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1

[HLA B 27 uveitis in ankylosing spondylitis and reactive arthritis].  

PubMed

Clinical features of uveitis HLA B27 in patients with uveitis associated with ankylosing spondylitis and reactive arthritis. The study was made on 64 patients with uveitis treated in the municipal hospital between 2005-2008. The diagnosis was established after a complex ophthalmologic investigation. Histocompatibility HLA-B27 was determined in all groups of patients. Each patient was consulted by the rheumatologist. In the study were included 50 (78%) men and 14 (22%) women. The frequency of HLA B27+ was 72%. At HLA B27+ associated with ankylosing spondylitis and reactive arthritis is present in the anterior form in 85%, unilateral affection in 92%. Their evolution is chronic in 17% and has a tendency for recidivism in 11% of patients. HLA B27 is a genetic factor of uveitis associated with spondylarthropathies in 72%. The study determined the disease in 78% of men, 72% were acute, 85% were anterior and 92% were unilateral. The study of HLA B27 in patients with uveitis is one of the shortest ways for the earlier diagnosis of ankylosing spondylitis. PMID:20540366

Dumbr?veanu, Lilia; Cu?nir, V; Groppa, Liliana; Calinina, Liana

2010-01-01

2

Immunohistological features of synovitis in ankylosing spondylitis: a comparison with rheumatoid arthritis.  

PubMed Central

The immunohistological features of the synovial membrane in ankylosing spondylitis, HLA-B27 associated oligoarthritis, and rheumatoid arthritis wer examined with particular reference to T lymphocyte subsets. T helper (CD4+) cells clearly outnumbered T suppressor/cytotoxic (CD8+) cells in rheumatoid arthritis, whereas both cell types were present in equal numbers in ankylosing spondylitis. A reduction of CD4+/CD45R+ suppressor/inducer cells relative to CD4+/UCHL1+ helper/inducer cells was apparent in all diagnostic groups. The observations were suggestive of disease specific inflammatory responses within synovial membrane. Images PMID:2522758

Kidd, B L; Moore, K; Walters, M T; Smith, J L; Cawley, M I

1989-01-01

3

Surgery in the Treatment of Rheumatoid Arthritis and Ankylosing Spondylitis  

PubMed Central

The pain, deformities and disabilities resulting from rheumatoid arthritis and ankylosing spondylitis must be treated by a team composed of physician, physical medicine expert, orthopædic surgeon, and, in certain cases, deep X-ray therapist working simultaneously. The principle of “rest” in order to relieve pain has to be combined with methods designed to preserve and restore function. The multiple joint deformities in these cases may necessitate a long programme of reconstructive or functional treatment, which entails whole-hearted co-operation on the part of the patient in intensive post-operative exercise regime. Procedures advocated for the upper limb include excision of the acromion process together with the subacromial bursa to allow free movement between the central tendon of the deltoid and the tendinous shoulder cuff: arthrodesis of the shoulder in cases where there is more severe joint destruction: in certain cases of elbow-joint arthritis, excision of the radial head and sub-total synovectomy may preserve joint function and avoid or delay the necessity for arthroplasty which can be carried out in two ways: (a) similar to the formal joint excision, or (b) re-shaping the lower end of the humerus and upper end of the ulna lining these surfaces with fascia. The former method is preferable in cases of rheumatoid arthritis. To overcome wrist-joint deformity and restore pronation and supination excision of the lower end of the ulna together with radiocarpal fusion in position for optimum function is advocated. Finger and toe joints may be corrected by resection of the bone ends and capsulectomy. In the lower limbs bilateral involvement of the hip-joint is best treated by vitallium mould arthroplasty which may be carried out in four ways: (1) Routine arthroplasty; (2) Modified Whitman procedure; (3) Modified Colonna operation; and (4) The proximal shaft or intertrochanteric arthroplasty. It is essential in these operations to have knowledge of the operative technique, the use of special hip gouges and reamers, and detailed post-operative supervision. For dorsal kyphosis of the spine, spinal osteotomy at the lumbar level provides excellent correction but is an operation demanding care and skill in its execution. The author's remarks are based on experience gained when working with Dr. M. N. Smith-Petersen at the Massachusetts General Hospital, Boston, U.S.A. PMID:18914877

Law, W. Alexander

1948-01-01

4

Ankylosing spondylitis  

MedlinePLUS

Spondylitis; Spondyloarthropathy ... Inman RD. The spondyloarthropathies. In: Goldman L, Schafer AI, eds. Cecil Medicine . 24th ed. Philadelphia, PA: Elsevier Saunders; 2011:chap 273. Sidiropoulos PI, ...

5

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

PubMed Central

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 arthritis only of wrist/hand or ankle/forefoot, or both, the Gm(1,2;21) frequency was even higher (31.3%; p less than 0.0005). Patients with AS negative for the HLA antigen B27 (n = 28) differed from the B27 positive patients (n = 205) with regard to the frequency of the Gm(1,2,3;5,21) phenotype (39.3% v 9.3%; p less than 0.0005). These findings support the notion of genetic heterogeneity among patients with AS. PMID:3264692

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

1988-01-01

6

Recommendations of the French Society for Rheumatology regarding TNF? antagonist therapy in patients with ankylosing spondylitis or psoriatic arthritis: 2007 update  

Microsoft Academic Search

ObjectiveTo update French Society for Rheumatology guidelines regarding the use of tumor necrosis factor ? (TNF?) antagonists for treating patients with ankylosing spondylitis (AS) or psoriatic arthritis (PsA).

Thao Pham; Bruno Fautrel; Emmanuelle Dernis; Philippe Goupille; Francis Guillemin; Xavier Le Loët; Philippe Ravaud; Pascal Claudepierre; Corinne Miceli-Richard; Michel de Bandt; Maxime Breban; Jean-Francis Maillefert; Charles Masson; Alain Saraux; Thierry Schaeverbeke; Daniel Wendling; Xavier Mariette; Bernard Combe

2007-01-01

7

Alternative Treatments for Ankylosing Spondylitis  

MedlinePLUS

... spinal mobility due to [ankylosing spondylitis] should avoid manipulation of their back or neck by chiropractors and ... a Consensus Process (inluding Contraindications for high-velocity manipulation to the lumbar spine - ankylosing spondylitis) Cheng-Chih ...

8

Imaging in ankylosing spondylitis  

PubMed Central

Imaging is an integral part of the management of patients with ankylosing spondylitis and axial spondyloarthritis. Characteristic radiographic and/or magnetic resonance imaging (MRI) findings are key in the diagnosis. Radiography and MRI are also useful in monitoring the disease. Radiography is the conventional, albeit quite insensitive, gold standard method for assessment of structural damage in spine and sacroiliac joints, whereas MRI has gained a decisive role in monitoring disease activity in clinical trials and practice. MRI may also, if ongoing research demonstrates a sufficient reliability and sensitivity to change, become a new standard method for assessment of structural damage. Ultrasonography allows visualization of peripheral arthritis and enthesitis, but has no role in the assessment of axial manifestations. Computed tomography is a sensitive method for assessment of structural changes in the spine and sacroiliac joints, but its clinical utility is limited due to its use of ionizing radiation and lack of ability to assess the soft tissues. It is exciting that with continued dedicated research and the rapid technical development it is likely that even larger improvements in the use of imaging may occur in the decade to come, for the benefit of our patients. PMID:22859929

Lambert, Robert G.W.

2012-01-01

9

Drug survival rates of tumor necrosis factor inhibitors in patients with rheumatoid arthritis and ankylosing spondylitis.  

PubMed

We investigated the compliance of Korean patients using tumor necrosis factor (TNF) inhibitors to treat rheumatoid arthritis (RA) and ankylosing spondylitis (AS), and identified potential predictors associated with treatment discontinuation. The study population comprised 114 RA and 310 AS patients treated with TNF inhibitors at a single tertiary center for at least 1 yr from December 2002 to November 2011. Of the 114 RA patients, 64 (56.1%) discontinued their first TNF inhibitors with a mean duration of 18.1 months. By contrast, 65 of 310 patients (21.0%) with AS discontinued their first TNF inhibitors, with a mean duration of 84 months. Although the survival rate did not differ among the three TNF inhibitors in the AS patients, the etanercept group had a lower discontinuation rate than the infliximab group in the RA patients. In addition, RA patients who received corticosteroids in combination with TNF inhibitors were more likely to discontinue their TNF inhibitors. The independent predictors of drug discontinuation in AS patients were male gender and complete ankylosis on radiographs of the sacroiliac joint. Our results provide further evidence that real-life treatment outcomes of RA and AS patients may be different from those observed in randomized clinical trials. PMID:25246737

Kang, Ji-Hyoun; Park, Dong-Jin; Lee, Jeong-Won; Lee, Kyung-Eun; Wen, Lihui; Kim, Tae-Jong; Park, Yong-Wook; Lee, Shin-Seok

2014-09-01

10

Drug Survival Rates of Tumor Necrosis Factor Inhibitors in Patients with Rheumatoid Arthritis and Ankylosing Spondylitis  

PubMed Central

We investigated the compliance of Korean patients using tumor necrosis factor (TNF) inhibitors to treat rheumatoid arthritis (RA) and ankylosing spondylitis (AS), and identified potential predictors associated with treatment discontinuation. The study population comprised 114 RA and 310 AS patients treated with TNF inhibitors at a single tertiary center for at least 1 yr from December 2002 to November 2011. Of the 114 RA patients, 64 (56.1%) discontinued their first TNF inhibitors with a mean duration of 18.1 months. By contrast, 65 of 310 patients (21.0%) with AS discontinued their first TNF inhibitors, with a mean duration of 84 months. Although the survival rate did not differ among the three TNF inhibitors in the AS patients, the etanercept group had a lower discontinuation rate than the infliximab group in the RA patients. In addition, RA patients who received corticosteroids in combination with TNF inhibitors were more likely to discontinue their TNF inhibitors. The independent predictors of drug discontinuation in AS patients were male gender and complete ankylosis on radiographs of the sacroiliac joint. Our results provide further evidence that real-life treatment outcomes of RA and AS patients may be different from those observed in randomized clinical trials. Graphical Abstract PMID:25246737

2014-01-01

11

Do the radiological changes of classic ankylosing spondylitis differ from the changes found in the spondylitis associated with inflammatory bowel disease, psoriasis, and reactive arthritis?  

Microsoft Academic Search

OBJECTIVEIn 1971 McEwen and colleagues suggested that the radiological changes of classic ankylosing spondylitis (AS), and the changes of the spondylitis associated with inflammatory bowel disease differ in several respects from the radiological features of psoriatic and reactive spondylitis. The findings of this study have never been confirmed. The aim of this study was to replicate the McEwen study comparing

P S Helliwell; P Hickling; V Wright

1998-01-01

12

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

PubMed Central

Introduction: 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. PMID:20694072

Kay, Jonathan; Rahman, Mahboob U

2010-01-01

13

[Genetics of ankylosing spondylitis].  

PubMed

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

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

2014-09-01

14

Pathogenesis of ankylosing spondylitis.  

PubMed

Ankylosing spondylitis (AS) is a potentially disabling form of seronegative spondyloarthritis. The main symptom of AS is inflammatory spinal pain; with time, some patients develop ankylosis and spinal immobility. The pathology mainly affects the entheses, where ligaments, tendons and capsules are attached to the bone. Three processes are observed at the entheses: inflammation, bone erosion and syndesmophyte (spur) formation. Tumor necrosis factor is an important mediator of the inflammatory processes, but this proinflammatory cytokine is not closely involved in bone erosion or syndesmophyte formation. The major causative factors of AS are genetic, with the gene encoding HLA-B27 being the most important genetic factor. Several other susceptibility genes have also been identified. An enormous number of papers have been published and many diverse hypotheses have been generated regarding the pathogenesis of AS. This Review outlines the key areas of current research in this field, describes several hypotheses regarding the pathogenesis of AS, which are under intense investigation, and concludes with a dissection of the processes involved in bone erosion and syndesmophyte formation. PMID:20517295

Tam, Lai-Shan; Gu, Jieruo; Yu, David

2010-07-01

15

Ankylosing spondylitis: an overview  

PubMed Central

Ankylosing spondylitis (AS) is a complex, potentially debilitating disease that is insidious in onset, progressing to radiological sacroiliitis over several years. Patients with symptomatic AS lose productivity owing to work disability and unemployment, have a substantial use of healthcare resources, and reduced quality of life. The pathogenesis of AS is poorly understood. However, immune mediated mechanisms involving human leucocyte antigen (HLA)-B27, inflammatory cellular infiltrates, cytokines (for example, tumour necrosis factor ? and interleukin 10), and genetic and environmental factors are thought to have key roles. The detection of sacroiliitis by radiography, magnetic resonance imaging, or computed tomography in the presence of clinical manifestations is diagnostic for AS, although the presence of inflammatory back pain plus at least two other typical features of spondyloarthropathy (for example, enthesitis and uveitis) is highly predictive of early AS. Non-steroidal anti-inflammatory drugs (NSAIDs) effectively relieve inflammatory symptoms and are presently first line drug treatment. However, NSAID treatment has only a symptomatic effect and probably does not alter the disease course. For symptoms refractory to NSAIDs, second line treatments, including corticosteroids and various disease modifying antirheumatic drugs, are employed but are of limited benefit. Emerging biological therapies target the inflammatory processes underlying AS, and thus, may favourably alter the disease process, in addition to providing symptom relief. PMID:12381506

Sieper, J; Braun, J; Rudwaleit, M; Boonen, A; Zink, A

2002-01-01

16

Pulmonary manifestations of ankylosing spondylitis.  

PubMed

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

Kanathur, Naveen; Lee-Chiong, Teofilo

2010-09-01

17

Drug Retention Rates and Treatment Discontinuation among Anti-TNF-? Agents in Psoriatic Arthritis and Ankylosing Spondylitis in Clinical Practice  

PubMed Central

Objective. The study aim was to determine treatment persistence rates and to identify causes of discontinuation in psoriatic arthritis (PsA) and ankylosing spondylitis (AS) patients in clinical practice. Methods. Patients treated with adalimumab (ADA), etanercept (ETA), or infliximab (INF) were retrospectively included. Treatment persistence rates were analyzed by means of a stepwise logistic regression. Differences between therapy duration were assessed by means of an analysis of variance model (ANOVA), while a chi-square test was used to evaluate relationships between therapies and causes of treatment discontinuation and the administration of concomitant disease-modifying antirheumatic drugs (DMARDs) among therapies and types of disease considering completed courses of therapy versus courses that were discontinued. Results. 268 patients received a total of 353 anti-TNF treatment courses (97 ADA, 180 ETA, and 76 INF). Comparison among therapies showed significant difference regarding the treatment persistence rates due to the contrast between ETA and INF (P = 0.0062). We observed that 84.7% of patients were still responding after 6 months of follow-up. Comparison among diseases showed that there were significant differences between PsA and AS (P = 0.0073) and PsA and PsA with predominant axial involvement (P = 0.0467) in terms of duration of the therapy, while there were no significant differences with regard to the persistence rate. Conclusions. In this cohort, anti-TNF-? therapy was associated with high drug persistence rates. As in rheumatoid arthritis, switching to another anti-TNF-? agent can be an effective option when, during the treatment of AS or PsA, therapy is suspended because of inefficacy or an adverse event. Combination therapy with DMARDs was associated with a better persistence rate. PMID:25110401

Fabbroni, Marta; Costa, Luisa; Pagano, Veronica Anna; Frediani, Bruno; Manganelli, Stefania; Galeazzi, Mauro

2014-01-01

18

Thrombin generation in ankylosing spondylitis  

Microsoft Academic Search

Ankylosing spondylitis (AS) is a chronic inflammatory disease associated with an increase in cardiovascular risk. Thrombin\\u000a generation is associated with the risk of thrombosis, and the endogenous thrombin potential (ETP) has been proposed as a parameter\\u000a for plasma-based hypercoagulability. The aim of the study was to evaluate the risk of thrombosis in a group of AS patients\\u000a in comparison to

Clément Prati; Evelyne Racadot; Jean-Pierre Cedoz; Daniel Wendling

2011-01-01

19

What Is Ankylosing Spondylitis?  

MedlinePLUS

... publication. To order the Ankylosing Spondylitiis Q&A full-text version, please contact the NIAMS using the contact ... mailed to you? Visit our online order form. Full NIAMS Site NIH… Turning Discovery Into Health ® ... Comments Moderation Policy Site Map | Viewers and Players

20

Advances in managing ankylosing spondylitis  

PubMed Central

Ankylosing spondylitis (AS) is a chronic inflammatory disease with prominent involvement of the spine and sacroiliac joints which frequently leads to significant spine deformity and disability. The development of effective therapies for AS, particularly with anti-tumor necrosis factor agents, has resulted in improved symptoms and functions for many patients, and clinical research increasingly suggests that effective therapy can also prevent destruction in the spine and other structures. Recent focus of disease classification in AS has emphasized that many individuals with features of inflammatory back pain but no visible changes on plain x-rays have active inflammatory disease when imaged with magnetic resonance imaging (MRI). Recent studies indicate that individuals with “non-radiographic” spondylitis can also respond to anti-inflammatory therapies. Several new agents are also showing promise for treatment of AS. These developments represent a significant advance in the management of this debilitating condition. PMID:25343035

Chen, Patty P.

2014-01-01

21

Cardiovascular manifestations of ankylosing spondylitis  

Microsoft Academic Search

Summary  In a retrospective study, 40 patients with ankylosing spondylitis were assessed for extraspinal manifestations. Cardiovascular\\u000a complications were found in 17 patients (42.5%)?5(12.5%) had aortic insufficiency, 3 (7.5%) had atrioventricular block and\\u000a 5 (12.5%) had bundle branch block. Wolff-Parkinson-White syndrome was diagnosed in one case and short PR syndrome in another.\\u000a Cardiovascular complications were more common in patients with longer disease

S. Sukenik; A. Pras; D. Buskila; A. Katz; Y. Snir; J. Horowitz

1987-01-01

22

Osteopoikilosis coexistent with ankylosing spondylitis and familial Mediterranean fever  

Microsoft Academic Search

Osteopoikilosis (OPK) is a rare benign sclerosing disease of the skeleton and inherited as an autosomal dominant trait. OPK\\u000a is associated with inflammatory rheumatic disorders, such as rheumatoid arthritis, scleroderma, reactive arthritis and familial\\u000a Mediterranean fever (FMF). We report a rare case of OPK coexistent with ankylosing spondylitis and FMF. The patient presented\\u000a multiple sclerotic lesions within and around the

Ismail Sari; Ismail Simsek; Inanc Guvenc; Hatice Tuba Sanal; Hakan Erdem; Salih Pay; Ayhan Dinc

2009-01-01

23

Osteopoikilosis coexistent with ankylosing spondylitis and familial Mediterranean fever.  

PubMed

Osteopoikilosis (OPK) is a rare benign sclerosing disease of the skeleton and inherited as an autosomal dominant trait. OPK is associated with inflammatory rheumatic disorders, such as rheumatoid arthritis, scleroderma, reactive arthritis and familial Mediterranean fever (FMF). We report a rare case of OPK coexistent with ankylosing spondylitis and FMF. The patient presented multiple sclerotic lesions within and around the sacroiliac joints and a series of radiological diagnostic challenges. PMID:18696073

Sari, Ismail; Simsek, Ismail; Guvenc, Inanc; Sanal, Hatice Tuba; Erdem, Hakan; Pay, Salih; Dinc, Ayhan

2009-01-01

24

Costovertebral joint erosion in ankylosing spondylitis.  

PubMed

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

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

2001-01-01

25

Scientists Gain New Insights into Genetic Mechanisms of Ankylosing Spondylitis  

MedlinePLUS

... January 2012 Scientists Gain New Insights into Genetic Mechanisms of Ankylosing Spondylitis New research supported, in part, ... scientists a step closer to understanding the genetic mechanisms underlying ankylosing spondylitis, a chronic inflammatory form of ...

26

Ankylosing spondylitis in a military aviator: air medical considerations.  

PubMed

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

Eslami, Reza; Momenzadeh, Mahmud; Ebadi, Ahmad

2014-01-01

27

Coexistence of Ankylosing Spondylitis and Löfgren's Syndrome.  

PubMed

A 46-year-old male patient diagnosed with ankylosing spondylitis presented to our polyclinic with complaints of pain, swelling, and limitation in joint mobility in both ankles and erythema nodosum skin lesions in both pretibial sites. The sacroiliac joint graphy and the MRI taken revealed active and chronic sacroiliitis. On the thorax CT, multiple mediastinal and hilar lymphadenopathies were reported. Mediastinoscopic excisional lymph node biopsy was taken and noncalcified granulomatous structures, lymphocytes, and histiocytes were determined on histopathological examination. The patients were diagnosed with ankylosing spondylitis, sarcoidosis, and Löfgren's syndrome. NSAIDs, sulfasalazine, and low dose corticosteroid were started. Significant regression was seen in the patient's subjective and laboratory assessments. PMID:24741443

Kobak, Senol; Sever, Fidan; Sivrikoz, Oya; Karaarslan, Ahmet

2014-01-01

28

Coexistence of Ankylosing Spondylitis and Löfgren's Syndrome  

PubMed Central

A 46-year-old male patient diagnosed with ankylosing spondylitis presented to our polyclinic with complaints of pain, swelling, and limitation in joint mobility in both ankles and erythema nodosum skin lesions in both pretibial sites. The sacroiliac joint graphy and the MRI taken revealed active and chronic sacroiliitis. On the thorax CT, multiple mediastinal and hilar lymphadenopathies were reported. Mediastinoscopic excisional lymph node biopsy was taken and noncalcified granulomatous structures, lymphocytes, and histiocytes were determined on histopathological examination. The patients were diagnosed with ankylosing spondylitis, sarcoidosis, and Löfgren's syndrome. NSAIDs, sulfasalazine, and low dose corticosteroid were started. Significant regression was seen in the patient's subjective and laboratory assessments. PMID:24741443

Kobak, Senol; Sever, Fidan; Sivrikoz, Oya; Karaarslan, Ahmet

2014-01-01

29

Coexistence of Ankylosing Spondylitis and Klinefelter's Syndrome  

PubMed Central

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, ?enol; Yalçin, Murat; Karadeniz, Muamer; Oncel, Guray

2013-01-01

30

Coexistence of Ankylosing Spondylitis and Klinefelter's Syndrome.  

PubMed

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

2013-01-01

31

Conventional treatments for ankylosing spondylitis  

PubMed Central

Management of ankylosing spondylitis (AS) is challenged by the progressive nature of the disease. To date, no intervention is available that alters the underlying mechanism of inflammation in AS. Currently available conventional treatments are palliative at best, and often fail to control symptoms in the long term. Current drug treatment may perhaps induce a spurious state of "disease remission," which is merely a low level of disease activity. Non-steroidal anti-inflammatory drugs are first line treatment, but over time, the disease often becomes refractory to these agents. Disease modifying antirheumatic drugs are second line treatment and may offer some clinical benefit. However, conclusive evidence of the efficacy of these drugs from large placebo controlled trials is lacking. Additionally, these drugs can cause treatment-limiting adverse effects. Intra-articular corticosteroid injection guided by arthrography, computed tomography, or magnetic resonance imaging is an effective means of reducing inflammatory back pain, but controlled studies are lacking. A controlled study has confirmed moderate but significant efficacy of intravenous bisphosphonate (pamidronate) treatment in patients with AS; further evaluation of bisphosphonate treatment is warranted. Physical therapy and exercise are necessary adjuncts to pharmacotherapy; however, the paucity of controlled data makes it difficult to identify the best way to administer these interventions. Surgical intervention may be required to support severe structural damage. Thus, for patients with AS, the future of successful treatment lies in the development of pharmacological agents capable of both altering the disease course through intervention at sites of disease pathogenesis, and controlling symptoms. PMID:12381510

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

2002-01-01

32

A meta-analysis of tumor necrosis factor inhibitors and glucocorticoids on bone density in rheumatoid arthritis and ankylosing spondylitis trials.  

PubMed

Objective: This systematic review examined the impact of anti-rheumatic drugs on bone mineral density (BMD) in rheumatoid arthritis (RA), ankylosing spondylitis (AS), psoriatic arthritis, and psoriasis. Methods: Electronic databases were systematically searched for randomized controlled trials. Studies were grouped based on disease, treatment, and site of BMD measurement. Change in BMD (?BMD) from baseline to end-of-study was recorded. Standardized mean difference (SMD) of ?BMD between treatment and controls was standardized for meta-analyses and 95% confidence interval (CI) calculated. Results: Treatment effects on BMD were not the primary outcomes of the trials. Thirteen studies were eligible (11 RA, 2 AS, 0 psoriatic arthritis, 0 psoriasis). For RA, significantly less hand bone loss was seen with TNF inhibitors (TNFi) (SMD ?BMD=0.33, CI 0.13-0.53, p=0.001, I(2) =0%) and glucocorticoids (SMD ?BMD=0.51, CI 0.20-0.81, p=0.001, I(2) =0%). TNFi had no significant effect on lumbar spine (LS) and hip BMD. Glucocorticoids were associated with a negative effect on LS (SMD ?BMD=-0.30, CI -0.55to-0.04, p=0.02, I(2) =52%) but not hip BMD. For AS, a significant increase in BMD was seen with TNFi at LS (SMD ?BMD=0.96, CI 0.64-1.27, p<0.001, I(2) =16%) and hip (SMD ?BMD=0.38, 95% CI 0.13-0.62, p=0.003, I(2) =0%). Data were insufficient to perform meta-analyses in psoriatic arthritis and psoriasis or for other anti-rheumatic drugs. Conclusion: In RA, TNFi and glucocorticoids appeared to attenuate hand bone loss. TNFi did not impact LS and hip BMD and glucocorticoids had negative effects on LS and no effect on hip BMD. In AS, TNFi was associated with improved LS and hip BMD. This article is protected by copyright. All rights reserved. PMID:25418272

Siu, Stephanie; Haraoui, Boulos; Bissonnette, Robert; Bessette, Louis; Roubille, Camille; Richer, Vincent; Starnino, Tara; McCourt, Collette; McFarlane, Alexandra; Fleming, Patrick; Kraft, John; Lynde, Charles; Gulliver, Wayne; Keeling, Stephanie; Dutz, Jan; Pope, Janet E

2014-11-21

33

RESEARCH ARTICLE Open Access Infliximab in ankylosing spondylitis: alone or in  

E-print Network

Introduction: Methotrexate (MTX) has been shown to modify infliximab pharmacokinetics in rheumatoid arthritis. However, its combination with infliximab in the treatment of ankylosing spondylitis (AS peripheral AS and those with psoriatic arthritis, the few attempts to treat predominantly axial disease were

Boyer, Edmond

34

Sexual functions in ankylosing spondylitis.  

PubMed

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

2011-07-01

35

Ankylosing Spondylitis: Diet and Nutrition  

MedlinePLUS

Diet & Nutrition: Quick Links Overview of Diet & Spondylitis >>> Medication & Diet >>> Dietary Supplements >>> Changing Your Diet >>> The London AS / Low Starch Diet >>> Back To The About Spondylitis Main Page >>> DIET & ...

36

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

PubMed Central

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

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

2013-01-01

37

Pain pressure threshold values in ankylosing spondylitis.  

PubMed

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

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

2002-08-01

38

Update on ankylosing spondylitis: current concepts in pathogenesis.  

PubMed

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

Smith, Judith A

2015-01-01

39

Circulating Protein Fragments of Cartilage and Connective Tissue Degradation Are Diagnostic and Prognostic Markers of Rheumatoid Arthritis and Ankylosing Spondylitis  

PubMed Central

Inflammation driven connective tissue turnover is key in rheumatic diseases, such as ankylosing spondylitis (AS). Few biomarkers are available for measuring disease prognosis or the efficacy of interventions applied in these tissue-related conditions. Type II collagen is the primary structural protein of cartilage and type III collagen of connective tissues, and obvious targets for the collagenalytic, which increase during tissue inflammation. The objective of the study was to investigate the diagnostic and prognostic utility of cartilage, C2M, and synovial, C3M, turnover biomarkers in AS. Serum samples were retrieved from patients suffering from AS (n?=?103), RA (n?=?47) and healthy controls (n?=?56). AS progressors were defined as having new vertebral syndesmophytes or more that 3 unit change in mSASSS over a two-year period. Type II collagen degradation markers in serum were measured by the C2M ELISA, and type III collagen degradation by the C3M ELISA. Logistic regression and dichotomized decision tree were used to analyze the prognostic value of the markers individually or in combination. Both C2M and C3M levels were significantly higher in RA patients than in healthy controls (p<0.0001). Diagnostic utility was analyzed by ROC and areas under the curve (AUCs) were 72% and 89% for C2M and C3M, respectively. Both C2M and C3M, were significantly higher in serum samples from AS patient than from healthy controls (p<0.0001). The AUCs of C2M and C3M, respectively, were 70% and 81% for AS. A combination of C2M and C3M, dichotomized according to best cut-offs for individual markers, could correctly identify 80% of the progressors and 61% of the non-progressors. The present study is the first to show that specific biomarkers of cartilage and connective tissue degradation facilitate both diagnosis and prediction of progression of RA and AS. PMID:23365672

Bay-Jensen, Anne C.; Wichuk, Stephanie; Byrjalsen, Inger; Leeming, Diana J.; Morency, Nathalie; Christiansen, Claus; Karsdal, Morten A.; Maksymowych, Walter P.

2013-01-01

40

Patient-reported adherence to coprescribed proton pump inhibitor gastroprotection in osteoarthritis, rheumatoid arthritis, and ankylosing spondylitis patients using nonsteroidal anti-inflammatory drugs  

PubMed Central

Background Patients with osteoarthritis (OA), rheumatoid arthritis (RA), or ankylosing spondylitis (AS) are commonly treated with nonsteroidal anti-inflammatory drugs (NSAIDs), sometimes with a concomitant gastroprotective proton pump inhibitor (PPI). The present study examines real-life patient adherence to PPIs when coprescribed with NSAIDs. Methods This retrospective medical record survey identified patients diagnosed with OA, RA, or AS who had PPIs coprescribed with NSAIDs for prevention of NSAID-associated gastrointestinal ulcers. Actual NSAID and PPI intake was retrospectively recorded using a self-reported questionnaire. Adherence to PPI treatment was assessed using descriptive statistics. Results In total, 96 patients (69% female, mean age 67 years, 72% OA, 16% RA, 12% AS) were included. The mean patient-reported adherence to coprescribed PPIs was 73%–81%. The percentage of patients with a self-reported adherence of ?80% was 26%. No predictive factors for low adherence could be identified. Conclusion Despite doctors’ instructions to use PPIs concomitantly with NSAIDs, the mean patient-reported adherence to coprescribed PPIs in this population indicates a risk of a “gastroprotective treatment gap”. The patients’ adherence to gastroprotective PPIs for the prevention of NSAID-associated upper gastrointestinal ulcers can be improved. PMID:25429206

Henriksson, Kenneth; From, Jesper; Stratelis, Georgios

2014-01-01

41

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

PubMed Central

The effects of the TNF-? blockers infliximab or etanercept on the levels of TNF-?, TNF-receptor 1 (TNF-R1), and TNF-receptor 2 (TNF-R2), as well as the levels of the inflammation markers CRP and IL-6, were measured in ankylosing spondylitis (AS) and rheumatoid arthritis (RA) patients receiving treatment with either compound. We found that RA patients tend to have higher levels of TNF-? than both healthy individuals and AS patients prior to treatment (P < 0.05). We measured greatly increased levels of TNF-? in both the AS and RA etanercept patient groups during the course of treatment, while in the infliximab treated patients, the amount of TNF-? measured remained unchanged. Elevated TNF-? in the etanercept treated patients does not appear to be a significant risk factor for the spontaneous development of further autoimmune diseases in our study group. Increased levels of TNF-R1 were determined in both AS (P < 0.05) and RA (P < 0.001) patients when compared to healthy controls. In AS patients, the levels of TNF-R1 dropped significantly when treated with either infliximab (P < 0.01) or etanercept (P < 0.001). In contrast, the levels of this receptor remained unchanged in RA patients treated with either compound. PMID:24783218

2014-01-01

42

A longitudinal study on an autoimmune murine model of ankylosing spondylitis  

PubMed Central

Background: Proteoglycan aggrecan (PG)-induced arthritis (PGIA) is the only systemic autoimmune murine model which affects the axial skeleton, but no studies have been performed characterising the progression of spine involvement. Objectives: To follow pathological events in experimental spondylitis, and underline its clinical, radiographic, and histological similarities to human ankylosing spondylitis (AS); and to determine whether the spondyloarthropathy is a shared phenomenon with PGIA, or an "independent" disease. Methods: Arthritis/spondylitis susceptible BALB/c and resistant DBA/2 mice, and their F1 and F2 hybrids were immunised with cartilage PG, and radiographic and histological studies were performed before onset and weekly during the progression of spondylitis. Results: About 70% of the PG immunised BALB/c mice develop spondyloarthropathy (proteoglycan-induced spondylitis (PGISp), and the progression of the disease is very similar to human AS. It begins with inflammation in the sacroiliac joints and with enthesitis, and then progresses upwards, affecting multiple intervertebral disks. In F2 hybrids of arthritis/spondylitis susceptible BALB/c and resistant DBA/2 mice the incidence of arthritis was 43.5%, whereas the incidence of spondylitis was >60%. Some arthritic F2 hybrid mice had no spondylitis, whereas others developed spondylitis in the absence of peripheral arthritis. Conclusions: The PGISp model provides a valuable tool for studying autoimmune reactions in spondylitis, and identifying genetic loci associated with spondyloarthropathy. PMID:15640265

Bardos, T; Szabo, Z; Czipri, M; Vermes, C; Tunyogi-Csapo, M; Urban, R; Mikecz, K; Glant, T

2005-01-01

43

Evaluation of the novel ultrasound score for large joints in psoriatic arthritis and ankylosing spondylitis: six month experience in daily clinical practice  

PubMed Central

Background To evaluate the utility of the recently introduced SOLAR score (sonography of large joints in Rheumatology), which has been validated in RA patients, in a cohort of patients with Psoriatic Arthritis (PsA) and Ankylosing Spondylitis (AS) presenting with involvement of large peripheral joints. Methods The recently established SOLAR score has been designed to determine the degree of inflammation in the shoulder, the elbow, the hip and the knee joint in patients suffering from RA. Since large joints are frequently involved in PsA and AS, synovitis and synovial vascularity were scored semiquantitatively (grade 0–3) by grey scale (GSUS) and power Doppler ultrasound (PDUS) utilizing the validated scoring system. Each joint was scanned from different angles, the knee joint for example was divided into four areas to score for synovitis: the suprapatellar longitudinal, the medial longitudinal, the lateral longitudinal, and the posterior region. Each area was scored from 0–3, so a maximum score of 12 could be achieved. PsA and AS patients presenting with peripheral joint disease involving large joints were examined at baseline, 3 and 6 months after initiation of local or systemic therapy (DMARDs/Biologics). For evaluation of the inflammatory status, the erythrocyte sedimentation rate (ESR) was determined. Results A cohort of 126 patients were enclosed, and 83 of these were followed for 6 months. At baseline before modification of the therapy, patients received DMARDs (n = 83), DMARDs plus biologics (n?=?30), or biologic monotherapy (n?=?29). Following intervention, all US scores demonstrated a marked improvement. The GSUS and the PDUS scores for all joint areas, except the PDUS score of the hip, exhibited a significant improvement (p?

2013-01-01

44

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

PubMed Central

To date, anti-tumor necrosis factor alfa (anti-TNF-?) therapy is the only alternative to nonsteroidal anti-inflammatory drugs for the treatment of ankylosing spondylitis. Etanercept is a soluble TNF receptor, with a mode of action and pharmacokinetics different to those of antibodies and distinctive efficacy and safety. Etanercept has demonstrated efficacy in the treatment of ankylosing spondylitis, with or without radiographic sacroiliitis, and other manifestations of the disease, including peripheral arthritis, enthesitis, and psoriasis. Etanercept is not efficacious in inflammatory bowel disease, and its efficacy in the treatment of uveitis appears to be lower than that of other anti-TNF drugs. Studies of etanercept confirmed regression of bone edema on magnetic resonance imaging of the spine and sacroiliac joint, but failed to reduce radiographic progression, as do the other anti-TNF drugs. It seems that a proportion of patients remain in disease remission when the etanercept dose is reduced or administration intervals are extended. Etanercept is generally well tolerated with an acceptable safety profile in the treatment of ankylosing spondylitis. The most common adverse effect of etanercept treatment is injection site reactions, which are generally self-limiting. Reactivation of tuberculosis, reactivation of hepatitis B virus infection, congestive heart failure, demyelinating neurologic disorders, hematologic disorders like aplastic anemia and pancytopenia, vasculitis, immunogenicity, and exacerbation or induction of psoriasis are class effects of all the anti-TNF drugs, and have been seen in patients with ankylosing spondylitis. However, etanercept is less likely to induce reactivation of tuberculosis than the other anti-TNF drugs and it has been suggested that etanercept might be less immunogenic, especially in ankylosing spondylitis. Acute uveitis, Crohn’s disease, and sarcoidosis are other adverse events that have been rarely associated with etanercept therapy in patients with ankylosing spondylitis. PMID:24101863

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

2013-01-01

45

T lymphocyte subset imbalances in patients contribute to ankylosing spondylitis  

PubMed Central

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

WANG, CHENGGONG; LIAO, QIANDE; HU, YIHE; ZHONG, DA

2015-01-01

46

T lymphocyte subset imbalances in patients contribute to ankylosing spondylitis.  

PubMed

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

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

2015-01-01

47

Surgical Management of Temporomandibular Joint Ankylosis in Ankylosing Spondylitis  

PubMed Central

Relatively few patients develop such severe degenerative temporomandibular joint (TMJ) disease that they require total joint replacement. Current indications include those conditions involving condylar bone loss such as degenerative (osteoarthritis) or inflammatory joint disease (ankylosing spondylitis, rheumatoid, and psoriatic). Ankylosis of the temporomandibular joint (TMJ) secondary to ankylosing spondylitis remains an under investigated entity. We aim to provide an overview of treatment objectives, surgical procedures, and our experience with total TMJ replacement for this condition. PMID:21547039

Felstead, Andrew M.; Revington, Peter J.

2011-01-01

48

Somatosensory Evoked Potential Findings in Ankylosing Spondylitis  

PubMed Central

Objective: Somatosensory evoked potential (SSEP) abnormalities were reported in patients with ankylosing spondylitis (AS). This study aimed to investigate SSEP abnormalities and its relation with clinical findings in AS patients. Materials and Methods: The study included 26 patients with AS and 17 age-matched health volunteers (Control for SSEP). Median nerve SSEP findings were normal in all AS cases. Results: However, delayed latency and/or very low amplitude of tibial nerve SSEP was found in 20 (76.9%) AS patients. There were significant correlations between tibial SSEP latency and disease duration (R=0.433 to 0.635). There was also an inverse correlation between tibial SSEP amplitude and disease duration (R=?0.429, p=0.047). Serum estradiol level, hip total bone mineral density, The Bath Ankylosing Spondylitis Functional Index (BASFI) score and Beck depression score were significantly lower in AS patients with SSEP abnormalities (37.3±10.8 pg/mL, 0.916±0.123 g/cm2, 35.0±27.9, 12.8±8.4, respectively) than in AS patients without SSEP abnormalities (53.7±12.3 pg/mL, 1.103±0.197 g/cm2, 64.8±15.5, 24.8±10.1, respectively). Conclusion: Significant inverse correlations between SSEP latencies and dehydroepiandrosterone sulphate (DHEAS) levels were found (R=?0.400 to ?0.713). There were also significant inverse correlation between SSEP latencies and DHEAS/oestrogen index (R=?0.596 to ?0.868), and between SSEP latencies and DHEAS/Progesterone index (R=?0.467 to ?0.685). As a conclusion, this study indicates that tibial nerve SSEP abnormalities are common in patients with AS and there are significant correlations between clinical findings of AS and SSEP abnormalities. PMID:25610293

Cidem, Muharrem; Sahin, Zerrin; Aydin, Teoman; Aysal, Fikret

2014-01-01

49

Study of Programmed Cell Death 1 ( PDCD1 ) Gene Polymorphims in Iranian Patients with Ankylosing Spondylitis  

Microsoft Academic Search

Ankylosing spondylitis (AS) is a chronic inflammatory disease, characterized by axial arthritis in which the genetic–environmental\\u000a factors seem to be involved in the pathogenesis of the disease. This study was performed to investigate the role of polymorphisms\\u000a of the programmed cell death 1 (PDCD1) gene on susceptibility to AS. In this study, 161 Iranian patients with AS and 208 normal

Narjes Soleimanifar; Ali Akbar Amirzargar; Mahdi Mahmoudi; Ali Akbar Pourfathollah; Esfandiar Azizi; Ahmad Reza Jamshidi; Nima Rezaei; Mohammad Taher Tahoori; Katayoon Bidad; Behrouz Nikbin; Mohammad Hossein Nicknam

50

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

PubMed Central

Background Ankylosing spondylitis is a chronic inflammatory rheumatic disorder which usually begins in early adulthood. The diagnosis is often delayed by many years. MR imaging has become the preferred imaging method for detection of early inflammation of the axial skeleton in ankylosing spondylitis. The goal of this study was to assess the frequency and distribution of abnormalities on whole body MR imaging in patients with suspected early ankylosing spondylitis and with active confirmed ankylosing spondylitis. Methods Ten patients with suspected early ankylosing spondylitis and ten patients with confirmed ankylosing spondylitis were enrolled. On an 18-channel MR system, coronal and sagittal T1 weighted and STIR sequences were acquired covering the entire spine, sacrum, anterior chest wall, shoulder girdle, and pelvis. The total examination time was 30 minutes. Results In both groups inflammatory lesions of the lower thoracic spine were frequent (number of patients with suspected early/confirmed ankylosing spondylitis: 7/9). In confirmed ankylosing spondylitis the upper thoracic spine (3/6) and the lumbar spine (4/8) were more commonly involved. The inferior iliac quadrant of the sacroiliac joints was frequently altered in both groups (8/8). The superior iliac (2/5), inferior sacral (6/10) and superior sacral (3/6) quadrants were more frequently affected in confirmed ankylosing spondylitis. Abnormalities of the manubriosternal joint (2/4), the sternoclavicular joints (1/2) and hip joint effusion (4/3) were also seen. Conclusion In both suspected early ankylosing spondylitis and confirmed ankylosing spondylitis, whole body MR examinations frequently demonstrate inflammatory lesions outside the sacroiliac joints. These lesions are similarly distributed but occur less frequently in suspected early compared to confirmed ankylosing spondylitis. Due to the small sample size in this pilot study these results need to be confirmed in larger studies with this emerging technique. PMID:17326845

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

2007-01-01

51

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

PubMed

The objective of this study was to evaluate the predictive factors for achieving partial remission (PR) in patients with ankylosing spondylitis (AS) treated with anti-TNF?. We longitudinally enrolled in a multi-center study 214 AS patients, classified according to New York criteria, treated with anti-TNF? drugs adalimumab (ADA), etanercept (ETA) and infliximab (INF) with at least 12 months of follow up. PR was reached when the score was <20 mm (on a visual analogue scale of 0-100 mm) in each of the following 4 domains: 1) patient global assessment (in the last week); 2) pain (spinal pain); 3) function [measured by the bath ankylosing spondylitis functional index (BASFI)]; 4) inflammation [mean of intensity and duration of morning stiffness, from the bath ankylosing spondylitis disease activity index (BASDAI)]. Two hundred fourteen AS patients (M/F=160/54; median age/range=43.2/19-78 years; median disease duration/ range=96/36-189 months) were treated with ADA (15.8%), ETA (28.9%) and INF (55.1%). At 12 and 24 months, high serum level of C reactive protein (CRP) (?2 vs ?0.8 mg/dL) were associated with higher rate of PR in AS patients treated with anti-TNF? drugs. At 24 months, PR was associated with shorter disease duration (?36 vs ?189 months) and higher erythrosedimentation rate (ESR) values (?45 vs ?17 mm/h). In male patients lower bath ankylosing spondylitis metrology index (BASMI) (?2 vs ?6) and absence of psoriasis were associated with higher PR rate only at 12 months. Other parameters assessed before treatment, such as BASDAI, BASFI, peripheral arthritis, inflammatory bowel disease and uveitis were not associated with PR. Our long-term longitudinal study in a setting of clinical practice showed that inflammatory parameters (i.e. CRP, ESR) and disease duration represent the most important predictive variables to achieve PR with an anti-TNF? treatment. PMID:25376955

Perrotta, F M; Addimanda, O; Ramonda, R; D'Angelo, S; Lubrano, E; Marchesoni, A; Olivieri, I; Punzi, L; Salvarani, C; Spadaro, A

2014-01-01

52

Ankylosing Spondylitis and Psoriatic Arthritis  

MedlinePLUS

... scaly rash that occurs most frequently on the elbows, knees and scalp, but can cover much of the body. It is a chronic, inflammatory disease of the skin, scalp, nails and joints. A normal skin cell matures and falls off the body's surface in 28 to 30 days, but a psoriatic skin ...

