February for wintertime. Disease activity were evaluated by Disease Activity Score-28, Bath Ankylosing Spondylitis Disease Activity Index, and Western Ontario and McMaster Universities Osteoarthritis Index in groups of Rheumatoid Arthritis, Ankylosing Spondylitis, and Osteoarthritis respectively. RESULTS: We did not find any correlation between serum 25(OH)D levels and Disease Activity Score-28, Bath Ankylosing Spondylitis Disease Activity Index, and Western Ontario and McMaster Universities Osteoarthritis Index scores in winter and summer. The difference of Disease Activity Score-28 and Western Ontario and McMaster Universities Osteoarthritis Index scores between winter and summer seasons were not significant in Rheumatoid Arthritis and Osteoarthritis patients (p>0.05). The mean Bath Ankylosing Spondylitis Disease Activity Index score was significantly higher in winter than in summer (p<0.05). Consequently we did not find any correlation between variations of seasonal serum 25(OH)D and the disease activity in the patients with Rheumatoid Arthritis, Ankylosing Spondylitis, and Osteoarthritis. CONCLUSION: These results suggest that vitamin D does not have an important role in the seasonal disease activity of these diseases and that seasonal changes in disease activity may play an important role in evaluating Ankylosing Spondylitis patients rather than Rheumatoid Arthritis and Osteoarthritis patients and should be taken into account when examining these patients. These conclusions need to be validated in multicenter studies with high number of patients.

Yazmalar L; Ediz L; Alpayci M; Hiz O; Toprak M; Tekeoglu I

2013-03-01

116

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.

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

2008-01-01

117

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

Science.gov (United States)

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

118

Clinical sacroiliac tests in ankylosing spondylitis and other causes of low back pain--2 studies.  

UK PubMed Central (United Kingdom)

Independent assessment by 2 observers of 4 tests for sacroiliac (SI) pain in patients with either mechanical/degenerative low back pain (M/D LBP) or ankylosing spondylitis (AS) showed all 4 to be reproducible, but only 2 of them, namely, pressure over the anterior superior iliac spines and pressure over the lower half of the sacrum, gave worthwhile discrimination. Positive results in these 2 tests were significantly associated with definite AS but also with the combination of low back pain, the HLA B27 antigen, and normal or near normal radiographs, a condition we have called presumptive ankylosing spondylitis.

Blower PW; Griffin AJ

1984-04-01

119

Fatigue in ankylosing spondylitis: treatment should focus on pain management.  

UK PubMed Central (United Kingdom)

OBJECTIVES: Fatigue is an important symptom associated with ankylosing spondylitis (AS). This study examines patients' perspectives and clinical associations of fatigue to help inform potential strategies to alleviate fatigue in AS. METHODS: A mixed methods approach was taken to examine fatigue in a cohort of people with AS. Fatigue levels were evaluated from 3 consecutive monthly questionnaires. Open-ended questions on fatigue were analyzed using thematic analysis and logistic regression was used to examine quantitative data. In addition, fatigue levels were examined before and after treatment with anti-tumor necrosis factor (TNF) compared to nontreated controls. RESULTS: Three hundred forty-eight of 385 participants completed a fatigue questionnaire. Fatigue was reported to have significant physical, social, and psychological effects. A third of the participants reported that there was nothing they could do to reduce their fatigue, whereas other participants reported that medication, exercise, and resting helped. The main factor associated with fatigue was pain [?-coefficient: 0.74 (95% CI: 0.66 to 0.81)], whereas depression was much less strongly associated. However, these factors only explained 40% of the variation in fatigue levels. Starting anti-TNF therapy reduced fatigue and pain levels compared to the period of time before taking anti-TNF [difference: 14.4 (95% CI: 5.3 to 23.5) on a scale of 0-100] and this reduction was not seen in controls over the same period. CONCLUSIONS: Fatigue is not strongly associated with anxiety, motivation, and depression; instead the factor most associated with fatigue is pain. This suggests that in addition to treatments to reduce disease activity, strategies for alleviating fatigue in AS should focus on pain management techniques and actively treating inflammation.

Brophy S; Davies H; Dennis MS; Cooksey R; Husain MJ; Irvine E; Siebert S

2013-02-01

120

Importance of posture assessment in ankylosing spondylitis. Preliminary study.  

UK PubMed Central (United Kingdom)

AIM: The aim of this study is to perform a screening of patients diagnosed with ankylosing spondylitis (AS) in order to evaluate the static spinal disorders and correlate the results with the main clinical and functional parameters that characterize this disease. MATERIAL AND METHODS: Ninety-five patients diagnosed with AS according to the 1994 New York criteria were screened, and 68 of them (all males) presenting static spinal disorders and on physical therapy programs in different outpatient physical therapy units throughout 2011 entered the study. RESULTS: The distribution of the patients according to static spinal disorders was almost even. There were no statistically significant differences in mean age and disease duration (p>0.05). The assessment oflumbosacral pain in the morning (VAS1) and daytime lumbosacral pain (VAS2) showed a higher scores in patients suffering from kyphoscoliosis than in those with scoliosis (p=0.020), (p=0.000), or kyphosis. Ott and modified Schöber index, and chest expansion, had higher mean values in patients with scoliosis compared with the other postural disorders (p<0.001). Statistically higher mean BASFI values were recorded in patients with kyphoscoliosis (p=0.038), while the mean BASMI values were lower in scoliosis patients (p<0.001). As to the quality of life of AS patients, HAQ-DI index recorded significantly lower mean values for kyphoscoliosis compared with other postural disorders (p<0.001). CONCLUSIONS: Our study suggests that posture assessment and implicitly the correction of possible misalignments should be part of the kinetic physical therapy program. Rigorous observing of postural recommendations can prevent the respiratory system complications.

Ro?u MO; Ancu?a C; Iordache C; Chirieac R

2012-07-01

 
 
 
 
121

MICA, a gene contributing strong susceptibility to ankylosing spondylitis.  

UK PubMed Central (United Kingdom)

OBJECTIVE: The human major histocompatibility complex class I chain-related gene A (MICA) controls the immune process by balancing activities of  natural killer cells, ?? T cells and ?? CD8 T cells, and immunosuppressive CD4 T cells. MICA is located near HLA-B on chromosome 6. Recent genomewide association studies indicate that genes most strongly linked to ankylosing spondylitis (AS) susceptibility come from the region containing HLA-B and MICA. While HLA-B27 is a well-known risk genetic marker for AS, the potential effect of linkage disequilibrium (LD) shields any associations of genes around HLA-B with AS. The aim of this study was to investigate a novel independent genetic association of MICA to AS. METHODS: We examined 1543 AS patients and 1539 controls from two ethnic populations by sequencing MICA and genotyping HLA-B alleles. Initially, 1070 AS patients and 1003 controls of European ancestry were used as a discovery cohort, followed by a confirmation cohort of 473 Han Chinese AS patients and 536 controls. We performed a stratified analysis based on HLA-B27 carrier status. We also conducted logistic regression with a formal interaction term. RESULTS: Sequencing of MICA identified that MICA*007:01 is a significant risk allele for AS in both Caucasian and Han Chinese populations, and that MICA*019 is a major risk allele in Chinese AS patients. Conditional analysis of MICA alleles on HLA-B27 that unshielded LD effect confirmed associations of the MICA alleles with AS. CONCLUSIONS: Parallel with HLA-B27, MICA confers strong susceptibility to AS in US white and Han Chinese populations.

Zhou X; Wang J; Zou H; Ward MM; Weisman MH; Espitia MG; Xiao X; Petersdorf E; Mignot E; Martin J; Gensler LS; Scheet P; Reveille JD

2013-06-01

122

MICA, a gene contributing strong susceptibility to ankylosing spondylitis.  

Science.gov (United States)

OBJECTIVE: The human major histocompatibility complex class I chain-related gene A (MICA) controls the immune process by balancing activities of  natural killer cells, ?? T cells and ?? CD8 T cells, and immunosuppressive CD4 T cells. MICA is located near HLA-B on chromosome 6. Recent genomewide association studies indicate that genes most strongly linked to ankylosing spondylitis (AS) susceptibility come from the region containing HLA-B and MICA. While HLA-B27 is a well-known risk genetic marker for AS, the potential effect of linkage disequilibrium (LD) shields any associations of genes around HLA-B with AS. The aim of this study was to investigate a novel independent genetic association of MICA to AS. METHODS: We examined 1543 AS patients and 1539 controls from two ethnic populations by sequencing MICA and genotyping HLA-B alleles. Initially, 1070 AS patients and 1003 controls of European ancestry were used as a discovery cohort, followed by a confirmation cohort of 473 Han Chinese AS patients and 536 controls. We performed a stratified analysis based on HLA-B27 carrier status. We also conducted logistic regression with a formal interaction term. RESULTS: Sequencing of MICA identified that MICA*007:01 is a significant risk allele for AS in both Caucasian and Han Chinese populations, and that MICA*019 is a major risk allele in Chinese AS patients. Conditional analysis of MICA alleles on HLA-B27 that unshielded LD effect confirmed associations of the MICA alleles with AS. CONCLUSIONS: Parallel with HLA-B27, MICA confers strong susceptibility to AS in US white and Han Chinese populations. PMID:23727634

Zhou, Xiaodong; Wang, Jiucun; Zou, Hejian; Ward, Michael M; Weisman, Michael H; Espitia, Maribel G; Xiao, Xiangjun; Petersdorf, Effie; Mignot, Emmanuel; Martin, Javier; Gensler, Lianne S; Scheet, Paul; Reveille, John D

2013-06-01

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Logistic transmission modeling of HLA and ankylosing spondylitis  

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

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

1994-09-01

124

Successful catheter-directed venous thrombolysis in an ankylosing spondylitis patient with phlegmasia cerulea dolens.  

Science.gov (United States)

Ankylosing spondylitis (AS) is an inflammatory rheumatic disease. Phlegmasia cerulea dolens is a severe form of deep vein thrombosis characterized by swelling, pain, and bluish discoloration. Treatment delay may cause venous gangrene, tissue ischemia, limb loss or death. Here, we present an AS case who presented with phlegmasia cerulea dolens and treated by catheter-directed thrombolysis. PMID:24046784

Rokni Yazdi, Hadi; Rostami, Nematollah; Hakimian, Homa; Mohammadifar, Mehdi; Ghajarzadeh, Mahsa

2013-05-20

125

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

2006-01-01

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

Scientific Electronic Library Online (English)

Full Text Available 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 (more) 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 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 avai (more) lable 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

2006-06-01

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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 pres...

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

128

[The efficacy and safety of long-term thalidomide in the treatment of ankylosing spondylitis].  

UK PubMed Central (United Kingdom)

OBJECTIVE: To investigate the long term efficacy and safety of thalidomide in the treatment of refractory ankylosing spondylitis. METHODS: A total of 232 patients with refractory ankylosing spondylitis were recruited into open study using thalidomide at a dose of 150 mg/d, bath ankylosing spondylitis disease activity index (BASDAI), spinal pain score and thalidomide related side effects were observed regularly. RESULTS: From the third month, BASDAI and spine pain score decreased significantly when compared with those of the base line (P<0.05). Such improvement became more obvious as time went on. A total of 148 patients (63.8%) got >50% improvement in BASDAI and spine pain score, and 76 cases (32.8%) reported absence of spine pain. The major side effects were drowsiness, constipation, dry mouth, dizziness and dandruff. Thirty two patients (13.8%) withdrew from the study because of adverse events. Most of the adverse effects disappeared as thalidomide was stopped. CONCLUSION: Long term thalidomide is effective and safe for treating resistant ankylosing spondylitis and it has cumulative effect as duration prolongs.

Zhu J; Huang F; Zhang JL

2010-08-01

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Successful catheter-directed venous thrombolysis in an ankylosing spondylitis patient with phlegmasia cerulea dolens.  

UK PubMed Central (United Kingdom)

Ankylosing spondylitis (AS) is an inflammatory rheumatic disease. Phlegmasia cerulea dolens is a severe form of deep vein thrombosis characterized by swelling, pain, and bluish discoloration. Treatment delay may cause venous gangrene, tissue ischemia, limb loss or death. Here, we present an AS case who presented with phlegmasia cerulea dolens and treated by catheter-directed thrombolysis.

Rokni Yazdi H; Rostami N; Hakimian H; Mohammadifar M; Ghajarzadeh M

2013-06-01

130

Immunoglobulin allotype Gm(1,2;21) in ankylosing spondylitis with peripheral arthritis.  

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Frequencies of immunoglobulin G (Gm) allotypes were determined in 240 patients with ankylosing spondylitis (AS). The uncommon phenotype Gm(1,2;21) was increased in frequency in 55 patients with AS and peripheral arthritis (14.5% v 3.5% of healthy blood donors; p less than 0.05). In 16 patients with ...

Mierau, R; von Mühlen, C A; Zarnowski, H; Genth, E; Hartl, P W

131

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...

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

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

UK PubMed Central (United Kingdom)

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. © 2013 American College of Rheumatology.

Haroon N; Inman RD; Learch TJ; Weisman MH; Lee M; Rahbar MH; Ward MM; Reveille JD; Gensler LS

2013-07-01

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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; Santos-Ramírez C; Santos-Soler G; Salas-Heredia E; Sánchez-Barrioluengo M; Barber X; Rosas J

2013-01-01

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

UK PubMed Central (United Kingdom)

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 E; Ragunathan M

2012-01-01

135

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

2012-01-01

136

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; A. Scarno; A. Carboni; V. Bernardo; M. Montepaone; E. Lubrano; A. Spadaro

2013-01-01

137

Radiographic measurement reliability of lumbar lordosis in ankylosing spondylitis.  

UK PubMed Central (United Kingdom)

INTRODUCTION: Intraobserver and interobserver reliabilities of the several different methods to measure lumbar lordosis have been reported. However, it has not been studied sofar in patients with ankylosing spondylitis (AS). MATERIALS AND METHODS: We evaluated the inter and intraobserver reliabilities of six specific measures of global lumbar lordosis in patients with AS. Ninety-one consecutive patients with AS who met the most recently modified New York criteria were enrolled and underwent anteroposterior and lateral radiographs of whole spine. The radiographs were divided into non-ankylosis (no bony bridge in the lumbar spine), incomplete ankylosis (lumbar spines were partially connected by bony bridge) and complete ankylosis groups to evaluate the reliability of the Cobb L1-S1, Cobb L1-L5, centroid, posterior tangent L1-S1, posterior tangent L1-L5, and TRALL methods. RESULTS: The radiographs were composed of 39 non-ankylosis, 27 incomplete ankylosis and 25 complete ankylosis. Intra- and inter-class correlation coefficients (ICCs) of all six methods were generally high. The ICCs were all ?0.77 (excellent) for the six radiographic methods in the combined group. However, a comparison of the ICCs, 95 % confidence intervals and mean absolute difference (MAD) between groups with varying degrees of ankylosis showed that the reliability of the lordosis measurements decreased in proportion to the severity of ankylosis. The Cobb L1-S1, Cobb L1-L5 and posterior tangent L1-S1 method demonstrated higher ICCs for both inter and intraobserver comparisons and the other methods showed lower ICCs in all groups. The intraobserver MAD was similar in the Cobb L1-S1 and Cobb L1-L5 (2.7°-4.3°), but the other methods showed higher intraobserver MAD. Interobserver MAD of Cobb L1-L5 only showed low in all group. CONCLUSION: These results are the first to provide a reliability analysis of different global lumbar lordosis measurement methods in AS. The findings in this study demonstrated that the Cobb L1-L5 method is reliable for measuring the global lumbar lordosis in AS.

Lee JS; Goh TS; Park SH; Lee HS; Suh KT

2013-04-01

138

Risk factors for work disability in patients with ankylosing spondylitis.  

UK PubMed Central (United Kingdom)

OBJECTIVE: To identify risk factors for work disability in patients with ankylosing spondylitis (AS). METHODS: Risk factors for permanent work disability and for receipt of disability payments were assessed using Cox regression models in a retrospective cohort study of 234 patients with AS. Candidate risk factors included age at onset of AS, sex, race, education level, marital status, the presence of comorbid conditions, smoking and drinking history, recreational activity, occupation, and physical activity at work. Risk factors for changes in the type of work performed, decrease in number of hours worked, long sick leave, and the need for help at work were assessed using logistic regression models in a prospective study of the subset of 144 patients who reported working for pay during the study. Candidate risk factors for these aspects of work disability were age, sex, race, education level, levels of functional disability, pain and stiffness, changes in functional disability, pain or stiffness over the preceding 6 months, minutes/week of recreational exercise, back exercises, freedom of movement at work, control over the pace of work, and physical activity at work. RESULTS: In a cohort of 234 patients with a median duration of AS of 21.4 years, 31 patients (13.2%) developed permanent work disability and 57 patients (24.3%) had received disability payments. Older age at onset of AS, less formal education, and having had jobs that were more physically active were significant risk factors for permanent work disability. These factors, along with the presence of a comorbid condition and being female, were also significantly associated with the receipt of disability payments. In a prospective study of 144 patients followed for a median of 4 years, higher levels of functional disability and pain were associated with increased risks of decreased work hours, long sick leaves, and needing help at work, while higher levels of pain were also associated with an increased risk of changing the type of work performed. Women were significantly more likely than men to change their type of work or decrease their work hours. Patients whose jobs were more physically demanding were more likely to change their type of work or need help at work. CONCLUSION: Patients with AS who have physically demanding jobs are more likely to experience permanent or temporary work disability, or need to change the type of work done or receive help at work, than those with jobs that are less physically demanding.

Ward MM; Kuzis S

2001-02-01

139

[Symptoms, effects on quality of life, judgement and expectations of treatment in active ankylosing spondylitis: the patient's view  

UK PubMed Central (United Kingdom)

Symptoms, Effects on Quality of Life, Judgement and Expectations of Treatment in Active Ankylosing Spondylitis: The Patient's View.In ankylosing spondylitis uncertainty prevails among rheumatologists on how to define and measure activity. In the present study the patient's view of activity was evaluated. What does active ankylosing spondylitis mean for the patient? In a standardized interview the patient was asked to describe, from his own experience, what active ankylosing spondylitis means, what bothers him most, what helps most, and what he expects from therapy. For the patient, active ankylosing spondylitis means pain (99 responses), mobility restriction (19), muscle tension (10), inability to stay supine (6), restriction in chest mobility (5) and dyspnea (5). Fatigue was mentioned by two patients. In active states patients are mainly bothered by pain (77), mobility restriction (55), consequences for social life (20) and work (18), disturbed sleep (17) and difficult breathing (16). Drugs (84) and physical activity (42) were judged the best treatments during active ankylosing spondylitis. It was no surprise that pain and mobility restriction were cited most often by the patients. Breathing difficulties were cited rather often, whereas fatigue seems not to play an important role for most patients. The results suggest that modern rheumatology may have underestimated the relevance of difficult breathing and paid too much attention to fatigue.

Falkenbach A; Curda B

2001-10-01

140

[Symptoms, effects on quality of life, judgement and expectations of treatment in active ankylosing spondylitis: the patient's view].  

Science.gov (United States)

Symptoms, Effects on Quality of Life, Judgement and Expectations of Treatment in Active Ankylosing Spondylitis: The Patient's View.In ankylosing spondylitis uncertainty prevails among rheumatologists on how to define and measure activity. In the present study the patient's view of activity was evaluated. What does active ankylosing spondylitis mean for the patient? In a standardized interview the patient was asked to describe, from his own experience, what active ankylosing spondylitis means, what bothers him most, what helps most, and what he expects from therapy. For the patient, active ankylosing spondylitis means pain (99 responses), mobility restriction (19), muscle tension (10), inability to stay supine (6), restriction in chest mobility (5) and dyspnea (5). Fatigue was mentioned by two patients. In active states patients are mainly bothered by pain (77), mobility restriction (55), consequences for social life (20) and work (18), disturbed sleep (17) and difficult breathing (16). Drugs (84) and physical activity (42) were judged the best treatments during active ankylosing spondylitis. It was no surprise that pain and mobility restriction were cited most often by the patients. Breathing difficulties were cited rather often, whereas fatigue seems not to play an important role for most patients. The results suggest that modern rheumatology may have underestimated the relevance of difficult breathing and paid too much attention to fatigue. PMID:11579374

Falkenbach, A; Curda, B

2001-10-01

 
 
 
 
141

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; A.P. Rebrov

2008-01-01

142

A new mechanism of injury in ankylosing spondylitis: non-traumatic hyperextension causing atlantoaxial subluxation.  

UK PubMed Central (United Kingdom)

Ankylosing spondylitis (AS) is a progressive multisystem chronic inflammatory disorder. The hallmark of this pathological process is a progressive fusion of the zygapophyseal joints and disc spaces of the axial skeleton, leading to a rigid kyphotic deformity and positive sagittal balance. The ankylosed spine is unable to accommodate normal mechanical forces, rendering it brittle and susceptible to injury. Traumatic hyperextension injury of the cervical spine leading to atlantoaxial subluxation (AAS) in AS patients can often be fatal. We report a non-traumatic mechanism of injury in AS progressing to AAS attributable to persistent hyperextension, which resulted in fatal migration of C2 through the foramen magnum.

Samartzis D; Modi HN; Cheung KM; Luk KD

2013-02-01

143

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

International Nuclear Information System (INIS)

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.).

1983-01-01

144

Concurrent rheumatoid arthritis and ankylosing spondylitis in one patient: the importance of new classification criteria.  

UK PubMed Central (United Kingdom)

We report the case of concomitant ankylosing spondylitis and rheumatoid arthritis in a 65-year-old Caucasian male, who had symmetric polyarthritis with erosion of the metacarpophalangeal joint on conventional X-ray, inflammatory low back pain with HLA-B27 positivity, and sacroiliitis. Laboratory analysis showed high levels of rheumatoid factor and anti-cyclic citrullinated peptide antibody (anti-CCP). Clinical features of previously reported cases were compared with those of our case. This is the first case report on the coexistence of both diseases in the same patient, for whom anti- CCP testing and the latest versions of axial ASAS criteria and ACR/EULAR criteria for the classification of ankylosing spondylitis and rheumatoid arthritis, respectively, were used.

Azevedo VF; Buiar PG

2013-02-01

145

Tubulointerstitial nephritis and uveitis with Fanconi syndrome in a patient with ankylosing spondylitis.  

UK PubMed Central (United Kingdom)

We report a 40-year-old man with ankylosing spondylitis who was referred to our hospital because of a 2-month history of general fatigue, anorexia, and weight loss. Laboratory findings showed anemia and renal dysfunction. Fanconi syndrome was suggested by multiple proximal tubular defects including renal glucosuria, hyperuricosuria, hyperphosphaturia, proximal renal tubular acidosis, and kaliuresis leading to hypokalemia. Renal biopsy showed acute tubulointerstitial nephritis. Furthermore, bilateral uveitis was diagnosed by an ophthalmologist. The patient was treated with systemic corticosteroids. The renal and proximal tubular function returned to normal and uveitis disappeared by 4 weeks after commencement of corticosteroid treatment. To our knowledge, tubulointerstitial nephritis and uveitis has rarely been associated with Fanconi syndrome and had not been reported in ankylosing spondylitis.

Wen YK

2009-10-01

146

Tubulointerstitial nephritis and uveitis with Fanconi syndrome in a patient with ankylosing spondylitis.  

Science.gov (United States)

We report a 40-year-old man with ankylosing spondylitis who was referred to our hospital because of a 2-month history of general fatigue, anorexia, and weight loss. Laboratory findings showed anemia and renal dysfunction. Fanconi syndrome was suggested by multiple proximal tubular defects including renal glucosuria, hyperuricosuria, hyperphosphaturia, proximal renal tubular acidosis, and kaliuresis leading to hypokalemia. Renal biopsy showed acute tubulointerstitial nephritis. Furthermore, bilateral uveitis was diagnosed by an ophthalmologist. The patient was treated with systemic corticosteroids. The renal and proximal tubular function returned to normal and uveitis disappeared by 4 weeks after commencement of corticosteroid treatment. To our knowledge, tubulointerstitial nephritis and uveitis has rarely been associated with Fanconi syndrome and had not been reported in ankylosing spondylitis. PMID:19825339

Wen, Y K

2009-10-01

147

Interferon regulatory factor (IRF)-5: a potential therapeutic target for ankylosing spondylitis.  

Science.gov (United States)

Ankylosing spondylitis is a common inflammatory rheumatic disease that affects the axial skeleton, causing characteristic inflammatory back pain, which can lead to structural and functional impairments and a decrease in quality of life. New imaging techniques and therapies have substantially changed the management of this disease in the past decade. Whether inhibition of radiographic progression and structural damage can be reached with available drugs is as yet unclear. Furthermore, treatment with non-steroidal anti-inflammatory agents and physiotherapy remains an important approach to long-term management of patients with ankylosing spondylitis. The new treatment options with IRF-5 seem to be a breakthrough for patients' refractory to conventional and feasible treatment. PMID:21928121

Xu, Wang-Dong; Ye, Dong-Qing

2011-09-18

148

Interferon regulatory factor (IRF)-5: a potential therapeutic target for ankylosing spondylitis.  

UK PubMed Central (United Kingdom)

Ankylosing spondylitis is a common inflammatory rheumatic disease that affects the axial skeleton, causing characteristic inflammatory back pain, which can lead to structural and functional impairments and a decrease in quality of life. New imaging techniques and therapies have substantially changed the management of this disease in the past decade. Whether inhibition of radiographic progression and structural damage can be reached with available drugs is as yet unclear. Furthermore, treatment with non-steroidal anti-inflammatory agents and physiotherapy remains an important approach to long-term management of patients with ankylosing spondylitis. The new treatment options with IRF-5 seem to be a breakthrough for patients' refractory to conventional and feasible treatment.

Xu WD; Ye DQ

2012-12-01

149

Arachnoiditis ossificans in a patient with ankylosing spondylitis, syringomyelia, and a history of spinal surgery.  

UK PubMed Central (United Kingdom)

BACKGROUND AND OBJECTIVE: In this article, we describe a patient unusual presenting with both arachnoiditis ossificans and syringomyelia. We have reviewed the patient's evaluation, surgery, and treatment. CASE DESCRIPTION: This patient developed paraparesis following thoracolumbar spinal surgery to treat kyphosis secondary to ankylosing spondylitis. RESULTS: We performed a T9-T11 total laminectomy, drained the cyst, dissected and removed the calcified plaques posterior to the cord, and decompressed the neural structures. CONCLUSION: Symptomatic arachnoiditis ossificans (AO) a rare clinical manifestation is characterized by the calcification or ossification of the spinal arachnoid. The occurrence of AO with syringomyelia is rare. To date, a few cases with both AO and ankylosing spondylitis have been reported.

Hasturk AE; Coven I; Ozdemir O; Erinanc H; Bal A

2013-04-01

150

Concurrent rheumatoid arthritis and ankylosing spondylitis in one patient: the importance of new classification criteria.  

Science.gov (United States)

We report the case of concomitant ankylosing spondylitis and rheumatoid arthritis in a 65-year-old Caucasian male, who had symmetric polyarthritis with erosion of the metacarpophalangeal joint on conventional X-ray, inflammatory low back pain with HLA-B27 positivity, and sacroiliitis. Laboratory analysis showed high levels of rheumatoid factor and anti-cyclic citrullinated peptide antibody (anti-CCP). Clinical features of previously reported cases were compared with those of our case. This is the first case report on the coexistence of both diseases in the same patient, for whom anti- CCP testing and the latest versions of axial ASAS criteria and ACR/EULAR criteria for the classification of ankylosing spondylitis and rheumatoid arthritis, respectively, were used. PMID:23588521

Azevedo, Valderilio Feijó; Buiar, Pedro Grachinski

2013-02-01

151

Perfil gestacional na espondilite anquilosante Pregnancy profile in ankylosing spondylitis  

Directory of Open Access Journals (Sweden)

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

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

2005-01-01

152

Perfil gestacional na espondilite anquilosante/ Pregnancy profile in ankylosing spondylitis  

Scientific Electronic Library Online (English)

Full Text Available 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 Espondiloartropatias da FCM-UNICAMP no período entre 1990 e 2004. Foram avaliados os dados referentes ao número de gestações, partos e abortos, bem como o comportamento da (more) 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 Spondyloarthropathies Outpatient Clinic of the State University of Campinas in the period between 1990-2004. The number of pregnancies, deliveries and miscarriages was investigated, as well as t (more) he 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.

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

2005-06-01

153

[Clinical-functional evolution of patients with ankylosing spondylitis following physio-kinetotheraphy].  

UK PubMed Central (United Kingdom)

UNLABELLED: Ankylosing spondylitis enigmatic from the etiologic point of view, appears with subjects who are still in school or involved in a productive activity. If detected in its early stages, under complex, constant and long-term treatment, patients have a good evolution. AIMS: The objectives of the study are to describe the clinical and functional profile of patients with AS, sacroiliitis stage, and the evol ution of physical and functional parameters under traditional physio-kinetotherapy. MATERIAL AND METHODS: This retrospective study was performed on 40 patients with ankylosing spondylitis (AS), who were hospitalized in the Clinic of Rheumatology Ia?i, during 2008-1010, who satisfied the amended New York criteria for this. Subjects underwent an initial evaluation (first admission) and another one at the end of the study (second admission), after approximately 6 months. RESULTS: The demographic characteristics, the clinical and functional elements of the study sample have indicated: the average age of 24.83 +/- 3.948, predominantly male (82.5%) and 62.5% were from rural areas. Most cases occurred at the age of 19-25 (57.5%), beginning at 18-25 (77.5%), with an average of 19.60 +/- 2.318. Following the radiological changes in the various stages of sacroiliitis, stage II prevailed (40%), then stage III (32.5%) and IV (15%). The evaluation of ASAS (Assessment of Spondylo Arthritis International Society) parameters and the respiratory system showed significant improvements of: BASDAI score with 31.53%, BASFI with 37.62%, BASMI with 20.66%, DIE % with 27.53 and of CV with 5.08% as well as a decrease in pain perception measured by VAS scale (p = 0.017). CONCLUSIONS: In the early stages of the disease, as far as the sample involved in the study is concerned, when the spine and vertebrae joints were not blocked by the evolution of the disease, corrective gymnastics and respiratory exercises, stretching and a good posture are very important, along with other therapies used to prevent axial ankylosis.

Ro?u MO; Ancu?a C; Chirieac R

2012-04-01

154

Extracranial meningioma presenting as a neck mass in a patient with underlying ankylosing spondylitis.  

UK PubMed Central (United Kingdom)

Extracranial meningiomas are rare. They account for only 2% of meningiomas compared to the much more common intracranial site. We describe a rare case of extracranial meningioma presenting as a neck lump in a patient with preexisting neck disease due to ankylosing spondylitis. Extracranial meningioma should be considered in the differential diagnosis of atypical neck lumps. Investigations including magnetic resonance imaging and histopathology are discussed, as well as the results of a literature review on extracranial meningiomas.

Galm T; MacGregor F; Sinclair AM; Hunter J; McPhaden A

2006-09-01

155

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

Directory of Open Access Journals (Sweden)

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.

Filiz Eser; Hatice Bodur; Umit Seckin

2008-01-01

156

Comparison of complications of total hip arthroplasty in rheumatoid arthritis, ankylosing spondylitis, and osteoarthritis.  

UK PubMed Central (United Kingdom)

Between 1971 and 1985, 3080 arthroplasties were performed. The authors analyze patients reoperated because of primary surgery complications. Of the primary arthroplasties (2889), there were 1788 operations performed for primary osteoarthritis, and 379 hip replacements for rheumatoid arthritis, ankylosing spondylitis, and systemic lupus erythematosus (SLE). Reoperation rates in both groups were the same (3.4%). In the group with rheumatoid arthritis, the rate was 1.45%, much lower than the osteoarthritic group.

Lakatos J; Csákányi L

1991-01-01

157

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.)

Cellerini, M.; Gabbrielli, S. [Neuroradiology Unit, Trauma Center (CTO), Careggi Hospital, Florence (Italy); Bongi, S.M. [Section of Rheumatology, Univ. of Florence (Italy)

2001-12-01

158

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

International Nuclear Information System (INIS)

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.)

2001-01-01

159

Treatment of ankylosing spondylitis with TNF blockers: a meta-analysis.  