53

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

PubMed Central

Coexisting ankylosing spondylitis and hereditary multiple exostoses have rarely been reported (three patients) previously. A 27-year-old man with hereditary multiple exostoses is presented as a fourth report. At the age of 15 years, the patient had multiple exostoses around the knee, ankle and shoulder joints. He was diagnosed with ankylosing spondylitis 3 years ago. The patient’s sister and his 3 brothers also have multiple exostoses without any family history of spondyloarthropathy or inflammatory arthritis. The aim of this report is to discuss an interesting coexistence of these two diseases. The increasing number of reported patients who have a coexistence of these two diseases might suggest that the association of these two diseases is stronger than a coincidence. PMID:24693299

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

2014-01-01

54

Lung findings on high resolution CT in early ankylosing spondylitis  

Microsoft Academic Search

Objective: Ankylosing spondylitis (AS) is a chronic inflammatory disease mainly affecting the axial skeleton and pulmonary involvement is a well known feature of the disease. The aim of this study was to investigate the pulmonary high resolution computed tomography (HRCT) findings of patients with early AS. The relationship between pulmonary function tests (PFT) and HRCT findings was also determined. Subjects

Adem Kiris; Salih Ozgocmen; Ercan Kocakoc; Ozge Ardicoglu; Erkin Ogur

2003-01-01

55

Logistic transmission modeling of HLA and ankylosing spondylitis  

Microsoft Academic Search

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

R. H. Scofield; B. R. Neas; J. B. Harley

1994-01-01

56

Evaluation of the T helper 17 axis in ankylosing spondylitis.  

PubMed

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

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

2012-08-01

57

MR imaging features of foot involvement in ankylosing spondylitis  

Microsoft Academic Search

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

C. Zuhal Erdem; Selda Sarikaya; L. Oktay Erdem; Senay Ozdolap; Sadi Gundogdu

2005-01-01

58

Autoimmune thyroid disease in ankylosing spondylitis.  

PubMed

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

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

2014-07-01

59

Leukocytoclastic Vasculitis in a Patient with Ankylosing Spondylitis  

PubMed Central

A 26-year-old male patient presented to our rheumatology clinic with pain, swelling and limitation of movement in his right ankle, and also purpuric skin lesions in the lower extremity pretibial region. He was asked questions, and he said that he had been having chronic low back pain and morning stiffness for the last few years. His physical examination revealed that he had arthritis in his right ankle, purpuric skin lesions in pretibial regions of both legs, and bilateral FABERE/FADIR positivity. The sacroiliac joint imaging and MRI revealed bilateral sacroiliitis findings, and the lateral heel imaging revealed enthesitis. HLA-B27 was positive. Skin biopsy from lower skin lesions was reported to be consistent with leukocytoclastic vasculitis. Based on clinical, laboratory, radiological, and pathological examinations, the patient was diagnosed with ankylosing spondylitis and leukocytoclastic vasculitis. Administration of corticosteroid, salazopyrin, and nonsteroid anti-inflammatory medications was started. Notable clinical and laboratory regression was observed during his checks 3 months later. PMID:24653851

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

2014-01-01

60

Leukocytoclastic vasculitis in a patient with ankylosing spondylitis.  

PubMed

A 26-year-old male patient presented to our rheumatology clinic with pain, swelling and limitation of movement in his right ankle, and also purpuric skin lesions in the lower extremity pretibial region. He was asked questions, and he said that he had been having chronic low back pain and morning stiffness for the last few years. His physical examination revealed that he had arthritis in his right ankle, purpuric skin lesions in pretibial regions of both legs, and bilateral FABERE/FADIR positivity. The sacroiliac joint imaging and MRI revealed bilateral sacroiliitis findings, and the lateral heel imaging revealed enthesitis. HLA-B27 was positive. Skin biopsy from lower skin lesions was reported to be consistent with leukocytoclastic vasculitis. Based on clinical, laboratory, radiological, and pathological examinations, the patient was diagnosed with ankylosing spondylitis and leukocytoclastic vasculitis. Administration of corticosteroid, salazopyrin, and nonsteroid anti-inflammatory medications was started. Notable clinical and laboratory regression was observed during his checks 3 months later. PMID:24653851

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

2014-01-01

61

Regional migratory osteoporosis in a patient with ankylosing spondylitis.  

PubMed

We report the first case of regional migratory osteoporosis (RMO) in a patient with ankylosing spondylitis (AS). This middle-aged man suffered from an acute onset of knee pain that increased on weight bearing, followed by ankle pain. The diagnosis of RMO was confirmed using magnetic resonance imaging (MRI), after exclusion of other causes of knee pain. MRI revealed a large area of bone marrow oedema without a zone of demarcation or subchondral fracture with a demonstration of shifting marrow oedema on the follow-up MRI scan from the medial femur condyl to the tibia plateau lateral and then to the distal tibia epiphysis. Treatment with the bisphosphonate ibandronate, however, was unsuccessful. RMO is characterized clinically by migrating arthralgia of the weight-bearing joints of the lower limbs, mainly in middle-aged males. Although the aetiology is unknown, the pathophysiology of RMO seems to be closely related to transient osteoporosis of the hip (TOH), which has been considered a reversible stage of avascular necrosis of the hip (AVN). There is no causal treatment for RMO. Avoidance of weight bearing and use of analgesics are effective in reducing symptoms. The combination of RMO and AS yielded diagnostic difficulties, as the clinical picture and the marrow oedema seen on MRI could be attributed to several AS-related causes such as enthesitis, early stadium of arthritis, osteonecrosis, or sterile osteomyelitis. PMID:18991185

Straten, V H H P; Franssen, M J A M; den Broeder, A A; Obradov, M; van den Hoogen, F H J

2009-01-01

62

Four cases of ankylosing spondylitis in medieval skeletal series from Croatia.  

PubMed

Osteological changes consistent with ankylosing spondylitis were observed in three males and one female skeleton recovered from four medieval sites-Velim, Koprivno, Buje, and Rijeka-all situated on Croatia's eastern Adriatic coast and its immediate hinterland. The skeletons present changes in the spine, ribs, sacrum, and innominates that are typical of ankylosing spondylitis that is a progressive, inflammatory disease of connective tissue calcification. The disease most commonly affects the sacroiliac joints, the joints of the spine, and the costovertebral joints. In the final stages of the disease, the vertebral bodies remodel and together with the associated syndesmophytes form a continuous, smooth bone surface that is sometimes referred to as "bamboo spine." The prevalence of this disorder in the analyzed Croatian samples is 4/303 or 1.3% and thus corresponds with frequencies recorded in modern European populations. Differential diagnosis rules out the possibility of DISH, rheumatoid arthritis, and melorheostosis. These are the first cases of ankylosing spondylitis identified in Croatian archaeological series. PMID:22210271

Slaus, Mario; Novak, Mario; Cavka, Mislav

2012-12-01

63

Bone and stone in ankylosing spondylitis: osteoporosis and urolithiasis  

Microsoft Academic Search

Ankylosing spondylitis (AS) has well-defined renal complications, but urolithiasis has not been studied in detail. We aimed to evaluate the relation between AS and urolithiasis presence and the effect of this coexistence on the bone mineral status of patients. By dual-energy x-ray absorptiometry measurements at the femoral neck and lumbar vertebrae, we assessed the influence of urolithiasis, disease activity, and

Nurgül Arinci ?ncel; Figen Göko?lu; Bar?? Nacir; Nazmi ?ncel

2006-01-01

64

A Case of Ankylosing Spondylitis and Discussion of the Literature  

PubMed Central

Ankylosing spondylitis (AS) is a systemic inflammatory disease. Its pathogenesis has not been completely understood, but the HLA-B 27 positive immune cells are thought to be involved. Nonsteroidal anti-inflammatory agents are the first line drugs and they effectively relieve the symptoms. Biological agents such as Infliximab may help in targeting the underlying inflammatory process and have been used recently. Here, we are reporting a case of AS with established classical skeletal deformities. PMID:23905135

Ranjith, M.P.; Divya, R.

2013-01-01

65

Pelvic MRI findings of juvenile-onset ankylosing spondylitis  

Microsoft Academic Search

Ankylosing spondylitis (AS) is the most common clinical subgroup of sero-negative spondyloarthropathies. Radiographic and\\u000a clinical signs of bilateral inflammatory involvement of sacroiliac joints are the gold standard for the diagnosis of juvenile\\u000a AS. Although radiographic evidence of sacroiliitis is included in the definition, it is not mandatory for the diagnosis of\\u000a juvenile AS. The aim of this study is to

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

2010-01-01

66

Effect of Pilates training on people with ankylosing spondylitis  

Microsoft Academic Search

The objective of this study was to investigate the effects of Pilates on pain, functional status, and quality of life in patients\\u000a with ankylosing spondylitis. The study was performed as a randomized, prospective, controlled, and single-blind trial. Fifty-five\\u000a participants (30 men, 25 women) who were under a regular follow-up protocol in our Rheumatology Clinic with the diagnosis\\u000a of AS according

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

67

Evaluation of various endothelial biomarkers in ankylosing spondylitis.  

PubMed

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

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

2012-01-01

68

99mTc-MDP scintigraphy in ankylosing spondylitis.  

PubMed

99mTechnetium-MDP bone scintigrams in 11 patients with ankylosing spondylitis were reviewed. Increased activity in sacroiliac joints was present in five of 11 cases, all of whom had symptoms of less than 5 years duration. Patients with longstanding disease had normal or low sacroiliac joint activity. In the spine, appearances included diffuse symmetrical, unifocal or multifocal asymmetrical increased uptake involving the costovertebral, costotransverse and facet joints as well as the spinous processes. In advanced disease with extensive ankylosis, the lumbar spine was featureless on scintigraphy, except for focal increased activity at the site of previous fracture in one patient. Of six available views of the sternum, increased uptake was present in five at the manubriosternal joint and five at the sternoclavicular joints. Increased peripheral uptake was mainly in the hips and knees in advanced cases. Plain radiographic changes correlated poorly with scintigraphic changes, scintigraphy detecting considerably more lesions than radiography. Awareness of the scintigraphic appearances of ankylosing spondylitis may lead to diagnosis before the development of radiographic changes and avoid confusion with other pathology. Clinical indications for bone scintigraphy in ankylosing spondylitis are suggested. PMID:8293644

Collie, D A; Smith, G W; Merrick, M V

1993-12-01

69

Epicardial adipose tissue thickness in patients with ankylosing spondylitis.  

PubMed

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

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

2015-02-01

70

[Cross-sectional imaging of peripheral involvement in ankylosing spondylitis].  

PubMed

Ankylosing spondylitis is the most common spondyloarthropathy. It is characterized by enthesopathy (inflammation at the insertion of ligaments, tendons or fascia to bone). The os calcis is most frequently involved. Additional peripheral manifestations include synovitis and dactylitis. Unlike radiographs that demonstrate late manifestations of the disease, ultrasound and MRI demonstrate early inflammatory changes of bones and soft tissues. Multiple sites of involvement may also be detected on a single examination. Both imaging modalities facilitate early diagnosis, a crucial element for patient management. Both modalities may also monitor lesion regression during treatment. PMID:20212391

Miquel, A; Pradel, C; Jomaah, N; Bienvenot, P; Menu, Y

2010-01-01

71

Rehabilitation techniques in ankylosing spondylitis management: a case report  

PubMed Central

Ankylosing spondylitis (AS) is a chronic inflammatory disorder of the musculoskeletal system. Progressive complaints of axial stiffness and restriction in movement may not be addressed by general medical practitioners. While AS has a progressive natural history, chiropractors may play a significant role in early detection, patient education, and management. Early diagnosis and therapy may help to minimize future pain and disability. Chiropractic treatment methods coupled with individualized active rehabilitation techniques should be directed to reduce pain, minimize functional loss and optimize quality of life. ImagesFigure 1Figure 2Figure 3Figure 4

Henderson, Shawn

2003-01-01

72

What counselling do patients with ankylosing spondylitis receive? Results of a questionnaire survey.  

PubMed

This questionnaire survey of 71 patients with ankylosing spondylitis (members of the National Ankylosing Spondylitis Society of the UK) revealed that a substantial proportion of patients were apparently not told of several aspects of their illness by their doctors such as likely cause(s), familial clustering, role of HLA tissue typing and diet (appropriately). Only a small percentage (4.2%) were counselled to actively seek screening for close family members. As HLA B27 presence is not diagnostic of ankylosing spondylitis, and it cannot be prevented or arrested even if diagnosed at onset or early stages, routine screening of close family members cannot be justified at present. PMID:9776113

Pal, B

1998-01-01

73

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

Microsoft Academic Search

Objective: To develop and validate an extensive radiographic scoring system for ankylosing spondylitis (AS).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

M. C. W. Creemers; M. J. A. M. Franssen; M A van ’t Hof; F. W. J. Gribnau

2005-01-01

74

Costs and quality of life of patients with ankylosing spondylitis in Hong Kong  

Microsoft Academic Search

Methods. A retrospective, non-randomized, cross-sectional study was performed in a cohort of 145 patients with AS in Hong Kong. Participants completed questionnaires on sociodemographics, work status and out-of-pocket expenses. Health resources consumption was recorded by chart review. Functional impairment and disease activity were measured using the Bath Ankylosing Spondylitis Functional Index (BASFI) and the Bath Ankylosing Spondylitis Disease Activity Index

T. Y. Zhu; L.-S. Tam; V. W.-Y. Lee; W. W. Hwang; T. K. Li; K. K. Lee; E. K. Li

2008-01-01

75

Costovertebral joint changes in ankylosing spondylitis with thoracic pain.  

PubMed

CAT scan of the costovertebral joints has been performed in 17 patients with ankylosing spondylitis, all suffering from lower thoracic pain. Fourteen of them (82%) showed abnormal findings, including erosions and sclerosis, more pronounced in the vertebral side of the joint, and joint widening. Bony proliferation arising from the vertebral side in the anterior margin of the joint was also seen. One patient showed at the D12 level anterior bony bridges, similar to the vertebral syndesmophytes. Fusion was noted in five patients (including the three with longest disease duration) and represents the end result of the inflammatory process. These changes provide an anatomical basis for the understanding of the thoracic pain in AS patients. PMID:1596705

Pascual, E; Castellano, J A; López, E

1992-06-01

76

Relapsing polychondritis in a patient with ankylosing spondylitis using etanercept.  

PubMed

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

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

2014-01-01

77

Relapsing Polychondritis in a Patient with Ankylosing Spondylitis Using Etanercept  

PubMed Central

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

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

2014-01-01

78

Juvenile ankylosing spondylitis—is it the same disease as adult ankylosing spondylitis?  

Microsoft Academic Search

Objectives: Juvenile and adult forms of anky- losing spondylitis (AS) have been shown to have differ- ent clinical presentation and outcome in Caucasians. We did this retrospective analysis to see if similar differences exist in the Indian population. Patients and methods: Case records of 210 Indian patients diagnosed with AS according to modified New York criteria were reviewed. Data were

Amita Aggarwal; Pravin Hissaria; Ramnath Misra

2005-01-01

79

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

PubMed Central

Ankylosing spondylitis is a common form of inflammatory arthritis predominantly affecting the spine and pelvis that occurs in approximately 5 out of 1,000 adults of European descent. Here we report the identification of three variants in the RUNX3, LTBRTNFRSF1A and IL12B regions convincingly associated with ankylosing spondylitis (P < 5 × 10?8 in the combined discovery and replication datasets) and a further four loci at PTGER4, TBKBP1, ANTXR2 and CARD9 that show strong association across all our datasets (P < 5 × 10?6 overall, with support in each of the three datasets studied). We also show that polymorphisms of ERAP1, which encodes an endoplasmic reticulum aminopeptidase involved in peptide trimming before HLA class I presentation, only affect ankylosing spondylitis risk in HLA-B27–positive individuals. These findings provide strong evidence that HLA-B27 operates in ankylosing spondylitis through a mechanism involving aberrant processing of antigenic peptides. PMID:21743469

Evans, David M; Spencer, Chris C A; Pointon, Jennifer J; Su, Zhan; Harvey, David; Kochan, Grazyna; Oppermann, Udo; Dilthey, Alexander; Pirinen, Matti; Stone, Millicent A; Appleton, Louise; Moutsianas, Loukas; Leslie, Stephen; Wordsworth, Tom; Kenna, Tony J; Karaderi, Tugce; Thomas, Gethin P; Ward, Michael M; Weisman, Michael H; Farrar, Claire; Bradbury, Linda A; Danoy, Patrick; Inman, Robert D; Maksymowych, Walter; Gladman, Dafna; Rahman, Proton; Morgan, Ann; Marzo-Ortega, Helena; Bowness, Paul; Gaffney, Karl; Gaston, J S Hill; Smith, Malcolm; Bruges-Armas, Jacome; Couto, Ana-Rita; Sorrentino, Rosa; Paladini, Fabiana; Ferreira, Manuel A; Xu, Huji; Liu, Yu; Jiang, Lei; Lopez-Larrea, Carlos; Díaz-Peña, Roberto; López-Vázquez, Antonio; Zayats, Tetyana; Band, Gavin; Bellenguez, Céline; Blackburn, Hannah; Blackwell, Jenefer M; Bramon, Elvira; Bumpstead, Suzannah J; Casas, Juan P; Corvin, Aiden; Craddock, Nicholas; Deloukas, Panos; Dronov, Serge; Duncanson, Audrey; Edkins, Sarah; Freeman, Colin; Gillman, Matthew; Gray, Emma; Gwilliam, Rhian; Hammond, Naomi; Hunt, Sarah E; Jankowski, Janusz; Jayakumar, Alagurevathi; Langford, Cordelia; Liddle, Jennifer; Markus, Hugh S; Mathew, Christopher G; McCann, Owen T; McCarthy, Mark I; Palmer, Colin N A; Peltonen, Leena; Plomin, Robert; Potter, Simon C; Rautanen, Anna; Ravindrarajah, Radhi; Ricketts, Michelle; Samani, Nilesh; Sawcer, Stephen J; Strange, Amy; Trembath, Richard C; Viswanathan, Ananth C; Waller, Matthew; Weston, Paul; Whittaker, Pamela; Widaa, Sara; Wood, Nicholas W; McVean, Gilean; Reveille, John D; Wordsworth, B Paul; Brown, Matthew A; Donnelly, Peter

2013-01-01

80

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

PubMed

Ankylosing spondylitis is a common form of inflammatory arthritis predominantly affecting the spine and pelvis that occurs in approximately 5 out of 1,000 adults of European descent. Here we report the identification of three variants in the RUNX3, LTBR-TNFRSF1A and IL12B regions convincingly associated with ankylosing spondylitis (P < 5 × 10(-8) in the combined discovery and replication datasets) and a further four loci at PTGER4, TBKBP1, ANTXR2 and CARD9 that show strong association across all our datasets (P < 5 × 10(-6) overall, with support in each of the three datasets studied). We also show that polymorphisms of ERAP1, which encodes an endoplasmic reticulum aminopeptidase involved in peptide trimming before HLA class I presentation, only affect ankylosing spondylitis risk in HLA-B27-positive individuals. These findings provide strong evidence that HLA-B27 operates in ankylosing spondylitis through a mechanism involving aberrant processing of antigenic peptides. PMID:21743469

Evans, David M; Spencer, Chris C A; Pointon, Jennifer J; Su, Zhan; Harvey, David; Kochan, Grazyna; Oppermann, Udo; Opperman, Udo; Dilthey, Alexander; Pirinen, Matti; Stone, Millicent A; Appleton, Louise; Moutsianas, Loukas; Moutsianis, Loukas; Leslie, Stephen; Wordsworth, Tom; Kenna, Tony J; Karaderi, Tugce; Thomas, Gethin P; Ward, Michael M; Weisman, Michael H; Farrar, Claire; Bradbury, Linda A; Danoy, Patrick; Inman, Robert D; Maksymowych, Walter; Gladman, Dafna; Rahman, Proton; Morgan, Ann; Marzo-Ortega, Helena; Bowness, Paul; Gaffney, Karl; Gaston, J S Hill; Smith, Malcolm; Bruges-Armas, Jacome; Couto, Ana-Rita; Sorrentino, Rosa; Paladini, Fabiana; Ferreira, Manuel A; Xu, Huji; Liu, Yu; Jiang, Lei; Lopez-Larrea, Carlos; Díaz-Peña, Roberto; López-Vázquez, Antonio; Zayats, Tetyana; Band, Gavin; Bellenguez, Céline; Blackburn, Hannah; Blackwell, Jenefer M; Bramon, Elvira; Bumpstead, Suzannah J; Casas, Juan P; Corvin, Aiden; Craddock, Nicholas; Deloukas, Panos; Dronov, Serge; Duncanson, Audrey; Edkins, Sarah; Freeman, Colin; Gillman, Matthew; Gray, Emma; Gwilliam, Rhian; Hammond, Naomi; Hunt, Sarah E; Jankowski, Janusz; Jayakumar, Alagurevathi; Langford, Cordelia; Liddle, Jennifer; Markus, Hugh S; Mathew, Christopher G; McCann, Owen T; McCarthy, Mark I; Palmer, Colin N A; Peltonen, Leena; Plomin, Robert; Potter, Simon C; Rautanen, Anna; Ravindrarajah, Radhi; Ricketts, Michelle; Samani, Nilesh; Sawcer, Stephen J; Strange, Amy; Trembath, Richard C; Viswanathan, Ananth C; Waller, Matthew; Weston, Paul; Whittaker, Pamela; Widaa, Sara; Wood, Nicholas W; McVean, Gilean; Reveille, John D; Wordsworth, B Paul; Brown, Matthew A; Donnelly, Peter

2011-08-01

81

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

PubMed

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

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

2014-01-01

82

Current evidence for the management of ankylosing spondylitis: a systematic literature review for the ASAS/EULAR management recommendations in ankylosing spondylitis  

PubMed Central

Objective To assess available management strategies in ankylosing spondylitis (AS) using a systematic approach, as a part of the development of evidence based recommendations for the management of AS. Methods A systematic search of Medline, Embase, CINAHL, PEDro, and the Cochrane Library was performed to identify relevant interventions for the management of AS. Evidence for each intervention was categorised by study type, and outcome data for efficacy, adverse effects, and cost effectiveness were abstracted. The effect size, rate ratio, number needed to treat, and incremental cost effectiveness ratio were calculated for each intervention where possible. Results from randomised controlled trials were pooled where appropriate. Results Both pharmacological and non?pharmacological interventions considered to be of interest to clinicians involved in the management of AS were identified. Good evidence (level Ib) exists supporting the use of non?steroidal anti?inflammatory drugs (NSAIDs) and coxibs for symptomatic treatment. Non?pharmacological treatments are also supported for maintaining function in AS. The use of conventional antirheumatoid arthritis drugs is not well supported by high level research evidence. Tumour necrosis factor inhibitors (infliximab and etanercept) have level Ib evidence supporting large treatment effects for spinal pain and function in AS over at least 6?months. Level IV evidence supports surgical interventions in specific patients. Conclusion This extensive literature review forms the evidence base considered in the development of the new ASAS/EULAR recommendations for the management of AS. PMID:16126792

Zochling, J; van der Heijde, D; Dougados, M; Braun, J

2006-01-01

83

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

PubMed Central

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. PMID:23644848

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

2013-01-01

84

Biomechanical assessment of balance and posture in subjects with ankylosing spondylitis  

PubMed Central

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?ankylosing spondylitis subjects both hip (p?=?0.048) and ankle (p?=?0.029) joints angles differs significantly. When considering the posturographic parameters significant differences were observed for ellipse, center of pressure path and mean velocity (p?ankylosing spondylitis subjects. This methodology could help clinicians to plan rehabilitation treatments. PMID:22931459

2012-01-01

85

Sequential studies in ankylosing spondylitis. Association of Klebsiella pneumoniae with active disease.  

PubMed Central

A study of 163 patients with ankylosing spondylitis seen on 433 occasions showed that active inflammatory disease was strongly associated with the presence of Klebsiella pneumoniae in the faeces (P less than 0.001). Sequential studies showed that in patients with inactive disease the presence of a positive culture for Klebsiella was associated with the subsequent development of active inflammatory disease (P less than 0.001). These findings support the hypothesis that Kl. pneumoniae may be an initiating agent in ankylosing spondylitis. PMID:348130

Ebringer, R W; Cawdell, D R; Cowling, P; Ebringer, A

1978-01-01

86

Might axial myofascial properties and biomechanical mechanisms be relevant to ankylosing spondylitis and axial spondyloarthritis?  

PubMed Central

Ankylosing spondylitis and axial spondyloarthropathy have characteristic age- and sex-specific onset patterns, typical entheseal lesions, and marked heritability, but the integrative mechanisms causing the pathophysiological and structural alterations remain largely undefined. Myofascial tissues are integrated in the body into webs and networks which permit transmission of passive and active tensional forces that provide stabilizing support and help to control movements. Axial myofascial hypertonicity was hypothesized as a potential excessive polymorphic trait which could contribute to chronic biomechanical overloading and exaggerated stresses at entheseal sites. Such a mechanism may help to integrate many of the characteristic host, pathological, and structural features of ankylosing spondylitis and axial spondyloarthritis. Biomechanical stress and strain were recently documented to correlate with peripheral entheseal inflammation and new bone formation in a murine model of spondyloarthritis. Ankylosing spondylitis has traditionally been classified by the modified New York criteria, which require the presence of definite radiographic sacroiliac joint lesions. New classification criteria for axial spondyloarthritis now include patients who do not fulfill the modified New York criteria. The male-to-female sex ratios clearly differed between the two patient categories - 2:1 or 3:1 in ankylosing spondylitis and 1:1 in non-radiographic axial spondyloarthritis - and this suggests a spectral concept of disease and, among females, milder structural alterations. Magnetic resonance imaging of active and chronic lesions in ankylosing spondylitis and axial spondyloarthritis reveals complex patterns, usually interpreted as inflammatory reactions, but shows similarities to acute degenerative disc disease, which attributed to edema formation following mechanical stresses and micro-damage. A basic question is whether mechanically induced microinjury and immunologically mediated inflammatory mechanisms operate in both ankylosing spondylitis and degenerative disc disease but differ in relative degrees. The hypothesized biomechanical properties raised in this commentary require documentation of their association with the onset risk and course of ankylosing spondylitis and axial spondyloarthritis. If particular subsets of ankylosing spondylitis and axial spondyloarthritis patients are confirmed to have altered axial myofascial properties, their biological basis and underlying biomechanical mechanisms promise to become clarified. Understanding how biomechanical and physical properties can affect symptomatic and structural manifestations of these disorders could also improve their management. PMID:25166000

2014-01-01

87

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

PubMed Central

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. PMID:18538019

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

2008-01-01

88

Management of Acute Spinal Fractures in Ankylosing Spondylitis  

PubMed Central

Ankylosing Spondylitis (AS) is a multifactorial and polygenic rheumatic condition without a well-understood pathophysiology (Braun and Sieper (2007)). It results in chronic pain, deformity, and fracture of the axial skeleton. AS alters the biomechanical properties of the spine through a chronic inflammatory process, yielding a brittle, minimally compliant spinal column. Consequently, this patient population is highly susceptible to unstable spine fractures and associated neurologic devastation even with minimal trauma. Delay in diagnosis is not uncommon, resulting in inappropriate immobilization and treatment. Clinicians must maintain a high index of suspicion for fracture when evaluating this group to avoid morbidity and mortality. Advanced imaging studies in the form of multidetector CT and/or MRI should be employed to confirm the diagnosis. Initial immobilization in the patient's preinjury alignment is mandatory to prevent iatrogenic neurologic injury. Both nonoperative and operative treatments can be employed depending on the patient's age, comorbidities, and fracture stability. Operative techniques must be individually tailored for this patient population. A multidisciplinary team approach is best with preoperative nutritional assessment and pulmonary evaluation. PMID:22389792

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

2011-01-01

89

Effects of glossopharyngeal insufflation in ankylosing spondylitis: a pilot study.  

PubMed

In Ankylosing Spondylitis (AS), thoracic range of motion is often greatly limited. The objective of the study was to describe the effects of 12 weeks of Glossopharyngeal Insufflation (GI) training in patients with AS. Dynamic spirometry included vital capacity, forced expiratory volume, and peak expiratory flow. Thoracic and lumbar range of motion was assessed by tragus-to-wall distance, modified Schober test, and tape measure. Disease activity, activity limitation, and health perception were assessed using the BAS-Indices, and tension in the thoracic region during GI was assessed using the Borg CR-10 scale. Adherence to training was recorded in an activity log, along with any remarks on the training. Ten patients were recruited and six male patients fulfilled the study protocol. Three patients were able to learn GI by exceeding their maximal vital capacity with 5% using GI. A significant increase in thoracic range of motion both on costae IV (P = 0.04) and at the level of the xiphoid process (P = 0.04) was seen. Thus, patients with AS can practice GI, it is safe if maximal exertion is avoided, and patients with some mobility in the chest can increase their lung function substantially by performing GI during 12 weeks. PMID:25506364

Brodin, Nina; Lindholm, Peter; Lennartsson, Claudia; Nygren-Bonnier, Malin

2014-01-01

90

Scoring radiographic progression in ankylosing spondylitis: should we use the modified Stoke Ankylosing Spondylitis Spine Score (mSASSS) or the Radiographic Ankylosing Spondylitis Spinal Score (RASSS)?  

PubMed Central

Introduction Radiographic damage is one of the core outcomes in axial SpA and is usually assessed with the modified Stoke Ankylosing Spondylitis (AS) Spine Score (mSASSS). Alternatively, the Radiographic AS Spinal Score (RASSS) is proposed, which includes the lower thoracic vertebrae, under the hypothesis that most progression occurs in these segments. We aimed to compare the mSASSS and RASSS with regard to performance. Methods Two-yearly spinal radiographs from patients followed in the Outcome in AS International Study (OASIS) were used (scored independently by two readers). A total of 195 patients had at least one radiograph (12-year follow-up) to be included. We assessed the accessibility of vertebral corners (VCs) for scoring, as well as status and 2-year progression scores of both scoring methods. To assess the potential additional value of including the thoracic segment in the score, the relative contribution (in %) to the 2-year total RASSS progression of each spinal segment (cervical, thoracic and lumbar) was determined, and compared to the expected contribution, under the assumption that a balanced segmental progression would occur, proportional to the number of sites per segment. Results The mSASSS could be scored in a total of 809 radiographs and the RASSS in 78% of these. In 58% of the latter, the score was based on one to two available thoracic VCs scores, and the remaining two to three were imputed because they were missing. There were 520 two-year mSASSS intervals available, and in 63% of them RASSS progression could be assessed. The mean (SD) 2-year interval progression score (330 intervals) was 2.0 (3.6) for the mSASSS and 2.4 (4.4) for the RASSS, yielding a similar effect size (mSASSS 0.57 and RASSS 0.55). Exclusive progression of the thoracic segment occurred in only 5% of the cases. There was no significant difference between the observed (14%) and expected (16%) contribution to progression of the thoracic segment (P = 0.70). Conclusions The determination of RASSS for radiographic damage of the spine is frequently impossible or strongly influenced by non-contributory imputation. In comparison to the mSASSS, the contribution of thoracic VCs in the RASSS method is negligible, and does not justify the additional scoring efforts. PMID:23327723

2013-01-01

91

A case report on nephrotic syndrome associated with ankylosing spondylitis effectively treated with infliximab  

PubMed Central

Renal abnormalities have been reported to occur in patients with ankylosing spondylitis (AS). This study examined a patient who suffered from AS for two years. The 24-hour urine protein of the patient was 4.80 g/day. The result of renal biopsy showed minimal change. The patient was treated with infliximab. After two months, nephrotic syndrome was treated successfully. PMID:25356164

Feng, Xin; Li, Yao; Gao, Wei

2014-01-01

92

2010 update of the ASAS\\/EULAR recommendations for the management of ankylosing spondylitis  

Microsoft Academic Search

This first update of the ASAS\\/EULAR recommendations on the management of ankylosing spondylitis (AS) is based on the original paper, a systematic review of existing recommendations and the literature since 2005 and the discussion and agreement among 21 international experts, 2 patients and 2 physiotherapists in a meeting in February 2010. Each original bullet point was discussed in detail and

J. von Braun; R van den Berg; X. Baraliakos; H. Boehm; R. Burgos-Vargas; E. Collantes-Estevez; H. Dagfinrud; B. A. C. Dijkmans; M. Dougados; P Emery; P. Geher; M. Hammoudeh; R. D. Inman; M. Jongkees; M. A. Khan; U. Kiltz; TK Kvien; M Leirisalo-Repo; W. P. Maksymowych; I. Olivieri; K. Pavelka; J. Sieper; E. Stanislawska-Biernat; D. Wendling; S Özgocmen; C van Drogen; BJ van Royen; Heijde van der H. D

2011-01-01

93

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

Microsoft Academic Search

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

P W Blower; A J Griffin

1984-01-01

94

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

Microsoft Academic Search

The human leukocyte antigen-B27 is one of the class I molecules of the major histocompatibility complex which is strongly associated with ankylosing spondylitis (AS). The strength of the disease association with B27 varies markedly among racial and ethnic populations. It is an allele family, which constitutes about 31 subtypes, with a considerable geographic and ethnic difference in distribution. It is

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

95

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

ERIC Educational Resources Information Center

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

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

2007-01-01

96

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

PubMed

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

Korkmaz, Cengiz

2006-01-01

97

MRI of the Sacroiliac Joints in Patients with Moderate to Severe Ankylosing Spondylitis  

Microsoft Academic Search

OBJECTIVE. The objectives of our study were to evaluate whether MRI findings of the sacroiliac joints are able to distinguish between active and inactive disease in patients with es- tablished ankylosing spondylitis and to determine whether these findings correlate with mark- ers of clinical activity, disease duration, severity, and degree of radiographic damage. MATERIALS AND METHODS. Eighteen patients with symptomatic

Miriam A. Bredella; Lynne S. Steinbach; Stephanie Morgan; Michael Ward; John C. Davis; Bredella MA; Steinbach LS; Davis JC

98

Gender differences in Iranian patients with ankylosing spondylitis.  

PubMed

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

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

2015-02-01

99

Pharmacological treatment of ankylosing spondylitis: a systematic review.  

PubMed

The purpose of this study was to review the evidence regarding the efficacy and safety of pharmacological therapies currently available for the treatment of ankylosing spondylitis (AS).A literature search using MEDLINE from 1966 through to April 2005 and a hand search of abstracts from the American College of Rheumatology (ACR) meetings for 2001 through to 2004 were performed. References of articles retrieved were also searched. The MEDLINE search yielded 570 citations and 157 abstracts from ACR were identified. Eighty-four studies were randomised controlled trials (RCTs); 53 fulfilled the inclusion criteria (pharmacological treatment of AS and RCT) and were included in this review. Statistical pooling of data was not performed because of the disparate outcome measures used. Eight RCTs found nonselective NSAIDs and two RCTs found cyclo-oxygenase (COX)-2-selective NSAIDs to be superior to placebo for relief of pain and improvement in physical function. Twenty-nine RCTs showed comparable efficacy and safety between nonselective NSAIDs. One RCT showed no difference between methylprednisolone 1g and 375 mg. Seven RCTs assessing the efficacy of sulfasalazine (sulphasalazine) and two RCTs of methotrexate provided contradictory evidence as to their benefit for treatment of AS. One RCT showed intravenous pamidronate 60 mg to be more effective than 10mg intravenously for the treatment of axial pain. All six RCTs of anti-tumour necrosis factor (TNF)-alpha agents demonstrated superiority to placebo for the treatment of axial and peripheral symptoms. Nonselective as well as COX-2-selective NSAIDs can be used for pain control in patients with AS. Other proven treatment options include sulfasalazine for the treatment of peripheral joint symptoms, while limited evidence supports the use of pamidronate or methotrexate, which require further studies. Anti-TNFalpha agents have been found very effective for the treatment of both peripheral and axial symptoms in patients with AS, but their use is limited by cost and uncertainty over long-term efficacy and safety. PMID:16225367

Boulos, Pauline; Dougados, Maxime; Macleod, Stuart M; Hunsche, Elke

2005-01-01

100

An Epidemiological Study on Ankylosing Spondylitis in Southern Albania  

PubMed Central

Objectives: To evaluate the incidence and prevalence of ankylosing spondylitis (AS) in southern Albania and to assess the association of various demographic risk factors with the severity of disease. Material and methods: This is an observational study with cross-sectional analyses, conducted in the region of Gjirokaster, between 1995 until 2011. The diagnosis of AS was based on the modified New York criteria. Data on population are obtained from the reports of the National Institute of Statistics. Results: Between 1995 and 2011, there were 54 patients diagnosed with AS. Of them, 48 subjects were males (88.9%) and 6 subjects females (11.1%). The AS prevalence in adult population (?14 years of age), in December 2010, was 0.061%. The 5-year incidence (2006–2010) in adult population was 0.006 %. The mean age at the onset of disease was 29.7±8.4 years. The mean age in 2011 (n=50 subjects) was 51.6±12.7 years. The duration of the disease was 22.7±11.2 years. More than two thirds of the patients (70.3%) were in the advanced radiological stages of the disease. A younger age at the onset of the disease, longer delay in diagnosis, lower educational level and smoking were significant independent factors associated with the advanced forms of the disease. Conclusion: In southern Albania, the AS prevalence in 2010 was 0.061% and the 5-year incidence (2006-2010) was 6 new cases per 105 adults. The incidence and prevalence of AS in Southern Albania are close to the respective regional epidemiological data. PMID:24757397

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

2014-01-01

101

Ankylosing Spondylitis Disease Activity Score (ASDAS): defining cut-off values for disease activity states and improvement scores  

Microsoft Academic Search

BackgroundThe Ankylosing Spondylitis Disease Activity Score (ASDAS) is a new composite index to assess disease activity in ankylosing spondylitis (AS). It fulfils important aspects of truth, feasibility and discrimination. Criteria for disease activity states and improvement scores are important for use in clinical practice, observational studies and clinical trials and so far have not been developed for the ASDAS.ObjectiveTo determine

Pedro Machado; Robert Landewé; Elisabeth Lie; Tore K Kvien; Jürgen Braun; Daniel Baker; Désirée van der Heijde

2011-01-01

102

Symptomatic improvement in function and disease activity in a patient with ankylosing spondylitis utilizing a course of chiropractic therapy: a prospective case study  

PubMed Central

Background There is limited outcome measure support for chiropractic manipulative therapy in the management of ankylosing spondylitis. An improvement in specific indices for both function and disease activity during chiropractic therapy for ankylosing spondylitis has not previously been reported. Objective To measure changes in function and disease activity in a patient with ankylosing spondylitis during a course of chiropractic therapy. The clinical management of ankylosing spondylitis, including chiropractic manipulative therapy and the implications of this case study are discussed. Clinical Features A 34-year-old male with a 10 year diagnosis of ankylosing spondylitis sought chiropractic treatment for spinal pain and stiffness. His advanced radiographic signs included an increased atlantodental interspace and cervical vertebral ankylosis. Intervention and outcome The Bath Ankylosing Spondylitis Functional Index (BASFI), Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), finger-tip-to-floor distance and chest expansion were assessed during an 18 week course of chiropractic spinal manipulation and mobilization therapy. There was a 90% improvement in the disease activity index and an 85% improvement in the functional index from the pre-treatment baseline, as measured by the BASDAI and BASFI respectively. Spinal flexibility and chest expansion also improved. Conclusion To the authors knowledge this is the first study to incorporate ankylosing spondylitis specific indices, for both disease activity and function, to objectively support the use of chiropractic manipulative therapy in the management of ankylosing spondylitis. More intensive research is suggested. PMID:17549197

Rutherford, Susan M; Nicolson, Cameron F; Crowther, Edward R

2005-01-01

103

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

PubMed

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

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

2013-03-01

104

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

PubMed Central

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

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

2014-01-01

105

Transpedicular closed wedge osteotomy in ankylosing spondylitis: results of surgical treatment and prospective outcome analysis  

Microsoft Academic Search

\\u000a Abstract  Surgery in late stage ankylosing spondylitis (AS) most often tends to correct the sagittal balance with an extension osteotomy\\u000a of the spine. In the literature, extension osteotomy was first described as an open wedge osteotomy but recently closed wedge\\u000a osteotomy resecting the pedicles and posterior elements have become more popular. Only a limited number of cases have been\\u000a reported in

Thomas Kiaer; Martin Gehrchen

2010-01-01

106

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

PubMed

Recently, the Ankylosing Spondylitis Disease Activity Score (ASDAS), a new index, has been shown to be validated and highly discriminatory in assessing ankylosing spondylitis (AS) disease activity. This study is to evaluate the performance of ASDAS in a local Chinese cohort of AS in a cross-sectional setting and to compare it with the existing instrument, the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI). Consecutive patients with AS were recruited from a local rheumatology clinic. Data, including BASDAI, Bath Ankylosing Spondylitis Functional Index (BASFI), Visual Analogue Scale (VAS) for spinal pain, and patient and physician global assessments were gathered during clinic visit. Inflammatory markers, including erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), and high-sensitivity (hs)-CRP were collected. ASDAS was calculated accordingly. The discriminatory capacity of BASDAI and ASDAS was compared by: (1) standardized mean difference statistics, (2) R (2) in linear regressions, and (3) area under receiver operating characteristic curve (AUC) in logistic regression models. Both ASDAS and BASDAI showed satisfactory predictive value on disease activity with reference to patient and physician global assessment. R (2) in linear regression models ranged from 0.6-0.7. Both indices also demonstrated good discriminatory capacity as evidenced by a relatively high AUC (> 0.8) under the logistic regression models using either patient or physician global assessment score ?4 and <4 as cut off of high and low disease activity status, respectively. Although we could not demonstrate significant differences in the performance between them, subgroup analysis suggested better discriminatory ability of ASDAS in the high inflammatory marker subgroup. ASDAS and BASDAI showed similarly good performance in a cross-sectional setting in a local Chinese AS cohort. ASDAS performed better in subgroup with raised inflammatory markers. PMID:24981160

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

2014-08-01

107

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

PubMed

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

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

2010-02-01

108

Relationship of environmental exposures and ankylosing spondylitis and spinal mobility: US NHAENS, 2009-2010.  

PubMed

It was aimed to study the relationships of different sets of urinary environmental chemical concentrations and ankylosing spondylitis in a national and population-based setting. Data were extracted from United States National Health and Nutrition Examination Surveys, 2009-2010. Information on demographics was obtained by household interview and ankylosing spondylitis clinical measures and urines were taken at examination. People with abnormal occiput-to-wall distance were found to have higher urinary cadmium (OR 2.17, 95?% CI 1.34-3.52, p?=?0.004), antimony (OR 1.74, 95?% CI 1.15-2.62, p?=?0.012), tungsten (OR 1.91, 95?% CI 1.39-2.64, p?=?0.001), uranium (OR 1.49, 95?% CI 1.03-2.15, p?=?0.036), and trimethylarsine oxide (OR 5.01, 95?% CI 2.34-10.71, p?ankylosing spondylitis clinical measures, compared to those who resided in households that were built in 1990 or after. The odds were 1.74 for households built in 1978-1989 and 1.81 for those built in 1940 or earlier. PMID:25103950

Shiue, Ivy

2014-08-01

109

HLA class I and class II association with ankylosing spondylitis in a southern Indian population.  

PubMed

Ankylosing spondylitis (AS) is a chronic inflammatory condition associated with HLA B27. But the association is not absolute. Hence association with other HLA class I antigens and class II alleles was studied in a southern Indian population. Sixty-five patients with primary AS were typed serologically for HLA class I antigens. Age- and sex-matched disease controls (37 with enterogenic reactive arthritis [ReA] and 25 with undifferentiated spondyloarthropathy [UnSpA]) and 124 healthy controls were studied. PCR-based DNA-SSO typing for DQA1 and DQB1 was performed on 20 patients with AS and 38 healthy controls. Twenty-three patients with AS and 39 controls were typed for DRB1 alleles. HLA B27 was positive in 76.9 % of the cases of AS (RR 811), 59.5% of those with ReA (RR 9.3), and 40% of the patients with UnSpA (RR 9.3), while none of the controls were B27 positive. The P value for positive association was highly significant for B27 in all the three groups. B27 positivity was associated with earlier age of onset of disease in all the diseases compared to the B27-negative group. HLA Cw2 was positively associated with AS (P highly significant; OR 52) and ReA (P = 0.0003; OR 14.2). HLA A1 and CW6 were significantly negatively associated only with AS (P = 0.0001 and 0.00004 and OR 0.25 and 0.02, respectively). None of the HLA class II alleles were significantly associated with AS. The apparent association with DRB1*11 (P = 0.03) was lost after Yates correction. PMID:12021150

Madhavan, Radha; Parthiban, M; Rajendran, C Panchapakesa; Chandrasekaran, A N; Zake, L; Sanjeevi, C B

2002-04-01

110

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

PubMed Central

The goal of this study was to identify potential transcriptomic markers in developing ankylosing spondylitis by a meta-analysis of multiple public microarray datasets. Using the INMEX (integrative meta-analysis of expression data) program, we performed the meta-analysis to identify consistently differentially expressed (DE) genes in ankylosing spondylitis and further performed functional interpretation (gene ontology analysis and pathway analysis) of the DE genes identified in the meta-analysis. Three microarray datasets (26 cases and 29 controls in total) were collected for meta-analysis. 905 consistently DE genes were identified in ankylosing spondylitis, among which 482 genes were upregulated and 423 genes were downregulated. The upregulated gene with the smallest combined rank product (RP) was GNG11 (combined RP = 299.64). The downregulated gene with the smallest combined RP was S100P (combined RP = 335.94). In the gene ontology (GO) analysis, the most significantly enriched GO term was “immune system process” (P = 3.46 × 10?26). The most significant pathway identified in the pathway analysis was antigen processing and presentation (P = 8.40 × 10?5). The consistently DE genes in ankylosing spondylitis and biological pathways associated with those DE genes identified provide valuable information for studying the pathophysiology of ankylosing spondylitis.

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

2015-01-01

111

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

PubMed Central

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?

2012-01-01

112

IgM, IgG, and IgA response to enterobacteria in patients with ankylosing spondylitis in southern India.  

PubMed

IgM, IgA, and IgG response to three different antigenic preparations-lipopolysaccharide (LPS), culture supernatant proteins, and outer membrane protein (OMP) of Klebsiella pneumoniae, Escherichia coli and Salmonella typhi-were measured in the sera of 20 patients with primary ankylosing spondylitis (AS), 10 with enterogenic reactive arthritis (ReA) (disease controls), and 15 voluntary blood donors (healthy controls) by ELISA using biotinylated anti-human immunoglobulins M, G, and A. Serum immunoglobulin levels were measured by immunoturbidimetric assay in 20 AS patients, 20 patients with enterogenic reactive arthritis (ReA), 20 with ulcerative colitis (UC), and 20 voluntary blood donors. Student's t-test was applied for comparison. Compared to healthy controls, AS patients showed significantly elevated IgG response against culture supernatant proteins of all the three organisms (P <0.05), LPS of E. coli (P < 0.05) and Klebsiella (P < 0.005), as well as OMP only of Klebsiella pneumoniae. This was reflected as significantly elevated IgG level in AS compared to controls (P < 0.05 vs. ReA and 0.005 vs. UC and healthy controls). This suggests the involvement of outer membrane proteins of Klebsiella pneumoniae in the pathogenic mechanism of ankylosing spondylitis. PMID:12021151

Madhavan, Radha; Porkodi, R; Rajendran, C Panchapakesa; Chandrasekaran, A N; Umadevi, K R; Alamelu, Raja

2002-04-01

113

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

PubMed Central

Introduction Sweet’s syndrome is an acute neutrophilic dermatosis characterized by a diffuse dermal infiltrate of mature neutrophils. In most cases, it occurs as an isolated phenomenon (idiopathic Sweet’s syndrome) but it can be drug induced or associated with a variety of underlying diseases such as infections, neoplasms, and chronic inflammatory diseases. The association between Sweet’s syndrome and ankylosing spondylitis is rare. Only a few cases have been reported in the literature. We report a new case in which we describe an outbreak of acute neutrophilic dermatosis revealing ankylosing spondylitis. Case presentation A 33-year-old Moroccan man presented with large-joint polyarthralgia, inflammatory pain in his buttocks and lower lumbar spine, fever and skin lesions. On examination, the patient had a low-grade fever, six tender but not swollen joints, limitation of motion of the lumbar spine, and painful erythematous maculopapules over his face, neck, and hands. Laboratory tests showed hyperleukocytosis, and elevated erythrocyte sedimentation rate and C-reactive protein. The immunological tests and infectious disease markers were negative. Investigations for an underlying neoplastic disease remained negative. Magnetic resonance imaging showed a bilateral sacroiliitis. Skin biopsy findings were consistent with Sweet’s syndrome. The diagnosis of Sweet’s syndrome associated with ankylosing spondylitis was established. Nonsteroid anti-inflammatory drugs were started and the patient showed rapid clinical and biological improvement. Conclusion Three observations of the association between Sweet’s syndrome and spondylarthropathy have been reported in the literature. The cause of this association remains unclear. Some hypotheses have been developed, but further studies are needed to confirm or refute them. PMID:23305505

2013-01-01

114

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

PubMed

Study Design. A retrospective clinical study.Objective. To investigate the lung volume change of ankylosing spondylitis patients with thoracolumbar kyphosis following the pedicle subtraction osteotomy procedure.Summary of Background Data. Most untreated ankylosing spondylitis patients result in thoracolumbar kyphosis with respiratory impairment. Restrictive pulmonary function is prevalent in these patients. The ideal evidence for restrictive pulmonary function impairment is to investigate the lung volume. A computed tomography based method can help to obtain accurate lung volume change during the osteotomy.Method. Twenty-eight AS patients with thoracolumbar kyphosis were included. All of these patients received pedicle subtraction osteotomy to correct their sagittal deformity. Pre and postoperative full-length radiographs and computed tomography scans were reviewed. The sagittal correction of the spine was measured. CT scans were used to estimate the pre and postoperative lung volume with software. The relationship between the sagittal correction and the lung volume change was investigated. All the patients were followed up for 2 years at least.Results. The PSO procedure was performed safely on each patient without serious complications. The average preoperative T1-S1 Cobb was 67.7°(42°? 88°) and the postoperative was 7.6°(-11°? 21°). T1-S1 Cobb change was 60.0° in average(P<0.05). The lung volume increased 396 ml in average. Significant correlation was found between the percentage of lung volume change and T1-S1 Cobb change (r = 0.7219, P < 0.05). The location we selected for PSO osteotomy varied from T12 to L3. No relationship was found between the osteotomy location and the lung volume change.Conclusion. The PSO osteotomy effectively corrected the sagittal deformity of ankylosing spondylitis patients. Lung volume increased significantly following the osteotomy. PMID:25423303

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

2014-11-21

115

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

PubMed

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

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

2014-06-01

116

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

PubMed

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

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

2014-10-01

117

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

PubMed Central

Rotational and flexion deformity of C1-C2 due to ankylosing spondylitis is rare. We did surgical correction in one such case by lateral release, resection of the posterior arch of C1 and mobilization of the vertebral arteries, wedge osteotomy of the lateral masses of C1 and internal fixation under general anesthesia. There were no vascular and neurological complications during the surgery. After operation the atlantoaxial rotational deformity was corrected and the normal cervical lordosis was restored. At 1 year followup his visual field and feeding became normal and internal fixation was stable. PMID:24741145

Lin, Bin; Zhang, Bi; Li, Zhu-mei; Li, Qiu-sheng

2014-01-01

118

Association of CTLA4 Gene Polymorphism in Iranian Patients with Ankylosing Spondylitis  

Microsoft Academic Search

Introduction  Cytotoxic T-lymphocyte antigen 4 (CTLA-4) is a costimulatory molecule expressed by activated T cells. This study was performed\\u000a to investigate the allele and genotype frequencies of CTLA4 gene polymorphisms in Iranian patients with ankylosing spondylitis (AS).\\u000a \\u000a \\u000a \\u000a \\u000a Methods  One hundred and fifty-seven patients with AS and 103 controls were included in this study. Polymorphisms of CTLA4 gene at positions +49 (in exon

Esfandiar Azizi; Ahmad Massoud; Ali Akbar Amirzargar; Mahdi Mahmoudi; Narjes Soleimanifar; Nima Rezaei; Ahmad Reza Jamshidi; Behrouz Nikbin; Mohammad Hossein Nicknam

2010-01-01

119

Analysis of uveitis rates across all etanercept ankylosing spondylitis clinical trials  

Microsoft Academic Search

Objective:To assess uveitis (including iritis and iridocyclitis) incidence from clinical trials of etanercept in patients with ankylosing spondylitis (AS).Methods:Clinical trials of etanercept in AS (four placebo-controlled; one active-controlled; three open-label) were examined for reports of uveitis. Between-group differences with confidence intervals (CIs) in the uveitis rates were calculated for the double-blind, active-controlled and long-term studies.Results:In placebo-controlled trials, the uveitis rate

J Sieper; A Koenig; S Baumgartner; C Wishneski; J Foehl; B Vlahos; B Freundlich

2010-01-01

120

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

PubMed Central

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

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

2014-01-01

121

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

PubMed

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

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

1979-01-01

122

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

PubMed

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

123

Bone formation rather than inflammation reflects Ankylosing Spondylitis activity on PET-CT: a pilot study  

PubMed Central

Introduction Positron Emission Tomography - Computer Tomography (PET-CT) is an interesting imaging technique to visualize Ankylosing Spondylitis (AS) activity using specific PET tracers. Previous studies have shown that the PET tracers [18F]FDG and [11C](R)PK11195 can target inflammation (synovitis) in rheumatoid arthritis (RA) and may therefore be useful in AS. Another interesting tracer for AS is [18F]Fluoride, which targets bone formation. In a pilot setting, the potential of PET-CT in imaging AS activity was tested using different tracers, with Magnetic Resonance Imaging (MRI) and conventional radiographs as reference. Methods In a stepwise approach different PET tracers were investigated. First, whole body [18F]FDG and [11C](R)PK11195 PET-CT scans were obtained of ten AS patients fulfilling the modified New York criteria. According to the BASDAI five of these patients had low and five had high disease activity. Secondly, an extra PET-CT scan using [18F]Fluoride was made of two additional AS patients with high disease activity. MRI scans of the total spine and sacroiliac joints were performed, and conventional radiographs of the total spine and sacroiliac joints were available for all patients. Scans and radiographs were visually scored by two observers blinded for clinical data. Results No increased [18F]FDG and [11C](R)PK11195 uptake was noticed on PET-CT scans of the first 10 patients. In contrast, MRI demonstrated a total of five bone edema lesions in three out of 10 patients. In the two additional AS patients scanned with [18F]Fluoride PET-CT, [18F]Fluoride depicted 17 regions with increased uptake in both vertebral column and sacroiliac joints. In contrast, [18F]FDG depicted only three lesions, with an uptake of five times lower compared to [18F]Fluoride, and again no [11C](R)PK11195 positive lesions were found. In these two patients, MRI detected nine lesions and six out of nine matched with the anatomical position of [18F]Fluoride uptake. Conventional radiographs showed structural bony changes in 11 out of 17 [18F]Fluoride PET positive lesions. Conclusions Our PET-CT data suggest that AS activity is reflected by bone activity (formation) rather than inflammation. The results also show the potential value of PET-CT for imaging AS activity using the bone tracer [18F]Fluoride. In contrast to active RA, inflammation tracers [18F]FDG and [11C](R)PK11195 appeared to be less useful for AS imaging. PMID:22471910

2012-01-01

124

Polymorphism of the LMP2 gene and disease phenotype in ankylosing spondylitis: No association with disease severity  

Microsoft Academic Search

Although a number of reports have now described an association between polymorphism of the LMP2 gene and disease phenotype in HLA-B27 positive individuals with ankylosing spondylitis (AS), some describe associations with acute anterior uveitis, others with juvenile onset disease, and one report provides no association. A recent study describes yet a further association with disease severity in patients with juvenile

W. P. Maksymowych; N. Adlam; D. Lind; A. S. Russell

1997-01-01

125

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

PubMed

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

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

2013-09-01

126

Whole Genome Expression Profiling and Signal Pathway Screening of MSCs in Ankylosing Spondylitis  

PubMed Central

The pathogenesis of dysfunctional immunoregulation of mesenchymal stem cells (MSCs) in ankylosing spondylitis (AS) is thought to be a complex process that involves multiple genetic alterations. In this study, MSCs derived from both healthy donors and AS patients were cultured in normal media or media mimicking an inflammatory environment. Whole genome expression profiling analysis of 33,351 genes was performed and differentially expressed genes related to AS were analyzed by GO term analysis and KEGG pathway analysis. Our results showed that in normal media 676 genes were differentially expressed in AS, 354 upregulated and 322 downregulated, while in an inflammatory environment 1767 genes were differentially expressed in AS, 1230 upregulated and 537 downregulated. GO analysis showed that these genes were mainly related to cellular processes, physiological processes, biological regulation, regulation of biological processes, and binding. In addition, by KEGG pathway analysis, 14 key genes from the MAPK signaling and 8 key genes from the TLR signaling pathway were identified as differentially regulated. The results of qRT-PCR verified the expression variation of the 9 genes mentioned above. Our study found that in an inflammatory environment ankylosing spondylitis pathogenesis may be related to activation of the MAPK and TLR signaling pathways.

Li, Yuxi; Wang, Peng; Xie, Zhongyu; Huang, Lin; Yang, Rui; Gao, Liangbin; Tang, Yong; Zhang, Xin; Ye, Jichao; Chen, Keng; Cai, Zhaopeng; Wu, Yanfeng; Shen, Huiyong

2014-01-01

127

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

PubMed Central

Like rheumatoid arthritis, ankylosing spondylitis (AS) is also an inflammatory disease associated with accelerated atherosclerosis and the presence of metabolic syndrome (MeS) features. AS patients often display osteoporosis as well as new bone formation. Insulin-like growth factor 1 (IGF-1) is a protein involved in both inflammation and bone metabolism. In the present study we assessed whether disease activity, systemic inflammation, MeS features, adipokines, and biomarkers of endothelial activation were associated with IGF-1 and insulin-like growth factor binding protein-3 (IGFBP-3) levels in a series of 30 nondiabetic AS patients without CV disease undergoing TNF-? antagonist-infliximab therapy. All determinations were made in the fasting state, immediately before an infliximab infusion. Although no association of IGF-1 and IGFBP-3 levels with angiopoietin-2 or osteopontin was found, an inverse correlation between IGF-1 levels and asymmetric dimethylarginine (ADMA), an endogenous endothelial nitric oxide synthase inhibitor that impairs nitric oxide production and secretion promoting endothelial dysfunction, was found (r = ?0.397; P = 0.04). However, no significant association was found between IGF-1 and IGFBP-3 levels and disease activity, systemic inflammation, metabolic syndrome features, or adipokines. In conclusion, in nondiabetic patients with AS undergoing periodic anti-TNF-? therapy, IGF-1 and ADMA are inversely correlated. PMID:25295265

López-Mejías, Raquel; Rueda-Gotor, Javier; Miranda-Filloy, José A.; Villar-Bonet, Aurelia; Carnero-López, Beatriz; Gómez-Acebo, Inés; Blanco, Ricardo; Pina, Trinitario; González-Juanatey, Carlos; González-Gay, Miguel A.

2014-01-01

128

Division of Arthritis & Rheumatic Diseases at Oregon Health & Science University  

E-print Network

Division of Arthritis & Rheumatic Diseases at Oregon Health & Science University Our areas of expertise include: · Osteoarthritis · Rheumatoid Arthritis · Ankylosing Spondylitis · Psoriatic Arthritis · Dermatomyositis · Polymyositis · Early Arthritis · HIV Associated Arthritis · Joint Injections Contact Us Division

Chapman, Michael S.

129

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

SciTech Connect

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

130

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

PubMed

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

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

2014-12-01

131

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

PubMed

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

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

2014-01-01

132

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

PubMed

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

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

2013-11-01

133

The relationship between enthesitis indices and disease activity parameters in patients with ankylosing spondylitis.  

PubMed

In this study, patients with ankylosing spondylitis (AS) were assessed both by patient and physician using two enthesitis indices and the relationship between these indices and disease activity parameters was investigated. The study involved 100 AS patients. The patients were evaluated with 10-cm visual analog scale (VAS) for spinal pain (VAS-S), peripheral joint pain (VAS-P), global assessment of patient, and global assessment of doctor. In the laboratory evaluations, the erythrocyte sedimentation rates (ESR) and serum C-reactive protein levels of the patients were determined. Bath AS disease activity index (BASDAI), Bath AS functional index (BASFI), Bath AS metrology index, and Bath AS radiology index were calculated. The severity of enthesitis was evaluated according to Mander enthesitis index (MEI) and Maastricht ankylosing spondylitis enthesitis score applied by both the patient (MASES-P) him/herself and the physician (MASES-D). There was a correlation between BASDAI and BASFI as well as MEI, MASES-D, and MASES-P indices (r = 0.447, r = 0.342, r = 0.663, r = 0.530, r = 0.464, and r = 0.435, respectively). No correlation between the laboratory parameters and enthesitis indices were detected. In multiple linear regression analysis, BASFI, VAS-S, and female gender (41.3%) were the best predictors of MEI-D, whereas BASFI, VAS-S, female gender, and ESR (32.5%) were the best predictors for MASES-D and BASFI (18.9%) was the best predictor of MASES-P. The assessment of simple and easily applicable MASES score by a patient may be expected to help the physician in clinical practice. When the disease activity of the patients with AS are evaluated, both BASDAI, the clinical importance of which has been confirmed in numerous studies and which is recommended by ASAS, and BASFI, which is valued by patients, should be considered. PMID:18953622

Sivas, Filiz; Mermerci Ba?kan, Bedriye; Erkol Inal, Esra; Akbulut Aktekin, Lale; Barça, Nurdan; Ozoran, Kür?at; Bodur, Hatice

2009-03-01

134

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

PubMed

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

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

2015-01-01

135

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

PubMed Central

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. PMID:23659344

2013-01-01

136

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

PubMed Central

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. PMID:23818109

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

2014-01-01

137

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

PubMed Central

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

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

2010-01-01

138

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

E-print Network

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

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

139

Radiographic progression in patients with ankylosing spondylitis after 2 years of treatment with the tumour necrosis factor ? antibody infliximab  

Microsoft Academic Search

Background: Anti-tumour necrosis factor (TNF) treatment is clinically efficacious in patients with active ankylosing spondylitis (AS) and leads to improvement of spinal inflammation, as assessed by magnetic resonance imaging. It is unclear whether anti-TNF treatment affects chronic spinal changes in AS.Objectives: To analyse the effect of infliximab on the radiographic course of AS over 2 years.Methods: Complete sets of lateral

X Baraliakos; J Listing; M Rudwaleit; J Brandt; J Sieper; J Braun

2005-01-01

140

Characteristics and treatment responses of patients satisfying the BSR guidelines for anti-TNF in ankylosing spondylitis  

Microsoft Academic Search

Objective. We present the results of the response to anti-tumour necrosis factor (anti-TNF) of 30 ankylosing spondylitis (AS) patients where we have complied with the BSR guidelines. Method. All patients had pre-assessments of Bath AS Disease Activity Index (BASDAIs) at two points a month apart prior to commencing anti-TNF. They then had 2 week and 2 month assessments followed by

K. Gadsby; C. Deighton

2007-01-01

141

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

Microsoft Academic Search

Occurrence of multiple sclerosis (MS) in patients with ankylosing spondylitis (AS) has been reported in isolated cases. We\\u000a describe a white 33-year-old male with a definite familial HLAB27 positive AS and MS-like syndrome. The patient developed\\u000a acute onset of gait difficulty, postural unsteadiness, dysarthria and right side weakness that resolved within 1 month; after\\u000a 6 months he presented right-sided face sensory loss,

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

2009-01-01

142

Application of Biostatistics and Bioinformatics Tools to Identify Putative Transcription Factor-Gene Regulatory Network of Ankylosing Spondylitis and Sarcoidosis  

Microsoft Academic Search

Transcription factors and corresponding cis-regulatory elements are considered key components in gene regulation. We combined biostatistics and bioinformatics tools to streamline identification of putative transcription factor-gene regulatory networks unique for two immune-mediated diseases, ankylosing spondylitis and sarcoidosis. After identifying differentially expressed genes from microarrays, we employed tightCluster to find tight clusters of potentially co-regulated genes. By subsequently applying bioinformatics tools

Dongseok Choi; Srilakshmi M. Sharma; Sirichai Pasadhika; Zhixin Kang; Christina A. Harrington; Justine R. Smith; Stephen R. Planck; James T. Rosenbaum

2009-01-01

143

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

Microsoft Academic Search

Objective. To compare magnetic resonance (MR) imaging, computed tomography (CT), and radiography in the detection of sacroiliitis accompanying\\u000a ankylosing spondylitis (AS). Design and subjects. Nine volunteers and 24 patients were recruited. Radiography, CT, and MR imaging were completed within a 1-week period in\\u000a 24 patients with AS. In precontrast MR examination, spin-echo T1, fast spin-echo T2, and gradient echo with

W. Yu; F. Feng; Elizabeth Dion; Hongzen Yang; Ming Jiang; H. K. Genant

1998-01-01

144

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

Microsoft Academic Search

The objective of this study is to evaluate the role of MMP-3 and MRI in assessing disease activity in sacroiliac joints of\\u000a AS patients in comparison to the conventional measures Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), erythrocyte\\u000a sedimentation rate (ESR) and C-reactive protein (CRP). Serum MMP-3 was measured in 30 patients who fulfilled the modified\\u000a New York criteria for

Eiman Soliman; W. Labib; G. El-tantawi; A. Hamimy; A. Alhadidy; A. Aldawoudy

145

Analysis of the CD8+ T cell response to the G1 domain of aggrecan in ankylosing spondylitis  

PubMed Central

Background: CD4+ T cell responses to the G1 domain of aggrecan in patients with ankylosing spondylitis (AS) were recently reported. Whether such an immune response can be seen in the CD8+ subpopulation has not yet been determined. Objective: To determine if HLA-B27 restricted G1-specific CD8+ T cells are present in AS and to analyse immunodominant CD8+ T cell epitopes. Methods: Peripheral blood mononuclear cells of 45 patients with AS were stimulated with overlapping 18-mer peptides covering the whole G1 protein. Results were compared with those for patients with rheumatoid arthritis (RA) and healthy controls. For epitope analysis, G1-specific interferon gamma positive (IFN?+) T cells were isolated by magnetic activated cell sorting. After in vitro expansion, CD8+ T cells were restimulated with 14 subpools of G1 peptides. T cells responding to G1 peptide subpools were quantified by flow cytometry according to IFN? secretion. Predicted peptides were subsequently confirmed by stimulation with single peptides. Results: G1-specific CD8+ T cell responses were found in 29/45 (64%) patients with AS, 18/35 (51%) patients with RA, but not in healthy controls. Five CD8+ T cell epitopes were identified as immunodominant in five patients. However, the T cell response was not HLA-B27 restricted. Nonamer peptides with an HLA-B27 binding motif did not induce a T cell response. Conclusion: A G1 peptide-specific CD8+ T cell response is present in AS but also in patients with RA. It does not seem to be HLA-B27 restricted. Whether such a response has a role in the pathogenesis of AS needs clarification. PMID:15539415

Zou, J; Appel, H; Rudwaleit, M; Thiel, A; Sieper, J

2005-01-01

146

Ankylosing Spondylitis  

MedlinePLUS

... one or more of the following: Nonsteroidal Anti-Inflammatory Drugs (NSAIDs) These drugs relieve pain and inflammation, ... that the likelihood of having severe joint damage increased with age at disease onset, and that men ...

147

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

PubMed

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

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

2014-09-01

148

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

PubMed Central

The aim of this study is to explore the effects of icariin on cytokine induced ankylosing spondylitis fibroblast osteogenesis type expression and its molecular mechanism. The normal fibroblasts were collected as normal control group, and the fibroblasts of hip joint capsule of AS patients were collected, which were respectively added in fetal bovine serum (group AS), fetal bovine serum and cytokines (BMP-2+TGF-beta 1) (group AS), and cell factor solution (icariin group), and observed of the osteogenic expression of fibroblast, to evaluate the impact of Icariin on it. The ALP activity, the content of collagen, osteocalcin content and cbfa1mRNA and OCmRNA of fibroblast of AS group increased compared to the normal control group and AS control group (P < 0.01), indicating that icariin can significantly inhibit the above changes (P < 0.01). Icariin can inhibit fibroblast further osteogenic differentiation through inhibiting the effect of cytokines on the fibroblast osteogenesis type markers and osteogenic gene expression and osteogenic differentiation.

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

2014-01-01

149

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

PubMed

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

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

2014-08-01

150

Functionally distinct ERAP1 allotype combinations distinguish individuals with Ankylosing Spondylitis.  

PubMed

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

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

2014-12-01

151

The Risk of Asthma in Patients with Ankylosing Spondylitis: A Population-Based Cohort Study  

PubMed Central

Background The relationship between asthma and ankylosing spondylitis (AS) is controversial. We examined the risk of asthma among AS patients in a nationwide population. Methods We conducted a retrospective cohort study using data from the National Health Insurance (NHI) system of Taiwan. The cohort included 5,974 patients newly diagnosed with AS from 2000 to 2010. The date of diagnosis was defined as the index date. A 4-fold of general population without AS was randomly selected frequency matched by age, gender and the index year. The occurrence and hazard ratio (HR) of asthma were estimated by the end of 2011. Results The overall incidence of asthma was 1.74 folds greater in the AS cohort than in the non-AS cohort (8.26 versus 4.74 per 1000 person-years) with a multivariable Cox method measured adjusted HR of 1.54 (95% confidence interval (CI), 1.34–1.76). The adjusted HR of asthma associated with AS was higher in women (1.59; 95% CI, 1.33–1.90), those aged 50–64 years (1.66; 95% CI, 1.31–2.09), or those without comorbidities (1.82; 95% CI, 1.54–2.13). Conclusion Patients with AS are at a higher risk of developing asthma than the general population, regardless of gender and age. The pathophysiology needs further investigation. PMID:25658339

Shen, Te-Chun; Lin, Cheng-Li; Wei, Chang-Ching; Chen, Chia-Hung; Tu, Chih-Yen; Hsia, Te-Chun; Shih, Chuen-Ming; Hsu, Wu-Huei; Sung, Fung-Chang

2015-01-01

152

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

PubMed

The aim of this study is to explore the effects of icariin on cytokine induced ankylosing spondylitis fibroblast osteogenesis type expression and its molecular mechanism. The normal fibroblasts were collected as normal control group, and the fibroblasts of hip joint capsule of AS patients were collected, which were respectively added in fetal bovine serum (group AS), fetal bovine serum and cytokines (BMP-2+TGF-beta 1) (group AS), and cell factor solution (icariin group), and observed of the osteogenic expression of fibroblast, to evaluate the impact of Icariin on it. The ALP activity, the content of collagen, osteocalcin content and cbfa1mRNA and OCmRNA of fibroblast of AS group increased compared to the normal control group and AS control group (P < 0.01), indicating that icariin can significantly inhibit the above changes (P < 0.01). Icariin can inhibit fibroblast further osteogenic differentiation through inhibiting the effect of cytokines on the fibroblast osteogenesis type markers and osteogenic gene expression and osteogenic differentiation. PMID:25674296

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

2014-01-01

153

Functionally distinct ERAP1 allotype combinations distinguish individuals with Ankylosing Spondylitis  

PubMed Central

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

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

2014-01-01

154

Isolation of IgG Antibodies to Toxocara in Ankylosing Spondylitis Patients with Acute Anterior Uveitis  

PubMed Central

Purpose Since few reports had been published on the prevalence of toxocariasis in ankylosing spondylitis (AS) patients with acute non-granulomatous anterior uveitis (ANGAU), the aim of this work was to determine the presence of antibodies against Toxocara canis in AS patients with ANGAU. Methods Thirty-six patients (14 female and 22 male) with AS were enrolled in the study. The history of ANGAU was accepted only if diagnosed by an ophthalmologist. The detection of IgG antibodies to T. canis was determined by enzyme-linked immunosorbent assay. In addition, antibodies to Ascaris lumbricoides were also tested to verify non-specific reactions. Results The prevalence of ANGAU in the AS patients was 58% (21 / 36), and 38% (8 / 21) of the patients with ANGAU were positive for antibodies to Toxocara, while 7% (1 / 15) of AS patients without ANGAU were positive for T. canis (p = 0.038, two tails; mid-p exact). No antibodies were detected to A. lumbricoides antigens in the serum samples of patients with AS. Conclusions These data suggest that the seroprevalence of antibodies to T. canis is high in Mexican patients with AS-associated uveitis, suggesting a chronic asymptomatic toxocariosis, which could be associated with the pathogenesis of ANGAU; however, further larger-scale studies are needed to confirm this observation. PMID:24882953

Jiménez-Balderas, Francisco-Javier; García-Jaimes, Janete; Ríos, Rita; Zonana-Nacach, Abraham; Tapia-Romero, Raquel; Villanueva, Nayeli; Méndez-Samperio, Patricia

2014-01-01

155

A registry of ankylosing spondylitis registries and prospects for global interfacing  

PubMed Central

Purpose of review To review the optimal criteria and conditions for establishing a clinical registry, as well as detailing their application in a number of ankylosing spondylitis (AS) and axial spondyloarthritis (axSpA) Registries already in existence. Recent findings Recent genetic studies and studies of long-term treatment efficacy and side-effects have underscored the need for large numbers of patients, much larger than would be possible from a single center or consortium. An optimal Registry should have its aims established upfront, with appropriate governance and oversight, and inclusion and exclusion criteria for participating collaborators and subject defined. Collaborators contributing subjects to a Registry should use validated instruments for which they have been previously trained. The numerous cross-sectional and longitudinal Registries on AS and axSpA have been recently established that differ widely depending on the referral and selection issues. Summary The challenge of large-scale examinations of genetics, comorbidities, medication usage, and side-effects in spondyloarthritis underscores the need for combining data from well characterized registries of AS patients which require careful planning. There are currently many such registries available internationally, offering promise for collaborations and data pooling that can answer some of the pressing questions facing rheumatology clinicians and researchers. PMID:23656716

Reveille, John D.

2013-01-01

156

Application of Biostatistics and Bioinformatics Tools to Identify Putative Transcription Factor-Gene Regulatory Network of Ankylosing Spondylitis and Sarcoidosis  

PubMed Central

Transcription factors and corresponding cis-regulatory elements are considered key components in gene regulation. We combined biostatistics and bioinformatics tools to streamline identification of putative transcription factor-gene regulatory networks unique for two immune-mediated diseases, ankylosing spondylitis and sarcoidosis. After identifying differentially expressed genes from microarrays, we employed tightCluster to find tight clusters of potentially co-regulated genes. By subsequently applying bioinformatics tools to search for common cis-regulatory elements, putative transcription factor-gene regulatory networks were found. Recognition of these networks by applying this methodology could pave the way for new insights into disease pathogenesis. PMID:20037664

Choi, Dongseok; Sharma, Srilakshmi M; Pasadhika, Sirichai; Kang, Zhixin; Harrington, Christina A.; Smith, Justine R.; Planck, Stephen R.; Rosenbaum, James T.

2009-01-01

157

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  

PubMed Central

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. PMID:24013647

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

2014-01-01

158

Ankylosing spondylitis or diffuse idiopathic skeletal hyperostosis (DISH) in Royal Egyptian mummies of 18(th) -20(th) Dynasties? CT and archaeology studies.  

PubMed

Objective: We aimed to study the computed tomography (CT) scans of the royal Ancient Egyptian mummies dated to the eighteenth to early twentieth Dynasties for the claimed diagnoses of Ankylosing spondylitis and diffuse idiopathic skeletal hyperostosis (DISH) and to correlate the findings with the archaeology literature. Methods: We studied the CT images of thirteen royal Ancient Egyptian mummies (1492-1153 BC) for ankylosing spondylitis and DISH diseases. We correlated the findings with the archaeology literature. Results: CT findings excluded the diagnosis of ankylosing spondylitis based on absence of sacroiliac joints erosions, or fusion of the facet joints. Four mummies fulfilled the diagnostic criteria of DISH: Amenhotep III (18th Dynasty), Ramesses II, his son Merenptah, and Ramesses III (19th to early 20th Dynasties). Diagnosis of DISH, a commonly asymptomatic disease of the old age, in the four Pharaohs concord the longevity and active life styles that they have lived. Conclusion: CT findings excluded the diagnosis of ankylosing spondylitis in the studied royal Ancient Egyptian mummies and questioned the antiquity of the disease. CT features of DISH in this ancient period were similar to those commonly seen in modern populations and likely they will be in the future. Affection of Ramesses II and his son Merenptah supports familial clustering of DISH. The process of mummification may induce changes in the spine that should be considered during investigations of mummy diseases. © 2014 American College of Rheumatology. PMID:25329920

Saleem, Sahar N; Hawass, Zahi

2014-10-20

159

Decreased serum biochemical markers of muscle origin in patients with ankylosing spondylitis  

PubMed Central

OBJECTIVES—There is a lack of unanimity about (increased) serum levels of creatine kinase (CK) in patients with ankylosing spondylitis (AS), perhaps because of the inclusion of inappropriate controls. Therefore, serum levels of biochemical markers of muscle origin were assessed in AS patients compared with controls.?METHODS—In a comparative study serum levels of sarcoplasmic proteins indicating muscle cell leakage, creatinine, and C reactive protein (CRP) were measured. Fifty eight AS patients with a mean disease duration of 22 (SD 11) years and 58 age and sex matched controls (without back complaints) were included.?RESULTS—Lower serum levels in AS patients compared with controls were found for CK (mean (SD): 46 (21) v 76 (44) IU/l; p<0.001), aldolase (0.43 (0.36) v 0.58 (0.32) IU/l; p=0.001), creatinine (91 (13) v 96 (11) µmol/l; p=0.02), alanine aminotransferase (2.8 (1.5) v 4.1 (2.9) IU/l; p=0.001) and aspartate aminotransferase (7.0 (2.7) v 8.4 (3.5) IU/l; p=0.02). Also the lean body mass, as estimated by a formula using height, weight, age and sex, showed lower values in patients versus controls (56 (9) v 59 (9) kg; p=0.004), but creatinine clearance (by Cockcroft and Gault formula) was not different (p=0.48). Partial correlation coefficients adjusted for age and sex showed that CRP levels correlated negatively with CK and aldolase levels in AS patients (r= ?0.48, p<0.001 and r= ?0.37, p=0.005, respectively).?CONCLUSION—Serum levels of biochemical markers of muscle origin were lower in AS patients compared with controls. Patients with active AS, as reflected by high CRP levels, may have an increased protein degradation, predominantly in skeletal muscle.?? PMID:10460186

Giltay, E.; van Schaardenburg, D.; Gooren, L.; Kostense, P.; Dijkmans, B.

1999-01-01

160

Vertebral body corner oedema vs gadolinium enhancement as biomarkers of active spinal inflammation in ankylosing spondylitis  

PubMed Central

Objective To investigate the relative performance of T2 weighted short tau inversion–recovery (STIR) and fat-suppressed T1 weighted gadolinium contrast-enhanced sequences in depicting active inflammatory lesions in ankylosing spondylitis (AS). Methods Whole-spine MRI was performed on 32 patients with AS, who participated in a clinical trial of infliximab treatment, by STIR and contrast-enhanced sequences at baseline and after 30 weeks. The AS spine MRI-activity (ASspiMRI-a) scoring method was used. The images from these two imaging techniques were evaluated separately by two independent readers. Results For the pre-treatment lesion status, the intraclass correlation coefficients comparing STIR readings and contrast-enhanced readings were 0.69±0.23 for Reader 1 and 0.65±0.21 for Reader 2. At baseline, the mean ASspiMRI-a score was 15.4% and 17.7% higher for contrast-enhanced images than for STIR images for Reader 1 and Reader 2, respectively. After infliximab treatment, Reader 1 rated an ASspiMRI-a score reduction of 50.8±33.6% and 25.3±35.3% for STIR images and contrast-enhanced images, respectively, whereas Reader 2 rated an ASspiMRI-a score reduction of 42.4±50.4% and 32.9±35.6% for STIR images and contrast-enhanced images, respectively. Conclusion While both contrast-enhanced and STIR sequences showed sensitivity to change over a short period of time after infliximab treatment, these two sequences may reflect different disease mechanisms. PMID:22595499

Wang, Y-X J; Griffith, J F; Deng, M; Li, T K; Tam, L-S; Lee, V W Y; Lee, K K C; Li, E K

2012-01-01

161

Red blood cell distribution width: a potential maker estimating disease activity of ankylosing spondylitis  

PubMed Central

Ankylosing spondylitis (AS) is a autoimmune disease, early and accurate detection is vital for effective treatment. Very recently, a large of novel laboratory index were found to diagnose AS. However, the correlation between red blood cell distribution width (RDW) and AS has been poorly discussed in previous study. Then, our aim was to focus on the association between RDW and AS. AS patients without drugs treatments and healthy individuals were incorporated in our study. Laboratory parameters including RDW tests were conducted consecutively on the entire cohort of AS patients and healthy individuals. AS patients with increased RDW showed significant difference compared to healthy individuals (13.66±0.77 vs. 12.77±0.47, P<0.01), similarly, difference of AS patients and heathy individuals stratified by sex was almost the same as that in two groups. Some significantly positive correlation were observed between RDW and CRP, ESR, IgG, BASDAI score in patients with AS (r=0.356, P=0.018; r=0.481, P=0.001; r=0.385, P=0.010; r=0.586, P<0.01), almost identical results were showed when AS patients was stratified by gender. Finally, receiver operating characteristic (ROC) curves of RDW levels to identify AS patients exhibited a statistically significant level (area under the curve of 0.853; sensitivity of 72.7%, specificity of 81.4%). The results suggested that increased RDW was associated with AS and may be used as a potential marker estimating disease activity of AS. PMID:25664033

Peng, You-Fan; Zhang, Qiong; Cao, Ling; Liu, Yang; Chen, Dan; Sun, Yu-Kun; Zhang, Zhao-Xia

2014-01-01

162

Early Union of Grafted Bone in Ankylosing Spondylitis: Comparative Study with Degenerative Spinal Disease  

PubMed Central

Background Patients with ankylosing spondylitis (AS) achieve early bone union compared to those with other spinal diseases. This study compared the time to bone union after surgery between AS patients and degenerative spinal disease patients. Methods Patients with degenerative spinal diseases (control group) and AS (experimental group) underwent pedicle subtraction osteotomy followed by posterolateral fusion, and decompression and posterolateral fusion, respectively. There were 10 patients in the experimental group. The control group included 26 patients who were less than 50 years of age and underwent two-level autogenous grafting after decompression and spinal fusion. Autogenous grafts and a range of bone substitutes were used in the experimental group, whereas only autogenous grafts were used in the control group. Bone union was determined on the radiographs and 3-dimensional CT scan images. The level of union was assessed using the Lenke's and Christensen's classification systems. Results In the experimental group, the mean age was 41.3 years (range, 30 to 67 years), the mean follow-up period was 21.7 months (range, 12 to 43 months), and bone union was confirmed at an average of 3.5 months (range, 3 to 5 months) after surgery. In the control group, the mean age was 43.1 years (range, 35 to 50 years), the mean follow-up period was 21.8 months (range, 12 to 74 months), and bone union was observed at an average of 5.6 months (range, 4 to 12 months) after surgery. The difference in the time to bone union between the two groups was significant (p = 0.023). Conclusions The union of grafted bone was obtained earlier in patients with AS than in those with degenerative spinal diseases. Therefore, future studies should examine the factors affecting the early union in AS patients. PMID:21119936

Lee, Chang-Hun; Kim, Jae-Hun; Kim, Tae-Hwan

2010-01-01

163

Incidence and predictors of morphometric vertebral fractures in patients with ankylosing spondylitis  

PubMed Central

Introduction Ankylosing spondylitis (AS) is associated with an increased incidence of vertebral fractures (VFs); however the actual incidence and predictors of morphometric VFs are unknown. The present study examined the incidence and predictors of new VFs in a large AS cohort. Methods In total, 298 AS patients who fulfilled the modified New York criteria were enrolled and spinal radiographs were evaluated biennially. Clinical and laboratory data and radiographic progression were assessed according to the Bath AS Disease Activity Index, erythrocyte sedimentation rate, C-reactive protein (CRP), and the Stoke AS spine score (SASSS). VF was defined according to the Genant criteria. The incidence of VFs at 2 and 4 years was evaluated using the Kaplan-Meier method. The age-specific standardized prevalence ratio (SPR) for AS patients in comparison with the general population was calculated. Results Of 298 patients, 31 (10.8%) had previous VFs at baseline. A total of 30 new VFs occurred in 26 patients over 4 years. The incidence of morphometric VFs was 4.7% at 2 years and 13.6% at 4 years. Multivariate logistic regression analysis showed that previous VFs at baseline and increased CRP levels at 2 years were predictors of new VFs (odds ratio (OR) =12.8, 95% confidence interval (CI)?=?3.6-45.3 and OR?=?5.4, 95% CI?=?1.4–15.9). The age-specific specific standardized prevalence ratio of morphometric VFs in AS was 3.3 (95% CI 2.1–4.5). Conclusions The incidence of morphometric VFs increased in AS. Previous VFs and increased CRP levels predicted future VFs. Further studies are needed to identify the effects of treatment interventions on the prevention of new VFs. PMID:24935156

2014-01-01

164

Tim-3 polymorphism downregulates gene expression and is involved in the susceptibility to ankylosing spondylitis.  

PubMed

Ankylosing spondylitis (AS) is a chronic inflammatory disorder primarily affecting the sacroiliac joints and the spine. T-cell immunoglobulin- and mucin-domain-containing molecule 3 (TIM-3) has been established as a negative regulatory molecule that plays a critical role in controlling inflammation. Studies have shown that polymorphisms in TIM-3 gene may be associated with inflammatory diseases. The current study investigated the association between polymorphisms in the TIM-3 gene and susceptibility to AS, and it examined the effects of these polymorphisms on gene expression. Two polymorphisms in TIM-3 -574G/T and +4259T/G polymorphisms were identified by polymerase chain reaction-restriction fragment length polymorphism in 282 AS patients and 298 healthy controls. Results showed that frequency of the TIM-3 -574GT genotype was significantly increased in cases than in controls (Odd ratio [OR]=2.50, 95% confidence interval [CI]: 1.39-4.48, p=0.002). Similarly, TIM-3 -574T allele revealed a positive association with the disease (OR=2.39, p=0.002). The TIM-3 +4259T/G polymorphism did not show any correlation with AS. We further evaluated TIM-3 mRNA and protein levels in CD4(+) T cells, CD8(+) T cells, and monocytes from subjects carrying different TIM-3 genotypes. Results revealed that subjects carrying polymorphic -574GT genotype had significantly lower TIM-3 mRNA and protein levels in CD4(+) T cells, CD8(+) T cells, and monocytes than those with wild-type GG genotype. These data suggest that TIM-3 polymorphism is associated with increased susceptibility to AS possibly by downregulating gene expression. PMID:24905803

Wang, Mingfei; Ji, Bin; Wang, Jian; Cheng, Xiangyu; Zhou, Qiang; Zhou, Junjie; Cao, Chengfu; Guo, Qunfeng

2014-10-01

165

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

PubMed

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

Cock, I E; van Vuuren, S F

2015-02-01

166

Low sclerostin levels: a predictive marker of persistent inflammation in ankylosing spondylitis during anti-tumor necrosis factor therapy?  