Science.gov (United States)

Biological agents directed against tumor necrosis factor (TNF) represent therapeutic options for patients with ankylosing spondylitis with high disease activity despite use of non-steroidal anti-inflammatory drugs. To evaluate the efficacy and safety of the anti-TNF agents infliximab, etanercept, adalimumab, golimumab, and certolizumab for the treatment of ankylosing spondylitis, we performed a systematic review of randomized clinical trials on adult patients with ankylosing spondylitis using articles culled from the EMBASE, MEDLINE, Cochrane Controlled Trials Register and LILACS databases (September/2012), manual literature search, and the gray literature. Study selections and data collection were performed by two independent reviewers, with disagreements solved by a third reviewer. The following outcomes were evaluated: ASAS 20 response, disease activity, physical function, vertebral mobility, adverse events, and withdraws. The meta-analysis was performed using the Review Manager(®) 5.1 software by applying the random effects model. Eighteen studies were included in this review. No study of certolizumab was included. Patients treated with anti-TNF agents were more likely to display an ASAS 20 response after 12/14 weeks (RR 2.21; 95 % CI 1.91; 2.56) and 24 weeks (RR 2.68; 95 % CI 2.06; 3.48) compared with controls, which was also true for several other efficacy outcomes. Meta-analysis of safety outcomes and withdraws did not indicate statistically significant differences between treatment and control groups after 12 or 30 weeks. Adalimumab, infliximab, etanercept, and golimumab can effectively reduce the signs and symptoms of the axial component of ankylosing spondylitis. Safety outcomes deserve further study, especially with respect to long-term follow-ups. PMID:23686218

Machado, Marina Amaral de Ávila; Barbosa, Mariana Michel; Almeida, Alessandra Maciel; de Araújo, Vânia Eloisa; Kakehasi, Adriana Maria; Andrade, Eli Iola Gurgel; Cherchiglia, Mariangela Leal; Acurcio, Francisco de Assis

2013-05-18

160

Treatment of ankylosing spondylitis with TNF blockers: a meta-analysis.  

UK PubMed Central (United Kingdom)

Biological agents directed against tumor necrosis factor (TNF) represent therapeutic options for patients with ankylosing spondylitis with high disease activity despite use of non-steroidal anti-inflammatory drugs. To evaluate the efficacy and safety of the anti-TNF agents infliximab, etanercept, adalimumab, golimumab, and certolizumab for the treatment of ankylosing spondylitis, we performed a systematic review of randomized clinical trials on adult patients with ankylosing spondylitis using articles culled from the EMBASE, MEDLINE, Cochrane Controlled Trials Register and LILACS databases (September/2012), manual literature search, and the gray literature. Study selections and data collection were performed by two independent reviewers, with disagreements solved by a third reviewer. The following outcomes were evaluated: ASAS 20 response, disease activity, physical function, vertebral mobility, adverse events, and withdraws. The meta-analysis was performed using the Review Manager(®) 5.1 software by applying the random effects model. Eighteen studies were included in this review. No study of certolizumab was included. Patients treated with anti-TNF agents were more likely to display an ASAS 20 response after 12/14 weeks (RR 2.21; 95 % CI 1.91; 2.56) and 24 weeks (RR 2.68; 95 % CI 2.06; 3.48) compared with controls, which was also true for several other efficacy outcomes. Meta-analysis of safety outcomes and withdraws did not indicate statistically significant differences between treatment and control groups after 12 or 30 weeks. Adalimumab, infliximab, etanercept, and golimumab can effectively reduce the signs and symptoms of the axial component of ankylosing spondylitis. Safety outcomes deserve further study, especially with respect to long-term follow-ups.

Machado MA; Barbosa MM; Almeida AM; de Araújo VE; Kakehasi AM; Andrade EI; Cherchiglia ML; Acurcio Fde A

2013-09-01

 
 
 
 
161

Evaluation of circulating endothelial and platelet microparticles in men with ankylosing spondylitis.  

UK PubMed Central (United Kingdom)

OBJECTIVE: To evaluate the profiles of endothelial microparticles (EMP) and platelet microparticles (PMP) in men with ankylosing spondylitis (AS) and healthy subjects. We also aimed to determine whether microparticles (MP) correlate with disease activity, function, and spinal mobility indices. METHODS: There were 82 men with AS and 53 healthy controls. Subjects with a history of chronic diseases including coronary artery disease, hypertension, diabetes mellitus, and dyslipidemia were excluded. MP were stained with monoclonal antibodies against platelets and endothelial cells and quantified using flow cytometry. MP that were positive for both CD42a+/CD31+ and total CD42a+ were identified as PMP; and MP consisting of CD42a-/CD31+ and total CD144+ were considered EMP. RESULTS: EMP and PMP were similar between the patient and control groups (p > 0.05). Comparison of patients with AS in the active disease state (BASDAI ? 4) and in the inactive state showed that EMP and PMP were not different between the groups (p > 0.05). Correlation analysis revealed no correlation with Bath Ankylosing Spondylitis Disease Activity Index, Bath Ankylosing Spondylitis Functional Index, or Bath Ankylosing Spondylitis Metrology Index. C-reactive protein was significantly correlated with PMP and CD42a-/CD31+ EMP (p < 0.05). Comparison of patients with AS treated with anti-tumor necrosis factor (anti-TNF) drugs, subjects treated conventionally, and healthy controls revealed that PMP and CD42a-/CD31+ EMP were significantly downregulated in patients receiving biological agents. CONCLUSION: Circulating EMP and PMP, known to be indicators and mediators of vascular injury, were not significantly altered in men with AS who did not have classical cardiovascular risk factors. Significantly downregulated MP in patients receiving biological agents suggested that anti-TNF treatment may have a beneficial effect on vascular function in AS.

Sari I; Bozkaya G; Kirbiyik H; Alacacioglu A; Ates H; Sop G; Can G; Taylan A; Piskin O; Yildiz Y; Akkoc N

2012-03-01

162

A case of childhood-onset ankylosing spondylitis: diagnosis and treatment.  

UK PubMed Central (United Kingdom)

BACKGROUND: A 14-year-old boy with a 6-year history of recurrent arthritis and enthesitis, which had not responded to previous treatment with NSAIDs, sulfasalazine and methotrexate, presented with a severe flare of these symptoms as well as spinal and sacroiliac joint pain. The patient's father had mild psoriasis. INVESTIGATIONS: Counts of tender and swollen joints and tender entheses; assessment of spinal mobility; assessments using the Childhood Health Assessment Questionnaire and the Bath Ankylosing Spondylitis Disease Activity and Functional Indices; measurement of erythrocyte sedimentation rate, serum C-reactive protein level and human leukocyte antigen B27 positivity; radiographs of the sacroiliac joints, hips and feet. DIAGNOSIS: Juvenile-onset ankylosing spondylitis according to the modified New York criteria for ankylosing spondylitis, on the basis of the presence of inflammatory back pain, reduced mobility of the spine and grade 3 bilateral radiographic sacroiliitis. MANAGEMENT: Treatment with NSAIDs, sulfasalazine and methotrexate did not improve the patient's symptoms. Administration of infliximab 5 mg/kg induced a substantial and rapid improvement in all parameters of disease activity.

Burgos-Vargas R

2009-01-01

163

Serum markers associated with clinical improvement in patients with ankylosing spondylitis treated with golimumab.  

UK PubMed Central (United Kingdom)

OBJECTIVE: Identify serum biomarkers modulated by golimumab treatment and associated with clinical response in patients with ankylosing spondylitis (AS). METHODS: Sera were collected at weeks 0, 4 and 14 from 100 patients with active AS in the GO-RAISE study. Patients were randomly assigned subcutaneous injections of placebo, golimumab 50 mg, or golimumab 100 mg every 4 weeks. Samples were tested for select inflammatory, bone and cartilage markers, and protein profiling was also performed. RESULTS: Golimumab treatment resulted in significant decreases in several serum proteins at weeks 4 and 14 compared with placebo. Patients who achieved clinical response at week 14, as assessed by a ?20% improvement in the Assessment in SpondyloArthitis international Society response criteria (ASAS 20), demonstrated a distinct biomarker profile with lower levels of acute phase reactants and inflammatory biomarkers compared with patients who did not. Notably, combinations of two or three biomarkers assessed at baseline were predictive of various clinical outcomes (ASAS 20, Bath ankylosing spondylitis disease activity index 50 or Bath ankylosing spondylitis functional index) using a logistic regression analysis, and the overall predictive values for these combined biomarkers were greater than observed for C-reactive protein (CRP) alone. CONCLUSION: Golimumab modulated acute phase reactants and inflammatory markers in patients with active AS. Specific combinations of biomarkers at baseline demonstrated a stronger prediction for clinical efficacy than CRP alone. These data provide insights into the mechanism of golimumab on inflammatory processes driving AS pathology, and may have utility in managing the treatment of patients with AS.

Wagner C; Visvanathan S; Braun J; van der Heijde D; Deodhar A; Hsu B; Mack M; Elashoff M; Inman RD

2012-05-01

164

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

UK PubMed Central (United Kingdom)

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 < 0.05). In a subgroup analysis, patients with active disease had significantly higher concentrations of OPG compared with the inactive group. Rest of the biomarkers and cytokines of bone turnover were similar between the active and inactive disease groups. Subgroup analysis of patients receiving anti-TNF? agents and conventional therapy revealed that OPG concentrations were significantly lower in the patients receiving biological drugs, while BAP and DKK-1 were significantly higher in the patients treated with conventional agents. 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 A; Sari I; Akinci B; Bilge S; Kozaci D; Akar S; Colak A; Yalcin H; Gunay N; Akkoc N

2012-01-01

165

Do patients with non-radiographic axial spondylarthritis differ from patients with ankylosing spondylitis?  

UK PubMed Central (United Kingdom)

OBJECTIVE: Patients with axial spondylarthritis (SpA) who have structural changes in the sacroiliac joints and/or the spine have been classified as having ankylosing spondylitis (AS), while those without such changes are now classified as having nonradiographic axial SpA (nr-axSpA). The differentiating features are incompletely understood. METHODS: Data from 100 consecutive patients with axial SpA not treated with tumor necrosis factor antagonists were compared clinically and with laboratory parameters, spinal radiographs, and magnetic resonance imaging (MRI) of the spine. Standardized clinical assessment tools were used to assess health status. RESULTS: AS was diagnosed in 56 patients and nr-axSpA in 44 patients. Signs of inflammation were significantly higher in patients with AS than in patients with nr-axSpA, with a median C-reactive protein level of 8.0 versus 3.8 mg/liter, a median Ankylosing Spondylitis Disease Activity Score of 2.2 versus 2.8, respectively, and a median amount of spinal inflammatory lesions on MRI of 2.0 versus 0.0, respectively. Significant differences between these 2 groups were seen in sex (76.8% male AS patients versus 31.8% male nr-axSpA patients). Clinical variables did not differ between patients with AS and nr-axSpA (Bath Ankylosing Spondylitis Disease Activity Index, Bath Ankylosing Spondylitis Functional Index, Ankylosing Spondylitis Quality of Life questionnaire, Short Form 36 health survey). CONCLUSION: Patients with nr-axSpA were characterized by the low proportion of male patients and the low burden of inflammation compared to patients with AS. While both groups did not differ regarding health status, disease activity, and physical function, they did differ in signs of inflammation; all were higher in patients with AS. Since many patients with nr-axSpA had not developed structural changes after years of symptoms, we propose that those patients should not be regarded as having preradiographic AS but rather as having nr-axSpA.

Kiltz U; Baraliakos X; Karakostas P; Igelmann M; Kalthoff L; Klink C; Krause D; Schmitz-Bortz E; Flörecke M; Bollow M; Braun J

2012-09-01

166

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

Scientific Electronic Library Online (English)

Full Text Available 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 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. 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 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.

Restrepo, Juan Pablo; Molina, María Del Pilar

2012-10-01

167

Assessment of Cardiac Functional Alterations of Ankylosing Spondylitis Patients without Cardiovascular Risk Factors  

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Full Text Available Introduction: The aim of this study is to evaluate cardiac functional alterations of ankylosing spondylitis patients without any cardiovascular risk factors.Patients and Methods: Thirty seven consecutive akylosing spondylitis patients without any cardiovascular risk factors constituted our study patient population (age: 41.4 ± 11.1 years, 28 male). Electrocardiographs (ECG) of all patients were obtained and all patients underwent comprehensive transthoracic echocardiographic examination. QRS durations, p wave dispersion and corrected QT dispersion (QTcd) values were calculated from 12-lead ECG’s. Data reflecting left ventricular systolic and diastolic functions were obtained from echocardiographic examinations. Data of patients were compared with the data of 28 age-and gender matched healthy control subjects (age: 40.1 ± 10.5 years, 19 male).Results: There were no significant differences between patients and controls regarding QRS durations, p wave dispersion and QTcd values. There were also no significant differences between patients and controls regarding parameters reflecting left ventricular systolic and diastolic functions. Annular velocities at mitral and tricuspid annulus levels evaluated with pulsed-wave tissue Doppler imaging were also similar as well. Two (7.2%) subjects in the control group and 2 (5.4%) patients in the akylosing spondylitis group had minimal aortic regurgitation (p= 0.51). Conclusion: We could not demonstrate any electrocardiographic or echocardiographic evidence of structural myocardial alterations in a small sample of akylosing spondylitis patients free of cardiovascular risk factors. Effects of frequently encountered co-existent cardiovascular risk factors of ankylosing spondylitis patients might have contributed to the conflicting literature data related with this topic.

Alper Kepez; ?lknur Akta?; Zeynep Demet ?lgezdi; Fatma Do?an Metin; Feyza Ünlü Özkan; Duygu ?ilte; Meryem Y?lmaz Kays?n; Kür?at Tigen; Okan Erdo?an

2013-01-01

168

[Total hip replacement in treatment of patients with deformity of the hip caused by ankylosing spondylitis].  

UK PubMed Central (United Kingdom)

BACKGROUND: Total hip replacement (THR) is at present an accepted treatment in patients with severe deformity of the hip caused by advanced ankylosing spondylitis. The aim of this paper is to evaluate the results of THR in patients suffering from ankylosing spondylitis, operated from 1987 to 2007 at the Orthopaedic and Traumatologic Department of Poznan University of Medical Sciences. Material. Material included 26 patients, 2 females and 24 males, on whom 34 THR were performed, lateral approach was used in all cases. At the time of operation, the age of patients ranged from 27 to 77 years (mean 57). Follow-up ranged from 3 to 21 years (mean 10.5 years). The operative treatment was a multistage process (during one operation only one joint was replaced). Cemented totalhip arthroplasty was used during 16 of the THR, 17 of them were cementless and 1 as a hybrid. METHOD: The patients were clinically and radiologically evaluated preoperatively, postoperatively, and at final examination. The clinical state was evaluated with Harris hip score and WOMAC scale. We based our radiological examination on Hip Society system. RESULTS: The average preoperative Harris score for the group of patients was 27.3, WOMAC score 78.5. After an average of 10 years follow-up all hips and knees were considered excellent, with average Harris score of 91.4, WOMAC Score of 5.0. All patients had increased function and decreased pain. The radiograms of all patients revealed that the acetabular and femoral components were correctly positioned with no radiographic evidence of loosening in the last examination. No ectopic ossification concentrations were found. CONCLUSION: Clinical and radiological evaluation of our material showed that total hip replacement in the treatment of severe deformity of the hip caused by advanced ankylosing spondylitis allows regaining good lower limb function, which helps the patients staying less dependant on the surrounding environment. Ectopic ossification is not the clinical problem during THR in patients who suffer from spondylytis deformans.

Pietrzak K; Strzyzewski W; Kaczmarek W; Pucher A; Ciesielczyk B

2010-09-01

169

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; Christoph Ackermann; Arthur Kavanaugh

2008-01-01

170

Effects of warming up on reliability of anthropometric techniques in ankylosing spondylitis.  

UK PubMed Central (United Kingdom)

To determine the effect of warm-up on anthropometric measures, 10 patients with ankylosing spondylitis and 10 normal control subjects were measured over a 1-hour period by one therapist. A series of 4 measures--a modified Schober's test, finger-to-floor with the subject standing on a 23-cm stool, chest expansion, and cervical rotation using an arthrodial protractor--were repeated completely 4 times. Subjects exercised between each series (except between the third and fourth series). Intra-rater reliability was determined by comparing measurement 3 with measurement 4, and the warm-up effect was determined by comparing measurement 1 with measurement 3. The Schober's test and chest expansion are stable measures and are not affected by warm-up. However, the finger-to-floor and cervical rotation exercises require warm-up to ensure stable values for clinical or research followup of spondylitis.

Roberts WN; Liang MH; Pallozzi LM; Daltroy LH

1988-04-01

171

Hip involvement in ankylosing spondylitis: epidemiology and risk factors associated with hip replacement surgery.  

UK PubMed Central (United Kingdom)

OBJECTIVES: Although clinicians recognize hip involvement, which frequently leads to hip replacement surgery, as an important feature of AS, data on the epidemiology, nature of the disease and therapeutic strategies are scarce. We aimed to describe the epidemiology of clinical and radiological hip involvement and define the risk factors for the hip replacement surgery in AS patients. METHODS: Data from 3 datasets were merged, including 847 Belgian (ASPECT database), 1405 Spanish (REGISPONSER database) and 466 Ibero-American (RESPONDIA database) AS patients. The ASPECT and REGISPONSER database (Dataset A) are used for exploratory analysis; the RESPONDIA database (Dataset B) is used for confirmative analysis. Factors associated with hip involvement and the hip replacement surgery were analysed. RESULTS: Twenty four (REGISPONSER) to 36% (RESPONDIA) of AS patients under rheumatologist's care presented clinical hip involvement, including the 5% (Dataset A) of AS patients who needed hip replacement surgery. Patients with hip involvement had significantly worse overall Bath Ankylosing Spondylitis Functional Index (BASFI) scores compared with patients without hip involvement (mean difference = 1.6, P < 0.001) (Dataset A, confirmed in B). Corrected for disease duration, patients with early disease onset, enthesial and axial disease needed most frequently hip replacement surgery (Dataset A, confirmed in B). CONCLUSION: Hip involvement is commonly recognized by rheumatologists in AS patients, and involves about one out of the three to four patients with AS and is associated with impaired functioning reflected by higher overall BASFI scores. Early onset of disease, axial and enthesial disease are associated with the hip replacement surgery in AS.

Vander Cruyssen B; Muñoz-Gomariz E; Font P; Mulero J; de Vlam K; Boonen A; Vazquez-Mellado J; Flores D; Vastesaeger N; Collantes E

2010-01-01

172

A rare cause of dysphagia: compression of the esophagus by an anterior cervical osteophyte due to ankylosing spondylitis  

Science.gov (United States)

Ankylosing spondylitis (AS) is a chronic inflammatory rheumatological disease affecting the axial skeleton with various extra-articular complications. Dysphagia due to a giant anterior osteophyte of the cervical spine in AS is extremely rare. We present a 48-year-old male with AS suffering from progressive dysphagia to soft foods and liquids. Esophagography showed an anterior osteophyte at C5-C6 resulting in esophageal compression. The patient refused surgical resection of the osteophyte and received conservative therapy. However, after 6 months there was no improvement in dysphagia. This case illustrates that a large cervical osteophyte may be the cause of dysphagia in patients with AS and should be included in the diagnostic workup in early stages of the disease.

Bagcac?, Sinan; Sall?, Ali; Kucuksen, Sami; Ugurlu, Hatice

2013-01-01

173

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

International Nuclear Information System (INIS)

[en] 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

174

Expression of IL-2 and IL-11 and its significance in patients with ankylosing spondylitis.  

UK PubMed Central (United Kingdom)

OBJECTIVE: To explore the expression of IL-2 and IL-11 and its significance in patients with ankylosing spondylitis (AS). METHODS: A total of 48 active AS patients in our hospital and 40 normal control subjects were selected in our study. Bath ankylosing spondylitis disease activity index (BASDAI), Bath ankylosing spondylitis functional index (BASFI), Bath ankylosing spondylitis metrology index (BASMI), ESR and CRP expression levels were compared before treatment, 12 h after treatment and 24 h after treatment. IL-2 and IL-11 expression were also compared between these two groups. RESULTS: The BASDAI score, BASFI score and BASMI score of the AS patients before treatment significantly decreased compared with those 12 weeks and 24 weeks after treatment (P<0.05). ESR and CRP levels of the AS patients 12 weeks and 24 weeks after treatment significantly decreased compared with those before treatment (P<0.05). Difference was significant in serum IL-2 and IL-11 levels between 12 weeks and 24 weeks after treatment and before treatment (P<0.05). And no statistically significance was observed for serum IL-2 and IL-11 levels between normal control group and those of patients in AS group 24 weeks after treatment (P>0.05). Pearson's linear-correlation analysis showed that serum IL-2 level had a positive correlation with BASDAI, BASFI, BASMI, ESR and CRP (r=0.661,0.547,0.474,0.362,0.416, P<0.05) and serum IL-11 level had a negative correlation with BASDAI, BASFI, BASMI, ESR and CRP (r=-0.629, -0.412, -0.422, -0.387, -0.408, -0.315, P<0.05). CONCLUSIONS: Serum levels of IL-2 in active AS patients significantly increase and will decrease after treatment. However, serum levels of IL-11 significantly decrease and will increase after treatment, which indicates that serum IL-2 has a positive correlation with the degree of AS and serum IL-11 has a negative correlation with the degree of AS, both of which are correlated closely with the onset of AS.

Liu F; Wang F; Wang CC; Li N; Li SF

2013-01-01

175

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; Clemens Hufnagl; Martin Jakab; Wolfgang Hitzl; Markus Ritter

2011-01-01

176

A parallel group comparison of tenoxicam and piroxicam in patients with ankylosing spondylitis.  

UK PubMed Central (United Kingdom)

Tenoxicam (20 mg/day) and piroxicam (20 mg/day) were compared in a double-blind, parallel group study over 4 weeks in 30 patients with ankylosing spondylitis. Both tenoxicam and piroxicam reduced spinal pain, but the improvement was greater with piroxicam. Tenoxicam and piroxicam were equally effective at improving duration of morning stiffness. Slight improvement was seen with other symptoms with both treatments. Patients were slightly more tolerant of piroxicam than tenoxicam and most patients elected to continue on their particular therapy at the end of the study.

Bird HA; Le Gallez P; Astbury C; Looi D; Wright V

1986-01-01

177

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

UK PubMed Central (United Kingdom)

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

Chung SH; Park SJ; Hong SP; Cheon JH; Kim TI; Kim WH

2013-08-01

178

[Infliximab in ankylosing spondylitis associated with chronic hepatitis B infection. Role of Lamivudine therapy].  

UK PubMed Central (United Kingdom)

Anti-tumor necrosis factor-a (TNF) therapy has been associated with reactivation of hepatitis B virus infection. Case reports have suggested the concomitant need of lamivudine treatment in patients with HBV infection treated with antiTNFa agents. We describe a case of ankylosing spondylitis with positive HBV surface antigen (HBsAg) treated with infliximab and lamivudine. Clinical response was excellent but when lamivudine therapy was stopped, reactivation of replication viral occurred. After the reintroduction of lamivudine, viral replication was controlled and liver function tests were normalized. Preventive long-term lamivudine therapy is mandatory when anti-TNFa therapy is maintained in patients with chronic HBV infection.

Sanz Sanz J; Silva Fernández L; Calleja Panero JL; Fernández-Castro M; Andreu Sánchez JL

2008-07-01

179

[Association multiple exostoses and ankylosing spondylitis: about one case and a review of the literature].  

UK PubMed Central (United Kingdom)

We report the case of a 25-years-old man who had an ankylosing spondylitis associated with multiple exostoses. The patient had hip pain of inflammatory origin and back stiffness with x-ray findings suggestive of bilaterral sacroilitis, coxitis as well as exostosis of the humerus, radius, femor and tibia. This is occurred in Turkey, the association was described as a simple concidence due to the difference in the genetic mechanisms involved. A more detailed genetic study of these two entities well be helpful for a better understanding of this association.

Sahli H; Cheour E; Hamza S; Meddeb N; Ben Smida I; Ezzaouia K; Sellami S

2006-04-01

180

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; Jorge Elias Jr; Marcello Henrique Nogueira Barbosa; Júlio César Voltarelli

2003-01-01

 
 
 
 
181

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

International Nuclear Information System (INIS)

[en] 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

2003-01-01

182

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; Seçil Demirdal; Hüseyin Dursun; Tuncay Çak?r; Celal Kilit; Alaettin Av?ar; Vural Kavuncu

2010-01-01

183

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

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

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

2012-01-01

184

Increased numbers of IgG-containing cells in rectal lamina propria of patients with ankylosing spondylitis.  

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Using an indirect immunoperoxidase technique we found the numbers of IgG-containing cells in the rectal lamina propria to be increased in patients with ankylosing spondylitis compared with controls, but not in patients with acute anterior uveitis or rheumatoid arthritis, or in the first-degree relat...

Stodell, M A; Butler, R C; Zemelman, V A; Henry, K; Brewerton, D A

185

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

Science.gov (United States)

Background and Objectives. The human leukocyte antigen HLA-B27 is a class 1 antigen of the major histocompatibility complex and is strongly associated with ankylosing spondylitis (AS). The purpose of the present study is to investigate the distribution of HLA-B27 in patients with AS of different ethnic groups in Qatar. Design and Setting. Study design was cross-sectional and the setting was rheumatology clinics of Hamad General Hospital in Qatar where most of ankylosing spondylitis patients are followed up. Patients and Methods. Patients with diagnosis of AS who met the New York modified criteria for AS were tested for HLA-B27. 119 patients were tested for HLA-B27: 66 Arabs, 52 Asians (Indians, Pakistanis, Bengalis, and Iranians), and one Western (Irish). Results. Of all the individuals, 82 were positive (69%) for HLA-B27. Among the Arabs, 49/66 were positive (74%). Among the Asians, 32/52 were positive (61%). Furthermore, Qatari patients (10 males and one female) 9 were positive (82%), 14/19 Jordanians/Palestinians were positive, and 9/10 (90%) Egyptians were positive. Among the Asians, 19/26 Indians were positive (73%), which was similar to the Arabs. Conclusion. HLA-B27 in our small group of Arabs is present in 74%. Comparison with other data will be presented in detail. PMID:22548073

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

2012-04-04

186

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

Science.gov (United States)

Introduction: 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.

Hennigan, Stephanie; Ackermann, Christoph; Kavanaugh, Arthur

2007-01-01

187

Disability motivates patients with ankylosing spondylitis for more frequent physical exercise.  

UK PubMed Central (United Kingdom)

OBJECTIVE: To evaluate whether patients with ankylosing spondylitis who perform disease-specific exercises more frequently have fewer functional limitations and disability than those who exercise more often. DESIGN: Cross-sectional; retrospective chart review. SETTING: Rehabilitation center in Austria. PARTICIPANTS: A sample of 1,500 patients with ankylosing spondylitis (1,163 men, 337 women; mean age +/- standard deviation, 50+/-12 y; disease duration, 21+/-11 y) grouped by how many times per week they performed disease-specific exercises for at least 5 minutes: group A (n=542), less than 1 time; group B (n=691), 1 to 3 times; and group C (n=267), more than 3 times. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Self-report of exercise frequency and a German version of the Health Assessment Questionnaire for the spondyloarthropathies (HAQ-S). RESULTS: The HAQ-S showed significant differences among the groups (analysis of variance on ranks, P<.001). In pairwise multiple comparison, group A showed significantly less disability (median, 0.5; interquartile range [IQR], 0.2-0.8) than group B (median, 0.6; IQR, 0.3-0.9) or group C (median, 0.7; IQR, 0.3-1.0). CONCLUSION: Patients with less disability exercised less than their more disabled counterparts. The reasons for this difference, particularly the issue of motivation, deserve more attention.

Falkenbach A

2003-03-01

188

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

189

[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

190

Common bone turnover markers in rheumatoid arthritis and ankylosing spondylitis: a literature review.  

UK PubMed Central (United Kingdom)

We studied the impact of inflammatory rheumatism and its treatment on the most common bone turnover markers, based on six previously defined questions in a systematic literature review in order to define their place in daily clinical practice. The role of bone is currently considered of particular importance concerning cartilage damage in inflammatory rheumatism (rheumatoid arthritis and ankylosing spondylitis) and the new concept of osteoimmunology has emerged. Some bone turnover markers are available in clinical practice. In spite of rich and extensive literature on bone turnover markers, their use in inflammatory rheumatism or even osteoporosis is not clear, and a systematic literature review became necessary. In spite of a large number of different markers used in literature, few of them that are useful in common practice have been studied in the field of inflammatory rheumatism such as rheumatoid arthritis and ankylosing spondylitis. Although their study enables understanding of the physiopathological mechanisms of osteoporosis in inflammatory rheumatism, their use in current common practice cannot be recommended. Interesting data on the forecast of the structural evolution of rheumatoid arthritis has been found within the framework of clinical research, without any real practical impact today.

Coiffier G; Bouvard B; Chopin F; Biver E; Funck-Brentano T; Garnero P; Guggenbuhl P

2013-05-01

191

Factors influencing health status and disability of patients with ankylosing spondylitis in the Czech Republic.  

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The aim of the study was to evaluate factors that influence health status and work disability in patients with ankylosing spondylitis (AS) in the Czech Republic. Data were collected in a retrospective fashion directly from patients with AS using mailed questionnaires containing questions regarding sociodemographic characteristics of patients, the course of their disease, therapy, rehabilitation, quality of life, and ability to work. HAQ-DI (Health Assessment Questionnaire-Disability Index) and BASDAI (Bath Ankylosing Spondylitis Disease Activity Index) were also included in the questionnaires; 1,008 questionnaires were suitable for further statistical analysis. The average age +/- SD of patients was 50.2 +/- 10.7 years, the average symptom duration was 23.0 +/- 11.6 years. Mean time from first symptoms to diagnosis was 9.1 years. Full disability had been awarded to 303 patients (30%) at some point of their disease. Twenty seven percent of patients reported receiving full disability pension for 10 or more years. Four hundred fifty six subjects (45%) were currently or had been previously receiving partial disability pension. Receiving disability pension was more frequent among men (64%) compared to women (56%) (P = 0.012), despite the fact that women had higher BASDAI (P or =4 (current cutoff value for initiation of biological therapy), but only 1% of patients were treated by anti TNF alpha agents within the last year. Seven hundred ninety one patients underwent spa treatment in the previous year; 96% of them experienced improvement of their health condition. PMID:18247079

Forejtová, S; Mann, H; Stolfa, J; Vedral, K; Fenclová, I; Némethová, D; Pavelka, K

2008-02-05

192

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

UK PubMed Central (United Kingdom)

Background and Objectives. The human leukocyte antigen HLA-B27 is a class 1 antigen of the major histocompatibility complex and is strongly associated with ankylosing spondylitis (AS). The purpose of the present study is to investigate the distribution of HLA-B27 in patients with AS of different ethnic groups in Qatar. Design and Setting. Study design was cross-sectional and the setting was rheumatology clinics of Hamad General Hospital in Qatar where most of ankylosing spondylitis patients are followed up. Patients and Methods. Patients with diagnosis of AS who met the New York modified criteria for AS were tested for HLA-B27. 119 patients were tested for HLA-B27: 66 Arabs, 52 Asians (Indians, Pakistanis, Bengalis, and Iranians), and one Western (Irish). Results. Of all the individuals, 82 were positive (69%) for HLA-B27. Among the Arabs, 49/66 were positive (74%). Among the Asians, 32/52 were positive (61%). Furthermore, Qatari patients (10 males and one female) 9 were positive (82%), 14/19 Jordanians/Palestinians were positive, and 9/10 (90%) Egyptians were positive. Among the Asians, 19/26 Indians were positive (73%), which was similar to the Arabs. Conclusion. HLA-B27 in our small group of Arabs is present in 74%. Comparison with other data will be presented in detail.