PubMed Central

Introduction Sclerostin levels have been reported to be low in ankylosing spondylitis (AS), but there is no data regarding the possible role of this Wnt inhibitor during anti-tumor necrosis factor (TNF) therapy. The present study longitudinally evaluated sclerostin levels, inflammatory markers and bone mineral density (BMD) in AS patients under anti-TNF therapy. Methods Thirty active AS patients were assessed at baseline, 6 and 12 months after anti-TNF therapy regarding clinical parameters, inflammatory markers, BMD and baseline radiographic damage (mSASSS). Thirty age- and sex-matched healthy individuals comprised the control group. Patients' sclerostin levels, sclerostin binding low-density lipoprotein receptor-related protein 6 (LRP6) and BMD were evaluated at the same time points and compared to controls. Results At baseline, AS patients had lower sclerostin levels (60.5 ± 32.7 vs. 96.7 ± 52.9 pmol/L, P = 0.002) and comparable sclerostin binding to LRP6 (P = 0.387) than controls. Improvement of Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), Bath Ankylosing Spondylitis Functional Index (BASFI), Bath Ankylosing Spondylitis Metrology Index (BASMI), Ankylosing Spondylitis quality of life (ASQoL) was observed at baseline vs. 6 vs. 12 months (P < 0.01). Concomitantly, a gradual increase in spine BMD (P < 0.001) and a positive correlation between baseline mSASSS and spine BMD was found (r = 0.468, P < 0.01). Inflammatory parameters reduction was observed comparing baseline vs. 6 vs. 12 months (P <0.01). Sclerostin levels progressively increased [baseline (60.5 ± 32.7) vs. 6 months (67.1 ± 31.9) vs. 12 months (72.7 ± 32.3) pmol/L, P <0.001]. At 12 months, the sclerostin levels remained significantly lower in patients compared to controls (72.7 ± 32.3 vs. 96.70 ± 52.85 pmol/L, P = 0.038). Moreover, sclerostin serum levels at 12 months were lower in the 10 patients with high C reactive protein (CRP) (? 5 mg/l) compared to the other 20 patients with normal CRP (P = 0.004). Of note, these 10 patients with persistent inflammation also had lower sclerostin serum levels at baseline compared to the other patients (P = 0.023). Univariate logistic regression analysis demonstrated that AS patients with lower sclerostin serum levels had an increased risk to have high CRP at 12 months (odds ratio = 7.43, 95% CI 1.23 to 45.01, P = 0.020) than those with higher sclerostin values. Conclusions Persistent low sclerostin levels may underlie continuous inflammation in AS patients under anti-TNF therapy. PMID:23062122

2012-01-01

167

Raised incidence of ankylosing spondylitis among Inuit populations could be due to high HLA-B27 association and starch consumption.  

PubMed

Ankylosing spondylitis (AS) is a chronic inflammatory arthritis mainly affecting the spinal joints. It would appear that the most likely causative agent in the development of AS is an environmental factor in the genetically susceptible, HLA-B27 positive, individuals. Extensive data from several countries support the notion that Klebsiella pneumonia bacteria are the most likely culprit in the causation of AS. These microbes possess antigens which resemble HLA-B27 and spinal collagens. Increased intake of high-starch diet is directly proportional to the gut-associated bacterial load, especially in the large intestine, and among these microbial agents, Klebsiella is considered as one of the main constituting components. Therefore, a low-starch diet intake alongside the currently used medical therapeutic modalities could be beneficial in the management of patients with early AS. It is suggested that a change in the dietary habits from high protein, low-starch marine components to the Westernized high-starch diet among the Inuit peoples of Alaska and Canada could be considered as one of the main contributing factors in the increased prevalence of AS during the last few decades within this genetically unmixed native population. PMID:25385438

Rashid, Taha; Wilson, Clyde; Ebringer, Alan

2014-11-11

168

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

PubMed

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

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

2012-01-01

169

Ratio of neutrophil/lymphocyte and platelet/lymphocyte in patient with ankylosing spondylitis that are treating with anti-TNF  

PubMed Central

Ankylosing spondylitis (AS) is a type of chronic inflammatory arthritis resulting in ankylosis of the spine and inflammation in the tendons. After NSAIDs, the use of anti-TNF medications has provided a significant contribution to the treatment of patients with AS. The present study was a retrospective, controlled and multicenter study. A total of 105 patients followed in the outpatient clinics of the Department of Physical Therapy in Abant Izzet Baysal University and Harran University and 50 healthy controls were included in the study. The patients had been receiving anti-TNF therapy at least for 6 months. Hemogram results of the patient and control groups examined retrospectively. There was no significant difference between the groups in terms of N/L ratio; however, the P/L ratio was significantly different between the two groups. The present study found a significantly different P/L ratio in patients with AS when compared to the control group. However, the N/L ratio was not significantly different between the groups. The P/L ratio can be used as a marker to monitor disease progression and indicate subclinical inflammation in patients with AS. PMID:25356158

Boyraz, ?smail; Koç, Bünyamin; Boyac?, Ahmet; Tuto?lu, Ahmet; Sarman, Hakan; Özkan, Hilal

2014-01-01

170

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

PubMed

The evidence-based recommendations on the management of ankylosing spondylitis (AS) have enjoyed a high level of acceptance and circulation in Germany, as well as in other European countries. To make patient participation in the decision-making process regarding their disease easier, as well as to strengthen the physician-patient relationship, the ASAS and EULAR have set up an initiative to formulate a patient-friendly version of the recommendations, initially in English. In order that this lay version can also be used in German-speaking countries, a group predominantly comprising patients was formed to ensure that the German translation of this version has the broadest possible basis. In cooperation with the German (DVMB), Austrian (OVMB) and Swiss Morbus Bechterew Associations (SVMB), as well as the German Rheumatology League, patients from Germany, Austria and Switzerland with appropriate English skills were invited to a meeting in 2008. The aim of the translation was to leave the content unchanged while finding a level of speech easily understandable to the lay person. The translated text was considered as accepted when a minimum of 12 patients (>80%) gave their approval on the wording of the translation of individual recommendations in an open vote. The rheumatologist given the function of moderator was not entitled to vote. The level of approval for each recommendation was determined (0: no approval to 10: full approval). The 14 patients were able to translate the English patient version into German. Choice of words and style of speech were discussed intensively. Acceptance of the translation of the 10 recommendations was generally high. The content was clearly accepted with an approval rate of 8.4+/-1.6. This was the first time that patients, in cooperation with rheumatologists, have translated an international patient version on AS management into German under controlled conditions. The translation text was approved by the majority in terms of both form and content. Acceptance and circulation of the German patient version should be evaluated in the near future. PMID:19214540

Kiltz, U; Feldtkeller, E; Braun, J

2010-03-01

171

Etanercept in the treatment of ankylosing spondylitis: A systematic review and meta-analysis  

PubMed Central

Etanercept (ETN) has been widely applied in the treatment of ankylosing spondylitis (AS). As the use of ETN has increased, associated adverse effects have been reported frequently. Previous meta-analyses have focused on comparing the differences in clinical outcomes between ETN and placebo (PBO). The present meta-analysis evaluated randomised controlled trials (RCTs) to compare the effects of ETN and a PBO or sulfasalazine (SSZ) in patients with AS. The study population characteristics and the main results, including the Assessment in AS 20% response (ASAS 20), the Bath AS Disease Activity Index (BASDAI) and the Bath AS Functional Index (BASFI), were extracted. The pooled odds ratios (ORs) or weighted mean differences (MDs) were calculated using a fixed or random effects model. Fifteen randomised controlled trials (RCTs) involving 2,194 subjects were included. Compared with a PBO, ETN significantly improved the ASAS 20 [P<0.00001; OR, 8.25; 95% confidence interval (CI), 5.92–11.50], BASDAI (P<0.00001; MD, ?18.81; 95% CI, ?24.47 to ?13.15) and BASFI (P<0.00001; standard MD, ?0.68; 95% CI, ?0.85 to ?0.50). In comparison with SSZ, ETN significantly decreased the BASDAI (P<0.00001; MD, ?2.40; 95% CI, ?2.89 to ?1.90) and C-reactive protein (CRP) levels (P<0.0001; MD, ?8.01; 95% CI, ?11.73 to ?4.29). The most common adverse effect of ETN was an injection site reaction. This meta-analysis shows that ETN monotherapy is effective in improving physical function and reducing disease activity in patients with AS. Compared with SSZ, ETN markedly decreased the BASDAI and CRP levels. However, the efficacy of ETN in treating AS requires further evaluation by more RCTs in a larger population of patients prior to recommending ETN as a substitute for synthetic disease-modifying antirheumatic drug (DMARD) monotherapy, or combinations of synthetic DMARDs. PMID:25289064

LIU, YA-FEI; DONG, HUI; TU, SHENG-HAO; ZHENG, CUI-HONG; LIU, PEI-LIN; HU, YONG-HONG

2014-01-01

172

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

PubMed

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

Jelci?, A; Jaji?, I; Fürst, Z

1992-01-01

173

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

PubMed Central

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. PMID:24009460

Ba?cac?, Sinan; Sall?, Ali; Kucuksen, Sami; U?urlu, Hatice

2013-01-01

174

The epidemiology of ankylosing spondylitis and the commencement of anti?TNF therapy in daily rheumatology practice  

PubMed Central

Objectives This study aimed to describe the epidemiology of ankylosing spondylitis (AS) in rheumatology practice at the beginning of the anti?TNF (tumour necrosis factor) era, and to evaluate the initiation of anti?TNF therapy in a clinical setting where prescription is regulated by the authority's imposed reimbursement criteria. Methods Between February 2004 and February 2005, all Belgian rheumatologists in academic and non?academic outpatient settings were invited to register all AS patients who visited their practice. A random sample of these patients was further examined by an in?depth clinical profile. In a follow?up investigation, we recorded whether patients initiated anti?TNF therapy and compared this to their eligibility at baseline evaluation. Results 89 rheumatologists participated and registered 2141 patients; 1023 patients were clinically evaluated. These 847 fulfilled the New York modified criteria for definite AS and 176 for probable AS. The profile of AS in rheumatology practice is characterised by longstanding and active disease with a high frequency of extra?articular manifestations and metrological and functional impairment. At a median of 2?months after the clinical evaluation, anti?TNF therapy was initiated in 263 of 603 (44%) evaluable patients with definite AS and in 22 of 138 (16%) evaluable patients with probable AS (total 38%). More than 85% of the patients who started anti?TNF therapy had an increased Bath Ankylosing Spondylitis Disease Activity Index despite previous NSAID (non?steroidal anti?inflammatory drug) use. Conclusions Of a representative cohort of 1023 Belgian AS patients seen in daily rheumatology practice, about 40% commenced anti?TNF therapy. Decision factors to start anti?TNF therapy may include disease activity and severity. PMID:17261531

Cruyssen, Bert Vander; Ribbens, Clio; Boonen, Annelies; Mielants, Herman; de Vlam, Kurt; Lenaerts, Jan; Steinfeld, Serge; Van den Bosch, Filip; Dewulf, Lode; Vastesaeger, Nathan

2007-01-01

175

Association of acute anterior uveitis with disease activity, functional ability and physical mobility in patients with ankylosing spondylitis: a cross-sectional study of Chinese patients in Taiwan  

Microsoft Academic Search

Acute anterior uveitis (AAU) is the most frequently extra-articular manifestation of ankylosing spondylitis (AS). To investigate\\u000a whether AAU has an association with disease activity, functional ability and physical mobility in AS patients, 146 Chinese\\u000a AS patients in Taiwan were enrolled in a cross-sectional study. These patients fulfilled the 1984 modified New York criteria\\u000a and visited the Outpatient Department of the

Chun-Hsiung Chen; Kuan-Chia Lin; Horng-An Chen; Hsien-Tzung Liao; Toong-Hua Liang; Hon-Pin Wang; Chung-Tei Chou

2007-01-01

176

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

Microsoft Academic Search

The home-based exercise therapy recommended to the patients with ankylosing spondylitis (AS) is a simply applicable and cheap\\u000a method. The aim of this study was to investigate the effects of home-based exercise therapy on pain, mobility, function, disease\\u000a activity, quality of life, and respiratory functions in patients with AS. Eighty patients diagnosed with AS according to the\\u000a modified New York

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

177

Effects of home-based daily exercise therapy on joint mobility, daily activity, pain, and depression in patients with ankylosing spondylitis  

Microsoft Academic Search

We investigated the effects of home-based daily exercise on joint mobility, functional capacity, pain, and depression in patients with ankylosing spondylitis (AS). The patients were randomly assigned to a wait-list control group or to an exercise-therapy group. The exercise-therapy group performed a 20-min exercise program once per day for 8 consecutive weeks. After 8 weeks, compared with the control group,

Hyun-Ja Lim; Young-Im Moon; Myeong Soo Lee

2005-01-01

178

Bone microarchitecture in ankylosing spondylitis and the association with bone mineral density, fractures, and syndesmophytes  

PubMed Central

Introduction Osteoporosis of the axial skeleton is a known complication of ankylosing spondylitis (AS), but bone loss affecting the peripheral skeleton is less studied. This study on volumetric bone mineral density (vBMD) and bone microarchitecture in AS was conducted to compare peripheral vBMD in AS patients with that in healthy controls, to study vBMD in axial compared with peripheral bone, and to explore the relation between vertebral fractures, spinal osteoproliferation, and peripheral bone microarchitecture and density. Methods High-resolution peripheral quantitative computed tomography (HRpQCT) of ultradistal radius and tibia and QCT and dual-energy x-ray absorptiometry (DXA) of lumbar spine were performed in 69 male AS patients (NY criteria). Spinal radiographs were assessed for vertebral fractures and syndesmophyte formation (mSASSS). The HRpQCT measurements were compared with the measurements of healthy controls. Results The AS patients had lower cortical vBMD in radius (P?=?0.004) and lower trabecular vBMD in tibia (P?=?0.033), than did the controls. Strong correlations were found between trabecular vBMD in lumbar spine, radius (rS?=?0.762; P?

2013-01-01

179

Heat shock proteins and reactive arthritis  

Microsoft Academic Search

\\u000a Reactive arthritis (ReA) is unusual amongst inflammatory joint diseases because the cause of arthritis has been identified,\\u000a namely preceding infection with certain bacteria, whereas the aetiology of rheumatoid arthritis or ankylosing spondylitis,\\u000a or at least the triggering event, remains unknown. Most subjects infected by Chlamydia,Salmonella, Campylobacter,Yersinia or Shigella develop symptoms due to the effects of the infection in the genito-urinary

J. S. Hill Gaston; Richard C. Duggleby; Jane C. Goodall; Roberto Raggiaschi; Mark S. Lillicrap

180

Aberrant expression of microRNAs in T cells from patients with ankylosing spondylitis contributes to the immunopathogenesis  

PubMed Central

Ankylosing spondylitis (AS) is a chronic inflammatory disorder characterized by dysregulated T cells. We hypothesized that the aberrant expression of microRNAs (miRNAs) in AS T cells involved in the pathogenesis of AS. The expression profile of 270 miRNAs in T cells from five AS patients and five healthy controls were analysed by real-time polymerase chain reaction (PCR). Thirteen miRNAs were found potentially differential expression. After validation, we confirmed that miR-16, miR-221 and let-7i were over-expressed in AS T cells and the expression of miR-221 and let-7i were correlated positively with the Bath Ankylosing Spondylitis Radiology Index (BASRI) of lumbar spine in AS patients. The protein molecules regulated by miR-16, miR-221 and let-7i were measured by Western blotting. We found that the protein levels of Toll-like receptor-4 (TLR-4), a target of let-7i, in T cells from AS patients were decreased. In addition, the mRNA expression of interferon (IFN)-? was elevated in AS T cells. Lipopolysaccharide (LPS), a TLR-4 agonist, inhibited IFN-? secretion by anti-CD3+anti-CD28 antibodies-stimulated normal T cells but not AS T cells. In the transfection studies, we found the increased expression of let-7i enhanced IFN-? production by anti-CD3+anti-CD28+ lipopolysaccharide (LPS)-stimulated normal T cells. In contrast, the decreased expression of let-7i suppressed IFN-? production by anti-CD3+anti-CD28+ LPS-stimulated AS T cells. In conclusion, we found that miR-16, miR-221 and let-7i were over-expressed in AS T cells, but only miR-221 and let-7i were associated with BASRI of lumbar spine. In the functional studies, the increased let-7i expression facilitated the T helper type 1 (IFN-?) immune response in T cells. PMID:23607629

Lai, N-S; Yu, H-C; Chen, H-C; Yu, C-L; Huang, H-B; Lu, M-C

2013-01-01

181

Translation into Brazilian Portuguese, cross-cultural adaptation and validation of the Stanford presenteeism scale-6 and work instability scale for ankylosing spondylitis.  

PubMed

Loss of productivity at work, as a result of health problems, is becoming an issue of interest due to the high burden it represents in society. The measurement of such phenomenon can be made using generic and specific scales for certain diseases such as the Stanford Presenteeism Scale (SPS-6) and the Work Instability Scale for Ankylosing Spondylitis (AS-WIS), specific for patients with ankylosing spondylitis (AS). The aim of this study was to translate and perform a cross-cultural adaptation of SPS-6 and AS-WIS into Portuguese and check their psychometric properties. The study also aimed to evaluate the relationship between the general scores of the scales and the main sociodemographic and clinical data, lifestyles, and absenteeism in patients with AS and correlate these variables with SPS-6 and AS-WIS scales. A sample of 120 patients with AS and 80 workers at a university hospital was evaluated. The processes for the translation and cross-cultural adaptation of the instruments followed preestablished steps and rules presented in the literature. For the evaluation of measurement properties and correlations between scales, intra-class correlation coefficient (reproducibility analysis), Cronbach alpha (internal consistency), and Pearson correlation coefficient (validity) were employed. The inter-observer (0.986) and intra-observer (0.992) reproducibilities of the AS-WIS were shown to be high as well as the internal consistency (0.995). Similarly, the inter-observer reliability of SPS-6 was considered good (0.890), although it showed a poorer performance when considering the same observer (Pearson correlation coefficient?=?0.675 and intra-class correlation?=?0.656). Internal consistency, for the total number of items, as measured by Cronbach alpha, was 0.889. The validity of the scales was evaluated thru the comparison of the achieved scores with the results of the WLQ, SF-36, ASQoL, BASFI, BASDAI, HAQ-S, and SRQ-20 instruments. Correlations between loss of productivity at work, worse quality of life, presence of emotional disturbances, and worse health conditions were positive. The process of translation, cross-cultural adaptation, and validation of the SPS-6 as a generic measurement for the loss of productivity at work and of the AS-WIS as a specific measurement for patients with AS are valid, reproducible, and specific instruments to be used in Brazil. In both scales, productivity at work was associated to advanced age, higher rate of absenteeism in the last month and year, presence of peripheral arthritis, and a larger number of comorbidities in patients with AS. The AS-WIS and SPS-6 showed a good correlation among them although they are not mutually exclusive but supplementary. PMID:24221505

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

2014-12-01

182

Increased risk of stroke among patients with ankylosing spondylitis: a population-based matched-cohort study.  

PubMed

Ankylosing spondylitis (AS) is a chronic inflammatory rheumatic disease. Although two prior studies detected increased prevalence ratios of cerebrovascular disease among AS patients, the results of the two studies investigating AS and stroke are in conflict. Therefore, the present cohort study set out to estimate the risk of subsequent stroke in AS patients compared with matched controls using a population-based dataset in Taiwan. This investigation analyzed administrative claims data sourced from the Taiwan National Health Insurance Database. Our study consisted of a study cohort comprising 1,479 AS patients and a comparison cohort of 5,916 subjects without AS. Cox proportional hazards regressions were performed to estimate the risk of subsequent stroke during the follow-up period. We also conducted additional analyses investigating the risk of subsequent stroke by gender and pharmaceutical prescription. After adjusting for chronic lower respiratory diseases, type 2 diabetes mellitus, hypertension, hyperlipidemia, renal disease, coronary heart disease, atrial fibrillation, income, and urbanization, compared with comparison patients, the hazard ratio for subsequent stroke among patients with AS was 2.3 (95 % CI 1.9-2.8). We also stratified our results by both gender and pharmaceutical prescription, but did not find a statistically significant difference for the risk of subsequent stroke either between men and women, or between AS patients taking various pharmaceutical regimens and the overall AS population. This is the first study to report an increased hazard ratio for subsequent stroke among AS patients when compared with matched comparison patients without AS. PMID:24322454

Keller, Joseph J; Hsu, Jung-Lung; Lin, Shiue-Ming; Chou, Chia-Chi; Wang, Li-Hsuan; Wang, Jui; Bai, Chyi-Huey; Chiou, Hung-Yi

2014-02-01

183

Killer-cell immunoglobulin-like receptors (KIR) and HLA-class I heavy chains in ankylosing spondylitis.  

PubMed

HLA-B27 (B27) interactions with the killer-cell immunoglobulin-like receptors (KIR) have been implicated in the pathogenesis of ankylosing spondylitis (AS), with consistent differences among populations. KIR3DL1 and possibly KIR3DS1 interact with classical B27, whereas KIR3DL2 binds B27 heavy chain dimers. The aim of this review is to summarize data from recent studies performed in our laboratory and from the literature, which provide support for a possible role of KIR3DL2/B27 dimer interactions in the pathogenesis of AS. Recent studies in cells from AS patients and from health controls carrying the predisposing B*2705 and the nonpredisposing B*2709 haplotypes, have shown a higher percentage of positive cells and a higher surface expression of KIR3DL2 receptors on natural killer (NK) and CD4+ T cells in B*2705 AS patients compared with B*2705, B*2709 and B27-negative healthy controls. Increased expression of HC10-reactive molecules on AS monocytes was seen, supporting the possible role of the KIR3DL2/B272 pair in the pathogenesis of AS. These results underline the importance of NK cells and innate immunity, and of CD4+ T cells in the inflammatory pathogenesis of AS. PMID:25381967

Cauli, Alberto; Piga, Matteo; Dessole, Grazia; Porru, Giovanni; Floris, Alberto; Vacca, Alessandra; Desogus, Elisabetta; La Nasa, Giorgio; Mathieu, Alessandro

2014-11-01

184

Low Body Mass Index and Blood Loss in Primary Total Hip Arthroplasty: Results from 236 Consecutive Ankylosing Spondylitis Patients  

PubMed Central

Objective. To evaluate the effect of low body mass index (BMI) on blood loss during primary total hip arthroplasty (THA) in ankylosing spondylitis (AS) patients. Methods. Two hundred seventy-seven consecutive AS patients who underwent primary THA were retrospectively studied. The patients were divided by BMI into an underweight group (BMI < 18.5?kg/m2) and a normal weight group (18.5?kg/m2 < BMI < 25?kg/m2). Demographics, perioperative laboratory values, intraoperative data, blood loss, transfusion rate, transfusion reactions, surgical complications, hospitalization cost, and length of stay (LOS) were collected and analyzed. Results. Of 277 AS patients, 236 were eligible for inclusion in the study. A total of 91 (39%) patients were underweight. The hidden blood loss, transfusion rate, transfusion reactions, and hospitalization cost in the underweight group were significantly higher than those in the normal weight group. Conclusions. For AS patients, BMI appears to be correlated with blood loss during primary THA. Compared with patients of normal weight, low BMI patients have the potential to suffer more postoperative hidden blood loss and to require a higher transfusion rate. PMID:24959587

Zhao, Jinzhu; Li, Jia; Zheng, Wei; Liu, Denghui; Sun, Xiaofeng; Xu, Weidong

2014-01-01

185

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

PubMed

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

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

2015-01-01

186

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

PubMed Central

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

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

2014-01-01

187

Adaptation and validation of the Ankylosing Spondylitis Work Instability Scale (AS-WIS) for use in Turkey.  

PubMed

The Ankylosing Spondylitis Work Instability Scale (AS-WIS) is a recently developed 20-item measure to assess work instability in AS. This study aimed to adapt the AS-WIS to Turkish and to test its reliability and validity. After the translation process, 132 AS patients were assessed by the AS-WIS, Bath AS Disease Activity Index, Bath AS Functional Index and the AS Quality of Life Questionnaire. Reliability was tested by internal consistency, person separation index (PSI) and intra-class correlation coefficient (ICC); internal construct validity by Rasch analysis; external construct validity by associations with comparator scales and cross-cultural validity by comparison with the original UK data. Reliability of the Turkish AS-WIS was good with Cronbach's ? and PSI of 0.88 and test-retest ICC of 0.91. Data showed good fit to Rasch model [mean item fit: -0.477 (SD 1.047), Chi-square interaction: 60.9 (df = 40, p = 0.018)]. There was no differential item functioning by age, gender, disease duration or work type. The scale was strictly unidimensional. 51 % of the patients were at moderate risk, and 9 % were at high risk of having to give up their work. External construct validity was confirmed by expected correlations with comparator scales, and a clear gradient of disease activity and functional status across increasing levels of risk. Cross-cultural validity showed some differences in item locations, but this cancelled out at the test level. Turkish version of the AS-WIS is reliable, valid and available for use in routine clinical setting to identify patients who are at risk of having to give up their current job. PMID:24889835

Küçükdeveci, Ay?e A; Ataman, ?ebnem; Genç, Aysun; Kutlay, ?ehim; Elhan, Atilla H; ?ztuna, Derya; Tennant, Alan

2015-01-01

188

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

PubMed

The objective of this work was to study the associations between ankylosing spondylitis (AS) and clinical vertebral and nonvertebral fractures. Data from a large population-based public health database in Spain, Sistema d'Informació per al Desenvolupament de l'Investigació en Atenció Primària (SIDIAP), were used in this parallel cohort study. All participants registered in SIDIAP on January 1, 2006, were screened to identify those with a diagnosis of AS. Five age-matched, gender-matched, and general practice surgery-matched controls were selected for each patient with AS. All participants were followed until December 31, 2011, transfer out date, or death date. Fractures during this time were classified as vertebral or nonvertebral. Adjustment was made for potential confounders (tobacco smoking, alcohol consumption, body mass index, and use of oral steroids). Of 4,920,353 eligible patients in SIDIAP, 6474 AS patients with matched controls (n?=?32,346) were available. A higher proportion of patients with AS versus controls had clinical vertebral (0.86% versus 0.41%) and nonvertebral (3.4% versus 2.7%) fractures. Adjusted Cox regression models showed an increased risk of clinical vertebral (hazard ratio [HR] 1.93; 95% confidence interval [CI], 1.39 to 2.68; p?

Muñoz-Ortego, Juan; Vestergaard, Peter; Rubio, Josep Blanch; Wordsworth, Paul; Judge, Andrew; Javaid, M Kassim; Arden, Nigel K; Cooper, Cyrus; Díez-Pérez, Adolfo; Prieto-Alhambra, Daniel

2014-08-01

189

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

PubMed Central

Background Prospective data on the association between ischemic stroke and ankylosing spondylitis (AS) in the young are sparse. The purpose of this population-based, age- and sex-matched longitudinal follow-up study was to investigate the risk of developing ischemic stroke in young patients with AS. Methods A total of 4562 patients aged 18- to 45-year-old with at least two ambulatory visits in 2001 with a principal diagnosis of AS were enrolled in the AS group. The non-AS group consisted of 22810 age- and sex-matched, randomly sampled subjects without AS. The two-year ischemic stroke-free survival rate for each group were calculated using the Kaplan-Meier method. Cox proportional hazards regression analysis was used to estimate the hazard ratio of ischemic stroke after adjusting for demographic and clinical covariates. Results During follow-up, 21 patients in the AS group and 53 in the non-AS group developed ischemic stroke. The ischemic stroke-free survival rate over the 2 year follow-up was lower in the AS group than the non-AS group (p?=?0.0021). The crude hazard ratio of ischemic stroke for the AS group was 1.98 (95% CI, 1.20–3.29; p?=?0.0079) and the adjusted hazard ratio after controlling for demographic and comorbid medical disorders was 1.93 (95% CI, 1.16–3.20; p?=?0.0110). Conclusion Our study showed an increased risk of developing ischemic stroke in young patients with AS. PMID:24714094

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

2014-01-01

190

Lumbar osteotomy for correction of thoracolumbar kyphotic deformity in ankylosing spondylitis. A structured review of three methods of treatment  

PubMed Central

OBJECTIVES—Three operative techniques have been described to correct thoracolumbar kyphotic deformity (TLKD) resulting from ankylosing spondylitis (AS) at the level of the lumbar spine: opening wedge osteotomy, polysegmental wedge osteotomies, and closing wedge osteotomy. Little knowledge exists on the indication for, and outcome of these corrective lumbar osteotomies.?METHODS—A structured review of the medical literature was performed.?RESULTS—A search of the literature revealed 856 patients reported in 41 articles published between 1945 and 1998. The mean age at time of operation was 41 years, male-female ratio 7.5 to 1. In 451 patients an open wedge osteotomy was performed. Polysegmental wedge osteotomies were performed in 249 patients and a closing wedge osteotomy in 156 patients. Most of the studies primarily focus on the surgical technique. Technical outcome data were poorly reported. Sixteen reports, including 523 patients, met the inclusion criteria of this study, and could be analysed for technical outcome data. The average correction achieved with each surgical techniques ranged from 37 to 40 degrees. Loss of correction was mainly reported in patients treated by open wedge osteotomy and polysegmental wedge osteotomies. Neurological complications were reported in all three techniques. The perioperative mortality was 4%. Pulmonary, cardiac and intestinal problems were found to be the major cause of fatal complications.?CONCLUSION—Lumbar osteotomy for correction of TLKD resulting from AS is a major surgery. The indication for these lumbar osteotomies as well as the degree of correction in the lumbar spine has not yet been established. Furthermore, there is a need for a generally accepted clinical score that encompasses accurate preoperative and postoperative assessment of the spinal deformity. The results of this review suggest that the data from the literature are not suitable for decision making with regard to surgical treatment of TLKD resulting from AS.?? PMID:10381482

Van Royen, B J; De Gast, A

1999-01-01

191

Combined Home Exercise Is More Effective Than Range-of-Motion Home Exercise in Patients with Ankylosing Spondylitis: A Randomized Controlled Trial  

PubMed Central

Home exercise is often recommended for management of patients with ankylosing spondylitis (AS); however, what kind of home exercise is more beneficial for patients with AS has not been determined yet. We aimed to compare the effectiveness of combined home exercise (COMB) and range-of-motion home exercise (ROM) in patients with AS. Nineteen subjects with AS completed either COMB (n = 9) or ROM (n = 10) program. The COMB program included range-of-motion, strengthening, and aerobic exercise while the ROM program consisted of daily range-of-motion exercise only. After exercise instruction, subjects in each group performed home exercise for 3 months. Assessment included cardiopulmonary exercise test, pulmonary function test, spinal mobility measurement, chest expansion, Bath Ankylosing Spondylitis Functional Index (BASFI), and other functional ability and laboratory tests. After exercise, the COMB group showed significant improvement in peak oxygen uptake (12.3%, P = 0.008) and BASFI (P = 0.028), and the changed score between pre- and postexercise data was significantly greater in the COMB group regarding peak oxygen uptake and BASFI. Significant improvement in finger-to-floor distance after 3-month exercise was found only in the COMB group (P = 0.033). This study demonstrates that a combined home exercise is more effective than range-of-motion home exercise alone in aerobic capacity and functional ability. PMID:25276785

Chuang, Chih-Cheng; Tseng, Ching-Shiang; Wei, James Cheng-Chung; Hsu, Wei-Chun; Lin, Yi-Jia

2014-01-01

192

Adipokine serum levels in patients with ankylosing spondylitis and their relation to clinical parameters and radiographic spinal progression.  

PubMed

Objectives: Adipokines have metabolic and inflammatory functions but can also affect bone metabolism. Here, we determined the relationship between adiponectin, resistin and visfatin serum levels and markers of inflammation, disease activity and radiographic spinal progression in patients with ankylosing spondylitis (AS). Methods: Adiponectin, visfatin and resistin were measured by ELISA in the serum of 86 AS patients at baseline and in 25 healthy controls. Radiographic spinal progression was determined by scoring of radiographs of the spine at baseline and after 2 years. Results: Mean baseline resistin and visfatin levels were significantly higher in AS patients compared to healthy controls (resistin 11.6 ±10.6 ng/ml vs. 6.6 ± 3.2 ng/ml; p=0.01; visfatin 20.9 ± 48.3 ng/ml vs. 3.4 ± 2.6 ng/ml, p=0.001). Adipokine serum levels did not correlate with disease activity or functional indices. Only restistin serum levels correlated with markers of inflammation. Baseline visfatin, but not resistin or adiponectin levels were significantly higher in patients with mSASSS worsening ? 2 units after 2 years (n=19) compared to patients without mSASSS worsening (37.7± 57.8 ng/ml vs. 16.1± 44.6 ng/ml, p=0.028) and in patients with syndesmophyte formation/progression (n=22) compared to patients without such progression (37.1± 55.3 ng/ml vs. 15.3 ±44.8 ng/ml, p=0.023). Visfatin levels of >8 ng/ml at baseline were predictive for subsequent radiographic spinal progression (adjusted OR=3.6 for mSASSS progression; adjusted OR=5.4 for syndesmophyte formation/progression). Conclusions: Serum levels of resistin and visfatin are elevated in AS patients. Elevated baseline visfatin levels are predictive for subsequent progression of radiographic damage in AS patients. This article is protected by copyright. All rights reserved. PMID:25417763

Syrbe, Uta; Callhoff, Johanna; Conrad, Kristina; Poddubnyy, Denis; Haibel, Hildrun; Junker, Susann; Frommer, Klaus W; Müller-Ladner, Ulf; Neumann, Elena; Sieper, Joachim

2014-11-21

193

Arthritis in Roman Britain.  

PubMed Central

The pattern of arthritis in Roman Britain was investigated by examining the skeletons of 416 adults from the Roman cemetery at Poundbury Camp near Dorchester, Dorset. The mean height of the people was not much less than that of the current British population, and the prevalence of right handedness was similar to our own. There was a high prevalence of osteoarthritis for such a relatively young community, with particularly severe changes in the vertebral column. The pattern of joints affected by osteoarthritis was different from that seen now, but the prevalence of vertebral ankylosing hyperostosis was much the same. Rheumatoid arthritis was seen as often as the expected rat would indicate, given that the population died young, but it was rare. Other forms of arthritis, including gout and ankylosing spondylitis, were not seen. Images FIG 1 FIG 2 FIG 3 FIG 4 PMID:6418269

Thould, A K; Thould, B T

1983-01-01

194

Effects and safety of allogenic mesenchymal stem cell intravenous infusion in active ankylosing spondylitis patients who failed NSAIDs: a 20-week clinical trial.  

PubMed

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

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

2014-01-01

195

Spectral domain-optical coherence tomographic findings in patients with ankylosing spondylitis under anti-tumor necrosis factor-alpha therapy.  

PubMed

Abstract Objective: To evaluate the effect of tumor necrosis factor-alpha (TNF-?) blockade on the thickness of the peripapillary retinal nerve fiber layer (RNFL), the ganglion cell-inner plexiform layers (GCIPL), and the macula in ankylosing spondylitis (AS) patients under anti-TNF-? therapy. Materials and methods: Twenty-one patients with AS received etanercept, or adalimumab, or infliximab for at least 6 months. Erythrocyte sedimentation rate (ESR), C-reactive protein (CRP) levels, and Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) scores were measured before and 6 months after the beginning of the treatment. Peripapillary RNFL, four regional fields (superior, inferior, nasal, and temporal), GCIPL, and macular thicknesses of the patients were analyzed by optical coherence tomography before the treatment, at 3 months and 6 months after the beginning of the treatment. Results: The mean BASDAI, ESR, and CRP values were 5.2?±?1.5, 31.6?±?21.7, and 15.7?±?13.9, respectively, at the beginning of the treatment and 2.3?±?1.7, 21.3?±?15.1, and 10.1?±?10.3, respectively, 6 months after the beginning of treatment. There were significant differences among the mean BASDAI, ESR, and CRP values at the beginning of treatment and 6 months later (p?

Ilhan, Nilufer; Ustun, Nilgul; Tuzcu, Esra Ayhan; Coskun, Mesut; Yagiz, Abdullah Erman; Ilhan, Ozgur; Parlakfikirer, Nihan

2014-11-01

196

A New Strategy of Drug Treatment in NSAID- Unresponsive Ankylosing Spondylitis: Combination of Pamidronate and Methylprednisolone Monthly Intravenous Infusions on The Background of A Combination of Disease Modifying Drugs Sulfasalazine and Methotrexate  

Microsoft Academic Search

Objectives: To assess short term efficacy and tolerability of a therapeutic strategy in patients with ankylosing spondylitis (AS) unresponsive to nonsteroidal anti-inflammatory drugs (NSAIDs) or coxibs and unable to take anti-tumour necrosis factor-? (anti-TNF?) biological treatment. Methods: Established AS patients were given a background treatment consisting of subcutaneous injections of methotrexate weekly (MTX, dose stepped up to a maximum of

AN Malaviya; S Kapoor; S Garg; I Ahmad; RR Raja

197

Diagnosis of Ankylosing Spondylitis  

MedlinePLUS

... MRI can be cost prohibitive. Blood Work & the HLA-B27 Test First, HLA-B27 is a perfectly normal gene found in 8% ... Secondly, it is important to note that the HLA-B27 test is not a diagnostic test for AS. ...

198

Symptoms of Ankylosing Spondylitis  

MedlinePLUS

... the neck. Pain and tenderness spreading to the ribs, shoulder blades, hips, thighs and heels is possible ... peripheral joints, as well as lack of spinal mobility because of chronic inflammation and possible spinal fusion.

199

Tomography-guided palisade sacroiliac joint radiofrequency neurotomy versus celecoxib for ankylosing spondylitis: a open-label, randomized, and controlled trial.  

PubMed

Sacroiliac joint (SIJ) pain is a common symptom in ankylosing spondylitis (AS). Palisade sacroiliac joint radiofrequency neurotomy (PSRN) is a novel treatment for the SIJ pain. In the current clinical trial, we treated AS patients with significant SIJ pain using PSRN under computed tomography guidance and compared the results with the celecoxib treatment. The current study included 155 AS patients. Patients were randomly assigned to receive PSRN or celecoxib treatment (400 mg/day for 24 weeks). The primary endpoint was global pain intensity in visual analog scale, at week 12. Secondary endpoints included pain intensity at week 24, disease activity, functional and mobility capacities, and adverse events at week 24. In comparison with the baseline collected immediately prior to the interventions, global pain intensity was significantly lower at both 12 and 24 weeks after the treatment in both arms. Pain reduction was more robust in the PSRN arm (by more than 1.9 and 2.2 cm at 12 and 24 weeks in comparison with the celecoxib arm, P < 0.0001 for both). The PSRN was also more effective in improving physical function and spinal mobility (P < 0.05 vs. celecoxib for both). Gastrointestional irritation was more frequent in the celecoxib arm than in the PSRN arm (P < 0.05). No severe complications were noted in either arm. PSRN is both efficacious and safe in managing SIJ pain in patients with AS. PMID:24518967

Zheng, Yongjun; Gu, Minghong; Shi, Dongping; Li, Mingli; Ye, Le; Wang, Xiangrui

2014-09-01

200

Effect of combined spa-exercise therapy on circulating TGF-?1 levels in patients with ankylosing spondylitis  

Microsoft Academic Search

\\u000a Zusammenfassung  ZIEL: Um einen objektiven Indikator für das biologische Ansprechen von Patienten mit ankylosierender Spondylitis (AS, M. Bechterew)\\u000a auf die Heilstollen-Behandlung in Badgastein zu finden, wurde die Rolle des anti-inflammatorischen Zytokins TGF-?1 (Transforming\\u000a Growth Factor ? 1) untersucht. METHODIK: 83 Patienten mit AS wurden 3–4 Wochen lang einer Therapie bestehend aus Hyperthermie,\\u000a Exposition mit niedrigen Radon-Dosen und gymnastischen Übungen unterzogen. Das

Medhat Shehata; Josef D. Schwarzmeier; Martin Hilgarth; Dita Demirtas; Dorothea Richter; Rainer Hubmann; Petra Boeck; Guenther Leiner; Albrecht Falkenbach

2006-01-01

201

A 17 year old with isolated proximal tibiofibular joint arthritis  

PubMed Central

The proximal tibiofibular joint (TFJ) is rarely affected in rheumatic diseases, and we frequently interpret pain of the lateral knee as the result of overuse or trauma. Nonetheless, the TFJ is a synovial joint that communicates with the tibiofemoral joint in a proportion of patients. While proximal TFJ arthritis has been rarely associated with existing spondyloarthritis, isolated TFJ arthritis as the presenting manifestation of spondyloarthritis has not yet been described. Here, we report the clinical and radiographic presentation of an adolescent with chronic proximal TFJ arthritis heralding spondyloarthritis highly suggestive of ankylosing spondylitis. PMID:23302539

2013-01-01

202

Composite measures in psoriatic arthritis: GRAPPA 2008.  

PubMed

At the 2008 annual meeting of GRAPPA (Group for Research and Assessment of Psoriasis and Psoriatic Arthritis) in Leeds, UK, members discussed the value and current status of composite measures for the assessment of psoriatic arthritis (PsA). In plenary presentations, examples of composite measures developed for rheumatoid arthritis (RA) and ankylosing spondylitis (AS) were reviewed, followed by a presentation of the assessment of disease activity in systemic lupus erythematosus. Three recently devised composite methods of assessing activity or response in PsA also were presented. Considerable discussion followed in breakout groups, and members agreed that a new composite measure specifically for PsA is necessary. The composite measure should include components that encompass the spectrum of psoriatic disease, i.e., in addition to assessment of peripheral joints, it should include assessment of sacroiliitis, spondylitis, enthesitis, and dactylitis, as well as skin and nail disease. PMID:20147481

Gladman, Dafna D; Landewé, Robert; McHugh, Neil J; Fitzgerald, Oliver; Thaci, Diamant; Coates, Laura; Mease, Philip J; Qureshi, Abrar A; Krueger, Gerald G; Ritchlin, Christopher T; Kavanaugh, Arthur F; Garg, Amit

2010-02-01

203

Double-blind, placebo-controlled randomized trial with adalimumab for treatment of juvenile onset ankylosing spondylitis (JoAS): significant short term improvement  

PubMed Central

Introduction While adalimumab is licensed for ankylosing spondylitis (AS), open uncontrolled studies suggest therapeutic efficacy of TNF-inhibitors in juvenile onset AS (JoAS). Methods A total of 32 patients aged 12 to 17 years with severe, active and refractory JoAS were enrolled in a multicenter, randomized, double-blind, placebo-controlled parallel study of 12 weeks, followed by open-label adalimumab until week 24 for all patients. ASAS40 was used as the primary, and ASAS20, PedACR and single items were used as the secondary outcome measures for the intention to treat population. Results A total of 17 patients were randomized to receive adalimumab 40 mg/2 weeks and 15 patients received placebo. Two patients (one of each group) discontinued prematurely due to insufficient efficacy and were labeled as non-responders. In the double-blind part, more patients on adalimumab achieved an ASAS40 at week 4 (41%), week 8 (53%) and week 12 (53%) than on placebo (20%, 33%, 33%), while differences at week 8 only reached borderline significance (P = 0.05). Also, at 4, 8 and 12 weeks ASAS20/PedACR30/70 response rates were higher in the adalimumab group (53%/53%/29%; 59%/76%/41%; 53%/65%/53%) compared to placebo (27%/27%/7%; 27%/33%/13%; 33%/40%/27%). In the adalimumab group a significant decrease of all disease activity parameters was noted at week 12 and was even more pronounced at week 24. At week 12 the Bath Ankylosing Spondylitis Disease activity spinal inflammation score decreased by 65% (P <0.001), the back pain score decreased by 50% (P <0.005), the Bath AS Functional Index (BASFI) score decreased by 47% (P <0.02), while the Childhood Health Assessment Questionnaire-Disability Index (CHAQ-DI) score improved by 65% (P <0.005). ANCOVA analysis demonstrated superiority of adalimumab over placebo for the physician global assessment of disease activity, parents' global assessment of subject's overall well-being, active joint count (all P <0.05) and erythrocyte sedimentation rate (ESR) (P <0.01). During the 12-week controlled phase, 29 AEs occurred in 10 patients on placebo compared to 27 AEs in 11 patients on adalimumab. Injection site reactions were the most common adverse events. There were 17 various infections occurring in the double-blind phase, 8 on placebo, 9 on adalimumab and a further 19 in the open label period. Conclusions Adalimumab was well tolerated and highly effective in a double-blind randomized trial in patients with JoAS. Treatment effects rapidly occurred and persisted for at least 24 weeks of treatment. Trial registration EudraCT 2007-003358-27. PMID:23095307

2012-01-01

204

Peptide handling by HLA-B27 subtypes influences their biological behavior, association with ankylosing spondylitis and susceptibility to endoplasmic reticulum aminopeptidase 1 (ERAP1).  

PubMed

HLA-B27 is strongly associated with ankylosing spondylitis (AS). We analyzed the relationship between structure, peptide specificity, folding, and stability of the seven major HLA-B27 subtypes to determine the role of their constitutive peptidomes in the pathogenicity of this molecule. Identification of large numbers of ligands allowed us to define the differences among subtype-bound peptidomes and to elucidate the peptide features associated with AS and molecular stability. The peptides identified only in AS-associated or high thermostability subtypes with identical A and B pockets were longer and had bulkier and more diverse C-terminal residues than those found only among non-AS-associated/lower-thermostability subtypes. Peptides sequenced from all AS-associated subtypes and not from non-AS-associated ones, thus strictly correlating with disease, were very rare. Residue 116 was critical in determining peptide binding, thermodynamic properties, and folding, thus emerging as a key feature that unified HLA-B27 biology. HLA-B27 ligands were better suited to TAP transport than their N-terminal precursors, and AS-associated subtype ligands were better than those from non-AS-associated subtypes, suggesting a particular capacity of AS-associated subtypes to bind epitopes directly produced in the cytosol. Peptides identified only from AS-associated/high-thermostability subtypes showed a higher frequency of ERAP1-resistant N-terminal residues than ligands found only in non-AS-associated/low-thermostability subtypes, reflecting a more pronounced effect of ERAP1 on the former group. Our results reveal the basis for the relationship between peptide specificity and other features of HLA-B27, provide a unified view of HLA-B27 biology and pathogenicity, and suggest a larger influence of ERAP1 polymorphism on AS-associated than non-AS-associated subtypes. PMID:25187574

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

2014-12-01

205

Effects of tumor necrosis factor inhibitor on serum level of HLA-B27 and PDCD-1 in patients with ankylosing spondylitis.  

PubMed

The aim of this study was to evaluate the effect of tumor necrosis factor-alpha (TNF-?) inhibitor-infliximab on ankylosing spondylitis (AS) patients and detect the serum level of HLA-B27 and PDCD-1 before and after TNF inhibitor treatment. 138 patients at active stage of AS were treated with infliximab; serum was collected before and after TNF-? inhibitor treatment for analysis. Reverse transcription-polymerase chain reaction (RT-PCR), flow cytometry, and enzyme-linked immuno sorbent assay were applied to detect the levels of HLA-B27 and PDCD-1 at different time points, which were used for statistical analysis with clinical data including two AS indicators (erythrocyte sedimentation rate--ESR and C-reactive protein--CRP). After the treatment for 6 weeks, RT-PCR showed that the gene expressions of HLA-B27 and PDCD-1 were significantly downregulated compared with baseline before infliximab treatment (P < 0.05); flow cytometry showed that the HLA-B27 and PDCD-1 double-labeled cells were significantly downregulated (P < 0.05). After 2, 6, or 10 weeks of infliximab treatment, the levels of ESR, CRP, serum HLA-B27, and PDCD-1 of the AS patients were all significantly lower than the baseline levels (P < 0.05), and the serum HLA-B27 and PDCD-1 levels were all significantly correlated with ESR (P < 0.05). Infliximab, an anti-TNF-? inhibitor, decreases significantly not only ESR and CRP, but also the serum levels of HLA-B27 and PDCD-1 in patients with AS. HLA-B27 and PDCD-1 are involved in the pathogenesis, and disease activities of AS. HLA-B27 and PDCD-1 are potentially the useful markers of AS activity and useful parameters to evaluate the effectiveness of anti-TNF-? inhibitor in treating AS. PMID:25005770

Chen, Xiaogang; Zhou, Xiaoqing; Li, Xia; Tang, Jinshan; Hu, Xiaowu; Wang, Junsheng; Xu, Cheng

2014-11-01

206

Analysing chronic spinal changes in ankylosing spondylitis: a systematic comparison of conventional x rays with magnetic resonance imaging using established and new scoring systems  

PubMed Central

Objectives: To compare conventional radiography and magnetic resonance imaging (MRI) for detection of chronic changes in the spine of patients with ankylosing spondylitis (AS). Methods: Assessment of chronic lesions in conventional x rays and T1 weighted MRI turbo spin echo sequences was performed with the established x ray scores BASRI and SASSS, the new Berlin score, and the MRI scoring system ASspiMRI-c All images were read twice and "blindly" by two readers. One vertebral unit (VU) was defined as the region between two virtual lines drawn through the middle of each vertebra. Definite involvement was defined as a score ?2 in a spinal segment. Results: Thirty nine patients with AS were examined (25 (64%) male, mean age 40.9 years, 33/36 (92%) HLA-B27 positive). The Berlin score correlated with the BASRI (r = 0.73, p = 0.01). The ASspiMRI-c correlated well with the BASRI and the Berlin score (r = 0.66 and r = 0.51, respectively, p = 0.01). The Berlin x ray score showed that 12/35 (34.3%), 13/35 (37.1%), and 12/28 (31.6%) patients had definite involvement of the cervical spine (CS), thoracic spine (TS), and lumbar spine (LS), respectively. The ASspiMRI-c showed that 10/36 (27.8%), 21/36 (58.3%), and 9/35 (25.7%) patients had definite involvement of the CS, TS, and LS, respectively. Syndesmophytes were found in 14.4% of all VUs with 90% agreement between the SASSS and Berlin score. Conclusions: T1 weighted MRI can detect chronic lesions in AS. The two new scoring systems proved valid in comparison with established scoring systems and based on aspects of the OMERACT filter. The thoracic spine is most commonly affected in AS. This part of the spine is best assessed by MRI. PMID:15066862

Braun, J; Baraliakos, X; Golder, W; Hermann, K; Listing, J; Brandt, J; Rudwaleit, M; Zuehlsdorf, S; Bollow, M; Sieper, J; van der Heijde, D

2004-01-01

207

Analysis on the interaction between IL-1F7 gene and environmental factors on patients with ankylosing spondylitis: a case-only study.  

PubMed

To examine the interaction between IL-1F7 gene and environmental factors in patients with ankylosing spondylities (AS). 150 AS Han Chinese patients (all human leukocyte antigen-B27 positive) were genotyped using a panel of single-nucleotide polymorphism markers within IL-1F7 gene (rs3811047) by ligase detection reactions. Polymerase chain reaction with sequence-specific primer was used to determine HLA-B27 subtypes. We analyzed the interaction between IF-1F7 gene and eight environmental factors in AS patients by using a case-only study. The genetic polymorphism and environmental factors were considered as dependent variables in logistic models, and P-values, ORi and 95% confidence intervals were used for estimating the effects of interaction. The different frequency of A/G between drinking group and non-drinking group was significant (ORi 3.163, 95% CI 1.368-7.317, P=0.006). Within the cooking oil group, odds ratio for interaction of G×E between main plants fats and half plants -half animal fats subunits was 4.273 (95% CI 1.590-11.479, P=0.004). Our data show that there was no interaction between IL-1F7 alleles and the other six environmental factors in AS patients (all P>0.05). We observed that there was an interaction between IF-1F7 gene and drinking in AS patients. Thus, drinking may be a risk exposure factor to take combined action with predisposing genes in AS patients. This action may increase the incident risk of AS. Also, main plants fats may be protective factors to AS. PMID:21072596

Ge, Rui; Pan, Faming; Liao, Fangfang; Xia, Guo; Mei, Yang; Shen, Beibei; Zhang, Tianchen; Gao, Jing; Zhang, Li; Duan, Zhenhua; Xu, Shengqian; Xu, Jianhua

2011-04-01

208

Survival of disease-modifying antirheumatic drugs used as the first antirheumatic medication in the treatment of ankylosing spondylitis in Finland. A nationwide population-based register study.  

PubMed

The tight national drug reimbursement regulations in the treatment of ankylosing spondylitis (AS) in Finland lead to the practice that at least one traditional disease-modifying antirheumatic drug (DMARD), if not contraindicated, has been tried and has failed before a patient can be eligible for reimbursement of anti-tumour necrosis factor (TNF) treatment. The aim of the present study is to evaluate drug survival of the firstly prescribed DMARDs in patients with AS. All AS patients from January 1, 2000 to December 31, 2007 were collected from the nationwide drug reimbursement registry maintained by the Social Insurance Institution (SII). Data on antirheumatic medication came from the prescription registry of SII. A total of 2,890 AS patients (60 % males) were identified. Sulfasalazine (SSA) monotherapy was the most common first antirheumatic treatment (2,319 patients, 87 %), followed by methotrexate (MTX) monotherapy (230 patients, 9 %) and by hydroxychloroquine monotherapy (77 patients, 3 %). A combination of two or more DMARDs was used by 44 patients (2 %). Only seven patients (0.3 %) had biological (etanercept or adalimumab) started as the first antirheumatic drug. Median survival time of SSA monotherapy was 4.5 years (95 % CI 4.2 to 4.8) and that of MTX was 1.9 years (95 % CI 1.5 to 2.1). SSA is almost the standard as the first antirheumatic treatment of AS in Finland. Although the clinical efficiency of SSA was not evaluable in the present study, these data suggest that the use of SSA can at least postpone the need and start of TNF inhibitors with marked economic consequences. PMID:24907035

Relas, Heikki; Kautiainen, Hannu; Puolakka, Kari; Virta, Lauri J; Leirisalo-Repo, Marjatta

2014-08-01

209

Increasing proportion of female patients with ankylosing spondylitis: a population-based study of trends in the incidence and prevalence of AS  

PubMed Central

Objective With the introduction of MRI in diagnosis and tumour necrosis factor inhibitors for treatment, the field of ankylosing spondylitis (AS) has undergone significant changes. We carried out a population-based study of the trends in incidence and prevalence of AS over the past 15?years. Methods This is a retrospective analysis of provincial health administrative databases. Residents of Ontario, Canada aged 15?years or older diagnosed with AS between 1995 and 2010 were included in the study. Crude as well as age-standardised and sex-standardised incidence and prevalence of AS between 1995 and 2010 were calculated. Trends in prevalence and incidence of male and female patients with AS were separately analysed. Results We identified 24?976 Ontarians with AS. Age/sex-standardised AS prevalence increased from 79/100?000 in 1995 to 213/100?000 in 2010. Men had higher prevalence than women, but the male/female prevalence ratio decreased from 1.70 in 1995 to 1.21 by 2010. A higher proportion of male compared with female patients with AS were diagnosed in the 15–45 age group. Annual incidence rates revealed increasing diagnosis of AS among women after 2003. Conclusions The prevalence of AS in Ontario has nearly tripled over the past two decades. The proportion of women with new diagnosis of AS is increasing, a trend that began around the year 2003. A higher proportion of male compared with female patients with AS are diagnosed at an earlier age. PMID:25510888

Haroon, Nisha N; Paterson, J Michael; Li, Ping; Haroon, Nigil

2014-01-01

210

High prevalence of spondyloarthritis and ankylosing spondylitis among familial Mediterranean fever patients and their first-degree relatives: further evidence for the connection  

PubMed Central

Introduction Familial Mediterranean fever (FMF) is an auto-inflammatory disease characterized by recurrent attacks of fever and serositis. Limited data suggest that the prevalence of sacroiliitis is increased in patients with FMF. In our present study, we assessed the prevalence of spondyloarthritis (SpA), including ankylosing spondylitis (AS), among a cohort of FMF patients and their unaffected first-degree relatives (FDRs). Methods The current study cohort comprised a consecutive group of 201 unrelated patients with FMF and 319 FDRs (? 16 years old). These subjects were examined according to a standard protocol. Results A total of 157 FMF patients (78.1%) and 233 (73%) unaffected FDRs reported back pain. Fifteen FMF patients (7.5%) and nine unaffected FDRs fulfilled the modified New York (mNY) criteria for AS. One additional FDR with AS was identified after review of the medical records. None of the FMF patients with AS was HLA-B27 positive. The allele frequency of M694V among the FMF patients with radiographic sacroiliitis was significantly higher in comparison with those without sacroiliitis (OR 4.3). When compared with the general population, the risk ratios for SpA and AS among the FDRs of our FMF patients were 3.3 (95% CI; 2.0 to 5.5) and for AS 2.9 (95% CI; 1.3 to 6.4), respectively. Conclusions Our study suggests that a) factors other than HLA-B27 play a role in the association of FMF and SpA/AS; b) MEFV gene variations may be one of the geographic/region-specific potential pathogenetic links between these two disorders in the Turkish population. PMID:23356447

2013-01-01

211

Serum fatty acid profiles and potential biomarkers of ankylosing spondylitis determined by gas chromatography-mass spectrometry and multivariate statistical analysis.  

PubMed

Ankylosing spondylitis (AS) is a common chronic inflammatory rheumatic disease. Early and accurate detection is essential for effective disease treatment. Recently, research has focused on genomics and proteomics. However, the associated metabolic variations, especially fatty acid profiles, have been poorly discussed. In this study, the gas chromatography-mass spectrometry (GC-MS) approach and multivariate statistical analysis were used to investigate the metabolic profiles of serum free fatty acids (FFAs) and esterified fatty acids (EFAs) in AS patients. The results showed that significant differences in most of the FFA (C12:0, C16:0, C16:1, C18:3, C20:4, C20:5, C22:5 and C22:6) and EFA (C12:0, C16:1, C18:0, C18:1, C18:2, C18:3, C20:4 and C22:6) concentrations were found between the AS patients and healthy controls (p?

Chen, Rui; Han, Su; Dong, Daming; Wang, Yansong; Liu, Qingpeng; Xie, Wei; Li, Mi; Yao, Meng

2014-09-15

212

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

PubMed Central

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. PMID:22626458

2012-01-01

213

Familial Mediterranean fever and seronegative arthritis.  

PubMed

Familial Mediterranean fever (FMF) is characterized by recurrent, self-limited episodes of polyserositis, with articular involvement also being a common manifestation. The pattern and joint predilection of arthritis show many similarities to those of spondyloarthritis. Moreover, case series suggest an increased prevalence of ankylosing spondylitis or spondyloarthritis among FMF patients. FMF is caused by mutations in the MEFV gene encoding pyrin, which is believed to be involved in regulation of interelukin-1? activation. Recent studies conducted in populations with a high background carrier rate of MEFV variants have reported an increased frequency of M694V among AS patients with no personal or family history of FMF. These findings are of interest, as both candidate gene and genome-wide association studies suggest that the interleukin-1 cytokine pathway may be implicated in the pathogenesis of ankylosing spondylitis. Therefore, association of M694V with ankylosing spondylitis can be recognized as a geographic region-specific risk factor affecting a common inflammatory pathway in the disease pathogenesis. PMID:21695514

Akkoc, Nurullah; Gul, Ahmet

2011-10-01

214

Is Nephrolithiasis an Unrecognized Extra-Articular Manifestation in Ankylosing Spondylitis? A Prospective Population-Based Swedish National Cohort Study with Matched General Population Comparator Subjects  

PubMed Central

Background Ankylosing spondylitis (AS) is associated with several extra-articular manifestations. Nephrolithiasis (NL) has not been recognized as one of those, however, several factors known to increase the risk of NL are at play in AS patients. The objective was to estimate rates and predictors of NL in Swedish patients with AS compared to the general population. Methods and Findings We performed a prospective population-based nationwide cohort study based on linkage of data from Swedish registries. 8,572 AS patients were followed for 49,258 person-years (py) and 39,639 matched general population comparators were followed for 223,985 py. Patients were followed prospectively together with comparator subjects from January 2001 through December 2009. The first occurrence of NL during follow-up was the primary outcome. Hazard Ratios (HR) were used to compare these rates adjusting for comorbidities and treatment, and to assess predictors for NL. Mean age at study entry was 46 years (inter quartile range 36–56 years), 65% were males. Based on 250 vs. 466 NL events, the adjusted HR of NL in AS patients was 2.1 (95%CI 1.8 to 2.4). Predictors of NL within the AS group included prior diagnosis of inflammatory bowel disease (IBD) (HR 2.3; 95%CI 1.7 to 3.3), prior diagnosis of NL (HR 16.4; 95%CI 11.5 to 23.4), and patients receiving anti-TNF treatment (HR 1.6; 95%CI 1.2 to 2.1). Male sex was a risk factor for NL both in AS patients and in the general population. Limitations The risk for residual confounding and inability to study the chemical nature of NL were considered the main limitations of the study. Conclusions Patients with AS are at increased risk of NL, which may be considered a novel extra-articular manifestation. Previous history of NL, IBD, AS disease severity and male sex were identified as predictors of NL in AS. PMID:25423471

Jakobsen, Ane Krag; Jacobsson, Lennart T. H.; Patschan, Oliver; Askling, Johan; Kristensen, Lars Erik

2014-01-01

215

Etoricoxib for arthritis and pain management  

PubMed Central

Nonsteroidal antiinflammatory drugs (NSAIDs), including selective cyclooxygenase (COX)-2 inhibitors, have come to play an important role in the pharmacologic management of arthritis and pain. Clinical trials have established the efficacy of etoricoxib in osteoarthritis, rheumatoid arthritis, acute gouty arthritis, ankylosing spondylitis, low back pain, acute postoperative pain, and primary dysmenorrhea. Comparative studies indicate at least similar efficacy with etoricoxib versus traditional NSAIDs. Etoricoxib was generally well tolerated in these studies with no new safety findings during long-term administration. The gastrointestinal, renovascular, and cardiovascular tolerability profiles of etoricoxib have been evaluated in large patient datasets, and further insight into the cardiovascular tolerability of etoricoxib and diclofenac will be gained from a large ongoing cardiovascular outcomes program (MEDAL). The available data suggest that etoricoxib is an efficacious alternative in the management of arthritis and pain, with the potential advantages of convenient once-daily administration and superior gastrointestinal tolerability compared with traditional NSAIDs. PMID:18360581

Brooks, Peter; Kubler, Paul

2006-01-01

216

High bone turnover assessed by 18F-fluoride PET/CT in the spine and sacroiliac joints of patients with ankylosing spondylitis: comparison with inflammatory lesions detected by whole body MRI  

PubMed Central

Background This study compares the frequency and distribution of increased activity on 18?F-fluoride PET/CT with the presence of bone marrow edema on whole-body MR imaging in the spine and sacroiliac joints (SIJ) of patients with active ankylosing spondylitis (AS). Methods Ten patients (6 men and 4 women), between 30 and 58?years old (median 44) with active AS, were prospectively examined with both whole-body MRI and 18?F-fluoride PET/CT. Patients fulfilled modified NY criteria and had a Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) of at least 4. Increased radiotracer uptake in PET/CT and bone marrow edema in whole-body MRI of spine and SIJ was evaluated independently by two blinded observers for each modality. Kappa statistics were used to compare interobserver agreement as well as scores of consensus reading of the two imaging modalities. Results Analysis of interobserver agreement for PET/CT yielded a kappa value of 0.68 for spinal lesions and of 0.88 for SIJ lesions. The corresponding kappa values for the MRI modality were 0.64 and 0.93, respectively. More spinal lesions were detected by MRI in comparison to PET/CT (68 vs. 38), whereas a similar number of SIJ quadrants scored positive in both modalities (19 vs. 17). Analysis of agreement of lesion detection between both imaging modalities yielded a kappa value of only 0.25 for spinal lesions and of 0.64 for SIJ lesions. Conclusion Increased 18?F-fluoride uptake in PET/CT is only modestly associated with bone marrow edema on MRI in the spine and SIJ of patients with AS, suggesting different aspects of bone involvement in AS. PMID:22788874

2012-01-01

217

Two-dimensional electrophoretic analysis of human leukocyte proteins from patients with rheumatoid arthritis  

SciTech Connect

Human leukocyte proteins from more than 150 patients with rheumatoid arthritis, together with age- and sex-matched controls, were analyzed by use of the ISO-DALT technique of two-dimensional polyacrylamide gel electrophoresis. Patients with ankylosing spondylitis, polymyalgia rheumatica, psoriatic arthritis, calcium tendinitis, post-infectious arthritis, and asymmetrical seronegative arthritis were also included as positive controls. Synthesis of several proteins, referred to by number as members of the Rheuma set, is shown to increase in the leukocyte preparations from patients with classical rheumatoid arthritis. Several of these proteins are specific to monocytes or granulocytes; others are of unknown cellular origin, but appear to be unique to rheumatoid arthritis. The Rheuma proteins appear to be indicators of disease activity, because their increased synthesis can be correlated with sedimentation rate and other clinical indices of rheumatoid disease activity.

Willard, K.E. (Argonne National Lab., IL); Thorsrud, A.K.; Munthe, E.; Jellum, E.

1982-04-01

218

Genetics Home Reference: Ankylosing spondylitis  

MedlinePLUS

... part of a family of genes called the human leukocyte antigen (HLA) complex. The HLA complex helps the immune system distinguish the body's own proteins from proteins made by foreign invaders ( ...

219

Optimisation of rheumatology indices: dactylitis and enthesitis in psoriatic arthritis.  

PubMed

Outcome measures are a key part of study design and clinical assessment. Enthesitis and dactylitis are typical features of psoriatic arthritis (PsA) and the spondyloarthritides but traditionally scoring systems for enthesitis have mainly been validated in ankylosing spondylitis (AS). There are many scoring systems which are not validated used for dactylitis although newer validated scores are now available. Recently there have been advances in composite scores that include enthesitis and dactylitis to assess disease activity. These are currently being validated further and have not yet been tested in routine clinical practice. PMID:25365099

Ferguson, E G; Coates, L C

2014-01-01

220

Comparison of ASDAS and BASDAI as a measure of disease activity in axial psoriatic arthritis.  

PubMed

The aim of this study was to compare the discriminative ability of Ankylosing Spondylitis Disease Activity Score (ASDAS) with Bath Ankylosing Spondylitis Activity Disease Activity Index (BASDAI) and other clinical disease activity parameters in patients with axial psoriatic arthritis (axPsA). Patients with axPsA were recruited from Erciyes Spondyloarthritis Cohort (ESPAC) and Anatolian Group for the Assessment in Rheumatic Disease (ANGARD) cohort and were assessed for BASDAI, ASDAS, BASFI (Bath Ankylosing Spondylitis Functional Index), Ankylosing Spondylitis Quality of Life (ASQoL), and visual analog scale (VAS) pain. The discriminant ability of ASDAS-C-reactive protein (-CRP) and ASDAS-erythrocyte sedimentation rate (-ESR) was assessed using standardized mean differences between patients with high and low disease activity. Fifty-four patients with axPsA were included in the study. Both ASDAS scores showed good discriminative ability between high and low disease activity states. Both ASDAS versions and BASDAI had relatively high area under the curve (AUC) according to ASAS partial remission, patient and physician global assessments in receiver operating characteristic (ROC) curve analysis. There was no significant difference between AUC scores for the models that compared ASDAS-CRP and ASDAS-ESR with BASDAI for each individual definition of disease activity states. ASDAS versions and BASDAI showed good similar discriminative ability between high and low disease activity as reflected by the AUC analysis in axPsA. The cutoff values for inactive disease and high disease activity were relatively similar to predefined cutoff values for AS. Further, prospective validation is now required to identify the appropriate assessment tools and cutoff values in axPsA. PMID:24985042

K?l?ç, Gamze; K?l?ç, Erkan; Nas, Kemal; Karkucak, Murat; Capk?n, Erhan; Da?l?, Abdullah Zübeyir; Cevik, Remzi; Ozgöçmen, Salih

2014-07-01

221

Polymorphisms of HLA-A, -B, -Cw and DRB1 antigens in Moroccan patients with ankylosing spondylitis and a comparison of clinical features with frequencies of HLA-B*27.  

PubMed

Ankylosing spondylitis (AS) is very often associated with human leukocyte antigen (HLA), particularly HLA-B*27. However, the strength of this association and clinical features may vary in different ethnic groups. Our study aims to assess the distribution of HLA-A, -B, -Cw and DRB1 alleles in Moroccan patients with AS and to compare the clinical features of AS and the frequencies of HLA-B27 in patients from Morocco with other series. Seventy-five patients diagnosed with AS and assessed for clinical manifestations were selected and compared to 100 healthy controls. HLA class I and II antigens were typed by polymerase chain reaction sequence-specific oligonucleotide. HLA-B27 subtypes were studied by polymerase chain reaction amplification with sequence-specific primers. HLA-B27 was found in 64% of patients. It was positively associated with younger age at disease onset, family history, and uveitis while it had a negative association with late onset. Six B*27 subtypes were identified in the AS group. HLA-B*2705 and B*2702 were the most common observed subtypes. Among other HLA genes, a significant increase in the prevalence of HLA-Cw*02 and HLA-DRB*15 was found in AS patients. HLA-B27 is involved in the predisposition of AS in the Moroccan population. HLA-B*2705 and B*2702 were the predominant subtypes supporting previous reports in Caucasian spondyloarthropathies. Other HLA genes, HLA-Cw*02 and HLA-DRB1*15, seem to confer predisposing effect to the disease. However, the lower frequency of HLA-B27 compared to the literature in our study suggests the existence of different genetic and/or environmental factors in Morocco. PMID:25626601

El Mouraghi, I; Ouarour, A; Ghozlani, I; Collantes, E; Solana, R; El Maghraoui, A

2015-02-01

222

Immunohistological examination of open sacroiliac biopsies of patients with ankylosing spondylitis: detection of tumour necrosis factor ? in two patients with early disease and transforming growth factor ? in three more advanced cases  

PubMed Central

Objective To characterise the immunohistological features of sacroiliitis in ankylosing spondylitis (AS) at different disease stages. Methods Biopsy samples from sacroiliac joints (SIJs) of five patients with AS, two with early, three with advanced changes and samples from age matched controls from one necropsy SIJ and two iliac bone marrow (BM) biopsies were studied. Paraffin sections were immunostained in triplicate for T cells (CD3, CD8), macrophages (CD68), and the cytokines tumour necrosis factor ? (TNF?), interferon ?, interleukin (IL) 1?, IL6, IL10, and transforming growth factor ?1 (TGF?1). Stained cells were counted over one entire high power field (×400) per section in BM, cartilage, and other connective tissue (CT). Results are the mean of three sections. Results CD3+ T cells were numerous in the BM of early AS, and in the CT of one patient with early and one with late AS, with variable proportions of CD8+ T cells. All patients with AS had more CD68+ macrophages than controls in BM and CT; in cartilage, one patient with early and one with late AS had increased CD68+ cells, some being osteoclasts. The patient with very early AS had large numbers of TNF? cells in the three tissular areas; for the other patient with early disease they were found only in CT and cartilage. IL6 was seen in 4/4 patients with AS in most areas. Patients with early disease had more T cells, TNF?, and IL6, and patients with advanced AS more TGF?1. Conclusion The immunohistological findings of a limited sample suggest a role for BM in sacroiliitis, for TNF? and IL6 in early, active lesions, and for TGF?1 at the time of secondary cartilage and bone proliferation. PMID:16249231

François, R J; Neure, L; Sieper, J; Braun, J

2006-01-01

223

The skin tissue is adversely affected by TNF-alpha blockers in patients with chronic inflammatory arthritis: a 5-year prospective analysis  

PubMed Central

OBJECTIVE: We evaluated the incidence of and the main risk factors associated with cutaneous adverse events in patients with chronic inflammatory arthritis following anti-TNF-? therapy. METHODS: A total of 257 patients with active arthritis who were taking TNF-? blockers, including 158 patients with rheumatoid arthritis, 87 with ankylosing spondylitis and 12 with psoriatic arthritis, were enrolled in a 5-year prospective analysis. Patients with overlapping or other rheumatic diseases were excluded. Anthropometric, socioeconomic, demographic and clinical data were evaluated, including the Disease Activity Score-28, Bath Ankylosing Spondylitis Disease Activity Index and Psoriasis Area Severity Index. Skin conditions were evaluated by two dermatology experts, and in doubtful cases, skin lesion biopsies were performed. Associations between adverse cutaneous events and clinical, demographic and epidemiological variables were determined using the chi-square test, and logistic regression analyses were performed to identify risk factors. The significance level was set at p<0.05. RESULTS: After 60 months of follow-up, 71 adverse events (73.85/1000 patient-years) were observed, of which allergic and immune-mediated phenomena were the most frequent events, followed by infectious conditions involving bacterial (47.1%), parasitic (23.5%), fungal (20.6%) and viral (8.8%) agents. CONCLUSION: The skin is significantly affected by adverse reactions resulting from the use of TNF-? blockers, and the main risk factors for cutaneous events were advanced age, female sex, a diagnosis of rheumatoid arthritis, disease activity and the use of infliximab. PMID:24141833

Machado, Natalia P.; dos Reis Neto, Edgard Torres; Soares, Maria Roberta M. P.; Freitas, Daniele S.; Porro, Adriana; Ciconelli, Rozana M.; Pinheiro, Marcelo M.

2013-01-01

224

Psoriatic arthritis: recent progress in pathophysiology and drug development  

PubMed Central

Psoriatic arthritis (PsA) is the second most common inflammatory arthropathy, after rheumatoid arthritis diagnosis, in early arthritis clinics. Most patients have established psoriasis, often for years, prior to the onset of joint pain and swelling; in addition, associated features of nail disease, dactylitis, enthesitis, spondylitis or uveitis may be present. Psoriasis may not be immediately apparent, as small or patchy lesions may occur in the scalp or perineum. PsA presents as a symmetrical polyarthritis, similar to rheumatoid arthritis, or an asymmetrical oligoarthritis with a predilection for the distal interphalangeal joints. Spinal involvement is similar, although not identical, to ankylosing spondylitis. Joint damage occurs early; up to 50% of PsA patients have an 11% annual erosion rate in the first 2 years of disease duration, suggesting it is not a benign condition. There have been significant advances in our understanding of PsA pathogenesis in recent years, in the areas of genetics and molecular biology, implicating both the innate and the adaptive immune systems. This has lead to the introduction of evidence-based targeted therapy, primarily with tumour necrosis factor inhibitor (TNFi) agents. Therapy with disease-modifying anti-rheumatic drugs, such as methotrexate and leflunomide, remains the first-choice therapeutic intervention, even though there are few randomised controlled trials with these agents. In contrast, a number of successful studies of TNFi agents demonstrate excellent efficacy, in combination with methotrexate, and several novel agents are currently in development for the treatment of PsA. PMID:24611179

2013-01-01

225

The Efficacy and Safety of Rituximab in a Patient with Rheumatoid Spondylitis  

PubMed Central

Rheumatoid arthritis (RA) is considered as a connective tissue disease while ankylosing spondylitis (AS) is a prototype of spondyloarthritis. These diseases are seen concomitantly only very rarely. Also, rituximab has proven efficacy in the treatment of RA while its role in the treatment of AS is unclear. In this presentation, the concomitant presence of RA and AS in a 43-year-old male patient as well as the efficacy and safety of rituximab is discussed. Rituximab was given due to lack of response to treatment with anti-TNF-alpha. Evaluations made at the 6th and 12th months of treatment showed complete response for RA and partial response for AS. PMID:24324911

Kobak, ?enol; Karaarslan, Ahmet; Oksel, Fahrettin

2013-01-01

226

The efficacy and safety of rituximab in a patient with rheumatoid spondylitis.  

PubMed

Rheumatoid arthritis (RA) is considered as a connective tissue disease while ankylosing spondylitis (AS) is a prototype of spondyloarthritis. These diseases are seen concomitantly only very rarely. Also, rituximab has proven efficacy in the treatment of RA while its role in the treatment of AS is unclear. In this presentation, the concomitant presence of RA and AS in a 43-year-old male patient as well as the efficacy and safety of rituximab is discussed. Rituximab was given due to lack of response to treatment with anti-TNF-alpha. Evaluations made at the 6th and 12th months of treatment showed complete response for RA and partial response for AS. PMID:24324911

Kobak, Senol; Karaarslan, Ahmet; Oksel, Fahrettin

2013-01-01

227

Arthritis  

MedlinePLUS

... or have trouble moving around, you might have arthritis. Most kinds of arthritis cause pain and swelling in your joints. Joints ... joint can become severely damaged. Some kinds of arthritis can also cause problems in your organs, such ...

228

Arthritis  

MedlinePLUS

What Is Arthritis? You may have heard about arthritis (say: ar- thry -tis), which is a disease that causes swelling and ... their joints ache less. Back Continue Living With Arthritis Kids with JIA can have a lot of ...

229

Arthritis  

MedlinePLUS

... arthritis is often a life-long, progressive disease. Gout Gout is a type of arthritis that usually only ... in the United States, including osteoarthritis, rheumatoid arthritis, gout, lupus, and fibromyalgia. In fact, about half of ...

230

Psoriatic arthritis assessment tools in clinical trials  

PubMed Central

In order to measure disease activity, progression, and change with therapy in psoriatic arthritis (PsA), it is important to use accurate, reliable, and feasible outcome measures that can ideally be employed in longitudinal cohorts, clinical trials, and clinical practice. Until recently, there has been little focus on this methodology in PsA. Clinical trials and long term clinical registries have used disparate outcome measures. With emerging therapies, the focus on the methodology of outcome assessment has increased to ensure that discriminant and responsive instruments are used. The Group for Research and Assessment of Psoriasis and Psoriatic Arthritis (GRAPPA), in conjunction with the society, Outcome Measures in Rheumatology (OMERACT), is focused on refining and developing outcome measures for a variety of disease domains reviewed in this report. Key domains to assess include joints, skin, enthesitis, dactylitis, spine, joint damage as assessed radiologically, quality of life, and function. These domains can be assessed by individual and composite measures. A number of measures have been "borrowed" from the fields of rheumatoid arthritis, ankylosing spondylitis, and psoriasis and adapted to PsA. Others are being developed specifically for PsA. Few are validated but most have been shown to perform well in distinguishing placebo from treatment response. This report reviews the current state of the art of assessment in PsA and points toward future directions of development of this field. PMID:15708937

Mease, P; Antoni, C; Gladman, D; Taylor, W

2005-01-01

231

The Role of Intracellular Organisms in the Pathogenesis of Inflammatory Arthritis  

PubMed Central

Inflammatory arthritis is a condition which is characterised by recurrent episodes of joint pain and swelling. It encompasses a spectrum of disorders ranging from rheumatoid arthritis to ankylosing spondylitis. In these conditions, for reasons that are poorly understood, the immune system raises an inflammatory response within the joint space. In some cases, autoantigens have been identified (e.g., anticitrullinated peptides in rheumatoid arthritis), but the absence of these, in the seronegative arthritides, for example, raises question as to the underlying pathogenesis. Interest has, therefore, turned to host-pathogen interactions and whether aberrant immune responses to these could explain the development of arthritis. This has been most widely studied in reactive arthritis (ReA), where an infectious episode precedes the development of the joint symptoms. In this review, we present the evidence for the role of host-bacterial interactions in the pathogenesis of joint inflammation with particular emphasis on ReA. We discuss a range of possible mechanisms including molecular mimicry, persistent low grade infections, and abnormal host responses to common bacterial causes of reactive arthritis as well as discussing some of the clinical challenges that we face in making the diagnosis and in treatment of persistent symptoms. PMID:24995143

2014-01-01

232

Treating axial and peripheral spondyloarthritis, including psoriatic arthritis, to target: results of a systematic literature search to support an international treat-to-target recommendation in spondyloarthritis  

PubMed Central

Background Current recommendations for the management of axial spondyloarthritis (SpA) and psoriatic arthritis are to monitor disease activity and adjust therapy accordingly. However, treatment targets and timeframes of change have not been defined. An international expert panel has been convened to develop ‘treat-to-target’ recommendations, based on published evidence and expert opinion. Objective To review evidence on targeted treatment for axial and peripheral SpA, as well as for psoriatic skin disease. Methods We performed a systematic literature search covering Medline, Embase and Cochrane, conference abstracts and studies in http://www.clinicaltrials.gov. Results Randomised comparisons of targeted versus routine treatment are lacking. Some studies implemented treatment targets before escalating therapy: in ankylosing spondylitis, most trials used a decrease in Bath Ankylosing Spondylitis Disease Activity Index; in psoriatic arthritis, protocols primarily considered a reduction in swollen and tender joints; in psoriasis, the Modified Psoriasis Severity Score and the Psoriasis Area and Severity Index were used. Complementary evidence correlating these factors with function and radiographic damage at follow-up is sparse and equivocal. Conclusions There is a need for randomised trials that investigate the value of treat-to-target recommendations in SpA and psoriasis. Several trials have used thresholds of disease activity measures to guide treatment decisions. However, evidence on the effect of these data on long-term outcome is scarce. The search data informed the expert committee regarding the formulation of recommendations and a research agenda. PMID:23740234

Schoels, M M; Braun, J; Dougados, M; Emery, P; Fitzgerald, O; Kavanaugh, A; Kvien, T K; Landewé, R; Luger, T; Mease, P; Olivieri, I; Reveille, J; Ritchlin, C; Rudwaleit, M; Sieper, J; Smolen, J S; de Wit, M; van der Heijde, D

2014-01-01

233

Risk of Multiple Myeloma in Rheumatoid Arthritis: A Meta-Analysis of Case-Control and Cohort Studies  

PubMed Central

Objectives multiple myeloma is a malignant neoplasm of plasma cells mainly affecting elderly patients. Despite the wealth of information available on therapeutic strategies, the etiology and pathogenesis of myeloma remain unclear. In the current study, a meta-analysis was conducted to assess the possible association between rheumatoid arthritis and myeloma. Methods a literature search was conducted with PubMed, EMBASE and Web of Science for relevant studies published by December 25, 2013. Additionally, we searched annual meeting abstracts of the American Society of Hematology from 2004 to 2013. Only original studies that investigated the association between rheumatoid arthritis and myeloma were included. In total, 8 case-control and 10 cohort studies were identified for analysis. Results the meta-estimate of the association between rheumatoid arthritis and myeloma was 1.14 (95% CI, 0.97–1.33) overall, with significant heterogeneity among studies. The relationship between myeloma and other autoimmune diseases was additionally examined from available data. Our results showed that myeloma risk is increased 1.31 to 1.65-fold in pernicious anemia and 1.36 to 2.30-fold in ankylosing spondylitis patients. Conclusion Rheumatoid arthritis does not appear to alter the risk of myeloma, while between-study heterogeneity analyses suggest caution in the interpretation of results. Pernicious anemia and ankylosing spondylitis may be potential risk factors for myeloma development. Future large-scale epidemiological studies with reliable exposure biomarkers are necessary to establish the possible contribution of autoimmune disorders to multiple myeloma. PMID:24626254

Wu, Qing; Zhou, Daobin; Li, Jian

2014-01-01

234

Spondylitis - Spondylodiszitis  

Microsoft Academic Search

Zusammenfassung Die Inzidenz der Spondylitis\\/Spondylodiszitis nimmt aufgrund multifaktorieller Ursachen, jedoch wesentlich aufgrund der Aids-Epidemie, der großen Anzahl der i. v.Drogenabhängigen, dem Wiederauftreten der Tuberkulose in den Industriestaaten und der zunehmende Anzahl an immunsupprimierten Patienten zu.Frühstadien ohne Lähmungssymptomatik und ohne wesentliche Instabilität können konservativ mit Bettruhe und testgerechter Antibiotikatherapie erfolgreich behandelt werden.Neu aufgetretene neurologische Ausfälle und septische Verläufe stellen chirurgische Notfälle

Thomas Mückley; Martin Kirschner; Christian Hierholzer; Gunther O. Hofmann

2003-01-01

235

Comparison of Pyogenic Spondylitis and Tuberculous Spondylitis  

PubMed Central

Pyogenic spondylitis and tuberculous spondylitis are common causes of spinal infection. It is difficult to differentiate tuberculous spondylitis and pyogenic spondylitis clinically and radiologically. Recently magnetic resonance imaging has been reported to be beneficial for early diagnosis and differential diagnosis of the spondylitis, and is being used extensively for diagnosis. However, the diagnosis must be considered in combination with corresponding changes in clinical manifestations, radiological findings, blood and tissue cultures and histopathological findings. Conservative treatments, including antimicrobial medications, are started initially. Surgical treatments, which include anterior or posterior approach, single-stage or two-stage surgery, with or without instrumentation, may be performed as indicated. PMID:24761207

2014-01-01

236

Johnson & Johnson Pharmaceutical Research & Development L.L.C., a member of Johnson and Johnson's family of companies, is recruiting for a Principal Research Scientist for Network  

E-print Network

. manufactures products including REMICADE® (infliximab) for the treatment of rheumatoid arthritis, Crohn's disease, ankylosing spondylitis and psoriatic arthritis, and ReoPro® (abciximab) for use in percutaneous

Dalkilic, Mehmet

237

Pyogenic spondylitis.  

PubMed

Pyogenic spondylitis is a neurological and life threatening condition. It encompasses a broad range of clinical entities, including pyogenic spondylodiscitis, septic discitis, vertebral osteomyelitis, and epidural abscess. The incidence though low appears to be on the rise. The diagnosis is based on clinical, radiological, blood and tissue cultures and histopathological findings. Most of the cases can be treated non-operatively. Surgical treatment is required in 10-20% of patients. Anterior decompression, debridement and fusion are generally recommended and instrumentation is acceptable after good surgical debridement with postoperative antibiotic cover. PMID:22033610

Cheung, W Y; Luk, Keith D K

2012-02-01

238

Rheumatoid arthritis, spondyloarthropathies, and relapsing polychondritis.  

PubMed

The neurologic complications of rheumatic disease are highly variable and their manifestations are linked to the pathogenesis and clinical phenotype of the specific rheumatologic syndrome. In active rheumatoid arthritis (RA), the peripheral nervous system is most commonly involved and mononeuritis multiplex, nerve entrapment and vascultitic sensorimotor neuropathy are not uncommon. Central nervous system complications such as pachymeningitis and cerebral vasculitis are rare. TNF blockade therapy of RA is rarely associated with demyelinating syndromes. In the spondyloarthropathies, especially ankylosing spondylitis (AS), neurologic complications are more frequent in long-standing, advanced disease and include atlantoaxial subluxation, cauda equina syndrome, spinal stenosis, and acute vertebral fractures. Peripheral nervous system involvement in any of the spondyloarthropaties is rare. Relapsing polychondritis (RP) is characterized by recurring bouts of inflammation, destruction of cartilaginous structures, and systemic and rarely central nervous system vasculitis. Visual-oculo and auditory complications are common. Definitive treatment of the neurologic complications and prevention of subsequent ones is dependent upon effective treatment of RA, AS or RP. PMID:24365312

Ostrowski, Rochella A; Takagishi, Troy; Robinson, John

2014-01-01

239

Epidemiologische und prognostische Aspekte bei der Spondylitis ankylosans  

Microsoft Academic Search

Zusammenfassung Die Spondyloarthritiden (SpA) umfassen die ankylosierende Spondylitis (AS), die reaktive Spondylo-Arthritis, bestimmte Formen der SpA bei Psoriasis-Arthritis (PsSpA) und die SpA bei den chronisch-entzündlichen Darmerkrankungen. Eine wichtige Bereicherung für die klinische Erfassung des ganzen Spektrums der SpA ist die Einführung des Begriffs undifferenzierte Spondyloarthritis (uSpA). Dabei handelt es sich um Patienten mit den klassischen Leitsymptomen einer SpA wie „entzündlicher

J. Braun

2004-01-01

240

Induction of Regulatory t Cells by Low Dose il2 in Autoimmune and Inflammatory Diseases  

ClinicalTrials.gov

Rheumatoid Arthritis; Ankylosing Spondylitis; Systemic Lupus Erythematosus; Psoriasis; Behcet's Disease; Wegener's Granulomatosis; Takayasu's Disease; Crohn's Disease; Ulcerative Colitis; Autoimmune Hepatitis; Sclerosing Cholangitis

2014-02-06

241

[Osteoscintigraphy in the diagnosis of rheumatoid arthritis and Bechterew's diseases].  