Abdelrahman MH; Mahdy S; Khanjar IA; Siam AM; Malallah HA; Al-Emadi SA; Sarakbi HA; Hammoudeh M

2012-01-01

193

[Critical study of radiculomedullary and neuromuscular complications of ankylosing spondylitis  

UK PubMed Central (United Kingdom)

Medullo-radicular and neuro-muscular involvements of ankylosing spondylarthritis, often reported in an analytic fashion in the literature, deserve to be the subject of a critical study. Various neurological manifestations secondary to exceptional atlo-occipital and sometimes axis-atlas subluxations and medullary lesions as well as syndromes of the cauda equina. The medullary lesions have an epidural origin (3 cases in the literature, 2 cases from the authors) or are secondary to a spondylodiscitis (4 cases in the literature) or secondary to both (1 case reported by the authors). As for syndromes of the cauda equina the authors report 3 cases to be added to the 55 published previously. It concerns always old spondylarthritis. The lesions combine posterior diverticula and lesions of the lamina. The treatment is usually ineffective. A special case is represented by forms with trophic disorders. More debatable are the radicular lesions, which, except for intercostal pain, should be linked to local pain. Electromyographic abnormalities are of no significance. Alterations of the paravertebral muscles viewed on the scanner X have, for now, an uncertain significance. Finally, various associations, without significance such as multiple sclerosis, diffuse muscular lesions and the classic spondylotic pseudo-tabes, should be rejected.

Serratrice G; Acquaviva P; Pouget J; Guerra L

1987-03-01

194

[Anterior uveitis in ankylosing spondylitis. A retrospective study  

UK PubMed Central (United Kingdom)

In ankylosing spondylarthritis (AS), there is sometimes an anterior uveitis (AUV) or a previous history of AUV. The authors have reviewed the medical files of 338 hospitalised AS and 30 AS seen in consultation. They found an AUV in 28 hospitalised AS, or 8.3 p. cent of all cases (7.7 p. cent in men and 14.8 p. cent in women). In 3 cases (0.9 p. cent), the AUV was the first manifestation of the disease, preceding joint involvement. AUV was never found in patients seen in consultation. The findings of this investigation agree, but only partially, with those from the literature which, usually, acknowledge a greater frequency of AUV. Comparison with other previous investigations conducted in Italy enables to confirm that among Italian AS, AUV is less frequent than in other European and out of Europe series. It is possible that in a certain number of cases the AUV is not diagnosed clinically. However, it seems that the reduced incidence of the AUV discovered by a few Italian authors is not fortuitous (genetic factors?).

Piergiacomi G; Agostinelli M; Baccarini V; Gasparini M; Pepi M; Cervini C

1988-12-01

195

[Ankylosing spondylitis with juvenile onset. Study of 62 cases  

UK PubMed Central (United Kingdom)

The study of 338 files of patients hospitalized for ankylosing spondylarthritis between 1977 and 1985, has enabled to select 52 cases (15 p. cent) of juvenile forms (onset before the age of 16). An additional 10 cases followed in pediatric clinic are included. The male predominance is definite (88.7 p. cent); the onset is late (mean age: 11.6 +/- 3.2 years) and, most of the time, at the level of a peripheral joint (79 p. cent). The evolution, studied with a mean follow-up of 11.2 +/- 4.8 years, is usually manifested by bouts of peripheral and/or axial arthritis (82.2 p. cent). Joint involvement predominates in the lower extremities: knees (23 cases) and feet (21 cases). The late appearance of spinal and/or sacro-iliac joint involvement explains the late diagnosis (5.6 +/- 4.8 years). Visceral involvement is less frequent (12 cases of eye involvement). The functional prognosis is dominated by a severe involvement of the coxo-femoral joints (46.6 p. cent). Heel pain with posterior and/or inferior talus erosions (15 cases) are, because of their frequency, interesting for making the diagnosis. The total functional prognosis is relatively good: Steinbrocker stage 0-1 for 26 patients (44 p. cent). A bilateral arthroplasty was performed in 9 patients with an excellent result in 7 cases.

Job-Deslandre C; Menkès CJ; Godran A; Amor B

1987-03-01

196

Increased occurrence of spinal fractures related to ankylosing spondylitis: a prospective 22-year cohort study in 17,764 patients from a national registry in Sweden  

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Abstract Background Ankylosing spondylitis (AS) is a rheumatoid disease leading to progressive ossification of the spinal column. Patients suffering from AS are highly susceptible to unstable vertebral fractures and often require surgical stabilisation due to long lever arms. Medica...

Robinson Yohan; Sandén Bengt; Olerud Claes

197

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

DEFF Research Database (Denmark)

To investigate frequencies and reasons for switching, treatment responses and drug survival in patients with ankylosing spondylitis (AS) switching tumour-necrosis-factor-? inhibitor (TNFi) treatment in routine clinical care.

Glintborg, Bente; Østergaard, Mikkel

2013-01-01

198

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?; Gamze ALAYLI; K?vanç CENG?Z; Hasan BA?CI; Ye?im AKYOL; ?lker ?LHANLI; Ferhan CANTÜRK

2008-01-01

199

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

2009-01-01

200

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

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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 /sup 51/Cr-release cytotoxicity assay, and possible reasons for the failure of others to confirm these observations, are briefly discussed.

Geczy, A.F.; van Leeuwen, A.; van Rood, J.J.; Ivanyi, P.; Breur, B.S.; Cats, A.

1986-11-01

 
 
 
 
201

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; Patel Heena; Patel Pranoti; Kharod Utpala

2010-01-01

202

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.

Makram Frigui; Manel Kechaou; Moez Jallouli; Neila Kaddour; Habiba Bouhamed Chaabouni; Zouhir Bahloul

2011-01-01

203

Vitamin D-deficient rickets mimicking ankylosing spondylitis in an adolescent girl.  

UK PubMed Central (United Kingdom)

Vitamin D-deficient rickets (VDDR) remains an important health problem especially in developing countries. Insufficient dietary intake of vitamin D and inadequate sun exposure increase the risk of vitamin D deficiency. Since their vitamin D requirement is increased, children and adolescents are potentially at higher risk for vitamin D deficiency. In adolescents, vitamin D deficiency causes osteomalacia, osteoporosis and muscle weakness. While osteoporosis is not associated with bone pain, osteomalacia has been associated with isolated or generalized bone pain. The present case suffered from generalized bone pain for three years. She was misdiagnosed as ankylosing spondylitis, which is a seronegative arthropathy, and was treated with corticosteroids and methotrexate, which have potential side effects. Hypocalcemia, hypophosphatemia, elevated alkaline phosphatase level, secondary hyperparathyroidism, and extremely low vitamin D level were consistent with the diagnosis of severe vitamin D deficiency. Complete clinical and biochemical resolution was achieved with vitamin D replacement.

Demirbilek H; Aydo?du D; Ozön A

2012-03-01

204

Vitamin D-deficient rickets mimicking ankylosing spondylitis in an adolescent girl.  

Science.gov (United States)

Vitamin D-deficient rickets (VDDR) remains an important health problem especially in developing countries. Insufficient dietary intake of vitamin D and inadequate sun exposure increase the risk of vitamin D deficiency. Since their vitamin D requirement is increased, children and adolescents are potentially at higher risk for vitamin D deficiency. In adolescents, vitamin D deficiency causes osteomalacia, osteoporosis and muscle weakness. While osteoporosis is not associated with bone pain, osteomalacia has been associated with isolated or generalized bone pain. The present case suffered from generalized bone pain for three years. She was misdiagnosed as ankylosing spondylitis, which is a seronegative arthropathy, and was treated with corticosteroids and methotrexate, which have potential side effects. Hypocalcemia, hypophosphatemia, elevated alkaline phosphatase level, secondary hyperparathyroidism, and extremely low vitamin D level were consistent with the diagnosis of severe vitamin D deficiency. Complete clinical and biochemical resolution was achieved with vitamin D replacement. PMID:22734306

Demirbilek, Hüseyin; Aydo?du, Didem; Ozön, Alev

205

Circulating cytotoxic CD8(+) CD28(-) T cells in ankylosing spondylitis.  

Science.gov (United States)

Circulating CD8(+) CD28(-) T cells were found to be expanded more in patients with ankylosing spondylitis than in an age-matched healthy population (41.2 +/- 17.7% versus 18.6 +/- 7.6%). The level of CD8(+)CD28(-) T cells was dependent on the disease status, but was independent of age. Most of the CD8(+) CD28(-) T cells produced perforin after stimulation in vitro, in contrast to their CD8(+)CD28(+) counterparts. From the clinical perspective, the percentage of the cytotoxic CD8(+) CD28(-) T cells reflected a more severe course of disease, as it correlated with distinct movement restrictions, as well as the metrology score summarizing cervical rotation (in sitting position), chin-to-jugulum distance, thoracic Schober, chest expansion, and fingers-to-floor distance (P = 0.032). PMID:11879540

Schirmer, Michael; Goldberger, Christian; Würzner, Reinhard; Duftner, Christina; Pfeiffer, Karl-P; Clausen, Johannes; Neumayr, Günther; Falkenbach, Albrecht

2001-10-16

206

Circulating cytotoxic CD8(+) CD28(-) T cells in ankylosing spondylitis.  

UK PubMed Central (United Kingdom)

Circulating CD8(+) CD28(-) T cells were found to be expanded more in patients with ankylosing spondylitis than in an age-matched healthy population (41.2 +/- 17.7% versus 18.6 +/- 7.6%). The level of CD8(+)CD28(-) T cells was dependent on the disease status, but was independent of age. Most of the CD8(+) CD28(-) T cells produced perforin after stimulation in vitro, in contrast to their CD8(+)CD28(+) counterparts. From the clinical perspective, the percentage of the cytotoxic CD8(+) CD28(-) T cells reflected a more severe course of disease, as it correlated with distinct movement restrictions, as well as the metrology score summarizing cervical rotation (in sitting position), chin-to-jugulum distance, thoracic Schober, chest expansion, and fingers-to-floor distance (P = 0.032).

Schirmer M; Goldberger C; Würzner R; Duftner C; Pfeiffer KP; Clausen J; Neumayr G; Falkenbach A

2002-01-01

207

Circulating cytotoxic CD8+ CD28- T cells in ankylosing spondylitis  

Science.gov (United States)

Circulating CD8+ CD28- T cells were found to be expanded more in patients with ankylosing spondylitis than in an age-matched healthy population (41.2 ± 17.7% versus 18.6 ± 7.6%). The level of CD8+CD28- T cells was dependent on the disease status, but was independent of age. Most of the CD8+ CD28- T cells produced perforin after stimulation in vitro, in contrast to their CD8+CD28+ counterparts. From the clinical perspective, the percentage of the cytotoxic CD8+ CD28- T cells reflected a more severe course of disease, as it correlated with distinct movement restrictions, as well as the metrology score summarizing cervical rotation (in sitting position), chin-to-jugulum distance, thoracic Schober, chest expansion, and fingers-to-floor distance (P = 0.032).

Schirmer, Michael; Goldberger, Christian; Wurzner, Reinhard; Duftner, Christina; Pfeiffer, Karl-P; Clausen, Johannes; Neumayr, Gunther; Falkenbach, Albrecht

2002-01-01

208

Treatment of ankylosing spondylitis in patients refractory to TNF-inhibition: are there alternatives?  

UK PubMed Central (United Kingdom)

PURPOSE OF REVIEW: Axial spondyloarthritis (SpA) - including ankylosing spondylitis (AS) - is a frequent chronic inflammatory disease that affects mainly the axial skeleton. There is evidence that NSAIDs and tumor necrosis factor (TNF) ? blockers are efficacious, but not all patients achieve remission or a major clinical response. A variety of new drug classes have been investigated during the last years for the treatment of patients with AS in whom TNF blockers have failed or are contraindicated. RECENT FINDINGS: Data for abatacept, anakinra, apremilast, bisphosphonates, rituximab, secukinumab, sulfasalazine, thalidomide and tocilizumab were found. All studies had problems with design and methodology. SUMMARY: Although some trends for efficacy were seen, there is at present insufficient evidence to support a recommendation for any of these compounds. So far, none of these new drugs has been shown to reach response rates compared to TNF-blockers.

Kiltz U; Heldmann F; Baraliakos X; Braun J

2012-05-01

209

Etanercept-induced Henoch-Schonlein purpura in a patient with ankylosing spondylitis.  

UK PubMed Central (United Kingdom)

Ankylosing spondylitis (AS) is a chronic inflammatory disease that primarily affects the axial skeleton. Extra-articular manifestations are less common relative to other rheumatic diseases, and vasculitic complications typically involve the ascending aorta and aortic valve. The use of tumor necrosis factor inhibitors is efficacious in the treatment of patients with AS. Since their routine use, however, tumor necrosis factor inhibitors have been associated with the development of drug-induced complications including the induction of lupus and both cutaneous and systemic vasculitis. In this report, we describe a patient with severe longstanding AS, who developed Henoch-Schönlein purpura after commencing therapy with etanercept. Tumor necrosis factor inhibitor-induced Henoch-Schönlein purpura has been very rarely reported and has been mostly recognized in patients with rheumatoid arthritis.

Rolle AS; Zimmermann B; Poon SH

2013-03-01

210

JMY polymorphism is related to severity of ankylosing spondylitis in Chinese Han patients.  

UK PubMed Central (United Kingdom)

Ankylosing spondylitis (AS) is a largely genetically determined autoimmune disease. JMY has recently been found to be associated with susceptibility to AS in patients of western European descent. We aimed to examine the influence of JMY polymorphisms on the severity of AS in the Chinese ethnic majority Han population. Blood samples were drawn from 396 Chinese Han AS patients whose duration of disease was about 9-12 years. Four tag single-nucleotide polymorphisms (tagSNPs) in JMY were selected and genotyped. Frequencies of different genotypes and clinical indexes about the severity of AS were analyzed. The rs2607142, rs16876619, and rs4704556 SNPs are related to BASFI. The rs2607142, rs4704556, and rs16876657 SNPs are related to BADAI. The rs4704556 and rs16876657 SNPs are related to mSASSS. JMY is related to the severity of AS in Chinese Han patients.

Chai W; Lian Z; Chen C; Liu J; Shi LL; Wang Y

2013-08-01

211

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)...

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

2011-01-01

212

[beta2-Microglobulin in ankylosing spondylitis and in Reiter's syndrome (author's transl)  

UK PubMed Central (United Kingdom)

In patients with ankylosing spondylitis (AS) the plasma level of beta2-microglobulin (beta2m) is signficantly higher (1.95 +/- 0.48 mg/l) than in osteoarthritis (1.48 +/- 0.47 mg/l). In Reiter's syndrome the level of beta2m is also higher than in controls, but the paucity of results do not allow definite conclusions. The plasma level of beta2m in AS and in Reiter's syndrome is not related to the presence of HLA B 27 antigen, neither to other biological parameters as sedimentaton rate, blood cell counts, electrophoresis of plasma proteins. In rheumatoid arthritis the plasma level of beta2m is 2,67 +/- 0.84 mg/l, significantly higher than in osteoarthritis or in AS even without any association with Sjögren's syndrome. In synovial fluid, the beta2m level is closely related to the degree of inflammation, suggesting a local production of this substance.

Amor B; Georgiadis A; Kahan A; Delbarre F

1978-09-01

213

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

Directory of Open Access Journals (Sweden)

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; Ayhan Bilgici; Ömer Kuru; Nebahat Sar?ca; ?ule Arslan; Ünal Erkorkmaz

2010-01-01

214

Peripheral B-cell activation and exhaustion markers in patients with ankylosing spondylitis.  

UK PubMed Central (United Kingdom)

AIMS: Ankylosing spondylitis (AS) is an autoimmune disease and is associated with abnormal B cell function. However, the roles of different B cell subsets are less clear. This study aimed to examine the frequency of different subsets of B cells in AS patients following standard therapies. MAIN METHODS: Eighteen newly diagnosed AS patients and 10 healthy controls (HC) were recruited in this study. The expression of CD27, CD38, CD86, CD95 and IgD on CD19(+) B cells was examined by flow cytometry. The disease activity was scored according to the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI). Serum levels of C-reactive protein (CRP), rheumatoid factor (RF), IgG, IgA and IgM, and the erythrocyte sedimentation rate (ESR) were measured. KEY FINDINGS: The frequency of CD27(+) B cells was decreased in AS patients compared with HC (p=0.018), while CD86(+) and CD27(-)CD95(+) B cell subsets increased in AS patients (p<0.001). Meanwhile, the frequencies of CD38(+) and CD95(+) B cell positively correlated with BASDAI (r=0.6505, p=0.0035; r=0.6854, p=0.0017, respectively), while CD38(-)CD86(+) B cell negatively correlated with BASDAI (r=-0.7329, p<0.001). We also found that CD27(-) and CD95(+) B cell negatively correlated with RF levels (r=-0.5141, p=0.0290; r=-0.4944, p=0.0370, respectively), while CD27(+) B cell positively correlated with IgG levels (p=0.0148, r=0.5640). Moreover, CD86(+) and CD27(-)CD95(+) B cell subsets increased following treatment with Meloxicam and Etanercept for one month (p<0.001; p<0.001). SIGNIFICANCE: These findings suggest that CD27(-)CD95(+)CD19(+) and CD86(+)CD19(+) B cells may be reasonable cellular targets for the therapeutic intervention of AS.

Niu XY; Zhang HY; Liu YJ; Zhao D; Shan YX; Jiang YF

2013-09-01

215

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

UK PubMed Central (United Kingdom)

BACKGROUND: Fatigue is a major component of living with ankylosing spondylitis (AS), though it has been largely over-looked, and currently there are no specific agreed management strategies. METHODS: This qualitative exploratory study involved participants who are members of an existing population-based ankylosing spondylitis (PAS) cohort. Participants residing in South West Wales were invited to participate in a focus group to discuss; (1) effects of fatigue, (2) self-management strategies and (3) potential future interventions. The focus groups were audio-recorded and the transcripts were analysed using thematic analysis. RESULTS: Participants consisted of 3 males/4 females (group 1) and 4 males/3 females (group 2), aged between 35 and 73?years (mean age 53?years). Three main themes were identified: (1) The effects of fatigue were multi-dimensional with participants expressing feelings of being 'drained' (physical), 'upset' (emotional) and experiencing 'low-mood' (psychological); (2) The most commonly reported self-management strategy for fatigue was a balanced combination of activity (exercise) and rest. Medication was reluctantly taken due to side-effects and worries over dependency; (3) Participants expressed a preference for psychological therapies rather than pharmacological for managing fatigue. Information on Mindfulness-Based Stress Reduction (MBSR) was received with interest, with recommendations for delivery in a group format with the option of distance-based delivery for people who were not able to attend a group course. CONCLUSIONS: Patients frequently try and manage their fatigue without any formal guidance or support. Our research indicates there is a need for future research to focus on psychological interventions to address the multi-faceted aspects of fatigue in AS.

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

2013-01-01

216

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

Energy Technology Data Exchange (ETDEWEB)

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

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

2007-12-15

217

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

International Nuclear Information System (INIS)

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

2007-01-01

218

Prevalence, clinical relevance and characterization of circulating cytotoxic CD4+CD28- T cells in ankylosing spondylitis.  

UK PubMed Central (United Kingdom)

Circulating CD3+CD4+CD28- cells exhibit reduced apoptosis and were found to be more enriched in patients with ankylosing spondylitis than in age-matched healthy control individuals (7.40 +/- 6.6% versus 1.03 +/- 1.0%; P < 0.001). Levels of CD4+CD28- T cells correlate with disease status as measured using a modified metrology score, but they are independent of age and duration of ankylosing spondylitis. CD4+CD28- T cells produce IFN-gamma and perforin, and thus they must be considered proinflammatory and cytotoxic. These T cells share phenotypic and functional properties of natural killer cells, strongly expressing CD57 but lacking the lymphocyte marker CD7. MHC class I recognizing and activating natural killer cell receptors on the surface of CD4+CD28- T cells may be involved in a HLA-B27 mediated co-stimulation of these proinflammatory and cytotoxic cells.

Duftner C; Goldberger C; Falkenbach A; Würzner R; Falkensammer B; Pfeiffer KP; Maerker-Hermann E; Schirmer M

2003-01-01

219

Prevalence, clinical relevance and characterization of circulating cytotoxic CD4+CD28- T cells in ankylosing spondylitis.  

Science.gov (United States)

Circulating CD3+CD4+CD28- cells exhibit reduced apoptosis and were found to be more enriched in patients with ankylosing spondylitis than in age-matched healthy control individuals (7.40 +/- 6.6% versus 1.03 +/- 1.0%; P < 0.001). Levels of CD4+CD28- T cells correlate with disease status as measured using a modified metrology score, but they are independent of age and duration of ankylosing spondylitis. CD4+CD28- T cells produce IFN-gamma and perforin, and thus they must be considered proinflammatory and cytotoxic. These T cells share phenotypic and functional properties of natural killer cells, strongly expressing CD57 but lacking the lymphocyte marker CD7. MHC class I recognizing and activating natural killer cell receptors on the surface of CD4+CD28- T cells may be involved in a HLA-B27 mediated co-stimulation of these proinflammatory and cytotoxic cells. PMID:12932293

Duftner, Christina; Goldberger, Christian; Falkenbach, Albrecht; Würzner, Reinhard; Falkensammer, Barbara; Pfeiffer, Karl P; Maerker-Hermann, Elisabeth; Schirmer, Michael

2003-07-16

220

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

International Nuclear Information System (INIS)

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)

2011-01-01

 
 
 
 
221

Decreased plasma vitamin D levels in patients with undifferentiated spondyloarthritis and ankylosing spondylitis.  

UK PubMed Central (United Kingdom)

OBJECTIVE: The aim of the present study was to evaluate the plasma vitamin D (vit D) levels and their association with the disease activity in patients with ankylosing spondylitis (AS) and undifferentiated spondyloarthritis (uSpA) compared with healthy populations. METHODS: This study included 161 spondyloarthritis patients (113 uSpA patients and 48 AS patients) attending our rheumatology out-patient clinic, along with 92 controls. RESULTS: The plasma vit D levels were 18 ?g/L (8-38) in the AS group, 20 ?g/L (4-92.3) in the uSpA group and 24.3 ?g/L (7.2-76.8) in the control group. The plasma vit D levels of the AS patients were significantly lower than those of the patients in the control group (p=0.004). The men in the AS group had significanly lower vit D levels than those in the control group (p=0.005). On the other hand, the women in the uSpA group had significanly lower vit D levels than those in the control group (p=0.011). The vit D levels were inversely related to both erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) in the AS patients (p=0.002, R=-0.428; p<0.001, R=-0.592, respectively). This correlation was not demonstrated in the uSpA patients. The vit D levels were not found to correlate with the Bath ankylosing spondylitis disease activity index (BASDAI) levels in either the AS or uSpA patients. CONCLUSION: 25-hydroxy-vit D deficiency is frequently observed in patients with SpAs. In this study, vit D deficiency was much more prominent in the male AS patients. On the other hand, among women, the uSpA patients exhibited much more prominent vit D deficiency than the control group subjects. The acute phase response may inversely affect the vit D levels in AS patients.

Erten S; Kucuksahin O; Sahin A; Altunoglu A; Akyol M; Koca C

2013-01-01

222

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

International Nuclear Information System (INIS)

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.)

1985-01-01

223

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

International Nuclear Information System (INIS)

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.)

2008-01-01

224

Relationship of the sexual functions with the clinical parameters, radiological scores and the quality of life in male patients with ankylosing spondylitis.  

UK PubMed Central (United Kingdom)

The aim of this study was to explore the impact of ankylosing spondylitis (AS) and the disease-related variables on the patients' sexual function according to the International Index of Erectile Function (IIEF) scoring system. A total of 70 sexually active male AS patients and 60 healthy controls were enrolled in this study. Their demographic data were evaluated, and the pain was assessed according to the visual analogue scale (VAS). Laboratory tests were conducted in order to measure the C-reactive protein (CRP) and erythrocyte sedimentation rates (ESR) of the patients. The disease activity was evaluated using the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI). Functional statement was evaluated with the help of the Bath Ankylosing Spondylitis Functional Index (BASFI) and with the scores obtained from the spinal measurements with the Bath Ankylosing Spondylitis Metrology Index (BASMI). The Bath Ankylosing Spondylitis Radiology Index (BASRI) was used to evaluate the radiological damage. The disease-related quality of life was measured with the Ankylosing Spondylitis Quality of Life Questionnaire (ASQoL). The anxiety and depression level of the patients was revealed through the Hospital Anxiety and Depression Scale (HADS). In comparison with the healthy control group, patients with AS had significantly lower scores in each of the 5 domains of the IIEF (p < 0.0001). The BASDAI, BASFI, BASMI, BASRI, ASQoL, HADS scores and CRP levels were negatively correlated with IIEF (p < 0.05). Orgasmic function and sexual desire scores were significantly lower in patients with peripheral arthritis (p < 0.05). No significant correlation was observed with the disease duration, smoking status, pain (VAS), and ESR levels when the total scores and the scores from the domains of IIEF were compared. The multivariate regression analyses indicated that BASFI and BASMI were independently associated with the sexual function. The sexual function is impaired in male patients with AS. This impairment in the sexual function is especially correlated with the BASFI and BASMI among the clinical and laboratory parameters.

Sariyildiz MA; Batmaz I; Dilek B; Inanir A; Bez Y; Tahtasiz M; Em S; Cevik R

2013-03-01

225

Deep external pudendal artery injury after percutaneous adductor tenotomy during THA in ankylosing spondylitis.  

UK PubMed Central (United Kingdom)

Arterial injuries following total hip arthroplasty (THA) are uncommon and are usually related to revision THA. Deep external pudendal artery injury and delayed bleeding due to percutaneous adductor tenotomy during THA has not been reported.A 62-year-old man with bilateral hip osteoarthritis and ankylosing spondylitis was treated with right cementless THA. Persistent severely limited hip abduction after prosthetic implantation required a percutaneous adductor tenotomy, which was performed bilaterally. No clinical signs of bleeding existed postoperatively. On postoperative day 3, the patient had a hypotensive attack, his right anteromedial thigh at the tenotomy site was distended, and the hemoglobin was 5.9 g/dL. Computed tomography angiography of the iliac and femoral vessels showed a right hematoma medial to the common femoral artery, with active contrast extravasation. Volumetric data reconstruction revealed active bleeding from the right external pudendal artery into an inguinal collection. Angiography was performed by the standard Seldinger technique via the contralateral femoral artery. A guiding catheter was placed as near to the lesion as possible. A microcatheter system and microguidewire were used for superselective catheterization, and 2 embolization coils were used to control the bleeding. The patient remained hemodynamically stable and was discharged 12 days later. Two-year follow-up was uneventful.The deep external pudendal artery may be injured during percutaneous adductor tenotomy, especially in patients with fragile arterial walls, and life-threatening complications may occur. Angiography and embolization are the best treatment options.

Sandri A; Regis D; Marino MA; Perandini S; Bonetti I; Toso M

2012-04-01

226

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

UK PubMed Central (United Kingdom)

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

Alvarez-Navarro C; López de Castro JA

2014-01-01

227

The relationship between peripheral arthritis and anti-cyclic citrullinated peptide antibodies in ankylosing spondylitis.  

UK PubMed Central (United Kingdom)

OBJECTIVES: Although ankylosing spondylitis (AS) primarily affects the axial skeleton, peripheral arthritis occurs in up to 35% of cases. Anti-cyclic citrullinated peptide (anti-CCP) antibodies are highly specific for rheumatoid arthritis, whereas their role in AS remains unclear. In this study we aimed to assess the prevalence of anti-CCP antibodies in AS patients with peripheral arthritis and their clinical association with peripheral arthritis. METHODS: We retrospectively selected for this study 625 AS patients who fulfilled the modified New York criteria. The patients were divided into those with and those without peripheral arthritis on smoking history, the basis of symptoms, physical examination and medical records. The presence of anti-CCP antibodies was investigated in all the patients. RESULTS: Anti-CCP antibodies were found in 4% (25/625) of the patients, and peripheral arthritis was diagnosed in 37.4% (234/625) of the patients. In multiple logistic regression, peripheral arthritis was significantly associated with female gender (P = 0.001) and the presence of anti-CCP antibodies (P = 0.001), especially with the presence of titers of anti-CCP antibodies over three times the normal upper limit of the laboratory and assay. CONCLUSIONS: Anti-CCP antibodies are occasionally present in AS, and their presence may be helpful as a serum marker for predicting peripheral arthritis.

Kim JO; Lee JS; Choi JY; Lee KH; Kim YB; Yoo DH; Kim TH

2013-07-01

228

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

International Nuclear Information System (INIS)

[en] 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)

2008-01-01

229

Associations between inflammation, nocturnal back pain and fatigue in ankylosing spondylitis and improvements with etanercept therapy.  

UK PubMed Central (United Kingdom)

OBJECTIVES: To investigate the relationships between inflammation, nocturnal back pain and fatigue in ankylosing spondylitis (AS) and the impact of 12 weeks' etanercept treatment versus sulfasalazine or placebo. METHODS: Data were combined from four clinical trials for patients with AS who received at least one dose of etanercept, sulfasalazine or placebo and had at least one postbaseline assessment value. Linear regression was performed (controlling for site, protocol and demographics), to explore the relationship between inflammation (C-reactive protein [CRP]), nocturnal back pain (visual analog scale [VAS] 0-100?mm) and fatigue (VAS 0-100?mm Bath AS Disease Activity Index fatigue item). RESULTS: Out of 1283 patients (etanercept, n?=?867; sulfasalazine, n?=?187; placebo, n?=?229), improvement in nocturnal back pain was a significant predictor of improvement in fatigue. Significant correlations were found between nocturnal back pain and fatigue, but not CRP levels. Etanercept provided significantly greater pain/fatigue improvement than sulfasalazine or placebo. Improvements in nocturnal back pain and fatigue had weak relationships with improvement in inflammation (CRP level). CONCLUSIONS: AS patients treated with etanercept demonstrated superior improvement in nocturnal back pain and fatigue versus sulfasalazine or placebo. Decrease in nocturnal back pain can improve fatigue. Assessing treatment response using CRP levels alone may be misleading without also examining patient-reported outcomes such as back pain and fatigue.

Hammoudeh M; Zack DJ; Li W; Stewart VM; Koenig AS

2013-08-01

230

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

Directory of Open Access Journals (Sweden)

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.

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

2012-01-01

231

TLR4 mutations (Asp299Gly and Thr399Ile) are not associated with ankylosing spondylitis.  

UK PubMed Central (United Kingdom)

BACKGROUND: Immunoregulatory genes and Gram negative gut bacteria are thought to be important in disease expression in ankylosing spondylitis (AS). OBJECTIVE: To compare the frequency of two common and functional TLR4 mutations (Asp299Gly, and Thr399Ile) between patients with AS and HLA-B27 healthy controls. METHODS: The TLR4 genotypes of patients and healthy HLA-B27 controls were determined using allele-specific PCR and restriction fragment length polymorphism analysis. Asp299Gly genotype was determined in 193 patients and 125 HLA-B27 positive controls and Thr399Ile genotype in 184 patients and 113 HLA-B27 controls. Allele frequencies were compared using a chi(2) test of association. RESULTS: 29/193 (15%) patients with AS had a polymorphism in the Asp299 site compared with 18/125 (14.4%) healthy HLA-B27 controls. Of the patients genotyped for the Thr399Ile allele, 29/184 (15.8%) carried the polymorphism compared with 19/113 (16.8%) HLA-B27 controls. No significant difference between the frequencies of the Asp299Gly genotype or the Thr399Ile genotype between patients with AS and healthy HLA-B27 controls was found. No significant difference in allele frequency was found at either site. CONCLUSION: Two common TLR4 polymorphisms, which cause a functional deficiency in host immune response to Gram negative bacteria, are not overrepresented in patients with AS.

Adam R; Sturrock RD; Gracie JA

2006-08-01

232

Can innominate motion be used to identify persons with ankylosing spondylitis? A pilot study.  

UK PubMed Central (United Kingdom)

Innominate movements during hip abduction and external rotation have recently been described in healthy individuals. In the present study the aim was to determine whether these hip movement tests could discriminate altered movement patterns in people with specific pelvic girdle pain (PGP) disorder. This pilot study is the first step in determining the usefulness of prone hip abduction and external rotation in the differential diagnosis of PGP disorders. A cross-sectional comparison between a convenient sample of 6 individuals who had been referred for exercise and advice following diagnosis of ankylosing spondylitis (AS) via a Medical/Rheumatological pathway and 18 healthy age and gender matched controls. Transverse and sagittal plane innominate motion was measured using a palpation and digitizing technique with a magnetic tracking device. Data analysis involved applying best-fit equations to the data and visual inspection of the produced graphs as well as conditional logistical regression for each test position to determine our ability to predict group association. Graphical comparisons demonstrate a distinction between the patients with AS and the healthy controls. Further, for all three hip conditions the innominate angle was a significant predictor of group association (p = 0.002 for AB, p = 0.005 for AB + ER and p = 0.007 for ER).