PubMed

The paper is concerned with an analysis of the results of clinical and radionuclide examination of 36 patients with ankylosing spondylitis (AS) and 63 patients with rheumatoid arthritis (RA). The period of observation lasted from several week to 5 yrs. Osteoscintigraphy was performed using labeled agents. The data obtained coincided with pain sensations whereas the correspondence of painful zones and x-ray findings was noted in 39% of the patients. In RA hyperfixation of the drug was determined mainly in small and big joints (130-250%) in 92% of the patients coinciding with the pain syndrome and with X-ray findings in 38% of the cases only. Radionuclide signs of therapeutic efficacy were noted in 56% of the patients with AS and in 82% of the patients with RA. Radiation exposure of the bone marrow in osteoscintigraphy and x-ray investigation was defined (4.1 and 14.4 microGy). A radioimmunoassay showed elevated content of PTH in 67% of the patients with AS up to 4.0 +/- 0.5 iu/ml. PMID:3561209

Naumenko, A Z; Kudriashova, A P; Korsunski?, V N; Belova, I A

1987-03-01

242

Global Metabolite Profiling of Synovial Fluid for the Specific Diagnosis of Rheumatoid Arthritis from Other Inflammatory Arthritis  

PubMed Central

Currently, reliable biomarkers that can be used to distinguish rheumatoid arthritis (RA) from other inflammatory diseases are unavailable. To find possible distinctive metabolic patterns and biomarker candidates for RA, we performed global metabolite profiling of synovial fluid samples. Synovial fluid samples from 38 patients with RA, ankylosing spondylitis, Behçet's disease, and gout were analyzed by gas chromatography/time-of-flight mass spectrometry (GC/TOF MS). Orthogonal partial least-squares discriminant and hierarchical clustering analyses were performed for the discrimination of RA and non-RA groups. Variable importance for projection values were determined, and the Wilcoxon-Mann-Whitney test and the breakdown and one-way analysis of variance were conducted to identify potential biomarkers for RA. A total of 105 metabolites were identified from synovial fluid samples. The score plot of orthogonal partial least squares discriminant analysis showed significant discrimination between the RA and non-RA groups. The 20 metabolites, including citrulline, succinate, glutamine, octadecanol, isopalmitic acid, and glycerol, were identified as potential biomarkers for RA. These metabolites were found to be associated with the urea and TCA cycles as well as fatty acid and amino acid metabolism. The metabolomic analysis results demonstrated that global metabolite profiling by GC/TOF MS might be a useful tool for the effective diagnosis and further understanding of RA. PMID:24887281

Xuan, Jinhua; Jung, Young Hoon; Cha, Hoon-Suk; Kim, Kyoung Heon

2014-01-01

243

C-reactive protein gene and Toll-like receptor 4 gene polymorphisms can relate to the development of psoriatic arthritis.  

PubMed

We aimed to determine in psoriatic arthritis (PsA) patients the Toll-like receptor (TLR) 4 and C-reactive gene (CRP) polymorphisms and allele frequency and to investigate the relationship between clinical parameters and gene polymorphisms. We enrolled in this study 31 PsA and 41 healthy control subjects. PsA diagnosis was according to CASPAR criteria. Bath ankylosing spondylitis diseases activity index, Maastricht ankylosing spondylitis enthesitis score, and Bath ankylosing spondylitis functional index were measured. C, A, and T alleles of CRP and A and G alleles of TLR 4 were determined using the analysis of melting curves after real-time PCR. CRP A, C, and T allele frequency in controls was 26.8, 73.2, and 36.6 %, respectively. In the PsA patient group, A, C, and T allele frequency was 9.7, 87.1, and 12.9 %, respectively. Between control and PsA groups, there was a significant difference in A, C, and T allele frequency (P?=?0.008, 0.038, and 0.001, respectively). The frequency of CRP gene polymorphisms (CA, AA, CT, TA, and TT alleles) in the control group was 56.1 % and in the PsA group was 22.6 %. There was a significant difference between the two groups (P?=?0.004). The absence of a CRP gene polymorphism was a risk factor for PsA (odds ratio 4.3, 95 % CI; 1.5-12.4, P?=?0.005). TLR gene haploid frequency was investigated, and all control subjects had the wild-type AA allele. PsA patient GA allele frequency was 6.5 %. There was no significant difference between the two groups (P?=?0.182). GA mutant allele frequency was related to PsA (odds ratio 7.03, 95 % CI; 0.32-151.9, P?=?0.214). We have shown that CRP gene polymorphisms are higher in control subjects than PsA patients, and TLR 4 gene polymorphisms were found to be related to PsA. PMID:24696367

Akbal, Ayla; O?uz, Sevilay; Gökmen, Ferhat; Bilim, Serhat; Re?orlu, Hatice; S?lan, Fatma; Uluda?, Ahmet

2015-02-01

244

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

PubMed

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

Vaverka, M; Hrabálek, L

2001-01-01

245

Switching TNF antagonists in patients with chronic arthritis: an observational study of 488 patients over a four-year period  

PubMed Central

The objective of this work is to analyze the survival of infliximab, etanercept and adalimumab in patients who have switched among tumor necrosis factor (TNF) antagonists for the treatment of chronic arthritis. BIOBADASER is a national registry of patients with different forms of chronic arthritis who are treated with biologics. Using this registry, we have analyzed patient switching of TNF antagonists. The cumulative discontinuation rate was calculated using the actuarial method. The log-rank test was used to compare survival curves, and Cox regression models were used to assess independent factors associated with discontinuing medication. Between February 2000 and September 2004, 4,706 patients were registered in BIOBADASER, of whom 68% had rheumatoid arthritis, 11% ankylosing spondylitis, 10% psoriatic arthritis, and 11% other forms of chronic arthritis. One- and two-year drug survival rates of the TNF antagonist were 0.83 and 0.75, respectively. There were 488 patients treated with more than one TNF antagonist. In this situation, survival of the second TNF antagonist decreased to 0.68 and 0.60 at 1 and 2 years, respectively. Survival was better in patients replacing the first TNF antagonist because of adverse events (hazard ratio (HR) for discontinuation 0.55 (95% confidence interval (CI), 0.34–0.84)), and worse in patients older than 60 years (HR 1.10 (95% CI 0.97–2.49)) or who were treated with infliximab (HR 3.22 (95% CI 2.13–4.87)). In summary, in patients who require continuous therapy and have failed to respond to a TNF antagonist, replacement with a different TNF antagonist may be of use under certain situations. This issue will deserve continuous reassessment with the arrival of new medications. PMID:16507128

Gomez-Reino, Juan J; Carmona, Loreto

2006-01-01

246

Prehistoric juvenile rheumatoid arthritis in a precontact Louisiana native population reconsidered.  

PubMed

Descriptions of skeletal pathological conditions evident in the prehistoric Tchefuncte adolescent 16ST1-14883b are clarified. The basis is reaffirmed for assigning to the described pathological conditions a diagnostic perspective of juvenile rheumatoid arthritis or juvenile Lyme disease--a disease that mimics juvenile rheumatoid arthritis in its arthritic presentation--rather than of assigning them as representative of juvenile onset ankylosing spondylitis or other juvenile spondyloarthropathies. A hypothesis (Lewis [1994] Am. J. Phys. Anthropol. 93:455-475) is restated that 1) the spirochete Borrelia burgdorferi was the infectious agent responsible for prevalence of adult rheumatoid arthritis in prehistoric southeastern Native American populations, 2) that B. burgdorferi is a possible cause of the arthritis evident in individual 16ST1-14883b, and 3) that antibodies to B. burgdorferi provided partial immunity to the related spirochete Treponema pallidum for the 16ST1 precontact Tchefuncte population from Louisiana, protecting them from severe treponemal response. Given the probable widespread existence of Ixodid tick vectors for B. burgdorferi in prehistoric North America, coupled with the existence of treponematosis, it follows that the transition of Native American hunting-gathering economies to more sedentary economies would predictably be linked to an increased incidence of treponematosis due to the loss of benefits of the above-stated partial immunity. In other words, as prehistoric Native American exposure to tick vectors for B. burgdorferi decreased, susceptibility to treponematosis increased. Inferences regarding biological controls interacting with and influencing prehistoric Native American migration patterns are suggested from the link of B. burgdorferi to an Ixodid tick common to northeast Asia. PMID:9637186

Lewis, B A

1998-06-01

247

Blocking the effects of interleukin-6 in rheumatoid arthritis and other inflammatory rheumatic diseases: systematic literature review and meta-analysis informing a consensus statement  

PubMed Central

Background Suppression of the immunoinflammatory cascade by targeting interleukin 6 (IL-6) mediated effects constitutes a therapeutic option for chronic inflammatory diseases. Tocilizumab is the only IL-6 inhibitor (IL-6i) licensed for rheumatoid arthritis (RA) and juvenile idiopathic arthritis (JIA), but also other agents targeting either IL-6 or its receptor are investigated in various indications. Objective To review published evidence on safety and efficacy of IL-6i in inflammatory diseases. Methods We performed systematic literature searches in Medline and Cochrane, screened EULAR and American College of Rheumatology meeting-abstracts, and accessed http://www.clinicaltrials.gov. Results Comprehensive evidence supports the efficacy of tocilizumab in RA in DMARD-naïve patients, and after DMARD- and TNFi-failure. Randomised comparisons demonstrate superiority of tocilizumab in JIA, but not ankylosing spondylitis (AS). Other indications are currently investigated. Additional IL-6i show similar efficacy; safety generally appears acceptable. Conclusions IL-6i is effective and safe in RA and JIA, but not in AS. Preliminary results in other indications need substantiation. PMID:23144446

Schoels, Monika M; van der Heijde, Désirée; Breedveld, Ferdinand C; Burmester, Gerd R; Dougados, Maxime; Emery, Paul; Ferraccioli, Gianfranco; Gabay, Cem; Gibofsky, Allan; Gomez-Reino, Juan Jesus; Jones, Graeme; Kvien, Tore K; Murikama, Miho M; Nishimoto, Norihiro; Smolen, Josef S

2013-01-01

248

Serum Soluble Bone Turnover Biomarkers in Psoriatic Arthritis and Psoriatic Spondyloarthropathy.  

PubMed

Because psoriatic arthritis (PsA) is an inflammatory disease of joints, serum soluble biomarkers specific for chronic joint and bone inflammation may predict future disease severity and response to therapy, thereby informing stratified medicine approaches. The objectives of our systematic review were to determine whether serum soluble bone and cartilage turnover biomarkers are (1) associated with PsA or psoriatic spondyloarthropathy; and (2) associated with disease activity, disease severity, or clinical phenotype. Ten studies met eligibility criteria. Matrix metalloproteinase (MMP)-3, Dickkopf (DKK)-1, macrophage colony-stimulating factor (M-CSF), crosslinked telopeptide of collagen-1, and tumor necrosis factor-related apoptosis-inducing ligand were associated with PsA, with equivocal results for osteoprotegerin (OPG) and bone alkaline phosphatase (ALP). MMP-3, DKK-1, M-CSF, CPII:C2C (ratio of cartilage degradation vs byproduct formation), and possibly OPG were associated with PsA independently of psoriasis. C1-2C (a neoepitope released when type 2 cartilage is degraded by collagenases) was associated with both tender and swollen joint counts, and bone morphogenetic protein-4 with patient global assessment of disease, pain score, and the Bath Ankylosing Spondylitis Disease Activity Index. Bone ALP was associated with disease activity. M-CSF and receptor activator of nuclear factor-?B ligand were associated with several plain radiographic features. No studies have investigated biomarker associations specifically with axial PsA. PMID:25362660

Jadon, Deepak R; Nightingale, Alison L; McHugh, Neil J; Lindsay, Mark A; Korendowych, Eleanor; Sengupta, Raj

2014-11-01

249

Centocor, Inc., a member of Johnson and Johnson's family of companies, is recruiting for an Associate Director, Molecular Profiling, located in Radnor, PA.  

E-print Network

® (infliximab) for the treatment of rheumatoid arthritis, Crohn's disease, ankylosing spondylitis and psoriatic arthritis, and ReoPro® (abciximab) for use in percutaneous coronary intervention. Next- generation products

Dalkilic, Mehmet

250

Arthritis - resources  

MedlinePLUS

Resources - arthritis ... The following organizations provide more information on arthritis : American Academy of Orthopaedic Surgeons - http://orthoinfo.aaos.org/menus/arthritis.cfm Arthritis Foundation - www.arthritis.org National Center for Chronic Disease Prevention ...

251

Evaluation of spinal mobility measurements in predicting axial psoriatic arthritis.  

PubMed

Axial psoriatic arthritis (PsA) represents a more severe form of disease than peripheral PsA. We evaluate the usefulness of various spinal mobility measurements in predicting a radiographically defined axial PsA. A cross-sectional study on PsA patients with spinal mobility measurement performed. PsA were classified to axial or peripheral PsA by the presence of sacroiliitis. Three Bath Ankylosing Spondylitis Metrology Indexes (BASMIs) were calculated. The sensitivity, specificity, and area under receiver operator curves (AUC) of each spinal mobility measurement in prediction of axial PsA were analyzed. A total of 125 subjects studied (males 52%) with mean age and duration of illness of 47.5?±?12.4 and 9.2?±?6.7 years. Twenty-nine patients (17 males and duration of illness 12 females) had axial PsA. Axial PsA patients had longer disease duration (p?=?0.05) and more limitation in spinal mobility. Axial PsA patients had higher inflammatory markers and a trend towards poorer global health, higher damaged joint count, and poorer physical function. The tragus-to-wall distance, modified schober test, and lumber side flexion had good sensitivity and specificity in predicting axial PsA. In the logistic regression model, the lumbar side flexion (OR 0.82, 95% CI 0.72-0.92) was independently associated with axial PsA. All three sets of composite scores BASMI(2), BASMI(10), and BASMI (lin) had good prediction for axial PsA (AUC 0.619, 0.626, and 0.618). Spinal mobility measurements and BASMI were useful in differentiating axial and peripheral PsA. Lumber side flexion and modified schober test best differentiate axial and peripheral PsA. PMID:21369764

Leung, Ying-ying; Ho, Kwok Wah; Tam, Lai Shan; Zhu, Tracy Y; Kwok, Lai W; Li, Tena K; Kun, Emily W; Li, Edmund K

2011-09-01

252

Spondylitis Web Info for Teens  

MedlinePLUS

... Stories Bailey Ryan Sarah Tyler Brian Carl Christine Stephanie Ryan P. Rachel Bridgette About Spondylitis Symptoms Diagnosis ... Meet Rachel July 2012 | Ryan P. July 2012 | Stephanie Join Us Join the S.W.I.F.T. ...

253

The CARRA Registry  

ClinicalTrials.gov

Juvenile Idiopathic Arthritis; Systemic Lupus Erythematosus; Mixed Connective Tissue Disease; Juvenile Ankylosing Spondylitis; Juvenile Dermatomyositis; Localized Scleroderma; Systemic Sclerosis; Vasculitis; Sarcoid; Fibromyalgia, Primary; Auto-inflammatory Disease; Idiopathic Uveitis Idiopathic

2014-03-17

254

Infectious Arthritis  

MedlinePLUS

... infected joint One type of infectious arthritis is reactive arthritis. The reaction is to an infection somewhere ... is usually the knee, ankle, or toe. Sometimes, reactive arthritis is set off by an infection in ...

255

High frequency of inflammatory back pain and other features of spondyloarthritis in patients with rheumatoid arthritis.  

PubMed

The aim of this study was to investigate the frequency of patients with rheumatoid arthritis (RA) who have inflammatory back pain (IBP) and meet the existing classification criteria for ankylosing spondylitis (AS) and spondyloarthritis (SpA). We included 167 patients fulfilling the ACR 1987 revised criteria for RA. After obtaining a medical history and performing a physical examination, standard pelvic X-rays for examination of the sacroiliac joints (SIJ) were ordered in all patients. A computed tomography (CT) or magnetic resonance imaging (MRI) of SIJ was performed in patients with suspected radiographic sacroiliitis and MRI of SIJ in those who have IBP but no radiographic sacroiliitis. IBP was defined according to both Calin and experts' criteria. The modified New York (mNY) criteria were used to classify AS, both ESSG and Amor criteria for SpA and ASAS classification criteria for axial SpA. There were 135 female and 32 male patients with a mean age of 54.8 years. The mean disease duration was 9.8 years. RF was positive in 128 patients (79.2 %) and anti-CCP in 120 patients (81.1 %). Twenty-eight patients with RA (16.8 %) had IBP (Calin criteria), and four (2.4 %) had radiographic sacroiliitis of bilateral grade 3. Three patients (1.8 %) fulfilled the mNY criteria for AS, 31 (18.6 %) ESSG and 26 (15.6 %) Amor criteria for SpA. Nine patients (five with MRI sacroiliitis) (5.3 %) were classified as having axial SpA according to new ASAS classification criteria. This study suggests that the prevalence of SpA features in patients with RA may be much higher than expected. PMID:23129430

Can, Gercek; Solmaz, Dilek; Binicier, Omer; Akar, Servet; Birlik, Merih; Soysal, Ozgul; Akkoc, Nurullah; Manisali, Metin; Onen, Fatos

2013-05-01

256

The validity of the diagnosis of inflammatory arthritis in a large population-based primary care database  

PubMed Central

Background Large population-based databases based on electronic medical records (EMRs) of patients in primary care are a useful data source to investigate morbidity and health care utilization. Diagnoses recorded in EMRs are doctor-defined, but their validity can be disputed. In this study we investigated the validity of the diagnosis inflammatory arthritis (IA), a group of chronic rheumatic diseases, including rheumatoid arthritis, psoriatic arthritis and ankylosing spondylitis, in primary care based EMRs. Methods In five general practices, participating in the Netherlands Information Network of General Practice (LINH), EMRs of 219 patients with a diagnostic code of IA were systematically reviewed on characteristics which are not routinely extracted for the LINH database. The diagnosis IA was confirmed when we found, based on a correspondence with a medical specialist, the following diagnoses in the free text fields of the EMR: oligoarthritis, polyarthritis, rheumatoid arthritis and/or spondyloarthropathy. These results were used to determine the validity of the diagnosis IA in EMRs and to develop an algorithm to improve diagnostic validity. Results From the 219 patients diagnosed as IA in the database, the diagnosis IA was confirmed in 155 patients (70.8%). The algorithm, which resulted in a group of patients with as many as possible confirmed IA-diagnosed patients without excluding too many patients from our dataset, was when patients fulfilled at least one of the following three criteria: 1) a repeat prescription for a disease-modifying antirheumatic drug (DMARD) and/or biological agent, 2) ? four contacts or one episode with a diagnostic code for IA, combined with at least two IA-related prescriptions (excluding DMARDs/biological agents), and 3) age at diagnosis ? 61 years. After applying this algorithm, the percentage of correctly diagnosed IA patients increased from 71% to 78% reducing the size of our study population by 36%. Conclusions Based on additional diagnostic information, the diagnosis IA from EMRs of patients in primary care is sufficiently valid when using the proposed algorithm. After applying the algorithm, the percentage of correctly diagnosed IA patients increased from 71% to 78%. PMID:24128086

2013-01-01

257

Determination of ANA specificity using multiplexed fluorescent microsphere immunoassay in patients with ANA positivity at high titres after infliximab treatment: preliminary results  

Microsoft Academic Search

To evaluate ANA specificity using the fully automated multiplexed fluorescent microsphere immunoassay in patients affected\\u000a either by rheumatoid arthritis or ankylosing spondylitis who developed strong positivity for ANA as assessed by indirect immunofluorescent\\u000a method on HEp-2 cells during infliximab treatment. Three men affected by ankylosing spondylitis and 12 women affected by rheumatoid\\u000a arthritis who developed ANA positivity at high titres

Paola Caramaschi; Orazio Ruzzenente; Sara Pieropan; Alessandro Volpe; Antonio Carletto; Lisa Maria Bambara; Domenico Biasi

2007-01-01

258

Juvenile Arthritis  

MedlinePLUS

... medicine, nursing, dentistry, veterinary medicine, the health care system, and preclinical sciences. Where Can People Find More Information About Juvenile Arthritis? National Institute of Arthritis and ...

259

Ventraler Wirbelkörperersatz bei Spondylitis der Lendenwirbelsäule  

Microsoft Academic Search

Zusammenfassung Operationsziel Vermeidung oder Beseitigung einer Kompression auf die nervalen Strukturen. Radikales Débridement mit Ausräumung des entzündlichen Herdes. Wiederherstellung des Wirbelsäulenprofils und Sicherung der Stabilität. Indikationen Spezifische und unspezifische Spondylitis mit neurologischen Ausfallserscheinungen. Spondylitis mit Abszessbildung, fortschreitender Wirbelkörperdestruktion und drohender Instabilität. Kontraindikationen Reduzierter Allgemeinzustand bei Multimorbidität. Operationstechnik Retroperitonealer Lendenwirbelsäulenzugang. Unterbindung der Segmentalgefäße. Ausräumung des entzündlichen Gewebes. Einpassung eines mit autogener

Henning Graßhoff; Jörg Franke; Konrad Mahlfeld

2000-01-01

260

Psoriatic arthritis  

SciTech Connect

This book contains 11 chapters. Some of the titles are: The history and epidemiologic definition of psoriatic arthritis as a distinct entity; Psoriatic arthritis: Further epidemiologic and genetic considerations; The radiologic features of psoriatic arthritis; and Laboratory findings and pathology of psoriatic arthritis.

Gerber, L.H.; Espinoza, L.R.

1985-01-01

261

[Treatment policy for craniovertebral spondylitis].  

PubMed

The paper summarizes the results of surgical treatment in 25 patients with atlantoaxial spondylitis, including 15 with spondylitis of tuberculous etiology and 10 with nonspecific etiology. Ten patients were found to have severe neurological disorder requiring application of skeletal traction behind the malar arches in 5 cases and that of a halo-apparatus to 2 cases in order to eliminate the occurred dislocation and to relieve neurological symptoms. According to the P. Denis concept adapted for the craniovertebral region, all the patients were divided into 3 groups in relation to the degree of anatomic and biomechanical changes. Group 1 patients received medical treatment with firm collar fixation. Group 2 patients with anterior pillar injury underwent transpharyngeal sanitation of an infectious focus and occipitospondylodesis. Decompressive stabilizing operations were performed in all the patients, which consisted of two stages: 1) occipitospondylodesis made, by using a titanium wire and No. 91/198 Simplex bone cement (Howmedica, United Kingdom); 2) transoral access with abscess cavity sanitation; removal of necrotic tissues; thrifty resections of bone tissue portions within the intact tissues; anterior stabilization of the affected portion with an autologous bone graft. Postoperatively, the cervical spine was fixed with a head holder for as long as 3-5 months (until there were clear X-ray signs of bony ankylosis (block) in the area of osteoplasty). Quaternary antituberculous therapy was compulsorily made for 6-9 months. The described procedure for surgical treatment of craniovertebral spondylitis could yield positive results in all cases, by abolishing neurological symptoms and forming bony ankylosis in the atlantoaxial area to restore the supporting capacity of the cervical spine. PMID:17918327

Lavrov, V N; Kiselev, A M

2007-01-01

262

Infection risk in Rheumatoid Arthritis and Spondyloarthropathy patients under treatment with DMARDs, Corticosteroids and TNF-? antagonists  

PubMed Central

Background Infections which complicate rheumatic diseases such as Rheumatoid Arthritis (RA) and Spondyloarthropathy (SpA) (Psoriatic Arthritis [PA] and Ankylosing Spondylitis [AS]), may cause significant morbidity and mortality. However, among the studies on the incidence rate (IR) of infections in such patients, very few have involved controls and the results have been controversial, probably due to methodological difficulties. To estimate infection rates in RA and SpA patients under disease-modifying anti-rheumatic drugs (DMARDs), corticosteroids (CS) and tumor necrosis factor (TNF)? antagonists, alone or combined, a single-centre retrospective observational cohort study has been performed. Patients and methods Incidence rates/100 patient-years of any infections were evaluated in RA and SpA outpatients observed in the period November 1, 2003 through December 31, 2009 and stratified according to therapy. Infection incidence rate ratios (IRR) were calculated using Poisson regression models which adjusted for demographic/clinical characteristics of the patients. Results Three hundred and thirtyone infections [318 (96.1%) non-serious and 13 (3.9%) serious] have been registered among 176 of the 341 patients (52%). The IR/100 patient-years of all infections was 36.3 ranging from 12.4 (DMARDs + CS) to 62.7 (anti-TNF??+?CS). The most frequent infection site was respiratory tract, and bacteria were responsible for three quarters of all infections. In the multivariate analysis, adding anti-TNF? to DMARDs doubled the IRR compared to DMARDs alone, anti-TNF??+?CS significantly tripled it, whereas anti-TNF??+?CS + DMARDs only increased the risk 2.5 times. The degree of disease activity was strongly and significantly associated with the infection risk (severe or moderate versus mild, IRR?=?4). Female sex was significantly associated with increased infection risk, while duration of disease and anti-influenza vaccination were protective, the latter even for cutaneous/soft-tissue (mainly herpetic) infections. Conclusion The combination anti-TNF? with CS was found to be the most pro-infective treatment, whereas DMARDs alone were relatively safe. Physicians, therefore, should be aware that there may be an increased risk of infection when using anti-TNF? and CS therapy together. Anti-influenza vaccination appears to provide broad protection, adding evidence to support its use in these patients, and deserves further study. PMID:24655394

2014-01-01

263

Review of Clinical Registries of Psoriatic Arthritis: Lessons Learned? Value for the Future?  

Microsoft Academic Search

Psoriatic arthritis (PsA), an inflammatory musculoskeletal disease associated with psoriasis, is a complex disease in terms\\u000a of its clinical presentation, etiology, and pathogenesis. Musculoskeletal presentations include peripheral arthritis, spondylitis,\\u000a enthesitis, and dactylitis. To learn about the course of and prognosis for such a complex disease, it is important to observe\\u000a patients longitudinally so that all aspects of the disease are

Dafna D. Gladman; Vinod Chandran

2011-01-01

264

Psoriatic Arthritis  

MedlinePLUS

... more severe skin disease is predictive of an increased risk of joint disease. Diagnostics. The similarity between psoriatic arthritis and other inflammatory forms of arthritis can delay an accurate diagnosis, ...

265

Psoriatic Arthritis  

MedlinePLUS

... of patients who have a skin rash called psoriasis. This particular arthritis can affect any joint in ... Psoriatic arthritis can occur in people without skin psoriasis, particularly in those who have relatives with psoriasis. ...

266

Figure 1: Confocal image of synovial fibroblasts -often called  

E-print Network

destruction" in rheumatoid arthritis. Figure 2: Schematic of the live-cell/supported membrane hybrid. Cells in the pathogenesis of autoimmune and/or systemic inflammatory diseases, such as rheumatoid arthritis (RA), ankylosing spondylitis, psoriatic arthritis, and Chron's disease. As a result, TNF- blockade is currently being explored

Mather, Patrick T.

267

Juvenile spondyloarthropathies: clinical manifestations and medical imaging  

Microsoft Academic Search

The spondyloarthropathies comprise four distinct entities — ankylosing spondylitis, psoriatic arthritis, the arthritis associated with inflammatory bowel disease, and Reiter's syndrome and other related forms of reactive arthritis. Although these are distinct diseases, they have a number of clinical, radiologie, and genetic characteristics in common which permit them to be classified under the unifying term “spondyloarthropathy”. They are diseases of

E. Michel Azouz; Ciarfin M. Duffy

1995-01-01

268

Diagnostic imaging of sacroiliac joints and the spine in the course of spondyloarthropathies  

PubMed Central

Summary Spondyloarthropathies belong to a group of rheumatic diseases, in which inflammatory changes affect mainly the sacroiliac joints, spine, peripheral joints, tendon, ligaments and capsule attachments (entheses). This group includes 6 entities: ankylosing spondylitis, arthritis associated with inflammatory bowel disease, reactive arthritis, undifferentiated spondyloarthropathy, psoriatic arthritis and juvenile spondyloarthropathy. In 2009, ASAS (Assessment in SpondyloArthritis international Society) association, published classification criteria for spondyloarthropathies, which propose standardization of clinical-diagnostic approach in the case of sacroiliitis, spondylitis and arthritis. Radiological diagnosis of inflammatory changes of sacroiliac joints is based on a 4 step radiographic grading method from 1966. According to modified New York criteria, the diagnosis of ankylosing spondylitis is made based on the presence of advanced lesions, sacroiliitis of at least 2 grade bilaterally or 3–4 unilaterally. In case of other types of spondyloarthropathies diagnosis is made based on presence of at least grade 1 changes. In MRI, active inflammation of sacroiliac joints is indicated by the presence of subchondral bone marrow edema, synovitis, bursitis, or enthesitis. ASAS discusses only the classic form of axial spondyloarthropathies, which is ankylosing spondylitis. To quantify radiological inflammatory changes in the course of the disease, Stoke Ankylosing spondylitis classification Spinal Score (SASSS) is recommended. The signs of inflammation and scarrying of the spinal cord in the course of ankylosing spondylitis, present in MRI include: bone marrow edema, sclerosis, fat metaplasia, formation of syndesmophytes, and ankylosis. PMID:23807884

Sudo?-Szopinska, Iwona; Urbanik, Andrzej

2013-01-01

269

Gut inflammation and spondyloarthropathies  

Microsoft Academic Search

Spondyloarthropathies (SpA) are a group of related disorders with common clinical and genetic characteristics. The prototype\\u000a disease in this group is ankylosing spondylitis; other entities include reactive arthritis, psoriatic arthritis, and arthritis\\u000a in patients with inflammatory bowel disease. Over recent years, there has been a special interest in the relation between\\u000a spondylitis\\/ synovitis and gut inflammation in patients with SpA.

Filip De Keyser; Dominique Baeten; Filip Van den Bosch; Martine De Vos; Claude Cuvelier; Herman Mielants; Eric Veys

2002-01-01

270

Comparison of two ELISA versions for infliximab serum levels in patients diagnosed with ankylosing spondylitis.  

PubMed

There are various immunosorbent assays which can be used to determine infliximab (IFX) levels. Results vary between assays complicating reliability in everyday clinical practice. The aim of this study was to determine whether quantitative or qualitative assay data prove more accurate in the assessment of infliximab levels in AS patients. We analyzed 40 serum samples, taken prior to infusion, from AS patients who had been undergoing IFX therapy as a first-line of biological treatment for more than a year. IFX levels and IFX-anti-drug antibodies (ADA) were measured using two different ELISA assays [Promonitor(®) IFX R1 and R2 (version 1), Promonitor(®) IFX and anti-IFX (version 2) (Progenika Biopharma, Spain)] strictly following the manufacturer's guidelines. Cohen's unweighted kappa and the intraclass correlation coefficient determined qualitative and quantitative agreement for serum levels in version 1 and version 2. Bland-Altman plots were drawn to compare both assays. The comparison of data measuring IFX levels for version 1 and version 2 resulted in questionable quantitative agreement (ICC 0.659; 95 % CI 0.317-0.830) and moderate qualitative agreement (? 0.607; 95 % CI 0.387-0.879) owing to systematically higher values in version 2 than version 1. Version 2 consistently detected higher levels of infliximab, particularly when analyzed in a quantitative context. Further research is needed to synchronize cutoff levels between essays and diseases so therapeutic drug ranges can be established. PMID:25410014

Hernández-Flórez, Diana; Valor, Lara; de la Torre, Inmaculada; Nieto, Juan Carlos; Martínez-Estupiñán, Lina; González, Carlos; López-Longo, Francisco Javier; Monteagudo, Indalecio; Garrido, Jesús; Naredo, Esperanza; Carreño, Luis

2014-11-20

271

Psychological correlates of self-reported functional limitation in patients with ankylosing spondylitis  

E-print Network

n, % Psychological variables: Mean resilience coping (BRCS)psychological measures evaluating depression, resilience,psychological variables were measured: active and pas- sive coping, depression, resilience

2009-01-01

272

Cost effectiveness of combined spa-exercise therapy in ankylosing spondylitis: A randomized controlled trial  

Microsoft Academic Search

Results. A total of 111 patients completed the diary. The between-group difference for the BASFI-AUC was 1.0 (95% confidence interval (95% CI) 0.4-1.6; P 0.001) for group 1 versus controls, and 0.6 (95% CI 0.1-1.1; P 0.020) for group 2 versus controls. The between-group difference for EQ-5Dutility-AUC was 0.17 (95% CI 0.09-0.25; P < 0.001) for group 1 versus controls,

Astrid Van Tubergen; Annelies Boonen; Alita Hidding; Sjef Van Der Linden

2002-01-01

273

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

Microsoft Academic Search

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 -

Astrid van Tubergen; Robert Landewé; Désirée van der Heijde; Alita Hidding; Nico Wolter; Max Asscher; Albrecht Falkenbach; Ekkehard Genth; Henk Goei Thè; Sjef van der Linden

2001-01-01

274

Mannose binding lectin levels are not related to radiographic damage in ankylosing spondylitis  

Microsoft Academic Search

In the current study we aimed to investigate the effect of MBL deficiency in radiographic damage of the spine in a large group\\u000a of AS patients. One hundred and ninety-one AS patients and 85 healthy controls were studied. Disease activity, radiological\\u000a scores, and demographic features were recorded. MBL levels were measured with standard ELISA kits. Results showed that median\\u000a MBL

Sibel Zehra Aydin; Pamir Atagunduz; Burak Erer; Cengiz Bahadir; Nevsun Inanc; Haner Direskeneli

2010-01-01

275

Arthritis: Frequently Asked Questions  

MedlinePLUS

... Program , the Arthritis Foundation Aquatic Program and Enhance Fitness ® and Walk with Ease are all examples of programs designed to help people with arthritis increase their physical activity . For management of specific types of arthritis, refer to Arthritis ...

276

Non-secretion of ABO blood group antigens as a host susceptibility factor in the spondyloarthropathies.  

PubMed Central

Gram negative bacteria precipitate reactive arthritis and may be concerned in the pathogenesis of ankylosing spondylitis and other spondyloarthropathies. Susceptibility to many infectious agents is associated with ABO blood group or secretor state, or both. The distribution of the ABO blood group or secretor state, or both, was therefore determined in 87 patients with ankylosing spondylitis and 32 with other forms of spondyloarthropathy. The prevalence of non-secretors was significantly increased in the total patient group (54/114; 47%) and in the subgroup with ankylosing spondylitis (41/84; 49%) compared with local controls (89/334; 27%) (p less than 0.001). Other subgroups of patients showed a similarly increased prevalence of non-secretion (33-47%). The distribution of ABO blood groups did not differ between patients and controls. The association between non-secretor state and ankylosing spondylitis strengthens the hypothesis that ankylosing spondylitis is a form of reactive arthritis. It also suggests several pathogenic mechanisms which may be relevant to the initial hostparasite interaction in ankylosing spondylitis. PMID:3101813

Shinebaum, R; Blackwell, C C; Forster, P J; Hurst, N P; Weir, D M; Nuki, G

1987-01-01

277

Gonococcal Arthritis  

MedlinePLUS

... sexually active adolescent girls. Two forms of gonococcal arthritis exist: One form involves skin rashes and many joints, usually large joints such as the knee, wrist, and ankle. The second, less common form involves ...

278

Psoriatic arthritis  

MedlinePLUS

... that often occurs with a skin condition called psoriasis . ... inflammatory condition. About 1 in 20 people with psoriasis will develop arthritis with the skin condition. In most cases, psoriasis ...

279

Rheumatoid Arthritis  

MedlinePLUS Videos and Cool Tools

... vertebrae to prevent slippage of the vertebrae. Self-Care Rheumatoid arthritis cannot be cured but it can be managed through medications and self-care. The following are important self-care tips: Exercise ...

280

Psoriatic Arthritis  

MedlinePLUS

Psoriasis is a skin disease that causes itchy or sore patches of thick, red skin with silvery ... other parts of your body. Some people with psoriasis have psoriatic arthritis. It causes pain, stiffness, and ...

281

Septic arthritis  

MedlinePLUS

... are caused by bacteria such as Staphylococcus or Streptococcus . Chronic septic arthritis (which is less common) is ... than adults to be infected with Group B streptococcus or Haemophilus influenza , if they have not been ...

282

Arthritis Advice  

MedlinePLUS

... people most often have osteoarthritis, rheumatoid arthritis, or gout. Osteoarthritis (OA) is the most common type of ... heart , muscles, blood vessels, nervous system, and eyes . Gout is one of the most painful kinds of ...

283

[Ankylosing vertebral hyperostosis and pulmonary function].  

PubMed

Ankylosing vertebral hyperostosis (HVA) or diffuse idiopathic skeletal hyperostosis (DISH) is a disease often seen in the middle-aged and elderly, frequently in patients older than 70 years (10.1% in men, 6.8% in women). Enthesal ossifications can occur at any site of tendinous or ligamentous insertion. The spine is commonly involved. The characteristic appearance is the presence of thick bony bridges between vertebral bodies of the right side of thoracic spine. Many authors, especially Fischer and Stecher, have described hyperostosis of the rib at the costo-vertebral articulation. In our study, 52 patients were examined. The physical examination consisted essentially in pulmonary function and measurement of thoracic and spinal mobility. In spite of severe ankylosing vertebral hyperostosis, which evokes important ossification of the costo-vertebral articulation, we couldn't demonstrate any change in pulmonary function. PMID:2500693

Pardon-Zryd, F; Gobelet, C; Saudan, Y

1989-05-23

284

Cauda Equina Syndrome Associated with Dural Ectasia in Chronic Anlylosing Spondylitis  

PubMed Central

Cauda equina syndrome (CES) associated with dural ectasia is a rare neurologic complication in patients with longstanding ankylosing spondylitis (AS). We report a 68-year-old male with a 30-year history of AS who presented a typical symptom and signs of progressive CES, urinary incontinence and neuropathic pain of the lumbosacral radiculopathy. Computed tomography (CT) and magnetic resonance imaging (MRI) findings showed the unique appearances of dural ectasia, multiple dural diverticula, erosion of posterior element of the lumbar spine, tethering of the conus medullaris and adhesion of the lumbosacral nerve roots to the posterior aspect of the dural ectasia. Considering the progressive worsening of the clinical signs, detethering of the conus medullaris through resection of the filum terminale was performed through a limited laminectomy. However, the urinary incontinence did not improve and there was a partial relief of the neuropathic leg pain only. The possible pathogenetic mechanism of CES-AS and the dural ectasia in this patient with longstanding AS are discussed with a literature review.

Ha, Sang-woo

2014-01-01

285

Hip joint disease in psoriatic arthritis: risk factors and natural history  

PubMed Central

Patients and methods: 504 patients with PsA according to ESSG criteria were studied. Mean follow up was 5.7 years (range <1–45). Mean age at onset of psoriasis was 32 years and of PsA, 39 years. The most common pattern of PsA at onset was oligoarticular (49%) and at the latest examination, polyarticular (65%). Sacroiliitis or spondylitis was diagnosed in 94 (18.7%) patients. Results: 32 (6.3%) patients developed psoriatic hip arthropathy, and of these, 26 (81%) also had sacroiliitis or spondylitis. In 7/17 (41%) patients the hip became affected within 1 year after the onset of PsA. Hip disease occurred more often in younger patients. Sex, pattern of peripheral arthritis, duration of psoriasis before arthritis affected the distal interphalangeal joints, dactylitis, or enthesitis were not associated with the risk of hip disease. Seventeen patients were followed up and nine required hip arthroplasty. Sixteen (50%) first had arthroplasty within 5 years after the onset of hip pain. Conclusions: Psoriatic hip arthropathy occurs infrequently in PsA and is associated with earlier onset of arthritis and psoriatic spondylitis. Bilateral hip involvement and rapid progression to hip arthroplasty are common. PMID:15958761

Michet, C; Mason, T; Mazlumzadeh, M

2005-01-01

286

Arthritis Pathology  

Microsoft Academic Search

The pathologic examination of failed joints, whether natural or artificial, is an indispensable part of the understanding of arthritis, as it is the last, and still best opportunity to determine or verify the correct diagnosis. Accuracy in pathologic diagnosis, based on a firm understanding of the various disease processes, provides reliable data for use in clinical registries, provides an opportunity

Edward F. DiCarlo; Michael J. Klein

287

Grammatical Arthritis.  

ERIC Educational Resources Information Center

Discusses grammatical arthritis (an internal buildup of rules that hinders writing flexibility); four new "rules" (concerning "data is,""none are,""hopefully," and the restrictive "which"); attitudes toward English grammar; how to be a helpful editor; and where to learn about grammar. (SR)

Bush, Don

1994-01-01

288

Reactive arthritis.  

PubMed

Reactive arthritis (ReA) is an immune-mediated seronegative arthritis that belongs to the group of spondyloarthropathies and develops after a gastrointestinal or genitourinary system infection. The condition is considered to be characterized by a triad of symptoms (conjunctivitis, arthritis and urethritis) although a constellation of other manifestations may also be present. ReA is characterized by psoriasiform dermatological manifestations that may resemble those of pustular psoriasis and, similar to guttate psoriasis, is a post-infectious entity. Also, the articular manifestations of the disorder are similar to those of psoriatic arthritis and both conditions show a correlation with HLA-B27. These facts have led several authors to suggest that there is a connection between ReA and psoriasis, listing ReA among the disorders related to psoriasis. However, the pathogenetic mechanism behind the condition is complex and poorly understood. Bacterial antigenicity, the type of host response (i.e. Th1/Th2 imbalance) and various genetic factors (i.e. HLA-B27 etc.) play an important role in the development of the disorder. It is unknown whether all the aforementioned factors are part of a mechanism that could be similar to, or share basic aspects with known psoriasis pathogenesis mechanisms. PMID:25199646

Stavropoulos, P G; Soura, E; Kanelleas, A; Katsambas, A; Antoniou, C

2015-03-01

289

Juvenile Rheumatoid Arthritis  

MedlinePLUS

Juvenile rheumatoid arthritis (JRA) is a type of arthritis that happens in children age 16 or younger. It causes joint swelling, ... reduce swelling and pain. NIH: National Institute of Arthritis and Musculoskeletal and Skin Diseases

290

Forms of Arthritis  

MedlinePLUS

... stiffness, inflammation, swelling and, sometimes, destruction of joints. Gout — a form of arthritis that occurs when uric ... the joints. Some 2.1 million Americans have gout. Lupus — a form of arthritis, like rheumatoid arthritis, ...

291

Calcium pyrophosphate arthritis (Pseudogout)  

MedlinePLUS

Calcium pyrophosphate dihydrate deposition disease; CPPD disease; Acute CPPD arthritis; Pseudogout ... Calcium pyrophosphate arthritis is caused by the collection of salt called calcium pyrophosphate dihydrate (CPPD). The buildup ...

292

Reactive arthritis or chronic infectious arthritis?  

PubMed Central

Microbes reach the synovial cavity either directly during bacteraemia or by transport within lymphoid cells or monocytes. This may stimulate the immune system excessively, triggering arthritis. Some forms of ReA correspond to slow infectious arthritis due to the persistence of microbes and some to an infection triggered arthritis linked to an extra-articular site of infection. PMID:12079895

Sibilia, J; Limbach, F

2002-01-01

293

Imaging of the seronegative spondyloarthropathies  

Microsoft Academic Search

The group of seronegative spondyloarthropathies consists of ankylosing spondylitis, psoriatic arthritis, Reiter’s disease,\\u000a enteropathic spondylitis, and a fifth entity known as undifferentiated spondyloarthropathy. All of these diseases share common\\u000a clinical and radiographic features with characteristic involvement of the sacroiliac joints, spine, and to various degrees,\\u000a the peripheral joints. Although plain radiographs are the first line of imaging investigation, they are

Angela A. Luong; David C. Salonen

2000-01-01

294

Performance of response scales of activity and functional measures of ankylosing spondylitis: numerical rating scale versus visual analog scale.  