Bussey MD; Milosavljevic S

2013-04-01

233

Coexistence of Multiple Sclerosis and Ankylosing Spondylitis: Report of Two Cases.  

UK PubMed Central (United Kingdom)

Background: Multiple sclerosis (MS) only rarely coexists with ankylosing spondylitis (AS). The optimal management of these patients represents a major challenge. Methods: In the present study, we report 2 cases of AS with definite MS comorbidity. One of the AS-MS cases had received anti-TNF? treatment, which was discontinued due to exacerbation of the MS. In addition, we discuss 3 more AS cases with neurological symptoms and atypical white matter demyelinating MRI lesions after anti-TNF? treatment. Discussion: Given the fact that anti-TNF? drugs can potentially exacerbate a latent MS or induce atypical demyelination in the central nervous system, they should be discouraged or discontinued in relevant cases. The remaining effective therapeutic options for MS are either contradictory for AS (interferon-?), have no definite data regarding their safety/efficacy in AS (glatiramer acetate, azathioprine, natalizumab, fingolimod), or their efficacy in MS-AS is associated with increased treatment risks (rituximab). Any of these proposed treatments may require active patient's informed consent.

Lourbopoulos A; Ioannidis P; Boura E; Antoniadis D; Karacostas D; Grigoriadis N

2013-07-01

234

Assessment of outcome in ankylosing spondylitis: an extended radiographic scoring system  

Science.gov (United States)

Methods: The Stoke Ankylosing Spondylitis Spinal Score (SASSS) was modified by adding a score for the cervical spine and defining squaring. This modified SASSS (mSASSS) is the sum of the lumbar and cervical spine score (range 0–72). 370 lateral views of the lumbar and cervical spine were used for development of the mSASSS, standardisation of observers, and for studying reliability. In a 48 week NSAID study of 57 patients, change over time and construct validity were studied. Results: Interobserver correlations of the lumbar and cervical spine scores were good (r>0.95). The interobserver duplicate error was 0.55 in a range from 0 to 36. The mean change in the cervical and lumbar spine scores between weeks 0 and 48 of all patients was 1.45 (range 0–6.0) and 1.06 (0–5.0), respectively (paired t testing, p<0.001). Change in radiological score was seen in 36/57 (63%) patients (lumbar and cervical spine 11, cervical spine 12, lumbar spine 13 patients). Conclusion: The mSASSS is useful for assessing extensive radiographic damage in AS. It is reliable, detects changes over 48 weeks, and shows a satisfactory face and construct validity.

Creemers, M; Franssen, M; van 't, Hof M A; Gribnau, F; van de Putte, L B A; van Riel, P L C M

2005-01-01

235

The link between ankylosing spondylitis, Crohn's disease, Klebsiella, and starch consumption.  

UK PubMed Central (United Kingdom)

Both ankylosing spondylitis (AS) and Crohn's disease (CD) are chronic and potentially disabling interrelated conditions, which have been included under the group of spondyloarthropathies. The results of a large number of studies support the idea that an enteropathic pathogen, Klebsiella pneumoniae, is the most likely triggering factor involved in the initiation and development of these diseases. Increased starch consumptions by genetically susceptible individuals such as those possessing HLA-B27 allelotypes could trigger the disease in both AS and CD by enhancing the growth and perpetuation of the Klebsiella microbes in the bowel. Exposure to increased levels of these microbes will lead to the production of elevated levels of anti-Klebsiella antibodies as well as autoantibodies against cross-reactive self-antigens with resultant pathological lesions in the bowel and joints. Hence, a decrease of starch-containing products in the daily dietary intake could have a beneficial therapeutic effect on the disease especially when used in conjunction with the currently available medical therapies in the treatment of patients with AS and CD.

Rashid T; Wilson C; Ebringer A

2013-01-01

236

The expression of HLA-B27 locus-associated antigens in ankylosing spondylitis  

UK PubMed Central (United Kingdom)

To study the expression of HLA-B27 locus-associated antigens in patients with ankylosing spondylitis(AS). The HLA-B27 associated antigens were exiamined in 418 patients with spondyloarthropathies(SpAs) and 30 controls individuals by complement dependent microcytotoxity assay. There were 73 patients with AS in the SpAs. The percentage of positive Bw6,B27(47),B27 and B7/B27/B73/ B81 were 31%,28%,25% and 22%,respectively. In both the HLA-B27-postive group and HLA-B27-negative group, there were significantly difference among B27 alleles antigens of B27(47),B27 and B7.There was negatively correlation in both antigens B13 and Bw6.Conversely,there was positively correlation in both match antigens of Bw4 and B27(47),B7 and B27. There were strongly linkage disequilibrium in five match antigens of B13 and Bw6,B13 and B60/61/47/48/81(13),B7 and B27,Bw4 and B27(47),Cw1 and B42/B45. B27 antigens are not the only a factor to determine susceptibility to AS, other alleles-associated antigens may be either enhancing,such as Cw1 and Cw2 or suppressive,on the development of AS.

Jiang Yuzhang; Chen Caiyun; Liu Liang

237

Association of HLA B27 antigen in Indian patients of ankylosing spondylitis and other autoimmune diseases.  

UK PubMed Central (United Kingdom)

One thousand three hundred and forty clinically suspected patients of Ankylosing Spondylitis (AS) and other autoimmune diseases and 5000 controls were studied to detect the association of HLA B27 antigen amongst them. Other alleles studied include HLA B7, B40 (B60), B22(B55), B13, etc. Our findings show a considerable and consistent association of HLA B27 with AS irrespective of the community to which the patient, belonged his hygiene or socio-economic conditions. We also found that people in the age group of 21-39 were the most vulnerable, when number of affected individuals or severity of the disease were taken into consideration. Male members showed a preponderance over females in HLA B27 positivity. Detection of HLA B27 could help in the diagnosis of AS. Patients suffering from other autoimmune diseases such as rheumatoid arthritis, psoriasis, Reiter's syndrome and uveitis and patients with inflammatory bowel disease, colitis, eczema, bacillary or fungal infection were also found to be HLA B27 positive. A study of other alleles shows that even they sometimes associate AS and other autoimmune diseases.

Kankonkar SR; Raikar SC; Joshi SV; Tijoriwala SJ

1998-04-01

238

Pelvis-shoulder coordination during level walking in patients with ankylosing spondylitis.  

UK PubMed Central (United Kingdom)

Pelvis-shoulder coordination while walking may, as a consequence of changes in spinal structure and posture, be susceptible to modifications in ankylosing spondylitis (AS) sufferers. We designed an explanatory, cross-sectional trial to assess whether Pelvis-shoulder coordination during walking in AS patients differs from that in healthy subjects. Seventeen AS patients and 10 healthy sex- and age-matched subjects were enrolled. Gait analysis was performed in order to define the time-distance and kinematic characteristics during walking. Pelvis-shoulder coordination was calculated in terms of the continuous estimate of relative phase (CRP) between the pelvis and shoulder girdles on the transversal plane for the whole gait cycle (GC), as well as for its sub-phases. No differences were found between patients and controls as regards mean velocity, cadence and stride length. When kinematic variables were compared with those of healthy controls, AS patients displayed greater pelvic tilt and increased hip flexion in both the loading response (LR) and pre-swing (PSw) sub-phases. The CRP mean values significantly differed between groups. Moreover, patients displayed a peculiar CRP pattern, chiefly in the LR, terminal stance and PSw sub-phases. This visual consideration was confirmed by the analysis of the CRP mean values in these sub-phases of the GC. Our results suggest that the walking pattern of AS patients is characterized by altered Pelvis-shoulder coordination during the GC.

Mangone M; Scettri P; Paoloni M; Procaccianti R; Spadaro A; Santilli V

2011-05-01

239

Pelvis-shoulder coordination during level walking in patients with ankylosing spondylitis.  

Science.gov (United States)

Pelvis-shoulder coordination while walking may, as a consequence of changes in spinal structure and posture, be susceptible to modifications in ankylosing spondylitis (AS) sufferers. We designed an explanatory, cross-sectional trial to assess whether Pelvis-shoulder coordination during walking in AS patients differs from that in healthy subjects. Seventeen AS patients and 10 healthy sex- and age-matched subjects were enrolled. Gait analysis was performed in order to define the time-distance and kinematic characteristics during walking. Pelvis-shoulder coordination was calculated in terms of the continuous estimate of relative phase (CRP) between the pelvis and shoulder girdles on the transversal plane for the whole gait cycle (GC), as well as for its sub-phases. No differences were found between patients and controls as regards mean velocity, cadence and stride length. When kinematic variables were compared with those of healthy controls, AS patients displayed greater pelvic tilt and increased hip flexion in both the loading response (LR) and pre-swing (PSw) sub-phases. The CRP mean values significantly differed between groups. Moreover, patients displayed a peculiar CRP pattern, chiefly in the LR, terminal stance and PSw sub-phases. This visual consideration was confirmed by the analysis of the CRP mean values in these sub-phases of the GC. Our results suggest that the walking pattern of AS patients is characterized by altered Pelvis-shoulder coordination during the GC. PMID:21377366

Mangone, Massimiliano; Scettri, Paola; Paoloni, Marco; Procaccianti, Rita; Spadaro, Antonio; Santilli, Valter

2011-03-04

240

The association between varicocele and ankylosing spondylitis via color duplex sonography.  

Science.gov (United States)

OBJECTIVE: To evaluate the relationship between varicocele and ankylosing spondylitis (AS) via color duplex sonography (CDS). METHODS: Thirty male patients (age range 18-40 years, mean age 30.27 years) with AS and 30 male healthy controls (age range 20-36 years, mean age 27.23 years) were evaluated for varicocele using CDS. RESULTS: Vein diameter in right and left pampiniform plexus (PP) in the AS group was significantly higher than in the control group (p varicocele was observed as 33.3 % in the AS group and 10 % in the control group. However, the difference was statistically significant (p = 0.028). The rate of right, left, and bilateral varicocele was 3.3 % (1 patient), 23.3 % (7 patients), and 6.6 % (2 patients), respectively, in the AS group, versus 0, 10, and 0 % in the control group (p = 1.000, p = 0.166, and p = 0.492, respectively). CONCLUSIONS: The incidence of varicocele in AS patients is higher than in control subjects, and the difference is statistically significant. Therefore, varicocele must be taken into consideration and investigated in patients with AS. PMID:23436011

Hamidi, Cihad; Batmaz, Ibrahim; Gümü?, Hatice; Penbegül, Necmettin; Cetinçakmak, Mehmet Guli; Tahtas?z, Mehmet; Bilici, Aslan; Nas, Kemal

2013-02-23

 
 
 
 
241

The association between varicocele and ankylosing spondylitis via color duplex sonography.  

UK PubMed Central (United Kingdom)

OBJECTIVE: To evaluate the relationship between varicocele and ankylosing spondylitis (AS) via color duplex sonography (CDS). METHODS: Thirty male patients (age range 18-40 years, mean age 30.27 years) with AS and 30 male healthy controls (age range 20-36 years, mean age 27.23 years) were evaluated for varicocele using CDS. RESULTS: Vein diameter in right and left pampiniform plexus (PP) in the AS group was significantly higher than in the control group (p < 0.001 and p = 0.003, respectively). The incidence of varicocele was observed as 33.3 % in the AS group and 10 % in the control group. However, the difference was statistically significant (p = 0.028). The rate of right, left, and bilateral varicocele was 3.3 % (1 patient), 23.3 % (7 patients), and 6.6 % (2 patients), respectively, in the AS group, versus 0, 10, and 0 % in the control group (p = 1.000, p = 0.166, and p = 0.492, respectively). CONCLUSIONS: The incidence of varicocele in AS patients is higher than in control subjects, and the difference is statistically significant. Therefore, varicocele must be taken into consideration and investigated in patients with AS.

Hamidi C; Batmaz I; Gümü? H; Penbegül N; Cetinçakmak MG; Tahtas?z M; Bilici A; Nas K

2013-02-01

242

Clinical efficacy of etanercept versus sulfasalazine in ankylosing spondylitis subjects with peripheral joint involvement.  

UK PubMed Central (United Kingdom)

OBJECTIVE: Etanercept, a fully human tumor necrosis factor soluble receptor, is effective in treatment of ankylosing spondylitis (AS). Current guidelines suggest sulfasalazine (SSZ) treatment as initial therapy for the management of patients with AS with peripheral arthritis versus therapy with biologics. We compared the efficacy of etanercept with SSZ in patients with AS with peripheral joint involvement. METHODS: The efficacy of etanercept 50 mg once weekly was compared with that of SSZ up to 3 g daily in subjects with ? 1 swollen peripheral joint at baseline, using data from a 16-week randomized double-blind study in subjects with AS. Efficacy was assessed by the Assessment in AS criteria and the Bath AS Disease Activity, Functional, and Metrology indices. The last observation carried forward method was used for imputation of missing values. RESULTS: Of 566 subjects included in original study, 181 (etanercept 121; SSZ 60) had ? 1 swollen peripheral joint and 364 (etanercept 250; SSZ 124) had none at baseline. AS patients treated with etanercept showed significantly greater improvement than those treated with SSZ in all joint assessments regardless of swollen joint involvement. CONCLUSION: In this analysis, etanercept was significantly more effective than SSZ for management of patients with AS and peripheral joint involvement.

Braun J; Pavelka K; Ramos-Remus C; Dimic A; Vlahos B; Freundlich B; Koenig AS

2012-04-01

243

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

Directory of Open Access Journals (Sweden)

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; Sevil Okan; Behcet Filiz

2013-01-01

244

Profiling of hla-B alleles for association studies with ankylosing spondylitis in the chinese population.  

UK PubMed Central (United Kingdom)

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 L; Wang J; Guo X; Espitia MG; Chen E; Assassi S; Jin L; Zou H; Reveille JD; Zhou X

2013-01-01

245

A systematic literature review of the economic impact of ankylosing spondylitis.  

UK PubMed Central (United Kingdom)

This article reviews the last decade studies on the economic impact of ankylosing spondylitis (AS). Interestingly, a common observation is that in AS indirect costs are higher than the use of direct healthcare resources. Country, age, gender, and severity of the diseases impact on per patient annual costs AS related. Different payment and reimbursement regimes may impact on the amount and distribution of indirect costs. The differences observed among countries on absolute and relative (compared with direct costs) amounts of indirect costs can be explained with the capability of a country of actually measure productivity losses and indirect costs. Low indirect costs without other indicators should not be considered as a sign of efficiency in AS care, but may be due to an underestimation of AS-related costs; as a consequence, indirect costs may be a net loss for patients that nobody can repay. A private insurance reimbursement regime has the highest capability of inducing players to define, select and actually identify indirect costs better than in different reimbursement regimes. Therefore indirect costs may become very high in case of private insurance regimes because of their more detailed identification.

Palla I; Trieste L; Tani C; Talarico R; Cortesi PA; Mosca M; Turchetti G

2012-07-01

246

Increased serum IL-17 and IL-23 in the patient with ankylosing spondylitis.  

UK PubMed Central (United Kingdom)

Interleukin 17 (IL-17) is a Th17 cytokine associated with inflammation, autoimmunity, and defense against some bacteria; it has been implicated in many chronic autoimmune diseases including psoriasis, multiple sclerosis, and systemic sclerosis. However, whether IL-17 plays a role in the pathogenesis of ankylosing spondylitis (AS) remains unclear. To analyze the content of IL-17 and IL-23 in the serum from patients with AS compared with health control subject, 50 patients with AS and 43 healthy volunteers were recruited. Serum IL-17 levels were examined by enzyme linked immunosorbent assay (ELISA). Statistic analyses were performed by SPSS 13.0. Results show that the serum IL-17 and IL-23 levels were significantly elevated in AS patients as compared with normal controls. Nevertheless, no associations of serum IL-17 and IL-23 levels with clinical and laboratory parameters were found; no significant difference regarding serum IL-17 and IL-23 levels was found between less active AS and more active AS. However, there was a strong positive association between the serum levels of IL-17 and IL-23 in the AS patients. Our results indicate increased serum IL-17 and IL-23 levels in AS patients, suggesting that this two cytokine may play critical roles in the pathogenesis of AS. Therefore, further studies are required to confirm this preliminary data.

Mei Y; Pan F; Gao J; Ge R; Duan Z; Zeng Z; Liao F; Xia G; Wang S; Xu S; Xu J; Zhang L; Ye D

2011-02-01

247

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; Chopra Gaurav; Chaudhary Amit; Rizvi Aslam; Sharma J

2009-01-01

248

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

Scientific Electronic Library Online (English)

Full Text Available 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 (more) 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 acomet (more) e 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 articulations and connective tissues can be affected by the inflammatory process. It affects mainly men between the ages of 20 and 40; it is rare after the age of 50. Women repres (more) ent a minority of patients. There is little information about AS in the anesthetic literature. The objective of this article was to review the characteristics of AS pertaining anesthesiology for an adequate perioperative handling. CONTENTS: The clinical characteristics of ankylosing spondylitis pertaining to the anesthetic conduct are reviewed. CONCLUSIONS: Patients with chronic diseases of the spine represent specific challenges to the anesthesiologist. Ha

Oliveira, Carlos Rogério Degrandi

2007-04-01

249

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

UK PubMed Central (United Kingdom)

OBJECTIVE: To investigate the changes in hip MR imaging, evaluate the frequency of hip involvement and compare the value of clinical symptoms, radiographs, and MR imaging in the detection of hip involvement in patients with ankylosing spondylitis (AS). METHODS: Anteroposterior radiographs of the pelvis, MR imaging of the hip and clinical evaluation were undertaken in 58 patients with definite AS. All patients were followed up 3 years. Annual radiographs and clinical evaluation were carried out. The imaging data were independently assessed by two experienced radiologists who were blinded to patient identity and clinical characteristics. Based on the Bath Ankylosing Spondylitis Radiology Hip Index (BASRI-hip) scoring system, BASRI-hip scores ? 2 were defined as radiological hip involvement. On MR imaging, both acute and chronic inflammatory changes were considered positive signs for hip involvement. Symptomatic hip involvement was defined as current or past pain or limitation of the hip movement. The statistical analysis was performed using the ?(2) test for comparison of sensitivity among clinical symptoms, radiographs, and MR imaging in the detection of hip involvement and the Student's t-test for comparison of disease duration between with and without hip involvement. A P value <0.05 was considered to be statistically significant. For interpreting MRI and radiographs, the percentage of agreement between the two assessors and the kappa coefficients were calculated. RESULTS: On MR imaging, positive changes were detected in 86 (74.1%) hips among 116 hips in all 58 patients. Joint effusion was observed in 73 (62.9%) hips; 23 out of 27 patients who underwent fat-saturated contrast-enhanced T1-weighted sequences had abnormal synovial enhancement in bilateral hips. The other abnormal MR findings included subchondral bone marrow edema in 35 (30.2%) hips, enthesitis in 22 (19.0%) hips, fatty accumulation of the bone marrow in 28 (24.1%) hips, bone erosive destruction in 32 (27.6%) hips, and joint-space narrowing in 4 (3.4%) hips. Based on the BASRI-hip scoring system, 68, 24, 18, 6 and 0 hips had no, suspicious, mild, moderate or severe damage on conventional radiographs of the pelvis, respectively. Thirty-five hips in 20 patients had current or past pain or limitation. The proportion of hip involvement according to MR imaging, radiographs, and clinical symptoms was 74.1% (86/116), 20.7% (24/116), and 30.2% (35/116), respectively. MR imaging yielded higher values than radiographs and clinical symptoms in the detection of hip involvement in patients with AS (?(2)=66.45 and 44.93, P <0.05). Interreader reliability for interpretation of findings was acceptable for both MRI and radiographs. During follow-up, radiological hip involvement were found in 10 hips with BASRI-hip scores ? 1 at baseline and clinical symptoms appeared in 15 sides of the original asymptomatic hip. On baseline MR imaging, inflammatory changes were seen in all hips which appeared symptoms and/or radiological involvement both at baseline and during follow-up. CONCLUSION: The proportion of hip involvement is much higher than that suggested by radiographic changes and clinical symptoms. MR imaging is superior to conventional radiographs and clinical symptoms in the detection of hip involvement. Joint effusion and synovial enhancement caused by synovitis are the commonest hip findings on MR imaging in patients with AS.

Huang ZG; Zhang XZ; Hong W; Wang GC; Zhou HQ; Lu X; Wang W

2013-09-01

250

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

Directory of Open Access Journals (Sweden)

Full Text Available JUSTIFICATIVA E OBJETIVOS: A espondilite anquilosante (EA) é uma doença inflamatória crônica das articulações, incluída no grupo das espondiloartropatias soronegativas. A característica principal dessa doença é a fusão óssea da coluna vertebral que leva à perda permanente da flexibilidade do dorso e do pescoço. Outras grandes articulações e tecidos conectivos poderão estar afetados pelo processo inflamatório. A EA acomete principalmente homens entre 20 e 40 anos; é rara após os 50 anos. As mulheres correspondem somente à minoria de pacientes. Há pouca informação sobre a EA na literatura anestésica. O objetivo deste artigo foi revisar aspectos da EA de interesse para o anestesiologista, permitindo um adequado manuseio perioperatório. CONTEÚDO: Estão definidas as características da espondilite anquilosante quanto à clínica e a conduta anestésica. CONCLUSÕES: Os pacientes com doenças crônicas da coluna vertebral apresentam desafios específicos para o anestesiologista. O manuseio da via aérea e o acesso ao neuroeixo poderão ser difíceis. Preferência tem sido dada à anestesia geral, mesmo com via aérea difícil reconhecida, evitando-se a anestesia no neuroeixo. O grau de envolvimento da coluna cervical determinará o quanto poderá ser difícil a intubação traqueal. Cuidado especial deve ser tomado para evitar a manipulação excessiva da coluna cervical, que poderia levar ao trauma da medula espinhal.JUSTIFICATIVA Y OBJETIVOS: La espondilitis anquilosante (EA) es una enfermedad inflamatoria crónica de las articulaciones, incluida en el grupo de las espondiloartropatías soronegativas. La característica principal de esa enfermedad es la fusión ósea de la columna vertebral que conlleva a la pérdida permanente de la flexibilidad del dorso y del cuello. Otras grandes articulaciones y tejidos conectivos podrán estar afectados por el proceso inflamatorio. La EA acomete principalmente a hombres entre los 20 y 40 años; es rara después de los 50 años. Las mujeres corresponden solamente a la minoría de pacientes. Existe poca información sobre la EA en la literatura anestésica. El objetivo de este artículo fue revisar aspectos de la EA de interés para el anestesiólogo, permitiendo un adecuado manoseo perioperatorio. CONTENIDO: Están definidas las características de la espondilitis anquilosante en cuanto a la clínica y la conducta anestésica. CONCLUSIONES: Los pacientes con enfermedades crónicas de la columna vertebral presentan desafíos específicos para el anestesiólogo. El manoseo de la vía aérea y el acceso al neuro-eje podrán ser difíciles. La preferencia ha sido dada a la anestesia general, incluso con la vía aérea de difícil acceso, evitando la anestesia en el neuro-eje. El grado de involucración de la columna cervical determinará cuanto podrá ser difícil la intubación traqueal. Un cuidado especial debe tenerse para evitar la manipulación excesiva de la columna cervical, lo que podría conllevar al trauma de la médula espinal.BACKGROUND AND OBJECTIVES: Ankylosing spondylitis (AS) is a chronic inflammatory disease of the joints, included in the group of seronegative spondyloarthropathies. Its main characteristic is the fusion of the bones in the spine, which causes loss of flexibility of the back and neck. Other large articulations and connective tissues can be affected by the inflammatory process. It affects mainly men between the ages of 20 and 40; it is rare after the age of 50. Women represent a minority of patients. There is little information about AS in the anesthetic literature. The objective of this article was to review the characteristics of AS pertaining anesthesiology for an adequate perioperative handling. CONTENTS: The clinical characteristics of ankylosing spondylitis pertaining to the anesthetic conduct are reviewed. CONCLUSIONS: Patients with chronic diseases of the spine represent specific challenges to the anesthesiologist. Handling of the airways and the access to the neuroaxis can be difficult. Most anesthesiol

Carlos Rogério Degrandi Oliveira

2007-01-01

251

Chest expansion in healthy adolescents and patients with the seronegative enthesopathy and arthropathy syndrome or juvenile ankylosing spondylitis.  

UK PubMed Central (United Kingdom)

OBJECTIVE: To determine chest expansion measurements in healthy children and those with juvenile spondyloarthropathies. METHODS: Chest expansion, as defined by the difference between maximal inspiration and maximal expiration was measured in 157 healthy adolescents (112 boys and 45 girls) aged 11 to 15 years, 20 patients with the seronegative enthesopathy and arthropathy (SEA) syndrome and 15 with juvenile ankylosing spondylitis (AS). RESULTS: The median and mean chest expansion (+/- 2 SD) were 5.0 cm and 5.6 cm (+/- 3.52) for the whole group of healthy adolescents, 6.0 cm and 5.9 cm (+/- 3.64) for boys and 5.0 cm and 4.8 cm (+/- 2.69) for girls. The frequency distribution of the values was leptokurtic and skewed to the right and did not follow the normal pattern; nearly 90% of the measurements fell within the interval from 3 to 9 cm. Of all variables analyzed (age, height, weight, sex and health/disease status), only height correlated with chest expansion (r = 0.20, p = 0.01). Even so, the effect of all these variables explained only 13% of the total variance of the measurements. Interobserver and intraobserver intraclass correlation coefficients were moderate (0.58 and 0.67, respectively). Mean values and cumulative frequency distribution in asymptomatic and symptomatic SEA syndrome and patients with juvenile AS were similar to those from healthy adolescents. CONCLUSION: Measuring chest expansion does not seem to be a useful method for the rare cases of early involvement of the chest joints in SEA syndrome and juvenile AS.

Burgos-Vargas R; Castelazo-Duarte G; Orozco JA; Garduño-Espinosa J; Clark P; Sanabria L

1993-11-01

252

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

International Nuclear Information System (INIS)

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

2010-01-01

253

Assessment of sexual functions in female patients with ankylosing spondylitis compared with healthy controls.  

UK PubMed Central (United Kingdom)

Healthy human sexuality is integral to a well-lived life. Recent studies reported that sexual problems were common in patients with ankylosing spondylitis (AS) in relation to the consequences of the illness such as pain, stiffness of the spine and depression. Twenty-three female patients with AS and 27 healthy female controls were applied the Female Sexual Function Index (FSFI) to determine the influence of the disease on sexual functions. The rate of low sexual function was 60.9% in female patients with AS and 66.7% in healthy controls (P > 0.05). Ten patients were depressed in our study group according to the Beck Depression Inventory (BDI), while 15 healthy controls were depressed (P > 0.05). No statistically significant differences were found between the female patients and controls in FSFI and BDI scores. There was a significant correlation between BDI and total FSFI, desire and orgasm domains in female patients with AS. Pain, disease activity and functional status of the patients with AS were correlated with FSFI. However, there was no correlation between spinal mobility, laboratory parameters and sexual functions. General health, vitality, emotional role and mental health subscales of Short Form-36 were correlated with total FSFI scores. We did not find any relationship between AS quality of life scale and sexual functions. Sexual dysfunctions are common, but not different in female patients with AS when compared with healthy controls. Sexual problems in female patients with AS seem to be associated with higher depression level, increased disease activity, decreased functionality, higher pain scores and decreased quality of life.

Demir SE; Rezvani A; Ok S

2013-01-01

254

Real-time sonoelastography of Achilles tendon in patients with ankylosing spondylitis.  

UK PubMed Central (United Kingdom)

OBJECTIVE: Real-time sonoelastography (SE) is a new ultrasound-based imaging technique that provides information on tissue elasticity and stiffness. We determined the efficacy of SE for assessing Achilles tendon abnormalities in patients with ankylosing spondylitis (AS). MATERIALS AND METHODS: Forty-one consecutive AS patients and 32 asymptomatic healthy subjects were enrolled. Achillodynia was scored on a 0- to 100-mm visual analog scale. A high-resolution ultrasound machine equipped with an elastography-compatible linear probe was used to perform bilateral B-mode ultrasound, Doppler ultrasound, and SE examinations of Achilles tendons. Tendons were divided into proximal, middle, and distal segments. B-mode examinations included tendon thicknesses, echotextures, and enthesopathic findings. SE using color-coded images was performed in the same areas. Normal consistent tendon structures were coded as blue or green, and moderately (yellow) or severely (red) softened areas were considered pathological. RESULTS: The distal third of the Achilles tendons was the most commonly affected part in the AS patients compared with healthy subjects (p?=?0.001), whose middle third was more commonly affected. Achillodynia intensity tended to be higher in patients with pathological B-mode or SE examination findings (p?=?0.09 and p?=?0.07 respectively). Softening detected by SE in the distal third was associated with enthesopathy findings such as calcaneal bone erosions (Fisher's X (2), p?=?0.07) and tendinous enlargement (Fisher's X (2), p?=?0.001). B-mode and SE findings had moderate to good correlation in the assessment of Achilles tendon abnormalities. CONCLUSIONS: Sonoelastography may be useful for the evaluation of tendon abnormalities in patients with AS; in addition; it may be useful for the evaluation of other inflammatory rheumatic conditions.

Turan A; Tufan A; Mercan R; Teber MA; Tezcan ME; Bitik B; Goker B; Haznedaro?lu S

2013-08-01

255

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

UK PubMed Central (United Kingdom)

OBJECTIVES: Exercise is reported to improve function for people with ankylosing spondylitis (AS) but it is not clear if this effect is causal or if patients with milder disease find it easier to exercise. This study examines the effect of exercise and motivation to exercise on function, while controlling for disease severity. METHODS: Participants who were members of an existing AS cohort were asked about physical activity, motivation to exercise, function, and disease severity. Path analysis on STATA was used to examine the correlation between factors associated with function at time of exercise and with function after 3 months of follow-up. RESULTS: The response rate to the questionnaire was 88% (326/371). Improvement in function was greatest for people with higher physical activity levels and those who were more motivated to exercise-this was especially the case for patients with the most severe disease activity. The effect of motivation to exercise not only had a direct effect on function, but also an indirect effect of improving activity levels thereby improving both current and future function. People with high intrinsic motivation (driven by pleasure) had the greatest benefit to activity and function. CONCLUSIONS: Exercise does improve function, especially for those with severe disease. In addition, motivation alone improves function as much as exercising itself. Therefore, interventions targeting motivation to exercise would have as much effect on improving function as interventions offering exercise opportunities. In addition, any intervention that both improves motivation and increases opportunities to exercise would have a 2-fold influence on function.

Brophy S; Cooksey R; Davies H; Dennis MS; Zhou SM; Siebert S

2013-06-01

256

Serum melatonin level in ankylosing spondylitis: is it increased in active disease?  

UK PubMed Central (United Kingdom)

In the recent years, the role of melatonin (MLT) in the pathogenesis of inflammatory arthritis has been investigated, and the serum levels of MLT have been evaluated, but clinical study concerning MLT and ankylosing spondylitis (AS) is little reported in literature. We aimed to investigate the serum levels of MLT and their relation with the disease activity parameters of patients with AS. Forty AS patients and 40 healthy controls (matched for age and sex with the patients) participated in this study. Demographic and clinical data were collected and assessed. Disease activity of AS patients was assessed clinically according to the Bath AS Disease Activity Index (BASDAI), while AS functional impairment was assessed using the Bath AS Functional Index (BASFI). Serum samples were collected from all subjects to evaluate serum MLT, ESR, and CRP. Serum MLT levels were significantly increased in AS patients as compared to healthy controls (95% CI: 4.63, 8.77, P < 0.001). ESR and CRP are significantly higher in the AS patients compared with the controls (P < 0.001). AS patients with active disease had significantly higher ESR (P = 0.0151), CRP (P = 0.0124), and BASFI (P = 0.0016). Also, the MLT serum level in AS patients with BASDAI ?40 was 39.7 ± 6.2 pg/ml compared with 35.2 ± 3.5 pg/ml in AS patients with BASDAI <40 (95% CI: 1.22, 7.78, P = 0.0106). Also, serum MLT level was significantly higher in the AS patients with enthesopathy than those without enthesopathy. Serum MLT levels were correlated with the duration of morning stiffness, BASDAI, BASFI, and CRP but not with ESR or duration of the disease. Serum levels of MLT were significantly increased in AS patients as compared to healthy controls. MLT levels correlated positively with BASDAI, BASFI, duration of morning stiffness, and CRP levels. Thus, it seems that MLT levels reflect the disease activity in AS patients.