PubMed

The aim of this study was to compare the performance characteristics of two answer modalities for BASDAI and BASFI in patients with AS and to show validity and reliability of NRS in Turkish version. BASDAI and BASFI were simultaneously employed with a 10-cm VAS and an 11-point NRS. Internal consistency was assessed by using Cronbach's alpha coefficients. Testing was performed on baseline and next day under standardized conditions. Construct validity was determined by association of these measures with ASDAS, DFI, global disease activity, pain scores, ASQOL, HAQ, and SF-36. We also tested the ability of NRS version of BASDAI and BASFI to detect changes. A total 114 patients with AS according to the modified New York criteria were included. There was a good agreement between the total scores of each instrument on day 0 (ICC values were 0.894-0.934). Scores of the both answering modality of each instrument were correlated with ASDAS-CRP, and the scores of DFI, patient global assessment of disease activity and patient-reported pain, ASQOL, HAQ. Response time for BASDAI and BASFI was significantly shorter in NRS answer modality (P < 0.001). Our patients found NRS modality more comprehensible and easier to understand (P < 0.001). Our results showed the validity of NRS version of BASDAI and BASFI and provided an evidence for using these questionnaires in 11-point NRS answer modality in Turkish AS patients. PMID:23736275

Akad, Kivanc; Solmaz, Dilek; Sari, Ismail; Onen, Fatos; Akkoc, Nurullah; Akar, Servet

2013-10-01

295

Potential of 18F-FDG-PET as a valuable adjunct to clinical and response assessment in rheumatoid arthritis and seronegative spondyloarthropathies  

PubMed Central

AIM: To evaluate the role of fluorine-18-labeled fluorodeoxyglucose positron emission tomography (18F-FDG PET) in various rheumatic diseases and its potential in the early assessment of treatment response in a limited number of patients. METHODS: This study involved 28 newly diagnosed patients, of these 17 had rheumatoid arthritis (RA) and 11 had seronegative spondyloarthropathy (SSA). In the SSA group, 7 patients had ankylosing spondylitis, 3 had psoriatic arthritis, and one had non-specific SSA. Patients with RA were selected as per the American College of Rheumatology criteria. One hour after FDG injection, a whole body PET scan was performed from the skull vertex to below the knee joints using a GE Advance dedicated PET scanner. Separate scans were acquired for both upper and lower limbs. Post-treatment scans were performed in 9 patients in the RA group (at 6-9 wk from baseline) and in 1 patient with psoriatic arthropathy. The pattern of FDG uptake was analysed visually and quantified as maximum standardized uptake value (SUVmax) in a standard region of interest. Metabolic response on the scan was assessed qualitatively and quantitatively and was correlated with clinical assessment. RESULTS: The qualitative FDG uptake was in agreement with the clinically involved joints, erythrocyte sedimentation rate, C-reactive protein values and the clinical assessment by the rheumatologist. All 17 patients in the RA group showed the highest FDG avidity in painful/swollen/tender joints. The uptake pattern was homogeneous, intense and poly-articular in distribution. Hypermetabolism in the regional nodes (axillary nodes in the case of upper limb joint involvement and inguinal nodes in lower limb joints) was a constant feature in patients with RA. Multiple other extra-articular lesions were also observed including thyroid glands (in associated thyroiditis) and in the subcutaneous nodules. Treatment response was better appreciated using SUVmax values than visual interpretation, when compared with clinical evaluation. Four patients showed a favourable response, while 3 had stable disease and 2 showed disease progression. The resolution of regional nodal uptake (axillary or inguinal nodes based on site of joint involvement) in RA following disease modifying anti-rheumatoid drugs was noteworthy, which could be regarded as an additional parameter for identifying responding patients. In the SSA group, uptake in the affected joint was heterogeneous, low grade and non-symmetrical. In particular, there was intense tendon and muscular uptake corresponding to symptomatic joints. The patients with psoriatic arthritis showed intense FDG uptake in the joints and soft tissue. CONCLUSION: 18F-FDG PET accurately delineates the ongoing inflammatory activity in various rheumatic diseases (both at articular and extra-articular sites) and relates well to clinical symptoms. Different metabolic patterns on FDG-PET scanning in RA and SSA can have important implications for their diagnosis and management in the future with the support of larger studies. FDG-PET molecular imaging is also a sensitive tool in the early assessment of treatment response, especially when using quantitative information. With these benefits, FDG-PET could play a pivotal clinical role in the management of inflammatory joint disorders in the future. PMID:23320137

Vijayant, Vishu; Sarma, Manjit; Aurangabadkar, Hrushikesh; Bichile, Lata; Basu, Sandip

2012-01-01

296

Investigation of joint disease  

Microsoft Academic Search

The role of nuclear medicine in the diagnosis and management of the major arthropathies is critically reviewed, with particular reference to osteoarthritis, rheumatoid and similar forms of arthritis, ankylosing spondylitis, non-specific back pain, gout, the neuropathic joint, avascular necrosis, infection and the consequences of prosthetic joint insertion. Attention is drawn both to practical applications and deficiencies in current techniques and

M. V. Merrick

1992-01-01

297

[Urgent indications for spinal surgery in patients with rheumatoid inflammation].  

PubMed

The urgency of spinal procedures for rheumatoid inflammatory disease is presented in three typical spinal involvements. Characteristic connections between rheumatoid arthritis and the cervical spine, spinal fractures in ankylosing spondylitis and the occurrence of bacterial spondylodiscitis as a side effect of immunosuppression are discussed. PMID:17268787

Wiesner, L; Steinhagen, J; Hansen-Algenstaedt, N; Rüther, W

2007-02-01

298

Clinical, radiographic and MRI findings of the temporomandibular joint in patients with different rheumatic diseases  

Microsoft Academic Search

The aim of this study was to investigate the condition of the temporomandibular joint (TMJ) in patients with different rheumatic diseases, and report correlations between the clinical, radiographic and magnetic resonance imaging (MRI) findings. The 67 patients were divided into four groups: 16 with rheumatoid arthritis (RA), 15 with mixed connective tissue disease (MCTD), 18 with ankylosing spondylitis (AS) and

L. M. J. Helenius; P. Tervahartiala; I. Helenius; J. Al-Sukhun; L. Kivisaari; R. Suuronen; H. Kautiainen; D. Hallikainen; C. Lindqvist; M. Leirisalo-Repo

2006-01-01

299

HLA B27 related 'unclassifiable' seronegative spondyloarthropathies  

Microsoft Academic Search

Twenty-five patients (22 males and 3 females) are described who had 'unclassifiable' seronegative peripheral arthritis affecting mainly the large joints of the lower limbs with other typical features of spondyloarthropathies such as heel pain, low back pain, and mucosal ulcers. But their disorders could not be diagnosed as any specific spondyloarthropathy such as ankylosing spondylitis, Reiter's disease, etc. The mean

S Prakash; N K Mehra; S Bhargava; A N Malaviya

1983-01-01

300

Treatment of spondyloarthropathies. Recent advances and prospects in 2001  

Microsoft Academic Search

The management of patients with spondyloarthropathy is undergoing radical changes in several areas and for several reasons. The main reason seems to be improved awareness of the fairly high prevalence of this group of disorders, which is close to that of rheumatoid arthritis. Evaluation of the various treatment modalities has benefited from work by the international Assessment in Ankylosing Spondylitis

Maxime Dougados

2001-01-01

301

What Is Psoriatic Arthritis?  

MedlinePLUS

... necessary for most people with psoriatic arthritis. Improved Quality of Life Recent advances are allowing many with psoriatic arthritis to experience remarkable improvements. It is believed that ongoing research will advance current treatments and continue to improve ...

302

Headache and Arthritis  

MedlinePLUS

... cases the spine may be involved, frequently the cervical spine (the vertebrae of the neck). The areas of the neck most commonly afflicted by rheumatoid arthritis are the first and second cervical vertebra. The more common form of arthritis is ...

303

Arthritis and the Feet  

MedlinePLUS

... percent of the most serious cases, usually of rheumatoid arthritis, result in such severe disability that walking aids or wheelchairs are required. The objectives in the treatment of arthritis are controlling inflammation, preserving joint function ( ...

304

What Is Juvenile Arthritis?  

MedlinePLUS

... workers. Do Children With Juvenile Arthritis Have to Limit Activities? Pain sometimes limits what children with juvenile arthritis can do. However, ... your child’s doctor may advise your child to limit certain activities. It will depend on the joints ...

305

Arthritis of the Hand  

MedlinePLUS

... American Academy of Orthopaedic Surgeons. Arthritis of the Hand The hand and wrist have multiple small joints that work ... Arthritis can occur in many areas of the hand and wrist and can have more than one ...

306

Sex and Arthritis  

MedlinePLUS

... Pain Pregnancy and Rheumatic Disease Sex and Arthritis Sex and Arthritis PRINT Download PDF Description Sexuality is ... sensation Erectile dysfunction or impotence Begin overcoming barriers Sex is not simply about reaching rapid orgasm with ...

307

Estimates Childhood Arthritis  

MedlinePLUS

... find a rheumatologist, use the American College of Rheumatology Geographic Membership Directory . Data Source: Sacks JJ, Helmick ... visits from selected pediatric conditions Childhood Arthritis and Rheumatology Research Alliance (CARRA) Arthritis Foundation American College of ...

308

Juvenile Idiopathic Arthritis  

MedlinePLUS

... of inflammatory problems. What is Juvenile Idiopathic Arthritis (JIA)? JIA is defined as arthritis (inflammation of the ... confirm the diagnosis. What are the symptoms of JIA? Symptoms include joint pain and tenderness, redness over ...

309

Decoronation for the management of an ankylosed young permanent tooth.  

PubMed

Replacement resorption rate is a variable process, and is dependent on age, basal metabolic rate, extra-alveolar time, treatment prior to replantation, amount of root dentin, severity of trauma, and extent of periodontal ligament necrosis. In patients 7-16 years old a tooth is lost 3-7 years after the onset of root resorption. The complications that may develop as a consequence of ankylosis of a permanent incisor in children are due to the inevitable early loss of the traumatized tooth and local arrest of alveolar bone development. An ankylosed tooth should be removed before the changes become so pronounced that they compromise future prosthetic treatment. The treatment options may involve: interceptive regenerative treatment, early extraction of the ankylosed tooth, orthodontic space closure, intentional replantation, extraction of the ankylosed tooth followed with immediate ridge augmentation/preservation, auto-transplantation, single tooth dento-osseous osteotomy, and decoronation. The purpose of this article was to review the considerations involved in the decision-making concerning the use of the decoronation technique for the treatment of a permanent incisor diagnosed as ankylosed. PMID:18173685

Sapir, Shabtai; Shapira, Joseph

2008-02-01

310

Rheumatoid Arthritis Educational Video Series  

MedlinePLUS

... Rheumatoid Arthritis Educational Video Series Rheumatoid Arthritis Educational Video Series This series of five videos was designed ... Activity Role of Body Weight in Osteoarthritis Educational Videos for Patients Rheumatoid Arthritis Educational Video Series Psoriatic ...

311

Quick Stats on Arthritis  

MedlinePLUS

... Publications Chronological Topic Based Healthy People Reports Podcasts Interventions Self-Management Campaigns Physical Activity. The Arthritis Pain Reliever Download Campaign Materials Download Spanish Materials Download ...

312

Classification of Psoriatic Arthritis  

MedlinePLUS

Toggle navigation Large Dropdown Menu Psoriasis About Psoriasis Treatments Related Conditions Women and Psoriasis Life with Psoriasis Access Health Care Resources and Tools Educational Webcasts Psoriatic Arthritis ...

313

Treating Psoriatic Arthritis  

MedlinePLUS

Toggle navigation Large Dropdown Menu Psoriasis About Psoriasis Treatments Related Conditions Women and Psoriasis Life with Psoriasis Access Health Care Resources and Tools Educational Webcasts Psoriatic Arthritis ...

314

Diagnosing Psoriatic Arthritis  

MedlinePLUS

Toggle navigation Large Dropdown Menu Psoriasis About Psoriasis Treatments Related Conditions Women and Psoriasis Life with Psoriasis Access Health Care Resources and Tools Educational Webcasts Psoriatic Arthritis ...

315

Hallux metatarsophalangeal arthritis.  

PubMed

Arthritis of the hallux metatarsophalangeal joint is a common disorder that affects shoewear, ambulation, and other activities of daily living. Etiologies include degenerative arthritis (hallux rigidus), crystal induced arthropathy (gout, pseudogout), rheumatoid arthritis, the seronegative spondyloathropathies, posttraumatic degeneration, and advanced hallux valgus. Accurate diagnosis and selection of the appropriate intervention depends on recognition of pertinent clinical and radiographic features. This study presents a synopsis of the senior author's (LCS) experience with 439 surgically treated patients with hallux metatarsophalangeal arthritis, focusing on origin and treatment. PMID:9584362

Weinfeld, S B; Schon, L C

1998-04-01

316

Ultrasonography of entheseal insertions in the lower limb in spondyloarthropathy  

Microsoft Academic Search

Objective: To compare ultrasonography (US) with clinical examination in the detection of entheseal abnormality of the lower limb in patients with spondyloarthropathy (SpA).Methods: 35 patients with SpA (ankylosing spondylitis 27; psoriatic arthritis 7; reactive arthritis 1) underwent independent clinical and ultrasonographic examination of both lower limbs at five entheseal sites—superior pole and inferior pole of patella, tibial tuberosity, Achilles tendon,

P V Balint; D Kane; H Wilson; I B McInnes; R D Sturrock

2002-01-01

317

Spondyloarthropathies  

Microsoft Academic Search

The spondyloarthropathies include ankylosing spondylitis, reactive arthritis (including Reiter's syndrome), psoriatic arthritis, inflammatory bowel disease-associated spondyloarthropathy, and undifferentiated spondyloarthropathy. These diseases are linked by their association with the HLA-B27 gene and by the presence of enthesitis as the basic pathologic lesion. Additional clinical features include inflammatory back pain, dactylitis, and extra-articular manifestations such as uveitis and skin rash. The history

RAJESH K. KATARIA; LAWRENCE H. BRENT

318

Profile of arthritis disability.  

PubMed Central

Using the 1994-95 National Health Interview Supplement Disability Supplement, the authors study levels of disabilities and accommodations among US adults with arthritis disability, compared to people with disability due to other conditions. Arthritis-disabled people are defined in two ways. One definition covers a broad range of arthritis and rheumatic conditions, and the other concentrates solely on arthritis. The authors find that arthritis-disabled people have more total disabilities than other-disabled peop e. However, their disabilities are less severe, have shorter durations, and accumulate more gradually over time. Despite more disabilities, people with arthritis disability use fewer assistive and service accommodations than other-disabled people. They do use more mobility aids. Because arthritis is the leading chronic condition for middle-aged and older adults, th s profile of extensive but mild-to-moderate disability is experienced by many millions of adults. Accommodations for arthritis may also be extensive but aimed more toward self-care than toward assistive and medical services. PMID:11889283

Verbrugge, L. M.; Juarez, L.

2001-01-01

319

Arthritis in children.  

PubMed

Chronic arthritis in children is uncommon. Careful clinical and laboratory studies over many years have defined subgroups of disease that have their characteristic pattern of joint development and disease course. The prognosis for children who have arthritis is generally excellent but it may take years of care by a variety of specialists to achieve optimum results. PMID:3899235

Craft, A W

1985-04-01

320

Heredity and Arthritis  

MedlinePLUS

... between smoking and DR4 that leads to an increased rheumatoid arthritis risk. Genetics and lupus Systemic lupus erythematosus (SLE) is a chronic inflammatory disease that can affect skin, joints, kidneys, lungs ...

321

Arthritis: Data and Statistics  

MedlinePLUS

... About CDC.gov . Arthritis Share Compartir Data and Statistics National Statistics Based on 2010-2012 data from the National ... survey conducted by the National Center for Health Statistics. Each year, the NHIS samples U.S. households and ...

322

[Yersinia arthritis (author's transl)].  

PubMed

Clinical picture and differential diagnosis of Yersinia arthritis are shown by means of three own observations. It is an acute oligoarthritis affecting especially knee- and ankle-joints. The involved joints are very painful, swollen and warm. There may be a history of enteritis or suspicion of acute appendicitis because of lower abdominal pain, but this is not obligatory. The laboratory parameters of inflammation (ESR, C-reactive protein, white blood count, serumproteinelectrophoresis) are changed significantly. Diagnosis is made by serum agglutination reaction (Widal-reaction) against ceesurface antigens (O-antigens) of Yersinia enterocolitica. Almost only people with the HL-A antigen B27 tend to get arthritis during Yersinia infection. The differential diagnosis has to consider reactive arthritis during Salmonella or Shigella infections, acute sarcoidosis, Reiter's disease and rheumatoid arthritis. PMID:522813

Herrlinger, J D; Wuthe, H H

1979-11-01

323

Arthritis in Children  

MedlinePLUS

... surgical drainage, and intravenous (IV) use of antibiotics. Lyme Disease An infection transmitted by the deer tick can cause a form of arthritis known as Lyme disease. (It’s called this because it was first diagnosed ...

324

What Is Psoriatic Arthritis?  

MedlinePLUS

About psoriasis Treating psoriasis Psoriatic arthritis Pso what? Bullying Info for parents Childhood psoriasis Treatments Diet Support your child Get involved At school Bullying Resources Parent's forum Find a pediatric derm Further ...

325

Arthritis and Rheumatic Diseases  

MedlinePLUS

... National Institutes of Health (NIH), leads the Federal medical research effort in arthritis and rheumatic diseases. The NIAMS ... The National Institutes of Health (NIH)—The Nation's Medical Research Agency—includes 27 Institutes and Centers and is ...

326

Arthritis in Children  

MedlinePLUS

... challenging. However, with care from a team of rheumatology professionals, most children with arthritis live full and ... JIA is used most by specialists in pediatric rheumatology, JRA is commonly used in the United States. ...

327

Juvenile Idiopathic Arthritis  

MedlinePLUS

... arthritis," or JRA.) What Happens When Someone Has JIA? People with JIA may have pain and stiffness ... or no permanent joint damage. Continue Types of JIA There are seven types of JIA: Systemic JIA ...

328

Arthritis: a family affair.  

PubMed

A diagnosis of arthritis affects not only those who have the disease, but also their family and close friends. Arthritis is not confined to old people, but affects people of all ages from the very young upwards. It is the biggest single cause of physical disability in the UK. It can produce a complex burden of physical and psycho-social effects. The misperception that it occurs only in later life is unhelpful for younger people. PMID:19911729

Spence, Jane

2009-01-01

329

Orthodontic treatment of an ankylosed maxillary central incisor through osteogenic distraction.  

PubMed

Tooth ankylosis is one of the various problems in dentistry and requires special treatment approaches for satisfactory results. In the orthodontic treatment of an ankylosed tooth, different treatment modalities have been put into practice including both orthodontic and orthodontic-surgical approaches. For favorable results, gingival margin esthetics must be considered as much as leveling the ankylosed tooth in the arch. Distraction osteogenesis accompanied by orthodontic mechanics is a sensible way of achieving this goal. However, devices used in the distraction protocol are high in price and bulky in shape, causing functional and esthetic problems for the patient. This report describes treatment of an infrapositioned ankylosed incisor with continuous distraction forces produced by conventional orthodontic mechanics. In conclusion, the ankylosed tooth was leveled in the upper arch successfully with a harmonic gingival margin. PMID:19905868

Dolanmaz, Do?an; Karaman, Ali Ihya; Pampu, A Alper; Topkara, Ahu

2010-03-01

330

Handout on Health: Rheumatoid Arthritis  

MedlinePLUS

... prevent or reduce the effects of rheumatoid arthritis. Moving to a new place with a different climate ... role in rheumatoid arthritis and thus are potential targets for new treatments. The path between identifying the ...

331

Interstitial granulomatous dermatitis with arthritis.  

PubMed

Interstitial granulomatous dermatitis with arthritis is an uncommon disorder. In its original description, the presence of linear inflammatory indurations on the lateral aspects of the trunk (the rope sign) in association with arthritis were considered the pathognomonic clinical features. Later cases presenting with plaques and papules have been reported. Herein we describe a case of interstitial granulomatous dermatitis with arthritis without the rope sign. The present case supports the idea that interstitial granulomatous dermatitis with arthritis may have variable clinical appearances. PMID:15257555

Altaykan, Asli; Erkin, Gül; Boztepe, Gonca; Gököz, Aytaç

2004-07-01

332

Rheumatoid arthritis impact survey.  

PubMed

A survey was undertaken to determine the effects of rheumatoid arthritis on the daily lives of patients. A randomly selected group of 135 Indians and blacks with rheumatoid arthritis were interviewed. Only 24% were employed and 35% were dependent on financial support from the state. Twenty-two per cent did not know the name of their illness and 89% expressed a desire to learn more about it. The most important problems encountered were pain (96%), stiffness (80%) and financial (58%). Activities such as toilet after-care, combing hair, bathing and dressing presented problems for a significant proportion of patients. The majority (73%) reported improvement on therapy. The survey showed that in rheumatoid arthritis, there is a great need for education and counselling of patients, there is a high unemployment rate and there is also a need for total patient care by a team of health professionals. PMID:3187821

Mody, G M; Shaw, J; Ramchurren, A

1988-10-15

333

Organizing Pneumonia Preceding Rheumatoid Arthritis  

PubMed Central

Rheumatoid arthritis patients are susceptible to interstitial lung disease, and joint manifestations of rheumatoid arthritis usually precede lung involvements by several years. Organizing pneumonia, as the first manifestation of rheumatoid arthritis, is extremely rare, and its clinical features remain currently unknown. We present a case and a literature review of patients who were pathologically diagnosed with organizing pneumonia first and met the diagnostic criteria of rheumatoid arthritis later. In this review, we observed the following: (1) patients with organizing pneumonia preceding rheumatoid arthritis have a high prevalence of rheumatoid factor or anticyclic citrullinated peptide antibodies; (2) almost all patients developed rheumatoid arthritis within one year after the diagnosis of organizing pneumonia. We suggest that patients with organizing pneumonia and positive for either rheumatoid factor or anticyclic citrullinated peptide antibody should be cautiously followed up regarding the development of rheumatoid arthritis, particularly during the first year after the diagnosis of organizing pneumonia. PMID:24600522

Kinoshita, Yoshiaki; Sakamoto, Atsuhiko; Hidaka, Kouko

2014-01-01

334

Reverse Latissimus Dorsi Muscle Flap for an Extensive Soft Tissue Defect Accompanied by Infectious Spondylitis  

PubMed Central

Spinal infection is an inflammatory process around the vertebral body, and it can extend to the epidural space, posterior elements and paravertebral soft tissues. Infectious spondylitis is a rare infectious disorder, which is often associated with significant neurologic deficits and mortality. When an extensive soft tissue defect is accompanied by infectious spondylitis, effective infection control and proper coverage of soft tissue are directly connected to successful outcomes. However, it is not simple to choose the appropriate treatment methods for infectious spondylitis accompanied by a soft tissue defect. Herein, we report a case of severe infectious spondylitis that was accompanied by an extensive soft tissue defect which was closed with a reverse latissimus muscle flap after traumatic spinal epidural hemorrhage. PMID:23133738

Yoo, Chai Min; Hwang, Soo Hyun; Park, Kyung Bum

2012-01-01

335

Cachexia in rheumatoid arthritis  

Microsoft Academic Search

Rheumatoid arthritis is a debilitating, chronic, systemic, autoimmune disease of unknown etiology that causes destruction of joint cartilage and bone. It generally occurs between the fourth and sixth decades of life, and affects two to three times more women than men. It is characterized by joint stiffness, pain, and swelling, and is accompanied by a loss of body cell mass.

Joseph Walsmith; Ronenn Roubenoff

2002-01-01

336

What Is Rheumatoid Arthritis?  

MedlinePLUS

... publication. To order Rheumatoid Arthritis Handout on Health full-text version, please contact NIAMS using the contact information ... mailed to you? Visit our online order form. Full NIAMS Site NIH… Turning Discovery Into Health ® ... Comments Moderation Policy Site Map | Viewers and Players

337

What Is Reactive Arthritis?  

MedlinePLUS

... NIAMS publication. To order Reactive Arthritis Q&A full-text version, please contact NIAMS using the contact information ... nih.gov Website: http://www.niams.nih.gov Full NIAMS Site NIH… Turning Discovery Into Health ® ... Comments Moderation Policy Site Map | Viewers and Players

338

Cachexia in rheumatoid arthritis.  

PubMed

Rheumatoid arthritis is a debilitating, chronic, systemic, autoimmune disease of unknown etiology that causes destruction of joint cartilage and bone. It generally occurs between the fourth and sixth decades of life, and affects two to three times more women than men. It is characterized by joint stiffness, pain, and swelling, and is accompanied by a loss of body cell mass. This loss of cell mass, known as rheumatoid cachexia, predominates in skeletal muscle, but also occurs in the viscera and immune system. Thus, rheumatoid cachexia leads to muscle weakness and a loss of functional capacity, and is believed to accelerate morbidity and mortality in rheumatoid arthritis. Currently there is no established mechanism for rheumatoid cachexia, but it is accompanied by elevated resting energy expenditure, accelerated whole-body protein catabolism, and excess production of the inflammatory cytokines, tumor necrosis factor-alpha and interleukin-1beta. Tumor necrosis factor-alpha is probably the central mediator of muscle wasting in rheumatoid arthritis, and is known to act synergistically with interleukin-1beta to promote cachexia. In general, tumor necrosis factor-alpha and interleukin-1beta are thought to alter the balance between protein degradation and protein synthesis in rheumatoid arthritis to cause muscle wasting. The precise mechanism by which they do this is not known. Reduced peripheral insulin action and low habitual physical activity are important consequences of rheumatoid arthritis, and have also been implicated as mediators of rheumatoid cachexia. Insulin inhibits muscle protein degradation. Consequently, reduced peripheral insulin action in rheumatoid arthritis is thought to be permissive to cytokine-driven muscle loss. The cause of reduced peripheral insulin action in rheumatoid arthritis is not known, but tumor necrosis factor-alpha has been shown to interfere with insulin receptor signaling and is probably an important contributor. Low habitual physical activity has consistently been observed in rheumatoid arthritis and is an important consequence of, and contributor to, muscle wasting. In addition, low physical activity predisposes to fat gain and is believed to precipitate a negative reinforcing cycle of muscle loss, reduced physical function, and fat gain in rheumatoid arthritis, which leads to 'cachectic obesity'. To date, there is no standard treatment for rheumatoid cachexia. However, physical exercise is currently believed to be the most important and clinically relevant countermeasure against rheumatoid cachexia. In general, a combination of skeletal muscle strength training and aerobic exercise is recommended, but must be prescribed with the patient's disease status, overall health, and safety in mind. Future studies should investigate the safety, efficacy, and required dose of anti-cytokine therapy for the treatment of rheumatoid cachexia. In this review, we outline the current definition of rheumatoid cachexia, and discuss the etiology, pathogenesis, and treatment of rheumatoid cachexia. PMID:12163213

Walsmith, Joseph; Roubenoff, Ronenn

2002-09-01

339

Perspectives on autoimmunity  

SciTech Connect

The contents of this book are: HLA and Autoimmunity; Self-Recognition and Symmetry in the Immune System; Immunology of Insulin Dependent Diabetes Mellitus; Multiple Sclerosis; Autoimmunity and Immune Pathological Aspects of Virus Disease; Analyses of the Idiotypes and Ligand Binding Characteristics of Human Monoclonal Autoantibodies to DNA: Do We Understand Better Systemic Lupus Erythematosus. Autoimmunity and Rheumatic Fever; Autoimmune Arthritis Induced by Immunization to Mycobacterial Antigens; and The Interaction Between Genetic Factors and Micro-Organisms in Ankylosing Spondylitis: Facts and Fiction.

Cohen, I.R.

1987-01-01

340

Diclofenac induced toxic manifestations on adjuvant induced arthritic rats pheripheral and reproductive organ of male wistar rats rattus norvegicus  

Microsoft Academic Search

Non-Steroidal Anti-inflammatory Drugs (NSAIDs) are the most frequently prescribed therapeutic agents, used for the treatment of rheumatic diseases, because they have analgesic, antipyretic and anti- inflammatory actions. Diclofenac (Voltaren) is a well-known member of the acetic acid family of NSAIDs, used to reduce inflammation and pain associated with arthritis osteoarthritis, and ankylosing spondylitis. There is considerable interest in the toxicity

Sambandam Subramanian

2009-01-01

341

Physical Therapy Management of Select Rheumatic Conditions in Older Adults  

Microsoft Academic Search

\\u000a Rheumatic diseases and their resultant musculoskeletal and cardiopulmonary impairments are primary conditions limiting activity\\u000a and function in older adults. Certain rheumatologic conditions such as polymyalgia rheumatica, degenerative spinal stenosis,\\u000a and osteoporosis occur later in life. Other conditions such as rheumatoid arthritis, osteoarthritis (OA), and ankylosing spondylitis\\u000a manifest at younger ages but their clinical manifestations may exacerbate with advancing age and

Maura Daly Iversen; Madhuri K. Kale

342

Perceptual variation in categorizing individual peripheral joints for the presence or absence of osteoarthritis using a standard homunculus: observations based on an australian twin registry study of osteoarthritis  

Microsoft Academic Search

The clinical diagnosis of osteoarthritis in the peripheral skeleton is dependent on the skilled examination of several features\\u000a characteristic of the condition. However, we have previously observed that even highly experienced rheumatologists in Australia\\u000a and Canada may not completely agree on the clinical examination in individuals with osteoarthritis (OA), rheumatoid arthritis,\\u000a ankylosing spondylitis, fibromyalgia, scleroderma and painful shoulder.

Nicholas Bellamy; Alexander Klestov; Kenneth Muirden; Petra Kuhnert; Louise O’gorman; Nicholas Martin

1999-01-01

343

What epidemiology has told us about risk factors and aetiopathogenesis in rheumatic diseases  

PubMed Central

This article will review how epidemiological studies have advanced our knowledge of both genetic and environmental risk factors for rheumatic diseases over the past decade. The major rheumatic diseases, including rheumatoid arthritis, juvenile idiopathic arthritis, psoriatic arthritis, ankylosing spondylitis, systemic lupus erythematosus, scleroderma, osteoarthritis, gout, and fibromyalgia, and chronic widespread pain, will be covered. Advances discussed will include how a number of large prospective studies have improved our knowledge of risk factors, including diet, obesity, hormones, and smoking. The change from small-scale association studies to genome-wide association studies using gene chips to reveal new genetic risk factors will also be reviewed. PMID:19490599

Oliver, Jacqueline E; Silman, Alan J

2009-01-01

344

Paradoxical Reaction to Golimumab: Tumor Necrosis Factor ? Inhibitor Inducing Psoriasis Pustulosa  

PubMed Central

Importance Golimumab is a human monoclonal antibody, used for rheumatoid arthritis, psoriatic arthritis and ankylosing spondylitis. Adverse reactions are increasing with this class of medication (tumor necrosis factor ? inhibitors). Observations The authors present a case of a female patient who presented with psoriasis pustulosa after the use of golimumab for rheumatoid arthritis. Conclusions and Relevance Paradoxically, in this case, golimumab, which is used for psoriasis, induced the pustular form of this disease. We are observing an increasing number of patients who develop collateral effects with tumor necrosis factor ? inhibitors, and the understanding of the mechanism of action and how these adverse reactions occur may contribute to avoid these sometimes severe situations. PMID:24348382

Soto Lopes, Marien Siqueira; Trope, Beatriz Moritz; Rochedo Rodriguez, Maria Paula Rua; Grynszpan, Rachel Lima; Cuzzi, Tullia; Ramos-e-Silva, Marcia

2013-01-01

345

Evolving concepts of rheumatoid arthritis  

Microsoft Academic Search

Rheumatoid arthritis is the most common inflammatory arthritis and is a major cause of disability. It existed in early Native American populations several thousand years ago but might not have appeared in Europe until the 17th century. Early theories on the pathogenesis of rheumatoid arthritis focused on autoantibodies and immune complexes. T-cell-mediated antigen-specific responses, T-cell-independent cytokine networks, and aggressive tumour-like

Gary S. Firestein

2003-01-01

346

Physical Activity and Psoriatic Arthritis  

MedlinePLUS

Toggle navigation Large Dropdown Menu Psoriasis About Psoriasis Treatments Related Conditions Women and Psoriasis Life with Psoriasis Access Health Care Resources and Tools Educational Webcasts Psoriatic Arthritis ...

347

Psoriatic arthritis: an update.  

PubMed

Advances in our understanding of the pathogenesis of psoriatic arthritis and clinical aspects of the disease justify the present review. Studies have identified common inflammatory pathways related to the innate immune response, such as the IL-12/IL-23 axis, along with numerous genes that affect susceptibility to both diseases and influence phenotypic development. Interest has grown in biomarkers that can be used for early diagnosis or prognosis or to predict joint destruction and the response to treatment. Recent reports describe important differences between the effects of disease-modifying antirheumatic drugs and biologics on the process of new bone formation. Other issues that have been discussed include the need for reliable screening methods, particularly for early detection of oligoarticular arthritis, and for protocols to guide referral to specialists, especially in newly created multidisciplinary practices. PMID:24674606

López-Ferrer, A; Laiz-Alonso, A

2014-12-01

348

Management of Rheumatoid Arthritis  

PubMed Central

Rheumatoid arthritis is a common disease, for which every physician should have a sound approach. This paper details the global management of the disease. Guidelines are given for educating the patient and assessing the level of disease activity. Common questions about the indications and uses of non-steroidal anti-inflammatory drugs, local corticosteroid injections, slow-acting agents, immunosuppressive drugs and steroids are discussed. PMID:21278947

Carette, Simon

1984-01-01

349

Arthritis and angioimmunoblastic lymphadenopathy.  

PubMed Central

We report 2 contrasting cases of a seronegative polyarthritis associated with angioimmunoblastic lymphadenopathy (AILD). Both cases were nonerosive, with symmetrical involvement of the elbows, wrists, knees, and ankles. In one the arthritis appeared concurrently with the main systemic manifestations of AILD. The second presented with polyarthritis 18 months before the onset of AILD. This patient received azathioprine for 11 months before developing AILD, which raises the possibility of this drug being the causative agent. Images PMID:6625700

Davies, P G; Fordham, J N

1983-01-01

350

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

SciTech Connect

The estimates of absorbed doses of x rays and excess risk of cancer in bone marrow and heavily irradiated sites are extremely crude and are based on very limited data and on a number of assumptions. Some of these assumptions may later prove to be incorrect, but it is probable that they are correct to within a factor of 2. The excess cancer risk estimates calculated compare well with the most reliable epidemiological surveys thus far studied. This is particularly important for cancers of heavily irradiated sites with long latent periods. The mean followup period for the patients was 16.2 y, and an increase in cancers of heavily irradiated sites may appear in these patients in the 1970s in tissues and organs with long latent periods for the induction of cancer. The accuracy of these estimates is severely limited by the inadequacy of information on doses absorbed by the tissues at risk in the irradiated patients. The information on absorbed dose is essential for an accurate assessment of dose-cancer incidence analysis. Furthermore, in this valuable series of irradiated patients, the information on radiation dosimetry on the radiotherapy charts is central to any reliable determination of somatic risks of radiation with regard to carcinogenesis in man. The work necessary to obtain these data is under way; only when they are available can more precise estimates of risk of cancer induction by radiation in man be obtained.

Fabrikant, J.I.; Lyman, J.T.

1982-02-01

351

Inverted 'V' osteotomy excision arthroplasty for bony ankylosed elbows  

PubMed Central

Background Bony ankylosis of elbow is challenging and difficult problem to treat. The options are excision arthroplasty and total elbow replacement. We report our midterm results on nine patients, who underwent inverted 'V' osteotomy excision arthroplasty in our hospital with good functional results. Materials Our case series includes 9 patients (seven males and two females) with the mean age of 34 years (13-56 years). Five patients had trauma, two had pyogenic arthritis, one had tuberculous arthritis, and one had pyogenic arthritis following surgical fixation. Results The average duration of follow up is 65 months (45 months-80 months). The mean Mayo's elbow performance score (MEPS) preoperatively was 48 (35-70). The MEPS at final follow up was 80 (60-95). With no movement at elbow and fixed in various degrees of either flexion or extension preoperatively, the mean preoperative position of elbow was 64°(30°to 100°). The mean post operative range of motion at final follow up was 27°of extension (20-500), 116°of flexion (1100-1300), and the arc of motion was 88°(800-1000). One patient had ulnar nerve neuropraxia and another patient developed median nerve neuropraxia, and both recovered completely in six weeks. No patient had symptomatic instability of the elbow. All patients were asymptomatic except one patient, who had pain mainly on heavy activities. Conclusion We conclude that inverted 'V' osteotomy excision arthroplasty is a viable option in the treatment of bony ankylosis of the elbow in young patients. PMID:22142391

2011-01-01

352

Airway obstruction and rheumatoid arthritis  

Microsoft Academic Search

The aim of this study was to assess the percentage of respiratory disorders and airway obstruction in patients with rheumatoid arthritis by com- paring lung function test results between patients with rheumatoid arthritis and control subjects with other rheumatological conditions. A prospective case-control study of respiratory symptoms and lung function abnormalities was performed in a series of 100 patients with

A. Vergnenègre; N. Pugnere; M. T. Antonini; M. Arnaud; B. Melloni; R. Treves; F. Bonnaud

1997-01-01

353

Video-Assisted Thoracic Surgery for Tubercular Spondylitis  

PubMed Central

The present study evaluated the outcome of video-assisted thoracic surgery (VATS) in 9 patients (males = 6, females = 3) with clinico-radiological diagnosis of tubercular spondylitis of the dorsal spine. The mean duration of surgery was 140.88 ± 20.09 minutes, mean blood was 417.77 ± 190.90?mL, and mean duration of postoperative hospital stay was 5.77 ± 0.97 days, Seven patients had a preoperative Grade A neurological involvement, while at the time of final followup the only deficit was Grade D power in 2 patients. In patients without bone graft placement (n = 6), average increase in Kyphosis angle was 16°, while in patients with bone graft placement (n = 3) the deformity remained stationary. At the time of final follow up, fusion was achieved in all patients, the VAS score for back pain improved from a pretreatment score of 8.3 to 2, and the function assessment yielded excellent (n = 4) to good (n = 5) results. In two patients minithoracotomy had to be resorted due to extensive pleural adhesions (n = 1) or difficulty in placement of graft (n = 1). Videoassisted thoracoscopic surgery provides a safe and effective approach in the management of spinal tuberculosis. It has the advantages of decreased blood loss and post operative morbidity with minimal complications. PMID:24804092

Singh, Roop; Gogna, Paritosh; Parshad, Sanjeev; Karwasra, Rajender Kumar; Karwasra, Parmod Kumar; Kaur, Kiranpreet

2014-01-01

354

Pain and microcrystalline arthritis.  

PubMed

Microcrystals are responsible for some of the most common and complex arthropathies which are often accompanied by intense, severe pain and inflammatory reactions. The main pathogens are crystals of monosodium urate (MSU), responsible for the gout, calcium pyrophosphate (CPP), which deposits also in various clinical forms of arthopathies, and basic calcium phosphate associated with osteoarthritis. In this context, the microcrystal arthritis is characterized by multiple, acute attacks followed by chronic pain, disability, impaired quality of life, and increased mortality. Given their chronic nature, they represent an ever more urgent public health problem. MSU and CPP crystals are also able to activate nociceptors. The pain in mycrocrystalline arthritis (MCA) is an expression of the inflammatory process. In the course of these diseases there is an abundant release of inflammatory molecules, including prostaglandins 2 and kinins. Interleukin-1 represents the most important cytokine released during the crystal-induced inflammatory process. Therefore, clinically, pain is the most important component of MCA, which lead to functional impairment and disability in a large proportion of the population. It is fundamental to diagnose these diseases as early as possible, and to this aim, to identify appropriate and specific targets for a timely therapeutic intervention. PMID:24938197

Ramonda, R; Frallonardo, P; Oliviero, F; Lorenzin, M G; Ortolan, A; Scanu, A; Punzi, L

2014-01-01

355

[Septic arthritis in adults].  

PubMed

Septic arthritis is a true rheumatological emergency requiring immediate and thoughtful effort for rapid diagnosis establishment and treatment initiation. Children and elderly persons as well as immunocompromised individuals, patients with pre-existing joint damage and with inflammatory rheumatic joint diseases are preferentially affected. Bacteremia, joint surgery and intra-articular injections pose risk situations for the development of joint infections. The most frequent causative organism is Staphylococcus aureus but other relevant pathogens include coagulase-negative staphylococci, streptococci and mycobacteria. Synovial fluid analysis (e.g. appearance, cell count and microbiological examination) is the most important step to establish the diagnosis. The two main components of therapy consist of joint drainage and antibiotic treatment. The approach to periprosthetic joint infections depends on the duration of symptoms, causative organism and individual factors. PMID:25115141

Loock, J; Haustedt, N; Wollenhaupt, J

2014-09-01

356

Psoriatic Arthritis: An Update  

PubMed Central

Psoriatic arthritis is a debilitating condition, which affects approximately one-quarter of psoriasis patients. Recent findings have furthered our understanding of the complex pathophysiology of PsA. There have been major advances in the identification of genes associated with joint involvement but not with cutaneous disease alone. The elucidation of key immunologic pathways has allowed the development of novel targeted therapies that are in the research pipeline. Currently, good screening tests and biomarkers to diagnose early PsA and to guide therapy are limited. In this paper, we present recent findings with regard to the immunopathogenesis and genetics of PsA, biomarkers, and screening tools and review the targeted therapies currently in clinical trials. PMID:23209897

Lloyd, Peter; Ryan, Caitriona; Menter, Alan

2012-01-01

357

Certolizumab for rheumatoid arthritis.  

PubMed

This is a review of the pharmacology of certolizumab pegol and its efficacy and safety in the treatment of patients with rheumatoid arthritis refractory to synthetic disease-modifying anti-rheumatic drugs (DMARDs). Certolizumab is a new anti-TNF-? biologic agent injected subcutaneously with an innovative molecular structure and unique pharmacodynamic and pharmacokinetic properties. Data from controlled clinical trials indicate that the drug is effective in reducing disease activity and disability. It also inhibits radiographic progression. Certolizumab administration has an acceptable safety profile. The clinical data available suggest that the nature of adverse events is generally comparable to that of other TNF-? blockers. Given its rapid onset of action certolizumab presents an attractive alternative therapeutic option for patients with moderate to severe RA refractory to DMARDs. PMID:24447441

Markatseli, T E; Papagoras, C; Nikoli, A; Voulgari, P V; Drosos, A A

2014-01-01

358

[Morphology of psoriatic arthritis].  

PubMed

Twenty-four biopsies of the synovial membrane, 8 biopsies of the cartilage and 8 samples of the synovial liquid from the knee joint were studied histologically, histochemically and by the immunofluorescent method. Proliferation, degeneration and desquamation of the synovial layer, localization of the inflammatory process in the superficial subsynovial layer, polynuclears in the inflammatory exudate, annular vascular sclerosis in the deep parts of the synovial villi are distinct features of psoriatic synovitis. The evidence for the involvement of humoral and cell immunity factors in the pathogenesis of the disease are obtained by means of immunological and immunofluorescent methods. On the basis of clinicomorphological data psoriatic arthritis is regarded as an independent nosological variety of the joint disease. PMID:4051805

Kop'eva, T N; Agababova, E R; Trushina, L S; Artem'eva, L S

1985-01-01

359

[Progression of rheumatoid arthritis].  

PubMed

In order to recognize courses with high and low progression in rheumatoid arthritis deviating from former approach the values of a locomotor function test were used which do not belong to the dispersion region for the adequate classes of duration of a disease. With the help of a material of an electronic data processing study of 1,000 cases with ascertained diagnosis correlations between high progression and, among others, following criteria could be ascertained: male sex, old age, early beginning of the disease, manual trades, unfavourable functional values and very much changed laboratory values including high titres of the rheumatoid factor. In this method there was no relation to the duration of the disease, as it was existing with other methods of the determination of progression which were comparatively included into the investigation. PMID:960871

Keitel, W; Uhle, R

1976-07-01

360

Pathophysiology of rheumatoid arthritis.  

PubMed

Understanding the pathophysiologic joint changes of rheumatoid arthritis will help the nurse practitioner educate clients in therapeutic modalities such as drugs, exercise, rest, heat and cold, and splints. Uncontrolled inflammation of the affected joints is the client's worst enemy. If inflammation could be controlled early in the disease process and thus limited to synovial tissue without pannus formation and subsequent cartilage destruction, normal joint function could be more optimally maintained. But once fibrotic tissue has formed, the resulting damage to the cartilage and joint destruction cannot be reversed. The earlier treatment is initiated and the sooner the client is educated, the less advanced and crippling this disease could be physically, psychologically, emotionally and socially. PMID:7110643

Strodthoff, C

1982-06-01

361

Smoking and Rheumatoid Arthritis  

PubMed Central

Rheumatoid arthritis (RA) is a chronic inflammatory disease caused by both genetic and environmental factors. Smoking has been implicated as one of the most important extrinsic risk factors for its development and severity. Recent developments have shed light on the pathophysiology of RA in smokers, including oxidative stress, inflammation, autoantibody formation and epigenetic changes. The association of smoking and the development of RA have been demonstrated through epidemiologic studies, as well as through in vivo and animal models of RA. With increased use of biological agents in addition to standard disease-modifying antirheumatic drugs (DMARDs), there has been interest in how smoking affects drug response in RA treatment. Recent evidence suggests the response and drug survival in people treated with anti-tumour necrosis factor (anti-TNF) therapy is poorer in heavy smokers, and possible immunological mechanisms for this effect are presented in the current paper. PMID:25479074

Chang, Kathleen; Yang, So Min; Kim, Seong Heon; Han, Kyoung Hee; Park, Se Jin; Shin, Jae Il

2014-01-01

362

Psoriatic arthritis in Asia.  