Senna MK; Olama SM; El-Arman M

2012-11-01

257

Association between ankylosing spondylitis and chronic periodontitis: a population-based study.  

UK PubMed Central (United Kingdom)

OBJECTIVE: Ankylosing spondylitis (AS) is one type of chronic inflammatory rheumatic disease. It has been suggested that rheumatic diseases may have additional underlying factors in common with chronic periodontitis. However, few studies have addressed the possible link between AS and chronic periodontitis. We undertook the present case-control study to investigate the possible association between AS and chronic periodontitis using a population-based data set in Taiwan. METHODS: We conducted this study by using administrative claims data sourced from the Taiwan National Health Insurance program database. Our study included 6,821 AS patients and 34,105 randomly selected controls. Conditional logistic regression analyses were performed to calculate the odds ratios (ORs) and 95% confidence intervals (95% CIs) for prior chronic periodontitis among AS patients and matched controls. RESULTS: There was a significant difference in the prevalence of prior chronic periodontitis between patients and controls (41.5% versus 25.9%; P<0.001). Conditional logistic regression analysis revealed that patients were more likely than controls to have been previously diagnosed as having chronic periodontitis (adjusted OR 1.84 [95% CI 1.74-1.98]). We further found that patients were only 1.70 (95% CI 1.56-1.89) times more likely than controls to have undergone a gingivectomy or periodontal flap operation (all patients had a history of chronic periodontitis) within the 5 years preceding the index date. After excluding those who had undergone either a gingivectomy or periodontal flap surgery, patients were even more likely than controls to have been previously diagnosed as having chronic periodontitis (adjusted OR 2.04 [95% CI 1.93-2.15]). CONCLUSION: This study detected an association between AS and a prior diagnosis of chronic periodontitis.

Keller JJ; Kang JH; Lin HC

2013-01-01

258

Thyroid involvement in ankylosing spondylitis and relationship of thyroid dysfunction with anti-TNF ? treatment.  

UK PubMed Central (United Kingdom)

Association between rheumatological and autoimmune thyroid disorders has been demonstrated by many studies. However, a few data exist indicating the association between thyroid disorders and ankylosing spondylitis (AS). In this study, the frequency of thyroid disorders in patients with AS and the impact of anti-TNF ? therapy on this were investigated. Data of 108 patients (female/male (F/M) 27/81) were analyzed. Data on free T3, free T4, thyroid-stimulating hormone, anti-thyroid peroxidase antibodies (TPO), anti-thyroglobulin antibodies, and thyroid ultrasound were assessed retrospectively. 44 (F/M 15/29) patients were receiving anti-TNF ?, while 64 (F/M 12/52) were receiving other drugs [(sulfasalazine, anti-inflammatory drug (NSAIDs)]. Among those not receiving anti-TNF ? therapy, TPO level was high in 23 patients (mean TPO value 86.69 ± 65.28 U/ml), while it was high only in nine receiving anti-TNF ? (mean TPO 36.61 ± 14.02 U/ml) (p < 0.05). Investigating the data regarding gender in both populations, autoimmune thyroid disease frequency was found to be lower in the patient group receiving anti-TNF ? treatment. Subclinical hyperthyroidism was discovered in three patients (one female two male), and subclinical hypothyroidism in two (two male). Thyroid nodule was detected in 29 patients. It was concluded that the frequency of thyroid autoimmune disease was higher in our study than that reported in the literature, and the frequency of thyroid disorder in patients with AS was lower in those receiving anti-TNF ? compared to those not. This may arise from the role of TNF ? on pathogenesis of thyroid disorders.

Tarhan F; Orük G; Niflio?lu O; Ozer S

2013-04-01

259

Cellular immune response to Klebsiella pneumoniae antigens in patients with HLA-B27+ ankylosing spondylitis.  

UK PubMed Central (United Kingdom)

OBJECTIVE: To study the reactivity of peripheral blood mononuclear cells (PBMC) of patients with ankylosing spondylitis (AS) and rheumatoid arthritis (RA) and healthy controls to Klebsiella pneumoniae antigens and to the GroEL-like proteins from K. pneumoniae (HSP60Kp) and Mycobacterium leprae recombinant heat shock protein 65 (rHSP65Ml). METHODS: PBMC of 13 patients with AS and 9 with RA and 10 controls were stimulated in vitro by heat shock induced K. pneumoniae antigens in a cell blot assay, by insolubilized HSP60Kp, by cytosolic proteins (CP) from K. pneumoniae cultivated at 37 degrees C or 45 degrees C, by soluble HSP60Kp, or by rHSP65Ml. RESULTS: In the cell blot assay 7/13 AS and 3/9 RA patients responded to fraction 4, which contains mainly HSP60Kp, and no controls responded (AS vs. controls: p = 0.007). The response to the insolubilized HSP60Kp was positive in 6/13 AS patients but negative in RA patients and controls (p = 0.004). The response to CP45 degrees C was positive in 7/13 AS, in 2/9 RA, and no controls (AS vs controls: p<0.015). Response to the soluble HSP60Kp was found in 7/13 AS and 5/9 RA patients, but no controls (AS vs. controls: p = 0.0075). Response to rHSP65Ml was positive in 3/13 AS, 7/9 RA patients, and 1/10 controls (AS vs RA: p = 0.027; RA vs. controls: p = 0.005; AS vs. controls: nonsignificant). CONCLUSION: In PBMC of the majority of patients with AS and in some with RA, but not in healthy controls, there are cells that proliferate in the presence of HSP60 of K. pneumoniae.

Domínguez-López ML; Cancino-Díaz ME; Jiménez-Zamudio L; Granados-Arreola J; Burgos-Vargas R; García-Latorre E

2000-06-01

260

Tumour necrosis factor blocking agents and progression of subclinical atherosclerosis in patients with ankylosing spondylitis.  

UK PubMed Central (United Kingdom)

BACKGROUND: Ankylosing spondylitis (AS) is associated with an increased cardiovascular risk that might be due to the chronic underlying inflammatory process. We investigated whether subclinical atherosclerosis of the carotid artery in patients with AS was reduced after anti-inflammatory treatment with tumour necrosis factor (TNF) inhibitors in a prospective observational cohort study. METHODS: 67 out of 81 AS patients who used TNF inhibitors and underwent ultrasonography at baseline returned for follow-up after 4.9 years. Of all patients, 12 (15%) discontinued the use of TNF inhibitors. Assessments of medication use, AS-related factors and cardiovascular risk factors were measured at baseline and repeated at follow-up. B-mode carotid ultrasonography was used to investigate arterial wall parameters, including carotid intima-media thickness (cIMT) and Young's elastic modulus (YEM). RESULTS: After a median 4.9 years of follow-up, cIMT did not change significantly (paired t test +0.011 mm, p=0.561) in those who continued the use of TNF inhibitors, while cIMT increased substantially (+0.057 mm, p=0.069) in those who did not continue their use of TNF inhibitors. The effect of TNF inhibitors was mainly mediated by a subsequent decrease in AS disease activity. Vascular elasticity (as measured with YEM) did not change significantly in patients who discontinued TNF inhibitors or those who continued TNF inhibitors. CONCLUSIONS: The use of TNF inhibitors might stabilise or slow down the progression of subclinical atherosclerosis in AS patients, reflecting a decreased cardiovascular risk in these patients.

van Sijl AM; van Eijk IC; Peters MJ; Serné EH; van der Horst-Bruinsma IE; Smulders YM; Nurmohamed MT

2013-10-01

 
 
 
 
261

The economic burden of the ankylosing spondylitis in the Czech Republic: comparison between 2005 and 2008.  

UK PubMed Central (United Kingdom)

To investigate the burden of ankylosing spondylitis in the Czech Republic as a baseline for future health economic evaluations. Data were obtained from two cross-sectional studies Beda I (2005) and Beda II (2008), performed in 1,008 and 509 patients, respectively. Methodology used was Cost-of-Illness prevalence-based analysis bottom-up approach. Analysis was performed from payer (health insurance companies) and societal perspective (including productivity costs using friction cost approach). Mean age of sample in Beda I and Beda II was 50.2 and 52.5 years, male were present by 61.0 and 62.7 %; average disease duration was 23.0 and 26.4 years, respectively. Mean total annual costs per patient in the sample were €4,782 in Beda I and €5806 in Beda II. Average direct costs per patient in the sample per year are estimated at €1,812 (Beda I) and €2,588 (Beda II) with the average productivity costs €2,970 (Beda I) and €3,218 (Beda II). We observed a small decrement in percentage (6.7 %) of productivity costs for Beda II as an influence of higher consumption of biologic drugs, hence higher direct costs and possible productivity preservation. The largest direct cost burdens were spa procedures (45.3 %, Beda I) and biological drugs (52.8 %, Beda II). Unique analysis of the burden of the AS in the Central-Eastern Europe presents health care resource and cost consumption by comparing two cross-sectional prevalence-based studies. Further analysis should be carried to obtain data connecting health status with costs consumption in order to analyse the AS from this perspective.

Pet?íková A; Doležal T; Klimeš J; Vocelka M; Sedová L; Kolá? J

2013-07-01

262

Preferential type 1 chemokine receptors and cytokine production of CD28- T cells in ankylosing spondylitis.  

UK PubMed Central (United Kingdom)

OBJECTIVE: To examine serum levels of type 1 and type 2 chemokines and lymphocytic expression of chemokine receptors, and to compare the results with lymphocytic cytokine production in patients with ankylosing spondylitis (AS). METHODS: Twelve patients with AS (mean (SD) age 44.9 (14.7) years) and 27 healthy controls (46.4 (12.8) years) were enrolled into the study. The expression of chemokine receptors (CCR-5, CXCR-3, CCR-4) and cytokines (interferon gamma (IFNgamma), interleukin (IL)2, IL4, IL10, tumour necrosis factor alpha (TNFalpha)) on CD28(+) and CD28(-) T cell subtypes was analysed by a three colour FACS technique of peripheral blood samples. Serum ELISAs were performed to detect the CCR-5 ligands CCL-5, CCL-3; the CXCR-3 ligands CXCL-10, CXCL-9; and the CCR-4 ligand, CCL-17 before and after administration of the TNFalpha blocking agent infliximab. RESULTS: CD4(+)CD28(-) T cells had higher ratios of CXCR-3 to CCR-4 than CD4(+)CD28(+) T cells. Both, CD4(+) and CD8(+)CD28(-) T cells of patients with AS produced more IFNgamma, TNFalpha, and IL10 than their CD28(+) counterparts (p<0.05), and lacked the production of IL2 and IL4. Serum levels of CXCL-9 were increased in patients with AS to 59.2 pg/ml (34.1-730.5) compared with 32.5 pg/ml (20.0-79.5) in healthy controls (p = 0.016). The levels of both type 1 (CCL-5, CXCL-9) and type 2 chemokines (CCL-17) decreased under blockade of TNFalpha (p<0.05). CONCLUSIONS: The profile of chemokine receptor expression and cytokine production by CD28(-) T cells suggests a type 1 immune reaction in AS, although IL10 is frequently produced by CD28(-) T cells. Treatment with TNFalpha blocking antibodies decreased both types of chemokines in patients' sera.

Duftner C; Dejaco C; Kullich W; Klauser A; Goldberger C; Falkenbach A; Schirmer M

2006-05-01

263

Preferential type 1 chemokine receptors and cytokine production of CD28? T cells in ankylosing spondylitis  

Science.gov (United States)

Objective To examine serum levels of type 1 and type 2 chemokines and lymphocytic expression of chemokine receptors, and to compare the results with lymphocytic cytokine production in patients with ankylosing spondylitis (AS). Methods Twelve patients with AS (mean (SD) age 44.9 (14.7)?years) and 27 healthy controls (46.4 (12.8)?years) were enrolled into the study. The expression of chemokine receptors (CCR?5, CXCR?3, CCR?4) and cytokines (interferon ? (IFN?), interleukin (IL)2, IL4, IL10, tumour necrosis factor ? (TNF?)) on CD28+ and CD28? T cell subtypes was analysed by a three colour FACS technique of peripheral blood samples. Serum ELISAs were performed to detect the CCR?5 ligands CCL?5, CCL?3; the CXCR?3 ligands CXCL?10, CXCL?9; and the CCR?4 ligand, CCL?17 before and after administration of the TNF? blocking agent infliximab. Results CD4+CD28? T cells had higher ratios of CXCR?3 to CCR?4 than CD4+CD28+ T cells. Both, CD4+ and CD8+CD28? T cells of patients with AS produced more IFN?, TNF?, and IL10 than their CD28+ counterparts (p<0.05), and lacked the production of IL2 and IL4. Serum levels of CXCL?9 were increased in patients with AS to 59.2?pg/ml (34.1–730.5) compared with 32.5?pg/ml (20.0–79.5) in healthy controls (p?=?0.016). The levels of both type 1 (CCL?5, CXCL?9) and type 2 chemokines (CCL?17) decreased under blockade of TNF? (p<0.05). Conclusions The profile of chemokine receptor expression and cytokine production by CD28? T cells suggests a type 1 immune reaction in AS, although IL10 is frequently produced by CD28? T cells. Treatment with TNF? blocking antibodies decreased both types of chemokines in patients' sera.

Duftner, C; Dejaco, C; Kullich, W; Klauser, A; Goldberger, C; Falkenbach, A; Schirmer, M

2006-01-01

264

Serum levels of novel noggin and sclerostin-immune complexes are elevated in ankylosing spondylitis.  

UK PubMed Central (United Kingdom)

BACKGROUND: Unravelling the basis of joint inflammation and ankylosis represents a major challenge in ankylosing spondylitis (AS) research. As noggin (NOG) and sclerostin (SOST) have recently been associated with the disease process in mouse and human studies, respectively, we explored the immune responses to these two molecules in AS. METHODS: Immune complexes (IC) composed of IgG autoantibodies to NOG and SOST were detected by immunoprecipitation and Western blot analyses. Epitope-specific IgG were measured using peptide-binding ELISA. Serum samples were obtained from healthy controls and patients with AS, mechanical back pain (MBP) and inflammatory bowel disease (IBD) with or without concomitant AS. RESULTS: NOG and SOST-IgG IC were present in NOG-treated and untreated ank/ank (progressive ankylosis), but not in wild-type mice. Higher than normal levels of NOG and SOST-IgG IC are present in AS sera (p<0.001). We showed a SOST peptide (SOST-S146, with homology to a bacterial glycotransferase peptide) binds to a NOG peptide (NOG-N54), which contains a N-glycosylation site. AS patients have higher levels of IgG recognising the NOG-N54 and SOST-S146 peptides compared to the levels in normal controls, IBD and MBP patients (one way analysis of variance p<0.0001). CONCLUSIONS: This is the first report showing IgG autoantibodies to NOG and SOST in normal individuals, and higher levels of NOG and/or SOST-IgG IC probably contribute to neo-ossification in AS patients. These novel findings hold the promise of earlier diagnosis, better management of AS with comorbidities and new therapeutic approaches to modulate ankylosis in AS.

Tsui FW; Tsui HW; Las Heras F; Pritzker KP; Inman RD

2013-07-01

265

Relationship between smoking and patient-reported measures of disease outcome in ankylosing spondylitis.  

UK PubMed Central (United Kingdom)

OBJECTIVE: To investigate the relationship between smoking and disease activity, pain, function, and quality of life in patients with ankylosing spondylitis (AS). METHODS: Patients with AS (n = 612) from areas across the United Kingdom took part in a cross-sectional postal survey. Patient-reported outcome measures including the Bath AS Disease Activity Index, the Bath AS Functional Index (BASFI), a numerical rating scale (NRS) of pain, the AS quality of life questionnaire (ASQoL), and the evaluation of AS quality of life measures (EASi-QoL) were analyzed in terms of smoking status and relationship with pack-year history. The influence of potential confounding factors [age, sex, disease duration, and social deprivation (Townsend Index)] were tested in multivariate logistic regression analyses. RESULTS: Median scores of BASFI, pain NRS, ASQoL, and the 4 EASi-QoL domains were all higher in the group that had ever smoked compared to those who had never smoked (p < 0.0001, p = 0.04, p = 0.003, p < 0.02, respectively). In stepwise multivariate logistic regression analyses, high disease activity and more severe pain were associated primarily with current smoking, disease duration, and Townsend Index score, while decreased function and poor quality of life measures were associated more closely with increasing pack-year history, disease duration, and Townsend Index score. These associations were independent of age and sex. CONCLUSION: Smoking has a dose-dependent relationship with measures of disease severity in AS. The association with increased disease activity, decreased function, and poor quality of life in smokers was independent of age, sex, deprivation level, and disease duration.

Mattey DL; Dawson SR; Healey EL; Packham JC

2011-12-01

266

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

Science.gov (United States)

Objectives Exercise is reported to improve function for people with ankylosing spondylitis (AS) but it is not clear if this effect is causal or if patients with milder disease find it easier to exercise. This study examines the effect of exercise and motivation to exercise on function, while controlling for disease severity. Methods Participants who were members of an existing AS cohort were asked about physical activity, motivation to exercise, function, and disease severity. Path analysis on STATA was used to examine the correlation between factors associated with function at time of exercise and with function after 3 months of follow-up. Results The response rate to the questionnaire was 88% (326/371). Improvement in function was greatest for people with higher physical activity levels and those who were more motivated to exercise—this was especially the case for patients with the most severe disease activity. The effect of motivation to exercise not only had a direct effect on function, but also an indirect effect of improving activity levels thereby improving both current and future function. People with high intrinsic motivation (driven by pleasure) had the greatest benefit to activity and function. Conclusions Exercise does improve function, especially for those with severe disease. In addition, motivation alone improves function as much as exercising itself. Therefore, interventions targeting motivation to exercise would have as much effect on improving function as interventions offering exercise opportunities. In addition, any intervention that both improves motivation and increases opportunities to exercise would have a 2-fold influence on function.

Brophy, Sinead; Cooksey, Roxanne; Davies, Helen; Dennis, Michael S.; Zhou, Shang-Ming; Siebert, Stefan

2013-01-01

267

Association between ED in ankylosing spondylitis: a population-based study.  

UK PubMed Central (United Kingdom)

Even though a growing number of studies have found that patients with ankylosing spondylitis (AS) suffer from sexual problems, only very few studies have specifically addressed the relationship between AS and ED. Using a population-based data set, this case-control study aimed to examine the association of ED with a prior diagnosis of AS in Taiwan. We selected 2213 ED patients ?40 years old and 17,704 matched controls. We considered the date of the first diagnosis of ED as the index date for cases. Multivariate logistic regression was performed to calculate the odds ratio (OR) and corresponding 95% confidence interval (CI) for the association between previously diagnosed AS and ED. A total of 224 out of the 19,917 sampled subjects (1.1%) had been diagnosed with AS before the index date. Prior AS was found in 42 (1.9%) cases and 182 (1.0%) controls. After adjusting for geographic location, urbanization level, hypertension, diabetes, coronary heart disease, hyperlipidemia, obesity, depressive disorder and alcohol abuse/alcohol-dependence syndrome, multivariate logistic regression revealed that cases were more likely to have been previously diagnosed with AS than controls (OR=1.58, 95% CI=1.09-2.19, P=0.019). There was an association between ED and AS. We suggest that physicians should be attentive to sexual complaints from AS patients in order to refer them to other specialists for multidisciplinary management.International Journal of Impotence Research advance online publication, 4 April 2013; doi:10.1038/ijir.2013.14.

Chung SD; Chen YK; Liu SP; Lin HC

2013-04-01

268

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

Science.gov (United States)

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

269

Comparison of the clinical expression of patients with ankylosing spondylitis from Europe and Latin America.  

UK PubMed Central (United Kingdom)

OBJECTIVE: To compare the clinical, demographic, and serologic characteristics and the treatment of patients diagnosed with ankylosing spondylitis (AS) from Europe (EU) and Latin America (LA). METHODS: We included 3439 patients from national registries: the Spanish Registry of Spondyloarthritis (REGISPONSER), the Belgian registry (ASPECT), and the Latin American Registry of Spondyloarthropathies (RESPONDIA). We selected patients with diagnosis of AS who met the modified New York classification criteria. Demographic, clinical, disease activity, functional, and metrological measurement data were recorded. Current treatment was recorded. The population was classified into 2 groups: patients with disease duration < 10 years and those with disease duration ? 10 years. A descriptive and comparative analysis of variables of both groups was carried out. RESULTS: There were 2356 patients in EU group and 1083 in LA group. Prevalence of HLA-B27 was 71% in LA group and 83% in EU group (p < 0.001). We found a greater frequency of peripheral arthritis and enthesitis (p < 0.001) in the LA population; prevalence of arthritis was 57% in LA and 42% in EU, and for enthesitis, 54% and 38%. Except for treatment with anti-tumor necrosis factor (anti-TNF), the use of nonsteroidal antiinflammatory drugs (NSAID), corticosteroids, and disease-modifying antirheumatic drugs (DMARD), and the association of anti-TNF and methotrexate use showed a significant difference (p < 0.001) in the 2 populations. CONCLUSION: The principal differences in the clinical manifestations of patients with AS from EU and LA were the greater frequency of peripheral arthritis and enthesitis in LA group, the higher percentage of HLA-B27 in EU group, and the form of treatment, with a greater use of NSAID, steroids, and DMARD in the LA group.

Benegas M; Muñoz-Gomariz E; Font P; Burgos-Vargas R; Chaves J; Palleiro D; Maldonado Cocco J; Gutiérrez M; Sáenz R; Steckmen I; Rillo O; Mulero J; Sampaio-Barros P; Barcelos A; Vander Cruyssen B; Vazquez-Mellado J; Collantes Estevez E

2012-12-01

270

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

UK PubMed Central (United Kingdom)

OBJECTIVE: 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-? (TNF-?) agents is more likely to develop into a de novo syndesmophyte visible on a radiograph as compared to a vertebral corner with no CIL. METHODS: Fifty patients with AS, who had MRI at baseline and at followup (mean 19.2 months), and spinal radiography at baseline and after 2 years, were followed prospectively. A persistent CIL was defined as being present on both MRI, while a resolved CIL was defined as present at baseline MRI and completely disappeared at followup MRI. Two readers read the MRI independently, and analyses were done for areas with agreement (concordant reads) and for individual reads. RESULTS: For patients receiving anti-TNF therapy (n = 23), new syndesmophytes developed more frequently from vertebral corners where a CIL had completely resolved on followup MRI (42.9% on concordant reads) as compared to vertebral corners where no CIL was demonstrable on either the baseline or followup MRI (2.4%; p < 0.0001). Results from individual readers showed similar differences. For patients receiving standard treatment (n = 27), the same pattern, although nonsignificant, was observed (20% vs 3.3%; p = 0.16) on concordant reads, as well as on individual reads. CONCLUSION: Our study of AS spines documents that MRI findings predict new bone formation on radiograph. Demonstration of an increased likelihood of developing new bone following resolution of inflammation after anti-TNF therapy supports the theory that TNF-? acts as a brake on new bone formation. Because the number of new syndesmophytes was low, further study is necessary to make firm conclusions.

Pedersen SJ; Chiowchanwisawakit P; Lambert RG; Østergaard M; Maksymowych WP

2011-07-01

271

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

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

Laura MUNTEAN; ?tefan I. ?IGAN; Siao-Pin SIMON; C?lin R. BOLO?IU; Simona ?TEFAN; Ana PETCU; Simona REDNIC; Hora?iu D. BOLO?IU

2009-01-01

272

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.

Samuel A. Sakyi; Margaret T. Agyei-Frempong; Robert E. Quansah

2012-01-01

273

Efficacy and safety of apremilast, an oral phosphodiesterase 4 inhibitor, in ankylosing spondylitis.  

UK PubMed Central (United Kingdom)

OBJECTIVES: To evaluate the efficacy and safety of an oral phosphodiesterase 4 inhibitor, apremilast, in treatment of ankylosing spondylitis (AS) by monitoring symptoms and signs in a pilot study including exploratory investigation of effects of PDE4 inhibition on blood biomarkers of bone biology. METHODS: In this double-blind, placebo-controlled, single-centre, Phase II study, patients with symptomatic AS with active disease on MRI were randomised to apremilast 30 mg BID or placebo over 12 weeks. Bath Indices were monitored serially. Patients were followed for 4 weeks after stopping medication. Bone biomarkers were assessed at baseline and day 85. RESULTS: 38 subjects were randomised and 36 subjects completed the study. Although the primary end-point (change in BASDAI at week 12) was not met, apremilast was associated with numerically greater improvement from baseline for all clinical assessments compared with placebo with mean change in BASDAI (-1.59±1.48 vs -0.77±1.47), BASFI (-1.74±1.91 vs -0.28±1.61) and BASMI (-0.51±1.02 vs -0.21±0.67); however, differences did not achieve statistical significance. The clinical indices returned to baseline values by 4 weeks after cessation of apremilast. Six apremilast patients (35.3%) vs 3 placebo (15.8%) achieved ASAS20 responses (p=0.25). There were statistically significant decreases in serum RANKL and RANKL:osteoprotegrin ratio and plasma sclerostin but no significant changes in serum DKK-1, bone alkaline phosphatase, TRAP5b, MMP3, osteoprotegrin, or osteocalcin. CONCLUSIONS: Although a small pilot study, these results suggest that apremilast may be effective and well tolerated in AS and modulates biomarkers of bone biology. These data support further research of apremilast in axial inflammation.

Pathan E; Abraham S; Van Rossen E; Withrington R; Keat A; Charles PJ; Paterson E; Chowdhury M; McClinton C; Taylor PC

2013-09-01

274

High disease activity is related to low levels of physical activity in patients with ankylosing spondylitis.  

UK PubMed Central (United Kingdom)

This study aims to compare physical activity (PA) level and exercise habits in patients with ankylosing spondylitis (AS) who have high disease activity with those who have low disease activity and, further, to compare both groups with population controls. Cross-sectional study design was used. The participants include 149 patients (mean age 49.3 (SD 11.1), 61 % men, 54 % high disease activity) and 133 controls (mean age 52.7 (SD11.3), 58 % men). PA was reported with the International PA Questionnaire-Long and results were presented as weekly energy expenditure (metabolic equivalent, MET) in different intensities, domains, and proportion reaching health enhancing physical activity (HEPA). Types of PA were registered in a structured interview. The AS Disease Activity Score was used to assess patients' disease activity. Patients with high disease activity reported significantly lower total weekly energy expenditure (MET) than patients with low disease activity and controls (p?=?0.02, p?=?0.01, respectively) and lower amounts of walking (p?

Fongen C; Halvorsen S; Dagfinrud H

2013-07-01

275

Increased occurrence of spinal fractures related to ankylosing spondylitis : a prospective 22-year cohort study in 17,764 patients from a national registry in Sweden.  

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BACKGROUND: Ankylosing spondylitis (AS) is a rheumatoid disease leading to progressive ossification of the spinal column. Patients suffering from AS are highly susceptible to unstable vertebral fractures and often require surgical stabilisation due to long lever arms. Medical treatment of these pati...

Robinson, Yohan; Sandén, Bengt; Olerud, Claes

276

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

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

2011-01-01

277

Serum 25-hydroxyvitamin D and parathyroid hormone in patients with ankylosing spondylitis before and after a three-week rehabilitation treatment at high altitude during winter and spring.  

UK PubMed Central (United Kingdom)

Does a sojourn at high altitude during the winter and spring improve vitamin D status (and possibly suppress parathyroid hormone [PTH]) in patients with ankylosing spondylitis (AS)? In 73 patients with AS, serum concentrations of 25-hydroxy-vitamin D [25(OH)D] and PTH were determined before and after a three-week rehabilitation treatment at Bad Gastein (1000 m above sea level). At the first examination, serum 25(OH)D was median (25th, 75th percentile) 15.5 ng mL-1 (10.0 ng mL-1, 20.6 ng mL-1). Thirteen patients (18%) had a 25(OH)D concentration below 8 ng mL-1. In 53 patients (73%) the level was below 20 ng mL-1. After the sojourn, 25(OH)D significantly (p = 0.02) increased to 19.7 (11.3, 24.6) ng mL-1. PTH did not change significantly, being 32 (22.4, 43.9) pg mL-1 before and 30.3 (24.1, 39.9) pg mL-1 after the sojourn. Analysing different periods of sojourn, a significant (p < 0.001) increase in 25(OH)D was found in April but not in the other months. Patients with ankylosing spondylitis may have extremely low levels of 25(OH)D. The results of the present study suggest that a sojourn at high altitude in early spring is liable to reduce vitamin D deficiency.

Falkenbach A; Tripathi R; Sedlmeyer A; Staudinger M; Herold M

2001-04-01

278

Serum 25-hydroxyvitamin D and parathyroid hormone in patients with ankylosing spondylitis before and after a three-week rehabilitation treatment at high altitude during winter and spring.  

Science.gov (United States)

Does a sojourn at high altitude during the winter and spring improve vitamin D status (and possibly suppress parathyroid hormone [PTH]) in patients with ankylosing spondylitis (AS)? In 73 patients with AS, serum concentrations of 25-hydroxy-vitamin D [25(OH)D] and PTH were determined before and after a three-week rehabilitation treatment at Bad Gastein (1000 m above sea level). At the first examination, serum 25(OH)D was median (25th, 75th percentile) 15.5 ng mL-1 (10.0 ng mL-1, 20.6 ng mL-1). Thirteen patients (18%) had a 25(OH)D concentration below 8 ng mL-1. In 53 patients (73%) the level was below 20 ng mL-1. After the sojourn, 25(OH)D significantly (p = 0.02) increased to 19.7 (11.3, 24.6) ng mL-1. PTH did not change significantly, being 32 (22.4, 43.9) pg mL-1 before and 30.3 (24.1, 39.9) pg mL-1 after the sojourn. Analysing different periods of sojourn, a significant (p < 0.001) increase in 25(OH)D was found in April but not in the other months. Patients with ankylosing spondylitis may have extremely low levels of 25(OH)D. The results of the present study suggest that a sojourn at high altitude in early spring is liable to reduce vitamin D deficiency. PMID:11388078

Falkenbach, A; Tripathi, R; Sedlmeyer, A; Staudinger, M; Herold, M

2001-04-30

279

Marked diversity of IL23R gene haplotype variants in rheumatoid arthritis comparing with Crohn's disease and ankylosing spondylitis.  

UK PubMed Central (United Kingdom)

Haplotype tagging SNPs of interleukin-23 receptor gene rs1004819, rs7517847, rs7530511, rs2201841, rs1343151 and rs10889677 were determined in 396 patients with rheumatoid arthritis, 190 patients with Crohn's disease, 206 patients with ankylosing spondylitis and 182 controls. Using regression analysis models the rs1004819, rs2201841, and rs10889677 SNPs were found to confer risk for Crohn's disease and ankylosing spondylitis, while rs1343151 had a protective effect in both of these diseases, and the rs2201841 and rs10889677 SNPs showed susceptibility nature for rheumatoid arthritis. Using these SNPs we could study the susceptibility haplotype profiles in these diseases with special attention to the rheumatoid arthritis, first in the literature. Seven different haplotypes could be differentiated. We found that the SNPs exert their susceptibility character in specific haplotype blocks: thus, for rheumatoid arthritis the rs1343151 SNP was risk factor only in a specific haplotype surrounding; this can explain the controversial results published so far about this variant. More importantly, we observed, that while a specific haplotype can confer risk for rheumatoid arthritis, the same haplotype tended to protect against the development of the other two diseases. The data presented here serve evidence for the need of haplotype analysis instead of just single standing SNP analysis when susceptibility to or protection against a certain disease are interpreted.

Szabo M; Safrany E; Pazar B; Melegh BI; Kisfali P; Poor G; Figler M; Szekanecz Z; Czirjak L; Melegh B

2013-01-01

280

Elevated miR-29a expression is not correlated with disease activity index in PBMCs of patients with ankylosing spondylitis.  

UK PubMed Central (United Kingdom)

OBJECTIVES: Ankylosing spondylitis (AS) is a chronic inflammatory disease characterized by new bone formation. Recent evidence suggests that new bone formation in AS may be due to upregulation of Wnt signaling in the osteoblastic pathway secondary to low serum Dickkopf homolog 1 (Dkk-1) levels. And miR-29a orchestrates osteoblast differentiation through direct targeting and negative regulation of Dkk-1. METHODS: We initially validated the expression levels of miR-29a in the peripheral blood mononuclear cells (PBMCs) of AS patients (n = 30), rheumatoid arthritis (RA) patients (n = 30) and healthy controls (n = 30) using real-time quantitative reverse transcription PCR (qRT-PCR). Correlation analysis was assessed between miR-29a level in PBMCs of AS patients and disease activity indexes, including erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), Bath ankylosing spondylitis disease activity index (BASDAI), Bath ankylosing spondylitis function index (BASFI) and modified Stoke ankylosing spondylitis spinal score (mSASSS). RESULTS: Significantly higher expression of miR-29a was observed in PBMCs of AS patients (Ct 9.18 ± 1.96) compared with that in RA patients (10.97 ± 0.70, p < 0.001) and healthy controls (Ct 11.45 ± 1.23, p < 0.001). There was no significant difference between RA patients and healthy controls in miR-29a expression (p > 0.05). Elevated miR-29a expression is not correlated with disease activity index (p > 0.05). A weak correlation was found between elevated miR-29a expression and mSASSS (r = -0.393, p = 0.032). CONCLUSIONS: We report for the first time elevated miR-29a expression in PBMCs of patients with ankylosing spondylitis, and miR-29a might be used as a useful diagnostic marker in new bone formation but cannot reflect disease activity.

Huang J; Song G; Yin Z; Luo X; Ye Z

2013-04-01

 
 
 
 
281

Elevated miR-29a expression is not correlated with disease activity index in PBMCs of patients with ankylosing spondylitis.  

Science.gov (United States)

OBJECTIVES: Ankylosing spondylitis (AS) is a chronic inflammatory disease characterized by new bone formation. Recent evidence suggests that new bone formation in AS may be due to upregulation of Wnt signaling in the osteoblastic pathway secondary to low serum Dickkopf homolog 1 (Dkk-1) levels. And miR-29a orchestrates osteoblast differentiation through direct targeting and negative regulation of Dkk-1. METHODS: We initially validated the expression levels of miR-29a in the peripheral blood mononuclear cells (PBMCs) of AS patients (n = 30), rheumatoid arthritis (RA) patients (n = 30) and healthy controls (n = 30) using real-time quantitative reverse transcription PCR (qRT-PCR). Correlation analysis was assessed between miR-29a level in PBMCs of AS patients and disease activity indexes, including erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), Bath ankylosing spondylitis disease activity index (BASDAI), Bath ankylosing spondylitis function index (BASFI) and modified Stoke ankylosing spondylitis spinal score (mSASSS). RESULTS: Significantly higher expression of miR-29a was observed in PBMCs of AS patients (Ct 9.18 ± 1.96) compared with that in RA patients (10.97 ± 0.70, p 29a expression (p > 0.05). Elevated miR-29a expression is not correlated with disease activity index (p > 0.05). A weak correlation was found between elevated miR-29a expression and mSASSS (r = -0.393, p = 0.032). CONCLUSIONS: We report for the first time elevated miR-29a expression in PBMCs of patients with ankylosing spondylitis, and miR-29a might be used as a useful diagnostic marker in new bone formation but cannot reflect disease activity. PMID:23632741

Huang, Jinxian; Song, Guoxiang; Yin, Zhihua; Luo, Xiuxia; Ye, Zhizhong

2013-04-30

282

Ankylosing spondylitis, late osteoarthritis, vascular calcification, chondrocalcinosis and pseudo gout: toward a possible drug therapy.  

UK PubMed Central (United Kingdom)

In this review we consider diseases associated with pathological mineralization/ossification, namely, ankylosing spondylitis (AS), osteoarthritis (OA), generalized artery calcification of infancy (GACI), vascular calcification as well as chondrocalcinosis (CC) and pseudo gout. Deciphering the key enzymes implicated in the calcification process is an objective of prime importance and the ultimate goal is to synthesize inhibitors of these enzymes in order to provide efficient alternate therapeutic strategies that will slow down the pathologic mineralization and complement the arsenal of anti-inflammatory drugs. One of the difficulties in the definition of diseases associated with pathologic mineralization/ossification lies in the controversial relationship between the type of calcification and the nature of the disease. Here, we propose to clarify this relationship by making a distinction between diseases associated with hydroxyapatite (HA) and calcium pyrophosphate dihydrate (CPPD) deposits. AS, OA, GACI and vascular calcification are usually characterized by mineralization/ossification associated with HA deposits, while CC and pseudo gout are mostly characterized by CPPD deposits. Although both HA and CPPD deposits may occur concomitantly, as in chronic pyrophosphate arthritis or in OA with CPPD, they are formed as a result of two antagonistic processes indicating that treatment of distinct diseases can be only achieved by disease-specific drug therapies. The hydrolysis of PPi, an inhibitor of HA formation, is mostly controlled by tissue non-specific alkaline phosphatase TNAP, while PPi production in the extracellular medium is controlled by ANK, a PPi transporter, and/or NPP1 which generates PPi from nucleotide triphosphates. Low PPi concentration may lead to a preferential deposition of HA while high PPi concentration will favor the formation of CPPD deposits. Thus, HA and CCPD deposition cannot occur concomitantly because they are determined by the Pi/PPi ratio which, in turn, depends on the relative activities of antagonistic enzymes, TNAP hydrolyzing PPi or ANK and NPP1 producing PPi. TNAP inhibitors could prevent HA formation in AS, in late OA, in GACI, as well as in vascular calcifications, while ANK or NPP1 inhibitors could slow down CCPD deposition in CC and pseudo gout.

Mebarek S; Hamade E; Thouverey C; Bandorowicz-Pikula J; Pikula S; Magne D; Buchet R

2011-01-01

283

Ankylosing spondylitis, late osteoarthritis, vascular calcification, chondrocalcinosis and pseudo gout: toward a possible drug therapy.  

Science.gov (United States)

In this review we consider diseases associated with pathological mineralization/ossification, namely, ankylosing spondylitis (AS), osteoarthritis (OA), generalized artery calcification of infancy (GACI), vascular calcification as well as chondrocalcinosis (CC) and pseudo gout. Deciphering the key enzymes implicated in the calcification process is an objective of prime importance and the ultimate goal is to synthesize inhibitors of these enzymes in order to provide efficient alternate therapeutic strategies that will slow down the pathologic mineralization and complement the arsenal of anti-inflammatory drugs. One of the difficulties in the definition of diseases associated with pathologic mineralization/ossification lies in the controversial relationship between the type of calcification and the nature of the disease. Here, we propose to clarify this relationship by making a distinction between diseases associated with hydroxyapatite (HA) and calcium pyrophosphate dihydrate (CPPD) deposits. AS, OA, GACI and vascular calcification are usually characterized by mineralization/ossification associated with HA deposits, while CC and pseudo gout are mostly characterized by CPPD deposits. Although both HA and CPPD deposits may occur concomitantly, as in chronic pyrophosphate arthritis or in OA with CPPD, they are formed as a result of two antagonistic processes indicating that treatment of distinct diseases can be only achieved by disease-specific drug therapies. The hydrolysis of PPi, an inhibitor of HA formation, is mostly controlled by tissue non-specific alkaline phosphatase TNAP, while PPi production in the extracellular medium is controlled by ANK, a PPi transporter, and/or NPP1 which generates PPi from nucleotide triphosphates. Low PPi concentration may lead to a preferential deposition of HA while high PPi concentration will favor the formation of CPPD deposits. Thus, HA and CCPD deposition cannot occur concomitantly because they are determined by the Pi/PPi ratio which, in turn, depends on the relative activities of antagonistic enzymes, TNAP hydrolyzing PPi or ANK and NPP1 producing PPi. TNAP inhibitors could prevent HA formation in AS, in late OA, in GACI, as well as in vascular calcifications, while ANK or NPP1 inhibitors could slow down CCPD deposition in CC and pseudo gout. PMID:21517761

Mebarek, S; Hamade, E; Thouverey, C; Bandorowicz-Pikula, J; Pikula, S; Magne, D; Buchet, R

2011-01-01

284

[Effects of comprehensive therapy on serum SPARC levels in ankylosing spondylitis patients accompanied with osteoporosis].  

UK PubMed Central (United Kingdom)

OBJECTIVE: To observe the effects of comprehensive therapy on serum secreted protein acidic and rich in cysteine (SPARC) levels in ankylosing spondylitis (AS) patients accompanied with osteoporosis (OP), and to explore the possible mechanisms for SPARC in AS patients accompanied with osteoporosis. METHODS: Totally 48 AS patients accompanied with OP (Group A) were treated with massage, intravenous infusion of Cervus and Cucumis Polypeptide Injection, and Bushen Quhan Zhiwang Decoction (BQZD) for 3 months. At the same time, 45 normal healthy subjects were recruited as the normal control group (Group B). Serum SPARC levels were measured by ELISA in Group A before and after comprehensive therapy and in those of Group B. The levels of bone mineral density of femoral neck (FN BMD), bone mineral density of 2 -4 lumbar spine (L2-4 BMD), bone specific alkaline phosphatase (BSAP), tumor necrosis factor alpha (TNF-alpha), and transforming growth factor beta-1 (TGF-beta1) were detected. Meanwhile, Bath AS disease activity index (BASDAI) and Bath AS functional index (BASFI) were detected in Group A before and after treatment. The correlations between the aforesaid indices and serum SPARC levels were analyzed. RESULTS: Serum SPARC levels were significantly lower in those of Group A than in those of Group B (175. 30 +/- 72.04 micro/L vs 190. 52 +/- 86. 13 microg/ L, P <0. 01). Serum SPARC levels in those of Group A were negatively correlated with TNF-alpha (r = -0.261, P <0.01), positively with L2-4 BMD, TGF-beta1, and BSAP (r =0.437,0.256, 0.385, P <0.05, P <0.01). L2-4BMD and BSAP were independently predictors of serum SPARC in patients of Group A. After comprehensive therapy, the levels of TNF-alpha, BASDAI, and BASFI obviously decreased, TGF-beta1, BSAP, L2-4 BMD, and FN BMD obviously increased (P <0. 05, P <0. 01). The serum SPARC levels also significantly increased (188.32 +/- 87.50 microg/L, P <0. 05). CONCLUSION: Comprehensive therapy could effectively improve the bone metabolism, clinical symptoms and the activity function of joints, and elevate serum SPARC levels.

Xu JR; Lin Y; Zhang CY; Li WM; Guo CJ; Ye L

2013-04-01

285

[Circulating immune complexes-like material and complement in rheumatoid arthritis and ankylosing spondylitis (author's transl)  

UK PubMed Central (United Kingdom)

Circulating immune complexes (IC) in 52 rheumatoid arthritis (RA) seropositive, 25 RA seronegative and 32 ankylosing spondylitis (AS) patients were assayed by two methods: 1) precipitation with a final 2% polyethylene glycol (PEG) concentration with immunoglobulins (Igs) quantitation in the precipitate and 2) the ability of IC to consume complement, evaluating conversion products from human C3 by bidimensional rocket immunoelectrophoresis. CH50, C3, C4, C3PA and circulating C3 conversion products were quantitated. IC precipitates with 2% PEG contained three classes of Igs: IgG, IgM and IgA, the latter being the most rare. In the control group Igs level precipitated with 2% PEG were: 2% PEG-IgG 2.5 mg/100 ml +/- 2; 2% PEG-IgM 0.72 mg/100 ml +/- 1.09; 2% PEG-IgA 0.04 mg/100 ml +/- 0.18. With 2% PEG IC-like material was detected in 58.5% of RA seropositive patients but none generated C3 conversion products. With neither methods was IC-like material detected in the RA seronegative group and none with 2% PEG in AS, either. However, in the latter, 21.8% generated C3 conversion products and 18.7% circulating C3 conversión products. In the RA seropositive patients no correlation was observed between the levels of 2% PEG-IgG and 2% PEG-IgM and the titre of antinuclear antibodies (ANA) nor between 2% PEG-IgG and that of IgG in serum. However, there was a low correlation between 2% PEG-IgM and that of IgM in serum and between 2% PEG-IgG and 2% PEG-IgM with rheumatoid factor (RF). It should be stressed that the value of the PEG method in the detection of IC-like material must be reconsidered, since using a 2% final concentration and a specific evaluation of Igs and complement components in the precipitate, it may be a method easy to perform and useful for clinical purposes.

Rodrigo MJ; Gallart MT; Lience E; Arnal C; Sans J

1981-04-01

286

UGT2B17 copy number gain in a large ankylosing spondylitis multiplex family.  

UK PubMed Central (United Kingdom)

BACKGROUND: The primary objective of this study is to identify novel copy number variations (CNVs) associated with familial ankylosing spondylitis (AS). A customized genome-wide microarray was designed to detect CNVs and applied to a multiplex AS family with six (6) affected family members. CNVs were detected using the built-in DNA analytics aberration detection method-2 (ADM-2) algorithm. Gene enrichment analysis was performed to observe the segregation. Subsequent validation was performed using real time quantitative fluorescence polymerase reaction (QF-PCR). The frequency of copy number variation for the UGT2B17 gene was then performed on two well-defined AS cohorts. Fisher exact test was performed to quantify the association. RESULTS: Our family-based analysis revealed ten gene-enriched CNVs that segregate with all six family members affected with AS. Based on the proposed function and the polymorphic nature of the UGT2B17 gene, the UGT2B17 gene CNV was selected for validation using real time QF-PCR with full concordance. The frequency of two copies of the UGT2B17 gene CNV was 0.41 in the Newfoundland AS cases and 0.35 in the Newfoundland controls (OR = 1.26(0.99-1.59); p < 0.05)), whereas the frequency of two (2) copies of the UGT2B17 gene CNV was 0.40 in the Alberta AS cases and 0.39 in the Alberta controls (OR = 1.05(95% CI: 0.83-1.33); p < 0.71)). CONCLUSIONS: A genome-wide microarray interrogation of a large multiplex AS family revealed segregation of the UGT2B17 gene CNV among all affected family members. The association of the UGT2B17 CNV with AS is particularly interesting given the recent association of this CNV with osteoporosis and the proposed function as it encodes a key enzyme that inhibits androgens. However, two copies of the UGT2B17 gene CNV were only marginally significant in a uniplex AS cohort from Newfoundland but not in a uniplex AS cohort from Alberta.

Uddin M; Maksymowych WP; Inman R; Gladman D; Munn A; Yazdani R; Pellett F; Hamilton S; O'Rielly DD; Rahman P

2013-01-01

287

An audit of anthropometric measurements by medical and physiotherapy staff in patients with ankylosing spondylitis.  

UK PubMed Central (United Kingdom)

BACKGROUND: The main treatments for ankylosing spondylitis (AS) are physical (exercise and stretching), and one way of measuring the effectiveness of these therapies is to record spinal movements in a standardized way. Patients are often seen in both medical (rheumatology) and physiotherapy clinics where duplicate information on their progress may be obtained. The purpose of this study was to assess the completeness of data collection for patients attending both medical and physiotherapy clinics. DESIGN: An audit of data recorded in medical and physiotherapy notes. SUBJECTS: Patient records identified either from computerized databases (Huddersfield and Bradford) or from a clinic at which only AS patients attended (Leeds). Data from attendances over a defined period were retrieved and recorded on a standard form. All patients thus identified were then cross-matched against those patients attending for physiotherapy during the same period and, where a match occurred, the same data were retrieved from the physiotherapy notes. MINIMUM DATA SET FOR AUDIT: Before data collection started all participants agreed on the minimum data set required for adequate monitoring of patients with AS. The anthropometric measurements included height, chest expansion, cervical rotation, tragus to wall, modified Schober's flexion, extension, lumbar side flexion, intermalleolar abduction, and interfingertip abduction. RESULTS: Of 182 medical notes screened, 46 patients had not been seen in the defined period, leaving 136 notes to be reviewed. Of these, 52 patients had been seen in physiotherapy in the same period. In general, measurements were infrequently found in medical notes (only chest expansion in 58%, Schober's flexion in 48% and tragus to wall in 47% were measured with any regularity by medical staff). In contrast, corresponding data from physiotherapy notes were more complete (Schober's flexion and lumbar side flexion in 96%, height in 87%, intermalleolar distance in 87% and cervical rotation in 83%). CONCLUSIONS: Follow-up and monitoring of AS patients in these medical clinics is clearly inadequate. Physiotherapy-led clinics have already been started in one of the study hospitals and the other centres are reviewing their arrangements for AS follow-up, including the possibility of a combined approach to patient management.

Lubrano E; Butterworth M; Hesselden A; Wells S; Helliwell P

1998-06-01

288

Combined spa-exercise therapy is effective in patients with ankylosing spondylitis: a randomized controlled trial.  

UK PubMed Central (United Kingdom)

OBJECTIVE: To determine the efficacy of combined spa-exercise therapy in addition to standard treatment with drugs and weekly group physical therapy in patients with ankylosing spondylitis (AS). METHODS: A total of 120 Dutch outpatients with AS were randomly allocated into 3 groups of 40 patients each. Group 1 (mean age 48 +/- 10 years; male:female ratio 25:15) was treated in a spa resort in Bad Hofgastein, Austria; group 2 (mean age 49 +/- 9 years; male:female ratio 28:12) in a spa resort in Arcen, The Netherlands. The control group (mean age 48 +/- 10 years; male:female ratio 34:6) stayed at home and continued their usual drug treatment and weekly group physical therapy during the intervention weeks. Standardized spa-exercise therapy of 3 weeks duration consisted of group physical exercises, walking, correction therapy (lying supine on a bed), hydrotherapy, sports, and visits to either the Gasteiner Heilstollen (Austria) or sauna (Netherlands). After spa-exercise therapy all patients followed weekly group physical therapy for another 37 weeks. Primary outcomes were functional ability, patient's global well-being, pain, and duration of morning stiffness, aggregated in a pooled index of change (PIC). RESULTS: Analysis of variance showed a statistically significant time-effect (P < 0.001) and time-by-treatment interaction (P = 0.004), indicating that the 3 groups differed over time with respect to the course of the PIC. Four weeks after start of spa-exercise therapy, the mean difference in PIC between group 1 and controls was 0.49 (95% confidence interval [CI] 0.16-0.82, P = 0.004) and between group 2 and controls was 0.46 (95% CI 0.15-0.78, P = 0.005). At 16 weeks, the difference between group 1 and controls was 0.63 (95% CI 0.23-1.02, P = 0.002) and between group 2 and controls was 0.34 (95% CI--0.05-0.73; P = 0.086). At 28 and 40 weeks, more improvement was found for group 1 compared with controls (P = 0.012 and P = 0.062, respectively) but not for group 2 compared with controls. CONCLUSION: In patients with AS, a 3-week course of combined spa-exercise therapy, in addition to drug treatment and weekly group physical therapy alone, provides beneficial effects. These beneficial effects may last for at least 40 weeks.

van Tubergen A; Landewé R; van der Heijde D; Hidding A; Wolter N; Asscher M; Falkenbach A; Genth E; Thè HG; van der Linden S

2001-10-01

289

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

Directory of Open Access Journals (Sweden)

Full Text Available Abstract Background Today, health care is patient-centred with patients more involved in medical decision making and taking an active role in managing their disease. It is important that patients are appropriately informed about their condition and that their health care needs are met. We examine the information utilisation, sources and needs of people with Ankylosing Spondylitis (AS). Methods Participants in an existing AS cohort study were asked to complete a postal or online questionnaire containing closed and open-ended questions, regarding their information access and needs. Participants were stratified by age and descriptive statistics were performed using STATA 11, while thematic analysis was performed on open-ended question narratives. Qualitative data was handled in Microsoft Access and explored for emerging themes and patterns of experiences. Results Despite 73% of respondents having internet access, only 49% used the internet to access information regarding AS. Even then, this was only infrequently. Only 50% of respondents reported accessing written information about AS, which was obtained mainly in specialist clinics. Women were more likely than men to access information (63% (women) 46% (men)) regardless of the source, while younger patients were more likely to use online sources. The main source of non-written information was the rheumatologist. Overall, the respondents felt there was sufficient information available, but there was a perception that the tone was often too negative. The majority (95%) of people would like to receive a regular newsletter about AS, containing positive practical and local information. Suggestions were also made for more information about AS to be made available to non-specialist medical professionals and the general public. Conclusions There appears to be sufficient information available for people with AS in the UK and this is mostly accessed by younger AS patients. Many patients, particularly men, choose not to access AS information and concerns were raised about its negative tone. Patients still rely on written and verbal information from their specialists. Future initiatives should focus on the delivery of more positive information, targeting younger participants in particular and increasing the awareness in the general population and wider non-specialist medical community.

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

2012-01-01

290

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

Science.gov (United States)

Ankylosing spondylitis (AS) is one of the most common causes of inflammatory arthritis, with an estimated prevalence of 0.1-0.9%. Genetic factors have been strongly implicated in its aetiology, and heritability as assessed by twin studies has been estimated to be >90%. HLA- B27 is almost essential for inheritance of AS; it is not merely sufficient for explaining the pattern of familial recurrence of the disease. This study's purpose is to investigate the association of ankylosing spondylitis with single-nucleotide polymorphisms (SNPs) in the IL-1 family: IL-1a (-889C/T) rs1800587, IL-1b (-511C/T) rs16944, IL-1b (+3962C/T) rs1143634, IL-1R (Pst-1 1970C/T) rs2234650 and IL-1RA (Mspa-1 11100C/T) rs315952. 99 unrelated Iranian AS patients and 217 healthy control subjects were selected. Cytokine typing was performed by the polymerase chain reaction with sequence-specific primers assay. The allele and genotype frequencies of the polymorphisms were determined: The IL1? rs1800587, IL1? rs16944 and IL1? rs1143634 were not significantly associated with AS. Genotype frequencies at IL1R rs2234650 differed between cases and controls (?(2)=8.85; p=0.01); the IL1R rs2234650 C/T and T/T genotypes were less common in AS patients than controls. The IL1R rs2234650 C/T genotype was inversely associated with AS comparing with the IL1R rs2234650 C/C genotype (OR=0.48; p=0.005). IL1R rs2234650 C/T genotype was less common in patients than controls (OR=0.37; p=0.02).Furthermore IL1R rs2234650 T allele was strongly associated with HLA-B2702 patients rather than HLA-B2705 but was not associated with HLA-B27 negative patients (OR=0.33; p=0.01). Polymorphisms of IL1? rs1800587, IL1? rs16944 and IL1? rs1143634 were not significantly associated with ankylosing spondylitis but inversely in this study IL1R rs2234650 was significantly associated and carriage of T allele in IL1R rs2234650 seems to be protective, while carriage of C allele result in two fold higher risk of developing AS. PMID:22285486

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

2011-12-01

291

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

UK PubMed Central (United Kingdom)

Ankylosing spondylitis (AS) is one of the most common causes of inflammatory arthritis, with an estimated prevalence of 0.1-0.9%. Genetic factors have been strongly implicated in its aetiology, and heritability as assessed by twin studies has been estimated to be >90%. HLA- B27 is almost essential for inheritance of AS; it is not merely sufficient for explaining the pattern of familial recurrence of the disease. This study's purpose is to investigate the association of ankylosing spondylitis with single-nucleotide polymorphisms (SNPs) in the IL-1 family: IL-1a (-889C/T) rs1800587, IL-1b (-511C/T) rs16944, IL-1b (+3962C/T) rs1143634, IL-1R (Pst-1 1970C/T) rs2234650 and IL-1RA (Mspa-1 11100C/T) rs315952. 99 unrelated Iranian AS patients and 217 healthy control subjects were selected. Cytokine typing was performed by the polymerase chain reaction with sequence-specific primers assay. The allele and genotype frequencies of the polymorphisms were determined: The IL1? rs1800587, IL1? rs16944 and IL1? rs1143634 were not significantly associated with AS. Genotype frequencies at IL1R rs2234650 differed between cases and controls (?(2)=8.85; p=0.01); the IL1R rs2234650 C/T and T/T genotypes were less common in AS patients than controls. The IL1R rs2234650 C/T genotype was inversely associated with AS comparing with the IL1R rs2234650 C/C genotype (OR=0.48; p=0.005). IL1R rs2234650 C/T genotype was less common in patients than controls (OR=0.37; p=0.02).Furthermore IL1R rs2234650 T allele was strongly associated with HLA-B2702 patients rather than HLA-B2705 but was not associated with HLA-B27 negative patients (OR=0.33; p=0.01). Polymorphisms of IL1? rs1800587, IL1? rs16944 and IL1? rs1143634 were not significantly associated with ankylosing spondylitis but inversely in this study IL1R rs2234650 was significantly associated and carriage of T allele in IL1R rs2234650 seems to be protective, while carriage of C allele result in two fold higher risk of developing AS.

Mahmoudi M; Amirzargar AA; Jamshidi AR; Farhadi E; Noori S; Avraee M; Nazari B; Nicknam MH

2011-12-01

292

Selection of instruments in the core set for DC-ART, SMARD, physical therapy, and clinical record keeping in ankylosing spondylitis. Progress report of the ASAS Working Group. Assessments in Ankylosing Spondylitis.  

Science.gov (United States)

To select specific instruments for each domain of the core set for endpoints in ankylosing spondylitis (AS), we gathered all instruments described in the literature to assess the domains chosen as endpoints in AS and sent them to 43 members of the Assessments in Ankylosing Spondylitis (ASAS) Working Group. The following domains were taken into account: function, pain, spinal mobility, patient global assessment, morning stiffness, peripheral joints and entheses, acute phase reactants, x-ray spine, x-ray hips, fatigue. For each instrument the members were asked to judge if the instrument was feasible and relevant. If an instrument was judged to be not feasible or not relevant by more than 50% of the respondents the instrument was deleted from the list. These data were presented during an ASAS workshop and the final decisions were about which instruments to include in the core set. This process was repeated separately for the settings disease controlling antirheumatic therapy (DC-ART), symptom modifying antirheumatic drugs (SMARD) and physical therapy, and clinical record keeping. The response rate to the questionnaire was 72%. For each domain one or more instruments were selected, except for Entheses and Fatigue. The chosen instruments were similar for the 3 above settings. Core sets of specific instruments were selected for the OMERACT filter test for relevance and feasibility. For all these instruments the remaining aspects of the OMERACT filter (truth and discrimination) should be assessed by literature review and if needed by additional research. It is recommended to use these instruments in all research projects in AS. PMID:10229426

van der Heijde, D; Calin, A; Dougados, M; Khan, M A; van der Linden, S; Bellamy, N

1999-04-01

293

Selection of instruments in the core set for DC-ART, SMARD, physical therapy, and clinical record keeping in ankylosing spondylitis. Progress report of the ASAS Working Group. Assessments in Ankylosing Spondylitis.  

UK PubMed Central (United Kingdom)

To select specific instruments for each domain of the core set for endpoints in ankylosing spondylitis (AS), we gathered all instruments described in the literature to assess the domains chosen as endpoints in AS and sent them to 43 members of the Assessments in Ankylosing Spondylitis (ASAS) Working Group. The following domains were taken into account: function, pain, spinal mobility, patient global assessment, morning stiffness, peripheral joints and entheses, acute phase reactants, x-ray spine, x-ray hips, fatigue. For each instrument the members were asked to judge if the instrument was feasible and relevant. If an instrument was judged to be not feasible or not relevant by more than 50% of the respondents the instrument was deleted from the list. These data were presented during an ASAS workshop and the final decisions were about which instruments to include in the core set. This process was repeated separately for the settings disease controlling antirheumatic therapy (DC-ART), symptom modifying antirheumatic drugs (SMARD) and physical therapy, and clinical record keeping. The response rate to the questionnaire was 72%. For each domain one or more instruments were selected, except for Entheses and Fatigue. The chosen instruments were similar for the 3 above settings. Core sets of specific instruments were selected for the OMERACT filter test for relevance and feasibility. For all these instruments the remaining aspects of the OMERACT filter (truth and discrimination) should be assessed by literature review and if needed by additional research. It is recommended to use these instruments in all research projects in AS.

van der Heijde D; Calin A; Dougados M; Khan MA; van der Linden S; Bellamy N

1999-04-01

294

Successful nonoperative treatment of a three-column thoracic fracture in a patient with ankylosing spondylitis: existence and clinical significance of the fourth column of the spine.  

UK PubMed Central (United Kingdom)

STUDY DESIGN: A case report. OBJECTIVE: To report the successful nonoperative management of a patient with progressive ankylosing spondylitis who sustained a three-column flexion-distraction injury of the upper thoracic spine with an intact sternal-rib complex, thereby emphasizing the existence and clinical relevance of the fourth-column concept in such patients. SUMMARY OF BACKGROUND DATA: Three-column injuries of the cervical and lumbar spine are typically unstable and require surgical stabilization. Patients with ankylosing spondylitis are at an increase risk to sustain three-column injuries of the spine due to their progressive inflammatory disease, a state that renders the spine brittle and alters its biomechanical function. A fourth-column model of the thoracic spine has been proposed and incorporates the sternal-rib complex; however, such a model has rarely been addressed in the literature and its role regarding three-column upper thoracic spine injury with an intact sternal-rib complex in patients with ankylosing spondylitis is unknown. METHODS.: A 68-year-old white man with ankylosing spondylitis and Pickwickian body habitus sustained a three-column flexion-distraction injury at T5 following a ground-level fall. The patient complained of midthoracic back pain; however, he was neurologically intact and ambulated without aids. RESULTS: Because of the patient's numerous active medical issues that substantially increased his perioperative risks combined with symptomatic improvement of his pain, the patient refused surgical stabilization. In addition, because of the patient's body habitus and pulmonary issues, external brace immobilization was not tolerated. At 17 months of follow-up, the patient remained neurologically intact, ambulated well, his midthoracic back pain had subsided, and no progressive kyphosis was noted. CONCLUSIONS: This case confirms the existence and clinical relevance of the fourth column of the thoracic spine and its role in providing added spinal stability in the patient with ankylosing spondylitis. As such, it is still possible to achieve a favorable clinical outcome in a select subpopulation of patients with ankylosing spondylitis that sustain three-column flexion-distraction injuries who are neurologically intact and are not candidates for surgical stabilization.

Shen FH; Samartzis D

2007-07-01

295

Association of ankylosing spondylitis with HLA-B27 and ERAP1: pathogenic role of antigenic peptide.  

UK PubMed Central (United Kingdom)

Ankylosing spondylitis (AS) is a form of seronegative inflammatory arthritis whose strong genetic association with the human leucocyte antigen (HLA)-B27 has been known for almost 4 decades. However, its mechanism remains poorly understood. Recently, with the development of genetics, further more genes have been robustly associated with the disease. Genome-wide association studies identified the association between AS and ERAP1 (endoplasmic reticulum associated aminopeptidase 1). And ERAP1 has shown the potential in trimming antigenic peptides to optimal length for binding to HLA-B27 in the ER (endoplasmic reticulum). However, the length of the peptides are strictly restricted in the process of peptide transporting, processing and presentation. A hypothesis is proposed that the abnormal mechanism of AS may related to the trimming of N-terminal sequences from antigenic precursors in the ER and the length of the antigenic peptides that are presented to the T-cell receptors.

Chen B; Li D; Xu W

2013-01-01

296

Diversity of killer cell immunoglobulin-like receptor genes in uveitis associated with autoimmune diseases: ankylosing spondylitis and Behcet disease.  

UK PubMed Central (United Kingdom)

PURPOSE: To determine whether the frequencies of specific killer cell immunoglobulin-like receptors (KIR) genotypes are associated with the incidence of uveitis in ankylosing spondylitis (AS) and Behçet disease (BD). METHODS: The authors analyzed the frequency of 16 KIR genes in Koreans with either AS (110 patients, all HLA-B27-positive) or BD (86 patients), using polymerase chain reaction sequence-specific oligonucleotide probing. RESULTS: The frequency of the inhibitory receptor KIR3DL1 was lower in AS patients affected by uveitis than that in the general population (p < 0.05). The frequency of the KIR3DL1(-)/2DS3(-) was significantly higher in AS patients with uveitis (odds ratio = 9.306, p = 0.007). CONCLUSIONS: The study suggests that KIR3DL1 might associate with the resistance to AS-associated uveitis by influencing natural killer cell activity.

Moon SJ; Oh EJ; Kim Y; Kim KS; Kwok SK; Ju JH; Park KS; Kim HY; Park SH

2013-04-01

297

Overexpression and unique rearrangement of VH2 transcripts in immunoglobulin variable heavy chain genes in ankylosing spondylitis patients.  

Science.gov (United States)

To identify immunoglobulin variable heavy chain (VH) gene usages in Korean ankylosing spondylitis (AS) patients, expression level of VH2 genes from peripheral blood mononuclear cells (PBMCs) of 8 AS patients and 9 healthy donors was analysed by quantitative real-time PCR (Q-PCR). Q-PCR results demonstrated VH2 genes were overexpressed in AS patients (Relative amount of mRNA of VH2 genes to a house-keeping gene, 7.13+/-7.77 vs, 0.68+/-0.55; PBPB) genes. The insertion of CDC42 BPB gene was confirmed by PCR with primers corresponding CDC42 BPB and CH genes. Our study revealed VH2 overexpression and unique rearrangement in Ig VH genes from peripheral blood of AS patients. This may imply aberrant immunoglobulin gene rearrangement in B cell occurs in Korean AS patients, which requires further investigation. PMID:20177145

Kim, Yeon Joo; Kim, Na Young; Lee, Min Kyung; Choi, Hyo Jin; Baek, Han Joo; Nam, Chang Hoon

2010-05-31

298

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

Scientific Electronic Library Online (English)

Full Text Available 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 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. 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 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

Chiuchetta, Fernando Augusto

2010-06-01

299

Low doses of etanercept can be effective in ankylosing spondylitis patients who achieve remission of the disease.  

UK PubMed Central (United Kingdom)

This study aims to explore the effectiveness of low dose of etanercept (ETN) in patients with ankylosing spondylitis (AS) who achieve a good control of their disease in daily clinical practice. This is a case series of AS patients treated with ETN. According to the judgment of the treating rheumatologist and patient's preferences, a dose reduction was done in those patients who achieved a good control of their disease defined by Bath ankylosing spondylitis disease activity index (BASDAI) <4 and C-reactive protein normal values. Fifty-one AS patients treated with ETN were identified and 16 of them (32%) were on dose reduction regimen. Several regimens of dose reduction were used. These patterns were fixed and they did not change along the time. Mean time receiving ETN before adjusting the dose was 17?±?12 months. Mean follow-up after dose change was 21?±?21 months. At this point, all the patients in whom dose reduction was done remained in the low-dose regimen. Median BASDAI (range) at starting the low-dose regimen and 6 months later were 1.6 (0.9-2.4) and 1.4 (0.3-3.2), respectively. Median CRP values (range) at starting the low dose regimen and 6 months later were 1 mg/l (0.1-2.8), and 1.3 mg/l (0.3-4.1), respectively. Other disease-related variables also remained unchanged. Patients with follow up at 12 and 24 months and longer remained in clinical remission with BASDAI values <2 and normal CRP values. Our data suggest that AS patients in clinical remission can use low doses of ETN without increasing disease activity. So, it can be a promising strategy but additional studies are needed to prove it.

Navarro-Compán V; Moreira V; Ariza-Ariza R; Hernández-Cruz B; Vargas-Lebrón C; Navarro-Sarabia F

2011-07-01

300

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

Directory of Open Access Journals (Sweden)

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

Jonathan Kay; Mahboob U Rahman

2009-01-01

 
 
 
 
301

Decrease of respiratory burst in neutrophils of patients with ankylosing spondylitis by combined radon-hyperthermia treatment.  

UK PubMed Central (United Kingdom)

OBJECTIVE: To define the respiratory burst activity of neutrophils, the total anti-oxidative status of plasma, and the parameters of systemic inflammation in patients with ankylosing spondylitis (AS) before and after a combined radon-hyperthermia treatment in the thermal tunnels of Böckstein-Bad Gastein in Austria. METHODS: In 20 patients with AS the effects of a total of 15 hours of radon-hyperthermia-treatment spread over a period of three weeks were studied. The respiratory burst activity of neutrophils was measured fluorometrically using dichlorofluorescein diacetate, the total anti-oxidant status was measured using azinodiethyl-benzthiazoline-sulphonate, and inflammation parameters were determined by routine laboratory assays. RESULTS: Before treatment, the basal neutrophil respiratory burst in patients (n = 20) was 409 +/- 62 fluorescence arbitrary units (AU; mean +/- SEM) and 359 +/- 37 AU in controls (n = 9; p > 0.5); the stimulated respiratory burst (fMet-Leu-Phe, 10(-6) M) was 1,027 +/- 133 AU in patients and 1,152 +/- 218 AU in controls (p > 0.5). After treatment, the basal neutrophil respiratory burst in patients (n = 19) was 137 +/- 16 and in controls it was 174 +/- 35 AU (n = 8; p > 0.1); the stimulated respiratory burst was 670 +/- 66 and 1,305 +/- 82 AU, in patients and controls respectively (p < 0.001). No effects of treatment on the total anti-oxidant status of the plasma or on the parameters of inflammation were detected. CONCLUSION: Combined radon-hyperthermia treatment reduces the respiratory burst activity of the blood circulating neutrophils in patients with AS. If respiratory burst activity from the neutrophils plays a role in the pathophysiology of ankylosing spondylitis, the observed reduction may be related to the beneficial effects of radon-hyperthermia treatment.

Reinisch N; Mur E; Herold M; Dunzendorfer S; Kähler CM; Falkenbach A; Wiedermann CJ

1999-05-01

302

Assessment of short-term symptomatic efficacy of tocilizumab in ankylosing spondylitis: results of randomised, placebo-controlled trials.  

UK PubMed Central (United Kingdom)

OBJECTIVES: BUILDER-1 and BUILDER-2 aimed to assess the efficacy and safety of tocilizumab (TCZ) in patients with ankylosing spondylitis (AS). METHODS: BUILDER-1 was a two part, phase II-III parallel-group trial in patients with AS naive to antitumour necrosis factor (aTNF) treatment. Patients in part 1 received TCZ 8 mg/kg or placebo for 12 weeks. In part 2 (beginning after part 1 enrolment ended), newly enrolled patients received TCZ 4 or 8 mg/kg or placebo for 24 weeks. The same treatment arms were used in BUILDER-2, a phase III study in aTNF-inadequate responders. The primary endpoint for both studies was the proportion of patients achieving 20% improvement in the Assessments in Axial SpondyloArthritis international Society (ASAS). Secondary and exploratory endpoints included ASAS40 response rates, Bath Ankylosing Spondylitis Disease Activity Index improvement, changes in joint counts, enthesitis score and C reactive protein (CRP). RESULTS: 102 patients were randomised in BUILDER-1 part 1; 99 (48 TCZ, 51 placebo) completed 12 weeks. Week 12 ASAS20 response rates were 37.3% and 27.5% in the TCZ and placebo arms, respectively (p=0.2823). Secondary and exploratory endpoints did not differ between treatment arms. CRP levels declined with TCZ treatment, suggesting adequate IL-6 receptor blockade. As a result, BUILDER-1 part 2 and BUILDER-2 were terminated. TCZ safety results were consistent with previous observations in rheumatoid arthritis, except for a cluster of anaphylactic and hypersensitivity events at Bulgarian study sites. No apparent explanation for this clustering could be found. CONCLUSIONS: BUILDER-1 failed to demonstrate TCZ efficacy in treating aTNF-naive patients with AS. CLINICAL TRIAL REGISTRATION NUMBERS:: NCT01209702 and NCT01209689 (www.clinicaltrials.gov).

Sieper J; Porter-Brown B; Thompson L; Harari O; Dougados M

2013-06-01

303

Assessment of short-term symptomatic efficacy of tocilizumab in ankylosing spondylitis: results of randomised, placebo-controlled trials.  

Science.gov (United States)

OBJECTIVES: BUILDER-1 and BUILDER-2 aimed to assess the efficacy and safety of tocilizumab (TCZ) in patients with ankylosing spondylitis (AS). METHODS: BUILDER-1 was a two part, phase II-III parallel-group trial in patients with AS naive to antitumour necrosis factor (aTNF) treatment. Patients in part 1 received TCZ 8 mg/kg or placebo for 12 weeks. In part 2 (beginning after part 1 enrolment ended), newly enrolled patients received TCZ 4 or 8 mg/kg or placebo for 24 weeks. The same treatment arms were used in BUILDER-2, a phase III study in aTNF-inadequate responders. The primary endpoint for both studies was the proportion of patients achieving 20% improvement in the Assessments in Axial SpondyloArthritis international Society (ASAS). Secondary and exploratory endpoints included ASAS40 response rates, Bath Ankylosing Spondylitis Disease Activity Index improvement, changes in joint counts, enthesitis score and C reactive protein (CRP). RESULTS: 102 patients were randomised in BUILDER-1 part 1; 99 (48 TCZ, 51 placebo) completed 12 weeks. Week 12 ASAS20 response rates were 37.3% and 27.5% in the TCZ and placebo arms, respectively (p=0.2823). Secondary and exploratory endpoints did not differ between treatment arms. CRP levels declined with TCZ treatment, suggesting adequate IL-6 receptor blockade. As a result, BUILDER-1 part 2 and BUILDER-2 were terminated. TCZ safety results were consistent with previous observations in rheumatoid arthritis, except for a cluster of anaphylactic and hypersensitivity events at Bulgarian study sites. No apparent explanation for this clustering could be found. CONCLUSIONS: BUILDER-1 failed to demonstrate TCZ efficacy in treating aTNF-naive patients with AS. CLINICAL TRIAL REGISTRATION NUMBERS:: NCT01209702 and NCT01209689 (www.clinicaltrials.gov). PMID:23765873

Sieper, Joachim; Porter-Brown, Benjamin; Thompson, Liz; Harari, Olivier; Dougados, Maxime

2013-06-13

304

Annual acquisition and administration cost of biologic response modifiers per patient with rheumatoid arthritis, psoriasis, psoriatic arthritis, or ankylosing spondylitis.  

Science.gov (United States)

Abstract Objective: To estimate annual biologic response modifier (BRM) cost per treated patient with rheumatoid arthritis, psoriasis, psoriatic arthritis, and/or ankylosing spondylitis receiving etanercept, abatacept, adalimumab, certolizumab, golimumab, infliximab, rituximab, or ustekinumab. Methods: This was a cohort study of 69,349 commercially insured individuals in a nationwide claims database with one of these conditions that had a claim for one of these BRMs between January 2008 and December 2010 (the index BRM/index date). Cost per treated patient was calculated as the total BRM acquisition and administration cost to the payer in the first year after the index date (including costs of other BRMs after switching) divided by the number of patients who received the index BRM. Etanercept was selected as the reference for comparisons. Results: Etanercept was the most commonly used index BRM (n?=?32,298; 47%), followed by adalimumab (n?=?20,582; 30%), infliximab (n?=?11,157; 16%), abatacept (n?=?2633; 4%), rituximab (n?=?1359; 2%), golimumab (n?=?687; certolizumab (n?=?245; <1%). Using etanercept as the reference, the cost per treated patient in the first year across all four conditions was 102% for adalimumab and 108% for infliximab. Newer BRMs had costs relative to etanercept that were 90% to 102% for rheumatoid arthritis, 132% for psoriasis, 100% for psoriatic arthritis, and 94% for ankylosing spondylitis. Limitations: Potential study limitations were the lack of clinical information (e.g., disease severity, treatment outcomes) or indirect costs, the inability to compare costs of newer BRMs across all four conditions, and much smaller sample sizes for newer BRMs. Conclusions: Of the BRMs that are approved for indications within all four conditions studied, etanercept had the lowest cost per treated patient when assessed across all four conditions. PMID:23808901

Bonafede, Machaon; Joseph, George J; Princic, Nicole; Harrison, David J

2013-07-18

305

Annual acquisition and administration cost of biologic response modifiers per patient with rheumatoid arthritis, psoriasis, psoriatic arthritis, or ankylosing spondylitis.  

UK PubMed Central (United Kingdom)

Abstract Objective: To estimate annual biologic response modifier (BRM) cost per treated patient with rheumatoid arthritis, psoriasis, psoriatic arthritis, and/or ankylosing spondylitis receiving etanercept, abatacept, adalimumab, certolizumab, golimumab, infliximab, rituximab, or ustekinumab. Methods: This was a cohort study of 69,349 commercially insured individuals in a nationwide claims database with one of these conditions that had a claim for one of these BRMs between January 2008 and December 2010 (the index BRM/index date). Cost per treated patient was calculated as the total BRM acquisition and administration cost to the payer in the first year after the index date (including costs of other BRMs after switching) divided by the number of patients who received the index BRM. Etanercept was selected as the reference for comparisons. Results: Etanercept was the most commonly used index BRM (n?=?32,298; 47%), followed by adalimumab (n?=?20,582; 30%), infliximab (n?=?11,157; 16%), abatacept (n?=?2633; 4%), rituximab (n?=?1359; 2%), golimumab (n?=?687; <1%), ustekinumab (n?=?388; <1%), and certolizumab (n?=?245; <1%). Using etanercept as the reference, the cost per treated patient in the first year across all four conditions was 102% for adalimumab and 108% for infliximab. Newer BRMs had costs relative to etanercept that were 90% to 102% for rheumatoid arthritis, 132% for psoriasis, 100% for psoriatic arthritis, and 94% for ankylosing spondylitis. Limitations: Potential study limitations were the lack of clinical information (e.g., disease severity, treatment outcomes) or indirect costs, the inability to compare costs of newer BRMs across all four conditions, and much smaller sample sizes for newer BRMs. Conclusions: Of the BRMs that are approved for indications within all four conditions studied, etanercept had the lowest cost per treated patient when assessed across all four conditions.

Bonafede M; Joseph GJ; Princic N; Harrison DJ

2013-09-01

306

Comparison of three methods for calculating the Bath Ankylosing Spondylitis Metrology Index in a randomized placebo-controlled study.  

UK PubMed Central (United Kingdom)

OBJECTIVE: To compare 3 methods for calculating the Bath Ankylosing Spondylitis Metrology Index (BASMI) score using patients who participated in the GO-RAISE study. METHODS: Patients with active ankylosing spondylitis (AS) were randomly assigned in a 1:1.8:1.8 ratio to receive subcutaneous injections of placebo, golimumab 50 mg, or golimumab 100 mg every 4 weeks. Lumbar flexion, tragus-to-wall distance, lumbar side flexion, intermalleolar distance, and cervical rotation angle measurements at baseline, week 14, and week 24 were used to calculate the BASMI 2-step (BASMI(2) ), 10-step (BASMI(10) ), and linear (BASMI(lin) ) scores. RESULTS: BASMI(2) scores were generally lower than BASMI(10) and BASMI(lin) scores, which were nearly identical. Median changes from baseline to week 14 in the combined golimumab group were similar to those in the placebo group when using the BASMI(2) calculation method (0.00 versus 0.00; P = 0.288). The combined golimumab group showed significantly greater improvement from baseline to week 14 than the placebo group when using the BASMI(10) (-0.20 versus 0.00; P = 0.018) and BASMI(lin) (-0.31 versus -0.07; P = 0.015) calculation methods, with the latter showing the greatest difference between golimumab and placebo. Guyatt's effect size was better for the BASMI(lin) and the BASMI(10) versus the BASMI(2) in the combined golimumab group at week 14 (0.58 and 0.53 versus 0.42, respectively) and week 24 (0.76 and 0.69 versus 0.61, respectively), despite the relatively short period to assess changes in spinal mobility. CONCLUSION: The BASMI(lin) method was the most sensitive to changes in range of motion exhibited by patients with AS who received golimumab.

van der Heijde D; Deodhar A; Inman RD; Braun J; Hsu B; Mack M

2012-12-01

307

Efficacy of certolizumab pegol on signs and symptoms of axial spondyloarthritis including ankylosing spondylitis: 24-week results of a double-blind randomised placebo-controlled Phase 3 study.  

UK PubMed Central (United Kingdom)

OBJECTIVES: To evaluate the efficacy and safety of certolizumab pegol (CZP) after 24 weeks in RAPID-axSpA (NCT01087762), an ongoing Phase 3 trial in patients with axial spondyloarthritis (axSpA), including patients with ankylosing spondylitis (AS) and non-radiographic axSpA (nr-axSpA). METHODS: Patients with active axSpA were randomised 1:1:1 to placebo, CZP 200 mg every 2 weeks (Q2W) or CZP 400 mg every 4 weeks (Q4W). In total 325 patients were randomised. Primary endpoint was ASAS20 (Assessment of SpondyloArthritis international Society 20) response at week 12. Secondary outcomes included change from baseline in Bath Ankylosing Spondylitis Functional Index (BASFI), Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), and Bath Ankylosing Spondylitis Metrology Index (BASMI) linear. RESULTS: Baseline disease activity was similar between AS and nr-axSpA. At week 12, ASAS20 response rates were significantly higher in CZP 200 mg Q2W and CZP 400 mg Q4W arms versus placebo (57.7 and 63.6 vs 38.3, p?0.004). At week 24, combined CZP arms showed significant (p<0.001) differences in change from baseline versus placebo in BASFI (-2.28 vs -0.40), BASDAI (-3.05 vs -1.05), and BASMI (-0.52 vs -0.07). Improvements were observed as early as week 1. Similar improvements were reported with CZP versus placebo in both AS and nr-axSpA subpopulations. Adverse events were reported in 70.4% vs 62.6%, and serious adverse events in 4.7% vs 4.7% of All CZP versus placebo groups. No deaths or malignancies were reported. CONCLUSIONS: CZP rapidly reduced the signs and symptoms of axSpA, with no new safety signals observed compared to the safety profile of CZP in RA. Similar improvements were observed across CZP dosing regimens, and in AS and nr-axSpA patients.

Landewé R; Braun J; Deodhar A; Dougados M; Maksymowych WP; Mease PJ; Reveille JD; Rudwaleit M; van der Heijde D; Stach C; Hoepken B; Fichtner A; Coteur G; de Longueville M; Sieper J

2013-09-01

308

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; Roberta Gonçalves; Sérgio Kowalski; Célio Roberto Gonçalves

2007-01-01

309

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

Scientific Electronic Library Online (English)

Full Text Available 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 investigação clínica (envolvimento axial e periférico, entesopatias, manifestações extra-articulares) e radiológica (sacroilíaca, coluna lombar, dorsal e cervical) co (more) mpletas, 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 clinical (axial and peripheral involvement, heel enthesopathies, extra-articular manifestations) and radiological (sacroiliac, lumbar, dorsal and cervical spine) investigation, HL (more) A-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.

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

2003-12-01

310

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

Scientific Electronic Library Online (English)

Full Text Available 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 (BASFI); 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 m (more) eio 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 quality 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 Impac (more) t 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

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

2010-12-01

311

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

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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; Manoel Barros Bértolo; Adil Muhib Samara

2003-01-01

312

Golimumab for the treatment of ankylosing spondylitis: a NICE single technology appraisal.  

Science.gov (United States)

As part of the National Institute for Health and Clinical Excellence (NICE) single technology appraisal (STA) process, the Evidence Review Group (ERG) produced a report to comment on the clinical and cost effectiveness of golimumab (Simponi(®), Merck Sharp & Dohme) for the treatment of ankylosing spondylitis (AS) relative to other comparators as presented in the manufacturer's submission (MS) to NICE. The population was those with active disease who had not responded to conventional therapy. The specified comparators were conventional care and two other tumour necrosis factor alpha (TNF-?) inhibitors (adalimumab and etanercept). Outcomes to be considered were disease activity, functional capacity, disease progression, adverse effects of treatment and health-related quality of life (HR-QOL). There were no head-to-head trials comparing TNF-? inhibitors. The submission included one trial of golimumab versus placebo (the GO-RAISE trial) and additionally seven placebo-controlled randomized controlled trials (RCTs) of other TNF-? inhibitor agents (five with etanercept, and two with adalimumab). The results of these trials were generally a statistically significant improvement from each of the TNF-? inhibitors. A Bayesian mixed treatment comparison (MTC) showed there was generally overlap in the 95 % credible intervals (CrIs) between the TNF-? inhibitors. Exceptions included a greater risk of discontinuation of treatment for golimumab than for etanercept (relative risk [RR] 4.30; 95 % CrI 1.01-18.50). The cost-effectiveness analysis (CEA) compared all of these TNF-? inhibitors. Relative effectiveness was informed only by RR of response (proportion achieving at least a 50 % improvement in Bath AS Disease Activity Index [BASDAI] score; BASDAI50) from the MTC. In the base-case analysis, the incremental cost-effectiveness ratio (ICER) of golimumab versus conventional care was £26,597 and adalimumab and etanercept were extendedly dominated by golimumab. The manufacturer concluded that golimumab is a cost-effective treatment option. Generally, the ERG agreed with the MTC analyses. The main problem was that the MS used data from one trial, which included a period of cross-over. The ERG found some problems with the CEA model, mainly that it did not allow for comparison of TNF-? inhibitor sequences and did not use MTC estimates for treatment discontinuation or adverse events (AEs). The ERG could not correct the sequencing problem, but re-ran the CEA with discontinuations and AEs estimated from the MTC and using the correct trial data. The results of the ERG analysis were that golimumab was extendedly dominated by etanercept, and the preferred treatment was either conventional treatment or etanercept, depending on the ICER threshold. Uncertainty was also substantial. NICE issued guidance (technology appraisal [TA] 233), which recommended golimumab according to the indications described in TA143 for etanercept and adalimumab, i.e. as first-line therapy among the TNF-? inhibitors unless patients are intolerant to one or both alternatives. Given the factors cited by NICE for their decision, the ERG recommends that there should be greater clarity in the NICE methods guidance on handling uncertainty in CEAs as well as the incorporation of benefit from process of care. PMID:23580355

Armstrong, Nigel; Joore, Manuela; van Asselt, Thea; Misso, Kate; Manning, Nathan; Tomini, Florian; Kleijnen, Jos; Riemsma, Rob

2013-05-01

313

Prehistoria, historia y arte de la Reumatología Gota y espondilitis anquilosante Prehistory, history and arts of rheumatology. Gout and ankylosing spondylitis. Part II  

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Full Text Available En esta segunda parte analizamos los inicios y la evolución de la Gota y de la Espondilitis Anquilosante. Relatamos nuevamente la importancia del arte en el desarrollo del conocimiento de estas enfermedades reumáticas.In this second part, we analyzed the beginning and the evolution of the Gout and Ankylosing Spondylitis. We relate again the importance of art in the development of knowledge of this rheumatic diseases.

Antonio Iglesias-Gamarra; Gerardo Quintana; José Félix Restrepo Suárez

2006-01-01

314

Prehistoria, historia y arte de la Reumatología Gota y espondilitis anquilosante/ Prehistory, history and arts of rheumatology. Gout and ankylosing spondylitis. Part II  

Scientific Electronic Library Online (English)

Full Text Available Abstract in spanish En esta segunda parte analizamos los inicios y la evolución de la Gota y de la Espondilitis Anquilosante. Relatamos nuevamente la importancia del arte en el desarrollo del conocimiento de estas enfermedades reumáticas. Abstract in english In this second part, we analyzed the beginning and the evolution of the Gout and Ankylosing Spondylitis. We relate again the importance of art in the development of knowledge of this rheumatic diseases.

Iglesias-Gamarra, Antonio; Quintana, Gerardo; Restrepo Suárez, José Félix

2006-06-01

315

Atherosclerosis in male patients with ankylosing spondylitis: the relation with methylenetetrahydrofolate reductase (C677T) gene polymorphism and plasma homocysteine levels.  

UK PubMed Central (United Kingdom)

The aim of this study was to determine the intima-media thickness (IMT) in carotid arteries and to assess the relation of these values with plasma homocysteine (pHcy) levels and methylenetetrahydrofolate reductase (MTHFR) C677T gene polymorphism in patients with Ankylosing spondylitis (AS). Serum lipids, vitamin B12, folic acid, pHcy and acute phase protein levels were measured in all cases. MTHFR C677T gene polymorphisms were determined, and IMT of main carotid artery were evaluated ultrasonographically in all subjects. Bath Ankylosing Spondylitis Disease Activity Index, Ankylosing Spondylitis Disease Activity score and Bath Ankylosing Spondylitis Metrology Index were used to assess disease activity and spinal mobility. Fifty AS patients (mean age of 36.6 ± 4.79 years) and 50 control subjects (36.34 ± 4.72 years) were included in the study. Plasma homocysteine levels of AS patients and control group were also similar (14.26 ± 9.96 vs. 11.81 ± 5.53 ?mol/L). Hyperhomocysteinemia was present in 11 subjects in patient group (22.0 %), while it was seen in 5 subjects in the control group (10.0 %). The MTHFR C677T genotype distribution was as follows: CC 31 (62 %), CT 14 (28 %), TT 5 (10 %) in AS patients. The mean carotid IMT values were also found to be similar between the groups. The most important factor influencing pHcy level was found as MTHFR 677TT genotype. We indicated no difference of atherosclerosis indices revealed by IMT values and pHcy levels AS patients and control subjects. But an association between MTHFR 677 gene polymorphism and pHcy levels was concluded, which may suggest that MTHFR 677 TT polymorphism may be a potential prognostic factor for cardiovascular disease in patients with AS.

Geçene M; Tuncay F; Borman P; Yücel D; Senes M; Y?lmaz BK

2013-06-01

316

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 habi...

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

317

Studies on Correlation Between Single-Nucleotide Polymorphisms of Tumor Necrosis Factor Gene and Different Stages of Ankylosing Spondylitis.  

UK PubMed Central (United Kingdom)

To examine if there is any correlation between ankylosing spondylitis (AS) and TNF-? gene promoter single-nucleotide polymorphisms (SNP) and their associated haplotypes. Using restriction fragment length polymorphism-polymerase chain reaction method, the polymorphism of TNF-?-238, -308, -850, -857, -863 locus, and TNF-? +252 were analyzed in patients with progressive AS, stable AS and control. (1) Neither the genotypes nor the allele frequencies of TNF-? (-308), (-238), (-863), and TNF-? +252 showed differences in each group. TNF-? (-850) CC genotype and C allele frequency distribution was significantly higher in healthy controls group than in the stable and progressive groups. TNF-? (-857) CT, CC genotype, and C, T allele frequency showed differences in all groups. (2) Polymorphism linkage equilibrium test revealed that association of six TNF-?, ? gene SNPs with haplotype GACTCG in progressive group is significantly higher than in the stable group and healthy control group (P < 0.05). TNF-? (-857), (-850) gene polymorphism may increase the susceptibility to AS, but do not reflect the disease active state. The CC genotype and C allele may play a protective role in the pathogenesis of AS. TNF-? (-308) may be a weak indicator reflecting the active state of AS. Haplotype GACTCG may indicate both the susceptibility and the activity of AS.

Ji Y; Yang X; Yang L; Wu D; Hua F; Lu T; Jia J; Ma C; Liang Q

2013-07-01

318

Interleukin-6 serum concentration in ankylosing spondylitis: a reliable predictor of disease progression in the subsequent year?  

UK PubMed Central (United Kingdom)

The aim of the present study was to evaluate whether in ankylosing spondylitis (AS), interleukin-6 (IL-6) is a reliable predictor of changes in mobility in the subsequent year. Of 261 AS patients who had been enrolled in a previous study, 128 returned for treatment at our health centre after 1 year (+/-3 months). The variables for mobility after 1 year (II) were compared with the findings of the previous year (I). Differences in parameters for mobility were related to the serum concentration of IL-6 in the previous year. Relation between serum concentration of IL-6 and difference (II-I) in occiput-to-wall distance (Spearman's rank correlation coefficient r(s), P value) was 0.02, 0.82; chin-chest distance -0.09, 0.31; cervical rotation -0.08, 0.39; chest expansion 0.05, 0.54; finger-floor distance -0.02, 0.84; Ott sign (flexibility of the thoracic spine) -0.11, 0.22; Schober sign 0.01, 0.94. After 1 year there was a significant improvement in cervical rotation in patients with low IL-6 serum concentration (lower quartile), but not in those with high levels of IL-6 (upper quartile). No further difference was seen between patients with high or low levels of IL-6. The present data suggest that the serum concentration of IL-6 does not allow a prediction of disease progression in the subsequent year.

Falkenbach A; Herold M; Wigand R

2000-01-01

319

Interleukin-6 serum concentration in ankylosing spondylitis: a reliable predictor of disease progression in the subsequent year?  

Science.gov (United States)

The aim of the present study was to evaluate whether in ankylosing spondylitis (AS), interleukin-6 (IL-6) is a reliable predictor of changes in mobility in the subsequent year. Of 261 AS patients who had been enrolled in a previous study, 128 returned for treatment at our health centre after 1 year (+/-3 months). The variables for mobility after 1 year (II) were compared with the findings of the previous year (I). Differences in parameters for mobility were related to the serum concentration of IL-6 in the previous year. Relation between serum concentration of IL-6 and difference (II-I) in occiput-to-wall distance (Spearman's rank correlation coefficient r(s), P value) was 0.02, 0.82; chin-chest distance -0.09, 0.31; cervical rotation -0.08, 0.39; chest expansion 0.05, 0.54; finger-floor distance -0.02, 0.84; Ott sign (flexibility of the thoracic spine) -0.11, 0.22; Schober sign 0.01, 0.94. After 1 year there was a significant improvement in cervical rotation in patients with low IL-6 serum concentration (lower quartile), but not in those with high levels of IL-6 (upper quartile). No further difference was seen between patients with high or low levels of IL-6. The present data suggest that the serum concentration of IL-6 does not allow a prediction of disease progression in the subsequent year. PMID:10836525

Falkenbach, A; Herold, M; Wigand, R

2000-01-01

320

Overexpression and unique rearrangement of VH2 transcripts in immunoglobulin variable heavy chain genes in ankylosing spondylitis patients.  

UK PubMed Central (United Kingdom)

To identify immunoglobulin variable heavy chain (VH) gene usages in Korean ankylosing spondylitis (AS) patients, expression level of VH2 genes from peripheral blood mononuclear cells (PBMCs) of 8 AS patients and 9 healthy donors was analysed by quantitative real-time PCR (Q-PCR). Q-PCR results demonstrated VH2 genes were overexpressed in AS patients (Relative amount of mRNA of VH2 genes to a house-keeping gene, 7.13+/-7.77 vs, 0.68+/-0.55; P<0.0001). The sequence analysis revealed the majority of them contained CDC42 binding protein kinase Beta (CDC42 BPB) genes. The insertion of CDC42 BPB gene was confirmed by PCR with primers corresponding CDC42 BPB and CH genes. Our study revealed VH2 overexpression and unique rearrangement in Ig VH genes from peripheral blood of AS patients. This may imply aberrant immunoglobulin gene rearrangement in B cell occurs in Korean AS patients, which requires further investigation.

Kim YJ; Kim NY; Lee MK; Choi HJ; Baek HJ; Nam CH

2010-05-01

 
 
 
 
321

Functional interaction of the ankylosing spondylitis-associated endoplasmic reticulum aminopeptidase 1 polymorphism and HLA-B27 in vivo.  

UK PubMed Central (United Kingdom)

The association of ERAP1 with ankylosing spondylitis (AS)1 among HLA-B27-positive individuals suggests that ERAP1 polymorphism may affect pathogenesis by altering peptide-dependent features of the HLA-B27 molecule. Comparisons of HLA-B*27:04-bound peptidomes from cells expressing different natural variants of ERAP1 revealed significant differences in the size, length, and amount of many ligands, as well as in HLA-B27 stability. Peptide analyses suggested that the mechanism of ERAP1/HLA-B27 interaction is a variant-dependent alteration in the balance between epitope generation and destruction determined by the susceptibility of N-terminal flanking and P1 residues to trimming. ERAP1 polymorphism associated with AS susceptibility ensured efficient peptide trimming and high HLA-B27 stability. Protective polymorphism resulted in diminished ERAP1 activity, less efficient trimming, suboptimal HLA-B27 peptidomes, and decreased molecular stability. This study demonstrates that natural ERAP1 polymorphism affects HLA-B27 antigen presentation and stability in vivo and proposes a mechanism for the interaction between these molecules in AS.

García-Medel N; Sanz-Bravo A; Van Nguyen D; Galocha B; Gómez-Molina P; Martín-Esteban A; Alvarez-Navarro C; de Castro JA

2012-11-01

322

The effects of combined spa therapy and rehabilitation on patients with ankylosing spondylitis being treated with TNF inhibitors.  

Science.gov (United States)

Despite advances in pharmacological therapy, physical treatment continues to be important in the management of ankylosing spondylitis (AS). The objective of the present study was to evaluate the effects and tolerability of combined spa therapy and rehabilitation in a group of AS patients being treated with TNF inhibitors. Thirty AS patients attending the Rheumatology Unit of the University of Padova being treated with TNF inhibitors for at least 3 months were randomized and assessed by an investigator independent from the spa staff: 15 were prescribed 10 sessions of spa therapy (mud packs and thermal baths) and rehabilitation (exercises in a thermal pool) and the other 15 were considered controls. The patients in both groups had been receiving anti-TNF agents for at least three months. The outcome measures utilized were BASFI, BASDAI, BASMI, VAS for back pain and HAQ. The evaluations were performed in all patients at the entry to the study, at the end of the spa treatment, and after 3 and 6 months. Most of the evaluation indices were significantly improved at the end of the spa treatment, as well as at the 3 and 6 months follow-up assessments. No significant alterations in the evaluation indices were found in the control group. Combined spa therapy and rehabilitation caused a clear, long-term clinical improvement in AS patients being treated with TNF inhibitors. Thermal treatment was found to be well tolerated and none of the patients had disease relapse. PMID:21947374

Ciprian, Luca; Lo Nigro, Alessandro; Rizzo, Michela; Gava, Alessandra; Ramonda, Roberta; Punzi, Leonardo; Cozzi, Franco

2011-09-27

323

The effects of combined spa therapy and rehabilitation on patients with ankylosing spondylitis being treated with TNF inhibitors.  

UK PubMed Central (United Kingdom)

Despite advances in pharmacological therapy, physical treatment continues to be important in the management of ankylosing spondylitis (AS). The objective of the present study was to evaluate the effects and tolerability of combined spa therapy and rehabilitation in a group of AS patients being treated with TNF inhibitors. Thirty AS patients attending the Rheumatology Unit of the University of Padova being treated with TNF inhibitors for at least 3 months were randomized and assessed by an investigator independent from the spa staff: 15 were prescribed 10 sessions of spa therapy (mud packs and thermal baths) and rehabilitation (exercises in a thermal pool) and the other 15 were considered controls. The patients in both groups had been receiving anti-TNF agents for at least three months. The outcome measures utilized were BASFI, BASDAI, BASMI, VAS for back pain and HAQ. The evaluations were performed in all patients at the entry to the study, at the end of the spa treatment, and after 3 and 6 months. Most of the evaluation indices were significantly improved at the end of the spa treatment, as well as at the 3 and 6 months follow-up assessments. No significant alterations in the evaluation indices were found in the control group. Combined spa therapy and rehabilitation caused a clear, long-term clinical improvement in AS patients being treated with TNF inhibitors. Thermal treatment was found to be well tolerated and none of the patients had disease relapse.

Ciprian L; Lo Nigro A; Rizzo M; Gava A; Ramonda R; Punzi L; Cozzi F

2013-01-01

324

MRI inflammation at the vertebral unit only marginally predicts new syndesmophyte formation: a multilevel analysis in patients with ankylosing spondylitis.  

UK PubMed Central (United Kingdom)

OBJECTIVE: To investigate the relationship between MRI inflammation at the vertebral unit and the formation and growth of syndesmophytes at the same vertebral unit. METHODS: An 80% random sample of the ASSERT database was analysed. MRI were scored using the ankylosing spondylitis (AS) spinal MRI activity score (at baseline, 24 and 102 weeks) and spinal x-rays were scored using the modified Stoke AS spine score (at baseline and 102 weeks). Data were analysed at the patient level and the vertebral unit level using a multilevel approach to adjust for within-patient correlation. RESULTS: There was a slightly increased probability of developing syndesmophytes in vertebral units with MRI activity, which was maintained after adjustment for within-patient correlation (per vertebral unit level) and treatment, and after further adjustment for potential confounders, resulting in significant OR ranging from 1.51 to 2.26. Growth of existing syndesmophytes at the vertebral unit level was not associated with MRI activity. At the patient level only a trend for an association was observed. CONCLUSION: MRI inflammation in a vertebral unit slightly increases the propensity to form a new syndesmophyte in the same vertebral unit, but does not predict the growth of already existing syndesmophytes. Despite this association, the large majority of new syndesmophytes developed in vertebral units without inflammation. The subtle association at the vertebral unit level did not translate into an association at the patient level.

van der Heijde D; Machado P; Braun J; Hermann KG; Baraliakos X; Hsu B; Baker D; Landewé R

2012-03-01

325

[Rehabilitation of coxitis in patients with ankylosing spondylitis. Observations in a series of 30 patients hospitalized at the Rheumatology and Recovery Hospital of Iasi].  

UK PubMed Central (United Kingdom)

UNLABELLED: The study aims to assess and compare the efficiency of two different kinetic programmes, in order to improve the treatment of patients with ankylosing spondylitis (AS). MATERIAL AND METHOD: Our study included two samples (control and cases) of 30 patients admitted for AS and unilateral coxitis in the Clinic of Rheumatology and Medical Rehabilitation Iasi, between 2008-2009. Certain paramentres such as: age, body mass index, disease evolution, Schober test, index-earth test, inspir-expir index, BASDAI activity index, BASFI functional index, Health Assessment Questionaire (HAQ), pain, morning ankylosing inflammatory tests, and general state of health were assessed at every patient. RESULTS: No variation with statistical significance were registered between the two samples. The Pilates method used in the rehabilitation treatment of patients with AS could have a favourable effect on indices regarding mobility, as well as patients' perception about their disease.

Berea S; Ancu?a C; Chiriac R

2010-10-01

326

Different clinical expression of patients with ankylosing spondylitis according to gender in relation to time since onset of disease. Data from REGISPONSER.  

UK PubMed Central (United Kingdom)

OBJECTIVE: To describe the differential characteristics by gender and time since disease onset in patients diagnosed with ankylosing spondylitis (AS) attending the Spanish rheumatology clinics, including those on the "Spanish Registry of spondyloarthritis" (REGISPONSER), as well as the diagnostic and therapeutic implications that this entails. PATIENTS AND METHODS: This is a transversal and observational study of 1514 patients with AS selected from 2367 spondyloarthritis cases included in REGISPONSER. For each patient, the demographics, epidemiology, geriatric, clinical, laboratory, radiological, and therapeutic aspects were were evaluated and comprehensively recorded under the aegis of REGISPONSER, constituting the Minimum Basic identifying data for the disease. Physical function was assessed by Bath Ankylosing Spondylitis Functional Index (BASFI). Clinical activity was evaluated using erythrocyte sedimentation rate, C reactive protein and Bath Ankylosing Spondylitis Disease Activity Index (BASDAI). Each patient underwent pelvic anteroposterior, anteroposterior and lateral lumbar spine as well as lateral cervical spine x rays; they were scored according to the Bath Ankylosing Spondylitis Spine Radiographic Index, which measures structural damage. RESULTS: Of the 1514 patients screened, 1131 (74.7%) were men. We found significant differences in age at onset of symptoms as well as in the day of inclusion, between the two groups, being lower in men. We also obtained differences in the duration of the disease, which was lower in women. As for the existence of a history of AS among first-degree relatives, family forms were more common among women. The mean BASDAI score was also higher in women, regardless of time since onset of disease. In contrast, the improvement of pain with the use of NSAID's and radiological severity were higher in men, both reaching statistical significance. CONCLUSIONS: Among the Spanish AS patients, there are some differences in the clinical manifestations, even when the time since onset of disease was controlled; we also found radiological differences by gender; men showing more structural damage, while women were more active. These data suggest that the phenotype of AS differs between genders. This can influence the subsequent diagnostic approach and therapeutic decisions.

Ortega Castro R; Font Ugalde P; Castro Villegas MC; Calvo Gutiérrez J; Muñoz Gomariz E; Zarco Montejo P; Almodóvar R; Mulero Mendoza J; Torre-Alonso JC; Gratacós Masmitjá J; Juanola Roura X; Ariza Ariza R; Fernández Dapica P; Linares Ferrando LF; Brito Brito ME; Cuende Quintana E; Vázquez Galeano C; Moreno Ramos MJ; Giménez Úbeda E; Rodríguez Lozano JC; Fernández Prada M; Queiro Silva R; Moreno Ruzafa E; Júdez Navarro E; Más AJ; Medrano Le Quement C; Ornilla E; Montilla Morales C; Pujol Busquets M; Clavaguera Poch T; Fernández-Espartero MC; Carmona Ortell L; Collantes Estévez E

2013-07-01

327

Pentax-airway scope for tracheal intubation breaks through the limitation of neck motion in an ankylosing spondylitis patient wearing halo vest--a case report.  

UK PubMed Central (United Kingdom)

The Airway Scope (AWS) provides better glottic view than the conventional direct laryngoscopy in tracheal intubation. With it, the endotracheal tube can be more easily inserted into the tracheal lumen easily. We hereby presented a 24-year-old ankylosing spondylitis (AS) patient wearing a halo vest who was successfully intubated for undergoing cervical spine surgery involving C1 and C2 under general anesthesia. Pre-operative airway assessment revealed that he was a case of difficult intubation. An AWS was used for oral tracheal intubation which was achieved smoothly in the first attempt. AWS can be an alternative device for airway management in a patient wearing halo vest.

Cheng WC; Jimmy-Ong; Lee CL; Lan CH; Chen TY; Lai HY

2010-12-01

328

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

Directory of Open Access Journals (Sweden)

Full Text Available 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. TENS currents have shown the highest degree of effect. All treated animals have shown improved motility after a few months of therapy. Despite the fact that all animals had an improved clinical picture none of the applied currents resulted in a complete loss of limping. Dogs treated with Intf currents displayed a decrease in muscular atrophy. Motility of the coxofemoural joint was most evident in the group treated with microwaves.

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

2010-01-01

329

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

UK PubMed Central (United Kingdom)

INTRODUCTION: Erosions of the sacroiliac joints (SIJ) on pelvic radiographs of patients with ankylosing spondylitis (AS) are an important feature of the modified New York classification criteria. However, radiographic SIJ erosions are often difficult to identify. Recent studies have shown that erosions can be detected also on magnetic resonance imaging (MRI) of the SIJ early in the disease course before they can be seen on radiography. The goals of this study were to assess the reproducibility of erosion and related features, namely, extended erosion (EE) and backfill (BF) of excavated erosion, in the SIJ using a standardized MRI methodology. METHODS: Four readers independently assessed T1-weighted and short tau inversion recovery sequence (STIR) images of the SIJ from 30 AS patients and 30 controls (15 patients with non-specific back pain and 15 healthy volunteers) ? 45 years old. Erosions, EE, and BF were recorded according to standardized definitions. Reproducibility was assessed by percentage concordance among six possible reader pairs, kappa statistics (erosion as binary variable) and intraclass correlation coefficient (ICC) (erosion as sum score) for all readers jointly. RESULTS: SIJ erosions were detected in all AS patients and six controls by ? 2 readers. The median number of SIJ quadrants affected by erosion recorded by four readers in 30 AS patients was 8.6 in the iliac and 2.1 in the sacral joint portion (P < 0.0001). For all 60 subjects and for all four readers, the kappa value for erosion was 0.72, 0.73 for EE, and 0.63 for BF. ICC for erosion was 0.79, 0.72 for EE, and 0.55 for BF, respectively. For comparison, the kappa and ICC values for bone marrow edema were 0.61 and 0.93, respectively. CONCLUSIONS: Erosions can be detected on MRI to a comparable degree of reliability as bone marrow edema despite the significant heterogeneity of their appearance on MRI.

Weber U; Pedersen SJ; Østergaard M; Rufibach K; Lambert RG; Maksymowych WP

2012-01-01

330

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 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 mercado 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 disc (more) utissem 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 aimed 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 sta (more) ndardized 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

2013-06-01

331

Evaluation of Tp-e interval and Tp-e/QT ratio in patients with ankylosing spondylitis.  

UK PubMed Central (United Kingdom)

OBJECTIVES: Ankylosing spondylitis (AS) is a chronic multi-systemic inflammatory rheumatic disorder. Several studies have suggested that the interval from the peak to the end of the electrocardiographic T wave (Tp-e) may correspond to the transmural dispersion of repolarization and that increased Tp-e interval and Tp-e/QT ratio are associated with malignant ventricular arrhythmias. The aim of this study was to evaluate ventricular repolarization by using Tp-e interval and Tp-e/QT ratio in patients with AS, and to assess the relation with inflammation. METHODS: Sixty-two patients with AS and 50 controls were included. Tp-e interval and Tp-e/QT ratio were measured from a 12-lead electrocardiogram, and the Tp-e interval corrected for heart rate. The plasma level of high sensitive C-reactive protein (hsCRP) was measured. These parameters were compared between groups. RESULTS: In electrocardiographic parameters analysis, QT dispersion (QTd) and corrected QTd were significantly increased in AS patients compared to the controls (31.7 ± 9.6 vs 28.2 ± 7.4 and 35.8 ± 11.5 vs 30.6 ± 7.9 ms, P = 0.03 and P = 0.007, respectively). cTp-e interval and Tp-e/QT ratio were also significantly higher in AS patients (92.1 ± 10.2 vs 75.8 ± 8.4 and 0.22 ± 0.02 vs 0.19 ± 0.02 ms, all P values <0.001). cTp-e interval and Tp-e/QT ratio were significantly correlated with hsCRP (r = 0.63, P < 0.001 and r = 0.49, P < 0.001, respectively). CONCLUSIONS: Our study revealed that Tp-e interval and Tp-e/QT ratio were increased in AS patients. These electrocardiographic ventricular repolarization indexes were significantly correlated with the plasma level of hsCRP.

Acar G; Yorgun H; Inci MF; Akkoyun M; Bakan B; Nacar AB; Dirnak I; Cetin GY; Bozoglan O

2013-04-01

332

High-dose etanercept in ankylosing spondylitis: results of a 12-week randomized, double blind, controlled multicentre study (LOADET study).  

UK PubMed Central (United Kingdom)

OBJECTIVES: Etanercept 50?mg a week is approved in the treatment of AS. Increasing the etanercept dose to 100?mg/week improves efficacy in cutaneous psoriasis, a clinical manifestation related to the spondylarthritis family, while maintaining its safety profile. The purpose of this study was to evaluate the efficacy and safety of etanercept 100 vs 50?mg/week in patients with AS. METHODS: Adult patients with AS were randomized to receive etanercept 50?mg twice a week (biw), or etanercept 50?mg once a week (qw) for 12 weeks. The primary efficacy endpoint was Ankylosing Spondylitis Assessment Study (ASAS20) response at Week 12; secondary endpoints included ASAS40, ASAS50, ASAS70 and ASAS5/6 responses, partial remission and quality of life. Safety was assessed until 15 days after the last visit. RESULTS: A total of 108 patients were randomly selected and treated, 54 in each arm. At 12 weeks, ASAS20 response was achieved by 34 (71%) out of 48 patients of the etanercept 50?mg biw group and by 37 (76%) out of 49 patients of the etanercept 50?mg qw group (not statistically significant differences). Other efficacy variables improved significantly over time, but not between treatment groups. Fifty-six patients experienced at least one adverse event (generally, infections and infestations, gastrointestinal disorders and injection site reactions), most of them mild or moderate. CONCLUSIONS: High-dose (100?mg/week) etanercept in the treatment of AS for 12 weeks is as safe as the standard dose (50?mg/week). However, it does not significantly increase its efficacy. Trial Registration. Clinicaltrials.gov, http://clinicaltrials.gov/, NCT00873730.

Navarro-Sarabia F; Fernández-Sueiro JL; Torre-Alonso JC; Gratacos J; Queiro R; Gonzalez C; Loza E; Linares L; Zarco P; Juanola X; Román-Ivorra J; Martín-Mola E; Sanmartí R; Mulero J; Diaz G; Armendáriz Y; Collantes E

2011-10-01

333

Whole-blood Gene Expression Profiling in Ankylosing Spondylitis Shows Upregulation of Toll-like Receptor 4 and 5  

Science.gov (United States)

Objective To identify differentially expressed genes in peripheral blood cells (PBC) of patients with ankylosing spondylitis (AS) relative to healthy controls and controls with systemic inflammation. Methods We investigated PBC samples of 16 patients with AS and 14 matched controls, in addition to systemic lupus erythematosus (SLE) and systemic sclerosis (SSc) samples utilizing Illumina Human Ref-8 BeadChips. Candidate genes were confirmed using quantitative PCR. Subsequently, these genes were also validated in a separate sample of 27 patients with AS [before and after antitumor necrosis factor (anti-TNF) treatment] and 27 matched controls. Results We identified 83 differentially expressed transcripts between AS patients and controls. This gene list was filtered through the lists of differentially expressed transcripts in SLE and SSc, which resulted in identification of 52 uniquely dysregulated transcripts in AS. Many of the differentially expressed genes belonged to Toll-like receptor (TLR) and related pathways. TLR4 and TLR5 were the only dysregulated TLR subtypes among AS patients. We confirmed the overexpression of TLR4 and TLR5 in AS patients in comparison to controls (p = 0.012 and p = 0.006, respectively) and SLE (p = 0.002, p = 0.008) using quantitative PCR in the same sample. Similarly, TLR4 (p = 0.007) and TLR5 (p = 0.012) were significantly upregulated among the AS patients before anti-TNF treatment in the confirmatory sample. TLR4 (p = 0.002) and TLR5 (p = 0.025) decreased significantly after anti-TNF treatment. Conclusion PBC gene expression profiling in AS shows an upregulation of TLR4 and TLR5. This supports the importance of TLR subtypes in the pathogenesis of AS that are responsible for the immune response to Gram-negative bacteria.

ASSASSI, SHERVIN; REVEILLE, JOHN D.; ARNETT, FRANK C.; WEISMAN, MICHAEL H.; WARD, MICHAEL M.; AGARWAL, SANDEEP K.; GOURH, PRAVITT; BHULA, JITEN; SHARIF, ROOZBEH; SAMPAT, KEERAN; MAYES, MAUREEN D.; TAN, FILEMON K.

2010-01-01

334

Daily physical activity in ankylosing spondylitis: validity and reliability of the IPAQ and SQUASH and the relation with clinical assessments.  

UK PubMed Central (United Kingdom)

INTRODUCTION: The aim of this study was to investigate the construct validity and test-retest reliability of the International Physical Activity Questionnaire (IPAQ; long form) and the Short QUestionnaire to Assess Health-enhancing physical activity (SQUASH) and to investigate the relation between daily physical activity and clinical assessments in patients with ankylosing spondylitis (AS). METHODS: For validity, the self-report questionnaires IPAQ and SQUASH were compared with daily physical activity assessed with the ActiGraph accelerometer during 7 consecutive days in 63 AS outpatients. For reliability, the IPAQ and SQUASH were administered twice approximately one week apart in 52 AS outpatients. In all 115 patients, clinical assessments were performed at the outpatient clinic. RESULTS: IPAQ and SQUASH total scores correlated significantly with accelerometer outcome: rho=0.38 and r=0.35, respectively. Intraclass correlation coefficients between first and second assessments of the IPAQ and SQUASH were 0.83 and 0.89, respectively. Bland-Altman analyses showed no systemic bias, but in particular for the IPAQ the 95% limits of agreement were wide. Daily physical activity assessed by accelerometer, IPAQ, and SQUASH correlated significantly with disease activity, physical activity, and quality of life. A relation with spinal mobility was found only for the accelerometer and SQUASH. The direction of these correlations indicates that higher daily physical activity is related to lower disease activity and better physical function, spinal mobility and quality of life. CONCLUSIONS: Both physical activity questionnaires showed modest construct validity. The SQUASH showed good test-retest reliability, superior to the IPAQ. These results indicate that the SQUASH is more suitable than the IPAQ to assess daily physical activity in AS population studies. However, it is desirable to add questions on AS-specific physical activity. Further studies are needed to investigate the causality of the relation between daily physical activity and clinical assessments.

Arends S; Hofman M; Kamsma YP; van der Veer E; Houtman PM; Kallenberg CG; Spoorenberg A; Brouwer E

2013-08-01

335

Role of matrix metalloproteinase-3 (MMP-3) and magnetic resonance imaging of sacroiliitis in assessing disease activity in ankylosing spondylitis.  

UK PubMed Central (United Kingdom)

The objective of this study is to evaluate the role of MMP-3 and MRI in assessing disease activity in sacroiliac joints of AS patients in comparison to the conventional measures Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP). Serum MMP-3 was measured in 30 patients who fulfilled the modified New York criteria for AS and in ten healthy volunteers. AS patients were categorized into those having high or low MMP-3 according to a cut-off value = 7.1 ng/ml. MRI of the sacroiliac joints (SIJs) was performed on all patients. SIJs were evaluated for enhancement and subchondral bone marrow edema. Results of MMP-3 and findings on MRI were correlated with multiple clinical parameters including BASDAI, ESR and CRP. Serum MMP-3 was significantly elevated in AS patients with active disease. Elevated MMP-3 levels were significantly associated with high BASDAI (P = 0.046), but not with ESR or CRP. MRI showed bone marrow edema and enhancement of SIJs in 19/30 patients with one patient showing enhancement only. These MRI findings were not correlated with MMP-3, BASDAI, CRP or ESR. In conclusion, serum MMP-3 is an objective measure reflecting clinical disease activity in AS. Bone marrow edema and enhancement detected by MRI of SIJs is another objective measure of disease activity, but are not correlated with MMP-3 or the conventional parameters as BASDAI, ESR, or CRP. Although both MMP-3 and MRI can reflect disease activity in AS they seem to be unrelated, perhaps each is reflecting a different aspect of disease activity. MMP-3 and MRI should be considered together with BASDAI in assessing disease activity and in guiding the available recommendations for initiation of biologics in AS.

Soliman E; Labib W; el-Tantawi G; Hamimy A; Alhadidy A; Aldawoudy A

2012-06-01

336

Effect of HLA-B*27 and its Subtypes on Clinical Manifestations and Severity of Ankylosing Spondylitis in Iranian patients.  

UK PubMed Central (United Kingdom)

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.

Fallahi S; Mahmoudi M; Nicknam MH; Gharibdoost F; Farhadi E; Saei A; Nourijelyani K; Ahmadzadeh N; Jamshidi AR

2013-12-01

337

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

2013-08-28

338

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

UK PubMed Central (United Kingdom)

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?

Moraes JC; Ribeiro AC; Saad CG; Lianza AC; Silva CA; Bonfá E

2013-06-01

339

Association of HLA-B27 genetic polymorphisms with ankylosing spondylitis susceptibility worldwide: a meta-analysis.  

UK PubMed Central (United Kingdom)

OBJECTIVES: Many publications have evaluated the correlation between HLA-B27 polymorphisms and ankylosing spondylitis (AS), with conflicting results. We carried out this new meta-analysis in order to collect all the relevant studies to further clarify the association of HLA-B27 polymorphisms with AS susceptibility. METHODS: Relevant published data were retrieved through Medline, PubMed, Web of Science, CNKI, and the Chinese BioMedical Literature Database on disc. The statistical analysis was conducted using Review Manager Version 5.0 and STATA 11.0. From these data, the odds ratio (OR) with a 95 % confidence interval (95 % CI) was calculated. RESULTS: (1) A total of 38 studies, including 3,410 AS cases and 1,735 healthy controls, were collected in this meta-analysis. (2) Our results showed that B2704 was a risk factor but B2703, B2706, B2707, B2727, B2729, and B2747 may be protective factors for AS worldwide. (3) These subtypes, such as B2701, B2702, B2705, B2708-15, B2717-20, B2723-24, B2733, B2735, B2740, B2746, B2749, and B2767, showed no association with susceptibility to AS. There was a huge difference with previous reports for B2702 and B2705. (4) The B2702, B2704 and B2705 subtypes have existed high heterogeneity but no publication bias. CONCLUSIONS: This meta-analysis in our study suggested that B2704 might be a potential risk factor, however, B2703, B2706, and B2707 might be potential protective factors of AS, especially in Asia.

Yang T; Duan Z; Wu S; Liu S; Zeng Z; Li G; Wang S; Fan D; Ye D; Xu S; Zhang L; Pan F

2013-02-01

340

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

UK PubMed Central (United Kingdom)

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

Huang ZX; Tan JH; Li TW; Deng WM; Qiu KW; Liao ZT; Zeng ZQ

2013-10-01

 
 
 
 
341

Factors associated with body function and disability in patients with ankylosing spondylitis: a cross-sectional study.  

UK PubMed Central (United Kingdom)

OBJECTIVE: To determine for patients with ankylosing spondylitis (AS) which factors are associated with disability and restricted body function. METHODS: In 1538 patients with AS, occiput-to-wall distance, chest expansion, cervical rotation, finger-floor distance, and modified Schober test were measured cross-sectionally, and for each measure the patient's respective percentile was calculated. The mean of the 5 percentiles was summarized in the mobility restriction score (MRS). In addition, patients answered questions on disease progression and completed the Bath AS Functional Index (BASFI) questionnaire. All data were coded into 40 variables, used as independent variables in multiple regression analyses to identify factors associated with BASFI and MRS. RESULTS: Finger-to-floor distance (beta positive, +), cervical rotation (-), time since first AS symptoms (-), age (+), height loss (+), maximum height (-), delay in diagnosis (+), hip replacement (+), regular practice of sports (-), chest expansion (-), sex (worse BASFI in females), exposure to cold and dampness (+), and regular participation in AS group physical exercises (+) were significantly associated with worse BASFI. Significantly associated factors for worse MRS were height loss (+), sex (higher MRS in males), active inflammation of the cervical region (+), age (+), maximum height (-), active inflammation of the hip region (+), involvement of shoulders (+), time since first AS symptoms (+), urethritis (-), regular practice of sports (-), involvement of feet (-), and hip replacement (+). The models explain 47% of the variance observed for both the BASFI and MRS. CONCLUSION: The amount of variance explained for both BASFI and MRS is rather high. The results apply primarily to groups of patients, but are insufficient to guide clinical decisions in individual patients. These findings contribute to our understanding of factors influencing disability and restriction in body function in AS.

Falkenbach A; Franke A; van der Linden S

2003-10-01

342

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

343

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

Directory of Open Access Journals (Sweden)

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; Dhouha Azzouz; Mohamed Mehdi Ghannouchi; Manel Haouel; Samir Kochbati; Kaouthar Saadellaoui; Abdelmajid Ben Hmida; Béchir Zouari; Mohamed Montacer Kchir

2012-01-01

344

Association of common variants in KIF21B and ankylosing spondylitis in a Chinese Han population: a replication study.  

UK PubMed Central (United Kingdom)

KIF21B polymorphisms were found associated with susceptibility to multiple sclerosis and ankylosing spondylitis (AS) in populations of white European ancestry. We aimed to replicate the association of polymorphisms around KIF21B and AS in a Chinese Han population. This case-control study included 665 patients with AS and 1,042 healthy controls genotyped for seven single nucleotide polymorphisms (SNPs) of KIF21B-rs12118246, rs4915464, rs502658, rs10494829, rs12089839, rs6687260, and rs957957-by TaqMan genotyping assay; statistical analyses involved the use of PLINK. We also estimated the linkage disequilibrium and haplotypes of these SNPs. Two SNPs-rs502658 (allelic p?=?0.0002, odds ratio [OR] 0.60, 95 % confidence interval [95 % CI] 0.47-0.76) and rs10494829 (allelic p?=?0.003, OR 1.30, 95 % CI 1.12-1.52)-were significantly associated with AS in the Chinese Han population. In addition, a linear regression test showed that they have independent contribution to disease susceptibility. For both SNPs, haplotype AT was strongly associated with AS and increased the risk of the disease (p?=?0.045, OR 1.183, 95 % CI 1.004-1.395), and the genotype GC reduced the risk (p?=?0.011, OR 0.715, 95 % CI 0.55-0.928). This work identified a significant association of two SNPs in KIF21B and AS in the Chinese Han population. KIF21B may play an important role in the pathogenesis of AS in the Chinese population and might be a new therapeutic target for AS.

Liu Y; Zhang H; Li J; Zhao H; Xin Q; Shan S; Dang J; Bian X; Liu Q

2013-09-01

345

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 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 intracelulares como a Leishmania. A terapia anti-TNF-α tem importante papel no tratamento de doenças reumáticas, mas o uso desses antagonistas está relacionado ao aume (more) nto 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 Leishmania. 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 (more) 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

2012-06-01

346

Golimumab reduces spinal inflammation in ankylosing spondylitis: MRI results of the randomised, placebo- controlled GO-RAISE study.  

UK PubMed Central (United Kingdom)

OBJECTIVE: To evaluate golimumab's effect on MRI-detected spinal inflammation in ankylosing spondylitis (AS). METHODS: Patients were randomly assigned to subcutaneous injections of placebo (n=78), golimumab 50 mg (n=138), or golimumab 100 mg (n=140) every 4 weeks. An MRI substudy comprising 98 patients (placebo n=23, 50 mg n=37, 100 mg n=38) at eligible MRI substudy sites had serial spine MRI scans (sagittal plane, 1.5T scanners, T1 and short tau inversion recovery sequences) at baseline and weeks 14 and 104. Two blinded (treatment, image order) readers independently evaluated MRI spinal inflammation using AS spine MRI-activity (ASspiMRI-a) scores; reader scores were averaged. Changes from baseline to weeks 14 and 104 were compared among treatment groups using analysis of variance on van der Waerden normal scores both with (post-hoc) and without (prespecified) adjustment for baseline ASspiMRI-a scores. RESULTS: Median baseline ASspiMRI-a scores were lower in the 100 mg (3.5) than placebo (6.8) and 50 mg (7.8) groups. Median decreases in activity scores from baseline to week 14 were -0.5 for placebo, -3.5 for 50 mg (p=0.047 vs placebo), and -1.5 for 100 mg (p=0.14 vs placebo). After adjusting for baseline ASspiMRI-a score imbalance, significant improvements were observed with both 50 mg (p=0.011) and 100 mg (p=0.002) versus placebo. ASspiMRI-a scores improvement achieved with golimumab was maintained at week 104. Improvement in ASspiMRI-a scores correlated with improvement in the recently developed AS disease activity score (ASDAS) and C-reactive protein (CRP) levels but not with other key AS clinical outcomes. CONCLUSION: Golimumab significantly reduced MRI-detected spinal inflammation of AS; improvements were sustained to week 104 and correlated with improvement in ASDAS and CRP.

Braun J; Baraliakos X; Hermann KG; van der Heijde D; Inman RD; Deodhar AA; Baratelle A; Xu S; Xu W; Hsu B

2012-06-01

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Effect of all-transretinoic acid on Th17 and T regulatory cell subsets in patients with ankylosing spondylitis.  

UK PubMed Central (United Kingdom)

OBJECTIVE: We compared Th17 and T regulatory cells in patients with ankylosing spondylitis (AS) and in healthy controls. The effect of all-transretinoic acid (ATRA) was studied on cultured CD4+ T cells of patients with AS compared to controls. METHODS: Eighteen patients with AS and 18 age- and sex-matched healthy controls were included. CD4+ T cells were separated and cultured in conditions of anti-CD3 and anti-CD28 stimulation with and without ATRA. Intracellular and secreted cytokines, transcription factors, and gene expression were evaluated after 72 h. RESULTS: The frequency of CD4+IL-17+ T cells was significantly higher in patients with AS compared to controls, and ATRA could significantly decrease it. The frequency of forkhead box protein 3 (FOXP3)+ retinoic acid-related orphan receptor ?t (ROR?t) negative T-bet negative CD4+ cells was significantly lower in cases compared to controls. Intracellular and secreted interferon-? (IFN-?) was not significantly different between cases and controls. ATRA significantly increased intracellular IFN-? in cases but not in controls. Tumor necrosis factor-? (TNF-?) secretion was significantly higher and interleukin 10 secretion was significantly lower in culture supernatant of cases compared to controls. ATRA could significantly decrease TNF-? secretion in cases. CONCLUSION: Our findings favor a pathogenic role for Th17 cells in AS. Th1 cells did not seem to contribute in the pathogenesis of this disease. The effect of ATRA as an immunomodulator on deviated immune cells was associated with decreased inflammatory markers. This association could be a reason for a clinical trial of ATRA in patients with AS.

Bidad K; Salehi E; Jamshidi A; Saboor-Yaraghi AA; Oraei M; Meysamie A; Mahmoudi M; Nicknam MH

2013-04-01

348

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 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 assoc