PubMed

Geographic or ethnic differences in the occurrence of disease often provide insights into causes of disease and possible opportunities for disease prevention. A wide variation on the incidence and prevalence of PsA was reported in different countries. The prevalence in China was similar to the rest of the world, whereas the incidence and prevalence of PsA was much lower in Japan. Among patients with psoriasis, 6-42% of the Caucasians were reported to have PsA, but figures were lower from Asian countries (1-9%). Divergent distribution of HLA in different ethnic groups and other genetic determinants may account for these differences in prevalence. PsA affects men and women almost equally in Chinese, Japanese and Iranians, which is similar to their Caucasian counterparts. Polyarthritis developing in the fourth decade was the commonest pattern of arthritis among Chinese, Indians, Iranians, Kuwaiti Arabs and Malays. Arthritis mutilans and eye lesions have rarely been reported in Asian countries. Chinese patients with nail disease and DIP joints involvement have a significantly higher risk of developing deformed joints. More data are required on the safety, efficacy and cost effectiveness of TNF blockers for the treatment of PsA in Asia. Premature atherosclerosis has been recognized as an important co-morbidity in Asian patients with PsA. Increased prevalence of traditional cardiovascular risk factors associated with PsA suggested that the two conditions may share the same inflammatory pathway. Carotid intima-media thickness can identify PsA patients with subclinical atherosclerosis who may benefit from early intervention. PMID:19713440

Tam, Lai-Shan; Leung, Ying-Ying; Li, Edmund K

2009-12-01

363

Literature Review and Clinical Presentation of Cervical Spondylitis Due to Salmonella Enteritidis in Immunocompetent  

PubMed Central

A 48-year-old woman was presented to our clinic with some fever and neck pains for about one month. Based on the symptoms and results of image, an empirical diagnosis of tuberculous cervical spondylitis was made. The pain was not significantly decreased after anti-tuberculosis therapy. And, 3 weeks later, she was re-admitted to our hospital for the unbearable pain. An exploration of the C4/5 by the anterior medial approach was recommended to evaluate the germ and debridement. Bacteriological tests showed that the pathogen was Salmonella Enteritidis. The pain was relieved significantly after operation and sensitive antibiotic treatments. Infections with Salmonella Typhi or Salmonella Paratyphi have been well-documented, while there are few reports of cervical spondylitis caused by Salmonella Enteritidis. We reported a case of a healthy woman with whom pyogenic cervical spondylitis of Salmonella Enteritidis was corroborated and treated and reviewed according to previous reports about spondylitis caused by Salmonella Enteritidis in the literature. PMID:24761205

Feng, Zhi-Yun; Guo, Fang

2014-01-01

364

Surgical Treatment of Pyogenic Spondylitis with the Use of Freeze-Dried Structural Allograft  

PubMed Central

Objective Radical debridement and reconstruction is necessary for surgical treatment of pyogenic spondylitis to control infection and to provide segmental stability. The authors identified 25 patients who underwent surgery for pyogenic spondylitis using freeze-dried structural allograft for reconstruction. This study aimed to evaluate and demonstrate the effectiveness and safety of a freeze-dried structural allograft during the surgical treatment of pyogenic spondylitis. Methods From January 2011 to May 2013, we retrospectively reviewed 25 surgically treated patients of pyogenic spondylitis. Surgical techniques used were anterior radical debridement and reconstruction with a freeze-dried structural allograft and instrumentation. In these 25 patients, we retrospectively examined whether the symptoms had improved and the infection was controlled after surgery by evaluating laboratory data, clinical and radiological outcomes. The average follow-up period was 15.7 months (range, 12.2-37.5 months). Results The infection resolved in all of the patients and there were no cases of recurrent infection. The mean Visual Analog Scale score was 6.92 (range, 5-10) before surgery and 1.90 (range, 0-5) at the time of the last follow-up. Preoperatively, lower extremity motor deficits related to spinal infection were noted in 10 patients, and they improved in 7 patients after surgery. Follow-up computed tomographic scans were obtained from 10 patients, and osseous union between the vertebral body and the structural allograft was achieved in 2 patients. Conclusion The freeze-dried structural allograft can be a safe and effective alternative for surgical treatment of pyogenic spondylitis, and another option for vertebral reconstruction instead of using the other materials. PMID:25346759

Kim, Seung-Soo; Yoon, Jong-Won; Park, Hyun; Lee, Chul-Hee; Hwang, Soo-Hyun

2014-01-01

365

Golimumab  

PubMed Central

Golimumab, a human anti-TNF? IgG1. monoclonal antibody, was approved in the US and Canada in April 2009 as a treatment for rheumatoid arthritis, psoriatic arthritis and ankylosing spondylitis, and is undergoing regulatory review in the EU for these indications. The product was developed by Centocor and Janssen Pharmaceutical KK (Johnson & Johnson subsidiaries), in collaboration with Schering-Plough and Mitsubishi Tanabe Pharma. Golimumab faces numerous protein therapeutic competitors on the market, but, as the first patient-administered, once-monthly dosed anti-TNF? drug, it will likely be an attractive option for patients. PMID:20065639

2009-01-01

366

Total Knee Arthroplasty in a Patient with an Ankylosing Knee after Previous Patellectomy  

PubMed Central

Patellectomized patients may have less satisfactory clinical outcomes following total knee arthroplasty (TKA) due to a decreased extensor mechanism efficiency and potential instability. Furthermore, the existing literature does not provide concrete guidance on the expected results of TKA or the type of implant that should be used in patellectomized patients. We present a case of a patient with an ankylosing knee who had undergone patellectomy due to gunshot injury 45 years ago and was treated with primary TKA using a posterior stabilized prosthesis at our institution. TKA using this prosthesis in the ankylosed knee with a previous history of patellectomy yielded good results in terms of postoperative clinical scores, range of motion and joint stability. PMID:25229049

Rhee, Seung Joon; Park, Shi Hwan; Hong, Sung Min

2014-01-01

367

Burden of childhood-onset arthritis  

Microsoft Academic Search

Juvenile arthritis comprises a variety of chronic inflammatory diseases causing erosive arthritis in children, often progressing to disability. These children experience functional impairment due to joint and back pain, heel pain, swelling of joints and morning stiffness, contractures, pain, and anterior uveitis leading to blindness. As children who have juvenile arthritis reach adulthood, they face possible continuing disease activity, medication-associated

Lakshmi N Moorthy; Margaret GE Peterson; Afton L Hassett; Thomas JA Lehman

2010-01-01

368

Clinical and immunogenetic characterization in psoriatic arthritis patients.  

PubMed

In psoriatic arthritis (PsA), genetic factors play a substantial role in disease susceptibility as well as in its expression. This study aims to determine the distribution of class I and class II HLA antigens in PsA patients and secondly to analyze the influence of genetic factors in the clinical expression of the disease. Consecutive PsA patients (CASPAR criteria) with less than 1 year of disease duration were included. Sociodemographic and clinical data were recorded. Blood samples were obtained, DNA was extracted by polymerase chain reaction (PCR), and class I (A, B, and C) and class II (DR) HLA antigens were determined by oligotyping. A control group of 100 nonrelated healthy controls from the general population served as control. p values were corrected (pc) according to the number of alleles tested. A total of 73 patients were included, 37 were females (50.7 %) with a median disease duration of 72 months (interquartile range (IQR) 24-149). Thirty-three patients (45.2 %) had a family history of psoriasis. When analyzing all the class I and class II HLA antigens, a significantly higher frequency of B38 (odds ratio (OR) 2.95, p?=?0.03) and Cw6 (OR 2.78, p?=?0.009) was found in PsA patients compared to the control group. On the contrary, the HLA-A11 (OR 0.14, p?=?0.04) and B7 (OR 0.31, p?=?0.03) were significantly more frequent among healthy controls. Furthermore, B18 was significantly more frequent in patients with early arthritis onset (less than 40 years): seven patients (22.6 %) with early onset compared to two patients (4.8 %) with late onset (p?=?0.03). No association between HLA-B27 and spondylitis or HLA-DR4 with polyarticular involvement was observed. The HLA-B38 and Cw6 alleles are associated with a greater PsA susceptibility in Argentine population. PMID:25008283

Schneeberger, Emilce Edith; Citera, Gustavo; Rodríguez Gil, Gustavo; Granel, Amelia; Arturi, Alfredo; Rosemffet, Gabriel Marcos; Maldonado Cocco, José Antonio; Berman, Alberto; Spindler, Alberto; Morales, Victor Hugo

2014-07-11

369

Treatment of arthritis, including rheumatoid arthritis, with radioactive isotopes  

SciTech Connect

A radioactive composition is described for the treatment of arthritis comprising, in combination, a ferric hydroxide or aluminum hydroxide aggregate suspension having a particle size of 3 to 20 microns, wherein a radionuclide is entrapped, the radionuclide being /sup 166/Holmium.

Lieberman, E.; Bordoni, M.E.; Thornton, A.K.

1988-06-21

370

Avian viral arthritis as a model for rheumatoid arthritis: a gross, histologic, and immunofluorescent study of experimentally induced viral arthritis in chickens  

E-print Network

in arthritis of unknown etiology (29). The discovery of hepatitis-associated antigen has increased interest in viral hepatitis arthritis as a potential model of arthritis induced by complexes of viral-associated antigen and antibody (29). The clinical case...AVIAN VIRAL ARTHRITIS AS A MODEL FOR RHEUMATOID ARTHRITIS-, - A GROSS, HISTOLOGIC, AND IMMUNOFLUORESCENT STUDY OF EXPERIMENTALLY INDUCED VIRAL ARTHRITIS IN CHICKENS A Thesis by SUSAN EMMAGENE WILSON Submitted to the Graduate College of Texas...

Wilson, Susan Emmagene

1976-01-01

371

Treatment of Acute Tuberculous Spondylitis by the Spinal Shortening Osteotomy: A Technical Notes and Case Illustrations  

PubMed Central

Surgical treatment for spinal tuberculosis is necessary in particular cases that a large amount of necrotic tissue is encountered and there is spinal cord compression. A spinal shortening osteotomy procedure has previously been described for the correction of the sagittal balance in a late kyphotic deformity, but there have been no reports on this as a surgical treatment in the acute stage. Thus, the aim of this report is to present the surgical techniques and clinical results of 3 patients who were treated with this procedure. Three patients with tuberculous spondylitis at the thoracic spine were surgically treated with this procedure. All the patients presented with severe progressive back pain, kyphotic deformity and neurological deficit. The patients recovered uneventfully from surgery without further neurological deterioration. Their pain was improved and the patients remained free of pain during the follow-up period. In conclusion, posterior spinal shortening osteotomy is an alternative method for the management of tuberculous spondylitis. PMID:22164318

Chanplakorn, Pongsthorn; Chanplakorn, Niramol; Kraiwattanapong, Chaiwat; Laohacharoensombat, Wichien

2011-01-01

372

Transferrin microheterogeneity in rheumatoid arthritis  

Microsoft Academic Search

We studied the relation between disease activity in rheumatoid arthritis (RA) and the microheterogeneity of transferrin. Using crossed immuno isoelectric focusing, transferrin microheterogeneity patterns were analyzed in sera of healthy individuals, nonanemic RA patients, iron deficient RA patients and RA patients with the anemia of chronic disease (ACD). In all RA groups a significant shift in the microheterogeneity pattern was

R. A. Feelders; G. Vreugdenhil; G. Jong; A. J. G. Swaak; H. G. Eijk

1992-01-01

373

Histopathology and genotyping in infectious spondylitis of HIV- and HIV+ patients.  

PubMed

Approximately 2 million South Africans are HIV/TB coinfected, and many develop skeletal disease. The resurgence of spinal tuberculosis, including atypical forms, is due largely to HIV-associated immune suppression. We investigated the impact of HIV coinfection on the histological features of the disease and the occurrence of atypical opportunistic organisms in infectious spondylitis in an HIV/TB endemic region. We analyzed blood and tissue biopsies from 60 patients with tuberculous spondylitis. Investigations included full blood counts, CD4/CD8 counts, HIV-1 serology and RNA quantification (tissue and plasma), acid-fast bacilli localization and routine TB culture, histopathologic evaluation of biopsies, and bacterial genotyping using the 16S rDNA gene. Twenty-two patients (37%) were HIV positive with a mean age of 29 years (range, 2-65 years). Forty-one (68%) tissue specimens were culture negative for Mycobacterium tuberculosis (Mtb), although nontuberculous mycobacteria (NTM) were identified in three HIV-negative patients. Histopathologic features were characteristic of TB infection in 91.4% of all specimens tested and 100% of the HIV-infected group. Genotyping of 10 culture-positive isolates identified Mtb (3/10), NTMs (2/10), and environmental bacilli (3/10). Our observations suggest HIV-induced immune suppression impacts the histological and clinical features of infectious spondylitis but has no impact on the incidence of NTMs in this setting. PMID:17471104

Danaviah, S; Govender, S; Cassol, S

2007-07-01

374

77 FR 14529 - Arthritis Advisory Committee; Notice of Meeting  

Federal Register 2010, 2011, 2012, 2013

...FDA-2012-N-0001] Arthritis Advisory Committee...Name of Committee: Arthritis Advisory Committee...Pfizer Inc., for the treatment of adult patients with...moderately to severely active rheumatoid arthritis who have had an...

2012-03-12

375

Psoriatic arthritis: Epidemiology, diagnosis, and treatment  

PubMed Central

Our understanding of psoriatic arthritis has evolved as new knowledge of the disease has emerged. However, the exact prevalence of psoriatic arthritis is unknown, and its pathogenesis has not been fully elucidated. Genetic, environmental, and immunologic factors have all been implicated in disease development. Early diagnosis and treatment have become primary objectives in clinical rheumatology. Psoriatic arthritis not only causes functional impairment, but also increases mortality risk of patients. The advent of new therapeutic agents capable of arresting the progression of joint damage is expected. However, early psoriatic arthritis assessment remains limited. The objectives of this article are to outline the epidemiology, diagnosis, and treatment of psoriatic arthritis and to suggest a paradigm for identifying early psoriatic arthritis patients. PMID:25232529

Liu, Jung-Tai; Yeh, Horng-Ming; Liu, Shyun-Yeu; Chen, Kow-Tong

2014-01-01

376

Epidemiology of Rheumatoid Arthritis: Rheumatoid Arthritis and Mortality  

Microsoft Academic Search

Increased mortality in rheumatoid arthritis (RA) is widely recognized but not fully explained. Despite substantial improvements\\u000a in management and growing knowledge of the determinants of increased mortality, evidence for reduction in mortality in RA\\u000a has lagged behind. Indeed, most studies report no apparent reduction in mortality in RA. However, emerging evidence from some\\u000a recent RA inception cohorts suggests no increased

Elena Myasoedova; John M. Davis; Cynthia S. Crowson; Sherine E. Gabriel

2010-01-01

377

Biologic therapies for juvenile arthritis  

PubMed Central

A group of therapies with exciting potential has emerged for children and young people with severe juvenile idiopathic arthritis (JIA) uncontrolled by conventional disease modifying drugs. Theoretical understanding from molecular biologic research has identified specific targets within pathophysiological pathways that control rheumatoid arthritis (RA) and JIA. This review identifies the pathways of autoimmunity to begin to show how biologic agents have been produced to replicate, mimic, or block culpable molecules and so promote or inhibit cellular activity or proliferation. Of these agents, cytokine antagonists have shown greatest promise, and early clinical studies of tumour necrosis factor (TNF) blockade have identified dramatic clinical benefit in many children with JIA. However, as will also be discussed, overlap of pathways within a complex immune system makes clinical response unpredictable and raises additional ethical and administrative concerns. PMID:12598373

Wilkinson, N; Jackson, G; Gardner-Medwin, J

2003-01-01

378

Microbial Infection and Rheumatoid Arthritis  

PubMed Central

Rheumatoid arthritis (RA) is a complex autoimmune disease affecting 1–2% of general worldwide population. The etiopathogenesis of RA involves the interplay of multiple genetic risk factors and environmental triggers. Microbial infections are believed to play an important role in the initiation and perpetuation of RA. Recent clinical studies have shown the association of microbial infections with RA. Accumulated studies using animal models have also found that microbial infections can induce and/or exaggerate the symptoms of experimental arthritis. In this review, we have identified the most common microbial infections associated with RA in the literature and summarized the current evidence supporting their pathogenic role in RA. We also discussed the potential mechanisms whereby infection may promote the development of RA, such as generation of neo-autoantigens, induction of loss of tolerance by molecular mimicry, and bystander activation of the immune system. PMID:25133066

Li, Song; Yu, Yangsheng; Yue, Yinshi; Zhang, Zhixin; Su, Kaihong

2014-01-01

379

Juvenile Psoriatic Arthritis (JPsA): juvenile arthritis with psoriasis?  

PubMed Central

Background Following the introduction of the ILAR criteria for juvenile idiopathic arthritis, juvenile psoriatic arthritis (JPsA) has become a better recognized category within the inflammatory arthritides of childhood.?There are fewer reports describing the characteristics and long-term outcome of patients with JPsA than other subtypes of JIA. The aim of our study was to determine the long-term outcome and clinical course of patients with juvenile psoriatic arthritis (JPsA) and to define subgroups of JPsA. Methods Clinical records of all patients meeting criteria for JPsA were reviewed and divided into 4 groups depending on their clinical features and onset type. Patient characteristics and clinical features at onset and during follow-up were determined. Results The cohort consisted of 119 patients: 65 with oligoarticular-onset (55%; persistent 44 and extended 21), 34 (29%) with RF(-) and 4 (3%) RF(+) polyarticular and 16 (13%) enthesitis-related arthritis (ERA). At diagnosis patients with ERA were oldest and more commonly male (p=0.001 and =0.01 respectively). Patients with a polyarticular course had more involvement of small joints of the hands and wrist when compared to patients with persistent oligoarticular and ERA (p<0.001) while patients with ERA had more hip and sacroiliac arthritis (p<0.001 for both). Nail changes were seen in 66 patients (57%) and were associated with DIP involvement (p=0.0034). Outcome: Time to first inactive disease on, but not off, therapy was significantly longer among patients with polyarticular course when compared to oligoarticular and ERA (p=0.016 and p=0.48 respectively). Patients with polyarticular course more frequently had contractures during follow-up than other groups (p=0.01). Conclusion The long-term outcome of with JPsA was generally good. Patients with JPsA did not appear to form distinct sub-group of patients but rather resembled JIA patients with onset types without psoriasis. PMID:23497068

2013-01-01

380

Rheumatoid arthritis and periodontal disease  

Microsoft Academic Search

The prevalence of periodontal disease has increased two-fold among patients with rheumatoid arthritis (RA) compared to the general population. This increased prevalence is unrelated to secondary Sjögren's syndrome but instead reflects shared pathogenic mechanisms, including an increased prevalence of the shared epitope HLA-DRB1-04; exacerbated T-cell responsiveness with high tissue levels of IL-17; exaggerated B-cell responses, with plasma cells being the

Jean-Marie Berthelot; Benoît Le Goff

2010-01-01

381

Pulmonary involvement in rheumatoid arthritis  

Microsoft Academic Search

The primary objective of this investigation was to assess the relationships between clinical characteristics, lung involvement, and frequency of pulmonary involvement in rheumatoid arthritis (RA). Using high-resolution computed tomography (HRCT) and pulmonary function tests (PFT), we prospectively evaluated 52 patients with RA (eight males and 44 females, mean age 53.6 years). The HRCT was abnormal in 35 patients (67.3%), the most

Ayhan Bilgici; H. Ulusoy; O. Kuru; Ç. Çelenk; M. Ünsal; M. Danac?

2005-01-01

382

Triggering infections in reactive arthritis.  

PubMed Central

Certain microbes like yersinia, salmonella, shigella, campylobacter, chlamydia, and possibly gonococcus can trigger reactive arthritis especially in patients of the HLA-B27 type. In the present study we have used serological and culture methods to identify the probable triggering infection in 50 consecutive HLA-B27 positive patients diagnosed as having reactive arthritis. The two most common triggering agents thus identified were Yersinia enterocolitica (12 patients) and Chlamydia trachomatis (11 patients). In addition six patients had high antistreptolysin O titres and two high teichoic acid antibody titres suggesting group A streptococci and Staphylococcus aureus as triggering agents. In 13 patients no preceding infection could be identified. The identity of the infective agent seems to have very little effect on the clinical picture of the reactive arthritis - the only difference between the various aetiological groups in the present material was absence of fever in the patients with a preceding C. trachomatis infection, of whom only one out of 11 had a temperature greater than or equal to 38 degrees C, whereas 13 of 16 patients with a preceding enterobacterial, and five of the eight patients with a streptococcal or staphylococcal infection had raised temperatures. PMID:3874607

Valtonen, V V; Leirisalo, M; Pentikäinen, P J; Räsänen, T; Seppälä, I; Larinkari, U; Ranki, M; Koskimies, S; Malkamäki, M; Mäkelä, P H

1985-01-01

383

Is juvenile rheumatoid arthritis\\/juvenile idiopathic arthritis different from rheumatoid arthritis?  

Microsoft Academic Search

CHAPTER SUMMARY: The chronic arthropathies of childhood share clinical and pathological features with rheumatoid arthritis (RA) in adults. Both are autoimmune diseases characterized by a destructive arthropathy. Both are likely to be complex genetic traits, with autoantibodies and with a type-1-T-helper-cell cytokine profile in disease tissues. In common with other autoimmune diseases, both have associations and linkage with human keukocyte

Sampath Prahalad; David N Glass

2002-01-01

384

Minimally invasive endoscopic treatment for lumbar infectious spondylitis: a retrospective study in a tertiary referral center  

PubMed Central

Background Spinal infections remain a challenge for clinicians because of their variable presentation and complicated course. Common management approaches include conservative administration of antibiotics or aggressive surgical debridement. The purpose of this study was to evaluate the efficacy of percutaneous endoscopic debridement with dilute betadine solution irrigation (PEDI) for treating patients with lumbar infectious spondylitis. Methods From January 2005 to July 2010, a total of 32 patients undergoing PEDI were retrospectively enrolled in this study. The surgical indications of the enrolled patients included single-level infectious spondylodiscitis, postoperative infectious spondylodiscitis, advanced infection with epidural abscess, psoas muscle abscess, pre-vertebral or para-vertebral abscess, multilevel infectious spondylitis, and recurrent infection after anterior debridement and fusion. Clinical outcomes were assessed by careful physical examination, Macnab criteria, regular serologic testing, and imaging studies to determine whether continued antibiotics treatment or surgical intervention was required. Results Causative bacteria were identified in 28 (87.5%) of 32 biopsy specimens. Appropriate parenteral antibiotics for the predominant pathogen isolated from infected tissue biopsy cultures were prescribed to patients. Twenty-seven (84.4%) patients reported satisfactory relief of their back pain after PEDI. Twenty-six (81.3%) patients recovered uneventfully after PEDI and sequential antibiotic therapy. No surgery-related major complications were found, except 3 patients with transient paresthesia in the affected lumbar segment. Conclusions PEDI was successful in obtaining a bacteriologic diagnosis, relieving the patient’s symptoms, and assisting in the eradication of lumbar infectious spondylitis. This procedure could be an effective alternative for patients who have a poor response to conservative treatment before a major open surgery. PMID:24669940

2014-01-01

385

Microalbuminuria in patients with rheumatoid arthritis  

Microsoft Academic Search

OBJECTIVES--To assess (a) the prevalence of microalbuminuria in patients with rheumatoid arthritis, (b) the association between urinary albumin excretion and disease activity as estimated by the erythrocyte sedimentation rate and C reactive protein (CRP), and (c) the association between urinary albumin excretion and treatment with antirheumatic drugs. METHODS--Sixty five patients with rheumatoid arthritis attending two rheumatology clinics were compared with

L M Pedersen; H Nordin; B Svensson; H Bliddal

1995-01-01

386

The nail dystrophy of psoriatic arthritis  

Microsoft Academic Search

Nail abnormalities occur frequently in patients with psoriatic arthritis. This study of the finger nails of 46 patients with psoriatic arthritis, 100 nonpsoriatic rheumatism patients, and 100 nonpsoriatic general medical patients was designed to characterise these abnormalities with particular reference to the severity of nail pitting. The results of the study suggest: (1) Onycholysis alone in the absence of previous

C J Eastmond; V Wright

1979-01-01

387

Group education for patients with rheumatoid arthritis  

Microsoft Academic Search

Patients with rheumatoid arthritis must learn to adjust their exercise, rest and medication to the varying activity of the disease. Patient education can help patients in making the right decisions about adjustments in their treatment regimen and in attaining ¿self-management¿ behaviors. We developed a group education program based on social learning theory and the `Arthritis Self Management Course¿ developed in

Erik Taal; Rob P. Riemsma; Herman L. M. Brus; Erwin R. Seydel; Johannes J. Rasker; Oene Wiegman

1993-01-01

388

Photoacoustic tomography to identify inflammatory arthritis  

NASA Astrophysics Data System (ADS)

Identifying neovascularity (angiogenesis) as an early feature of inflammatory arthritis can help in early accurate diagnosis and treatment monitoring of this disease. Photoacoustic tomography (PAT) is a hybrid imaging modality which relies on intrinsic differences in the optical absorption among the tissues being imaged. Since blood has highly absorbing chromophores including both oxygenated and deoxygenated hemoglobin, PAT holds potential in identifying early angiogenesis associated with inflammatory joint diseases. PAT is used to identify changes in the development of inflammatory arthritis in a rat model. Imaging at two different wavelengths, 1064 nm and 532 nm, on rats revealed that there is a significant signal enhancement in the ankle joints of the arthritis affected rats when compared to the normal control group. Histology images obtained from both the normal and the arthritis affected rats correlated well with the PAT findings. Results support the fact that the emerging PAT could become a new tool for clinical management of inflammatory arthritis.

Rajian, Justin Rajesh; Girish, Gandikota; Wang, Xueding

2012-09-01

389

[Immunogenetic aspects of early rheumatoid arthritis].  

PubMed

The study is aimed to investigate the distribution of alleles of HLA-DRB1 gene in patients with early rheumatoid arthritis and healthy individuals in Russian population, and evaluate their significance as molecular genetic markers of rheumatoid arthritis predisposition and protection. The association between alleles of HLA-DRB1 genes, antibodies to cyclic citrullinated peptides and IgM rheumatoid factor was also studied. Low and high resolution HLA-DRB1 genotyping were compared. In the cohort of patients with early rheumatoid arthritis, the alleles of HLA-DRB1 gene were found to be markers of rheumatoid arthritis protection/risk, especially in the homozygous state. They determined production of antibodies to cyclic citrullinated peptides but were not associated with rheumatoid factor IgM levels. These findings support different autoimmune mechanisms of rheumatoid arthritis pathogenesis. PMID:24003720

Guseva, I A; Demidova, N V; Soroka, N E; Novikov, A A; Luchikhina, E L; Aleksandrova, E N; Lukina, G V; Fedorenko, E V; Aronova, E S; Samarkina, E Iu; Boldyreva, M N; Trofimov, D Iu; Karateev, D E; Nasonov, E L

2013-01-01

390

Glucocorticoids in juvenile idiopathic arthritis.  

PubMed

Glucocorticoid (GC) drugs are a potent and rapidly effective therapeutic option for the treatment of juvenile idiopathic arthritis (JIA). These medications are mainly used for the management of the extra-articular features of systemic-onset disease. A course of low-dose prednisone may be considered for achieving a rapid disease control in patients with severe polyarthritis refractory to other therapies or while awaiting the full therapeutic effect of a recently initiated disease-modifying antirheumatic drug or biologic agent. Short-term systemic GC administration may also be indicated for chronic iridocyclitis unresponsive to topical therapy. The general objective of GC therapy is to limit the maximum dose and exposure to the highest doses to what is needed to achieve disease control, and then to gradually taper the dose until the minimum level sufficient to maintain disease quiescence over time is reached. High-dose intravenous 'pulse' methylprednisolone administration is sometimes chosen to treat the most severe or acute disease manifestations of systemic JIA, particularly macrophage activation syndrome. Intra-articular GC injection is a safe and rapidly effective treatment for synovitis in children with chronic arthritis. Triamcinolone hexacetonide is the optimal GC preparation for pediatric patients. Local injection therapy is used most frequently to treat oligoarthritis, but the strategy of performing multiple injections to induce disease remission, while simultaneously initiating therapy with second-line or biologic agents, has also been proposed for children with polyarticular JIA. Administration of GCs is associated with potentially deleterious adverse effects, some of which can be irreversible. This highlights the need of a judicious use of these medications and careful monitoring of their toxicity. The recently published recommendations for the management of JIA provide useful guidance to the clinicians for the administration of GCs in children with chronic arthritis. PMID:25227183

Schiappapietra, Benedetta; Varnier, Giulia; Rosina, Silvia; Consolaro, Alessandro; Martini, Alberto; Ravelli, Angelo

2015-01-01

391

Psoriatic arthritis for the dermatologist.  

PubMed

Psoriatic arthritis (PsA) is a chronic, progressive, inflammatory spondyloarthropathy that affects approximately one-third of patients with all types of psoriasis. Dermatologists are in a unique position to recognize early symptoms of PsA, initiate appropriate therapy, and prevent development of further disability. The course of PsA can be modulated by immunosuppressive therapy; patients with moderate-to-severe disease require aggressive management with medications proven to halt disease progression. It is essential for the dermatologist to understand the safety, tolerability, efficacy, cost, and potential to halt disease progression with available medications for this relatively common and potentially disabling disease. PMID:25412788

Tintle, Suzanne J; Gottlieb, Alice B

2015-01-01

392

Painful feet in rheumatoid arthritis.  

PubMed

Pain in the feet is an important diagnostic feature and a major management problem of rheumatoid arthritis. Of 50 hospitalized patients, 28% recalled painful feet as the sole presenting symptom of their disease.RHEUMATOID DISEASE COMMONLY AFFECTS THE FEET: 90% of the patients studied complained of foot pain at some time during the course of their disease, 86% had clinical involvement and 92% had radiological changes in their feet.The forefoot is most frequently involved. Midfoot involvement was noted in 68% but was symptomatic in only 22%. Changes in the ankle were least common but always symptomatic. PMID:4746132

Minaker, K; Little, H

1973-10-20

393

Metabolic Syndrome in Rheumatoid Arthritis  

PubMed Central

Insulin resistance is an essential feature of the metabolic syndrome that has been linked to rheumatoid arthritis (RA). Understanding how inflammation arising in one tissue affects the physiology and pathology of other organs remains an unanswered question with therapeutic implications for chronic conditions including obesity, diabetes mellitus, atherosclerosis, and RA. Adipokines may play a role in the development of atherogenesis in patients with RA. Biologic therapies, such as TNF-? antagonists, that block proinflammatory cytokines have beneficial effects on the insulin resistance that is often observed in patients with RA. PMID:23431244

Ferraz-Amaro, Iván; González-Juanatey, Carlos; López-Mejias, Raquel; Riancho-Zarrabeitia, Leyre; González-Gay, Miguel A.

2013-01-01

394

Endogenous IL-22 Plays a Dual Role in Arthritis: Regulation of Established Arthritis via IFN-? Responses  

PubMed Central

Objective IL-22 is elevated in patients with inflammatory arthritis and correlates with disease activity. IL-22 deficient mice have reduced incidence of arthritis. Recombinant IL-22 restrains progression of arthritis via increase in IL-10 responses when administered prior to onset of arthritis. These findings imply a possible dual role of IL-22 in inflammatory arthritis depending on the phase of arthritis. Experiments outlined here were designed to elucidate the contribution of endogenous IL-22 before and after the onset of arthritis. Methods Collagen induced arthritis (CIA) was induced in DBA1 or IFN-? deficient mice following immunization with collagen and complete Freund's adjuvant. Anti-IL-22 antibody or isotype control were administered prior to or after onset of arthritis and disease progression assessed by clinical scoring and histopathology. IL-22, IL-17 and IFN-? responses were measured by ELISA and flowcytometry. Anti-collagen antibody responses were analyzed by ELISA. Expression of IL-22R1 in CD4+ cells was elucidated by flowcytometry and real time PCR. Results Collagen specific IL-22 responses were expanded during arthritis and IL-22 producing cells were discrete from IL-17 or IFN-? producing cells. Neutralization of IL-22 after onset of arthritis resulted in significant increase in Th1 responses and significantly reduced severity of arthritis. CD4+ cells from arthritic mice showed increased surface expression of IL-22R1. In vitro, CD4+T cells cultured with antigen presenting cells in the presence or absence of IL-22 suppressed or induced IFN-?, respectively. The protective effect of anti-IL-22 was reversed in IFN-? deficient mice. Moreover, administration of anti-IL-22 prior to onset of arthritis augmented arthritis severity. Conclusion We show for the first time that IL-22 plays a dual role: protective prior to the onset of arthritis and pathogenic after onset of arthritis. The pathogenic effect of IL-22 is dependent on suppression of IFN-? responses. IL-17 responses remained unchanged with the administration of anti-IL22 antibody. IL-22R1 is upregulated on CD4+T cells during arthritis and regulates IFN-? in T cells. PMID:24676270

Justa, Shivali; Zhou, Xiaoqun; Sarkar, Sujata

2014-01-01

395

Leprosy and rheumatoid arthritis: consequence or association?  

PubMed Central

Leprosy or Hansen’s disease is a chronic granulomatous infectious disease caused by Mycobacterium leprae with a high prevalence in some developing countries however, it is rarely seen in non-endemic regions. Arthritis has been described in all types of Hansen’s disease. Chronic arthritis is known to exist even in paucibacillary forms, resolved or treated disease and in patients without reaction, suggesting a perpetuated inflammatory process. In these cases leprosy can mimic some autoimmune diseases such as rheumatoid arthritis. When a patient with a history of leprosy presents with a symmetric, distal, polyarthritis the diagnosis may not be linear. Possibly it is a rheumatoid-like leprous arthritis with M leprae acting as the trigger element for the chronic process or it is an overlap condition, with a concomitant rheumatoid arthritis? A case report of a patient with a chronic inflammatory arthritis with 10 years of evolution is presented. The differential diagnosis between leprous and rheumatoid arthritis is discussed. PMID:22891014

Henriques, Celia Coelho; Lopéz, Begoña; Mestre, Tiago; Grima, Bruno; Panarra, António; Riso, Nuno

2012-01-01

396

Rheumatoid Arthritis and Cardiovascular Disease  

PubMed Central

Background Rheumatic disease and heart disease share common underpinnings involving inflammation. The high levels of inflammation that characterize rheumatic diseases provide a “natural experiment” to help elucidate the mechanisms by which inflammation accelerates heart disease. Rheumatoid arthritis (RA) is the most common of the rheumatic diseases and has the best studied relationships with heart disease. Methods Review of current literature on heart disease and rheumatoid arthritis Results Patients with RA have an increased risk of developing heart disease that is not fully explained by traditional cardiovascular risk factors. Therapies used to treat RA may also affect the development of heart disease; by suppressing inflammation, they may also reduce the risk of heart disease. However, their other effects, as in the case of steroids, may increase heart disease risk. Conclusions Investigations of the innate and adaptive immune responses occurring in RA may delineate novel mechanisms in the pathogenesis of heart disease, and help identify novel therapeutic targets for the prevention and treatment of heart disease. PMID:24093840

Crowson, Cynthia S; Liao, Katherine P; Davis, John M; Solomon, Daniel H; Matteson, Eric L; Knutson, Keith L; Hlatky, Mark A; Gabriel, Sherine E

2014-01-01

397

The Drug Information Center Arthritis Project: Providing Patients with Interactive and Reliable Arthritis Internet Education  

Microsoft Academic Search

The objective of the Drug Information Center Arthritis Project was to create and assess the value of a patient-focused interactive arthritis education program. A multidisciplinary team developed three content areas: an interactive ask-a-pharmacist component with a satisfaction survey; health assessment tools (SF-8™, osteoarthritis [OA] Impact Survey™, and rheumatoid arthritis [RA] Impact Survey™); and disease and drug information. Results: There were

Nicole T. Ansani; Bethany A. Fedutes-Henderson; Robert J. Weber; Randall Smith; Jennine Dean; Molly Vogt; Kenneth Gold; C. Kent Kwoh; Thaddeus Osial; Terence W. Starz

2006-01-01

398

The disease formerly known as rheumatoid arthritis  

PubMed Central

Rheumatoid arthritis is a complex disease where predetermined and stochastic factors conspire to confer disease susceptibility. In light of the diverse responses to targeted therapies, rheumatoid arthritis might represent a final common clinical phenotype that reflects many pathogenic pathways. Therefore, it might be appropriate to begin thinking about rheumatoid arthritis as a syndrome rather than a disease. Use of genetics, epigenetics, microbiomics, and other unbiased technologies will probably permit stratification of patients based on mechanisms of disease rather than by clinical phenotype. PMID:25167330

2014-01-01

399

My Treatment Approach to Rheumatoid Arthritis  

PubMed Central

The past decade has brought important advances in the understanding of rheumatoid arthritis and its management and treatment. New classification criteria for rheumatoid arthritis, better definitions of treatment outcome and remission, and the introduction of biologic response-modifying drugs designed to inhibit the inflammatory process have greatly altered the approach to managing this disease. More aggressive management of rheumatoid arthritis early after diagnosis and throughout the course of the disease has resulted in improvement in patient functioning and quality of life, reduction in comorbid conditions, and enhanced survival. PMID:22766086

Davis, John M.; Matteson, Eric L.

2012-01-01

400

[Shoulder arthritis due to Haemophilus aphrophilus].  

PubMed

We report a case of shoulder arthritis due to Haemophilus aphrophilus. The patient, a 56 year-old woman, was immunocompetent. She presented with a septic arthritis of the left shoulder without portal of entry. A synovial fluid sample was cultured and positive for a gram-negative bacillus after 8 days. It was identified as Haemophilus aphrophilus, in the HACCEK group, by PCR ARN 16S. We did not find any associated endocarditis. The patient recovered. As far as we know, this is only the 5th reported case of arthritis due to this microorganism. PMID:15982845

Bouldouyre, M-A; Stawiarski, N; Michon, M; Nguyen Van, J-C; Ben-Ali, A; Rajzbaum, G; Goldstein, F-W

2005-06-01

401

Familial Mediterranean fever mimicking septic arthritis.  

PubMed

We report the case of a young Lebanese female who presented with recurrent episodes of left knee and calf swelling and a synovial fluid leucocyte count suggestive of septic arthritis, however bacteriologic cultures were negative. Familial Mediterranean fever (FMF) was suspected in view of a positive family history and genetic analysis for the mutations in the pyrin/marenostrin (MEFV) gene revealing a homozygote mutation at methionine-694-valine. The arthritis was controlled with prophylactic colchicine therapy. FMF should be considered in the differential diagnosis of acute monoarticular arthritis with elevated synovial fluid white blood cells counts in regions with high incidence of FMF. PMID:15700115

Uthman, Imad; El-Sayyad, Jinane; El-hajj, Ihab; Bizri, Abdul-Rahman

2005-10-01

402

Psoriatic arthritis in South and Central America.  

PubMed

Psoriasis and its related manifestations, including psoriatic arthritis, are prevalent disorders in the Western world, particularly among Caucasians. The study of these disorders in Latin America lags way behind the study of other more common rheumatic disorders, such as rheumatoid arthritis and systemic lupus erythematosus. From the scarce evidence available, however, it appears that the prevalence and incidence of psoriasis and psoriatic arthritis are lower than in other parts of the Western world and almost negligible among natives from the Andean region, although confirmatory epidemiologic studies are lacking. PMID:21552999

Toloza, Sergio M A; Valle-Oñate, Rafael; Espinoza, Luis R

2011-08-01

403

The window of opportunity: a relevant concept for axial spondyloarthritis  

PubMed Central

The window of opportunity is a concept critical to rheumatoid arthritis treatment. Early treatment changes the outcome of rheumatoid arthritis treatment, in that response rates are higher with earlier disease-modifying anti-rheumatic drug treatment and damage is substantially reduced. Axial spondyloarthritis is an inflammatory axial disease encompassing both nonradiographic axial spondyloarthritis and established ankylosing spondylitis. In axial spondyloarthritis, studies of magnetic resonance imaging as well as tumor necrosis factor inhibitor treatment and withdrawal studies all suggest that early effective suppression of inflammation has the potential to reduce radiographic damage. This potential would suggest that the concept of a window of opportunity is relevant not only to rheumatoid arthritis but also to axial spondyloarthritis. The challenge now remains to identify high-risk patients early and to commence treatment without delay. Developments in risk stratification include new classification criteria, identification of clinical risk factors, biomarkers, genetic associations, potential antibody associations and an ankylosing spondylitis-specific microbiome signature. Further research needs to focus on the evidence for early intervention and the early identification of high-risk individuals. PMID:25167369

2014-01-01

404

Rheumatoid Arthritis and Complementary and Alternative Medicine  

MedlinePLUS

... et al. Biological basis for the use of botanicals in osteoarthritis and rheumatoid arthritis: a review. Evidence-Based Complementary and Alternative Medicine: e-CAM . 2005;2(3):301–308. Cameron ...

405

ASTROMEDICINE IN THE TREATMENT OF RHEUMATOID ARTHRITIS  

PubMed Central

One patient of rheumatoid arthritis was treated according to astromedicine. Wearing of Coral beads had remarkable effect on the disease. The interesting finding are reported in this paper. PMID:22556538

Janai, Sudhakar; Biviji, A. T.; Naik, D. G.; Lakhe, R. T.; Rao, V. Bhaskar

1991-01-01

406

Psoriasis/Psoriatic Arthritis and Pregnancy  

MedlinePLUS Videos and Cool Tools

... have psoriasis/psoriatic arthritis? Are you pregnant or breastfeeding? Dr. Eichenfield, a pediatric and adolescent dermatologist with ... FACT SHEET . Now you can get pregnancy and breastfeeding health tips from OTIS throughout the day! Join ...

407

Accommodation and Compliance Series: Employees with Arthritis  

MedlinePLUS

... him with a cart. A vice president with osteoarthritis had difficulty maintaining her stamina during the workday. ... rheumatoid arthritis was limited in typing due to pain and stiffness in her hands due to cold ...

408

Sexual dysfunction among patients with arthritis  

Microsoft Academic Search

Summary  The relationship of arthritis and sexual dysfunction was investigated among 169 patients with rheumatoid arthritis, osteoarthritis and spondyloarthropathy, 130 of whom were pair-matched to controls. Assessments of marital happiness and depressed mood were also made using the CES-D and the Azrin Marital Happiness Scale (AMHS). Sexual dysfunctions were found to be common among patients and controls, the majority in both

D. J. Blake; R. Maisiak; A. Koplan; G. S. Alarcón; S. Brown

1988-01-01

409

Clinical management of septic arthritis in cattle.  

PubMed

Synovial fluid, ultrasound, and radiographic imaging are common diagnostic tools for septic arthritis. Mycoplasma septic arthritis is suspected in calves with clinical signs of otitis and pneumonia. Commonly affected joints are carpus, stifle, and tarsus. Treatment strategy must include long-term antibiotics, anti-inflammatories, and joint lavage. Knowledge of communication and boundaries for commonly affected joints is essential to perform joint lavage and arthrotomy. PMID:24534665

Desrochers, André; Francoz, David

2014-03-01

410

T cells in rheumatoid arthritis  

PubMed Central

Over the past decade and a half, advances in our understanding of the pathogenesis of immune-mediated diseases such as rheumatoid arthritis (RA) have translated directly into benefit for patients. Much of this benefit has arisen through the introduction of targeted biological therapies. At the same time, technological advances have made it possible to define, at the cellular and molecular levels, the key pathways that influence the initiation and persistence of chronic inflammatory autoimmune reactions. As our understanding grows, it is likely that this knowledge will be translated into a second generation of biological therapies that are tailor-made for the patient. This review summarizes current perspectives on RA disease pathogenesis, with particular emphasis on what RA T cells look like, what they are likely to see, and how they contribute to persistence of the chronic inflammatory response. PMID:19007421

Cope, Andrew P

2008-01-01

411

Rheumatoid arthritis affecting temporomandibular joint  

PubMed Central

Rheumatoid arthritis (RA) is a chronic, systemic, autoimmune inflammatory disorder that is characterized by joint inflammation, erosive properties and symmetric multiple joint involvement. Temporomandibular joint (TMJ) is very rare to be affected in the early phase of the disease, thus posing diagnostic challenges for the dentist. Conventional radiographs fail to show the early lesions due to its limitations. More recently cone-beam computed tomography (CBCT) has been found to diagnose the early degenerative changes of TMJ and hence aid in the diagnosis of the lesions more accurately. Our case highlights the involvement of TMJ in RA and the role of advanced imaging (CBCT) in diagnosing the bony changes in the early phase of the disease.

Sodhi, Amandeep; Naik, Shobha; Pai, Anuradha; Anuradha, Ardra

2015-01-01

412

Rheumatoid arthritis: coping with disability.  

PubMed

This article explains the components of disability as related to rheumatoid arthritis (RA) using an expansion of Nagi's Model of Disability (Jette, 2006) and the World Health Organization's (WHO) International Classification of Functioning, Disability, and Health (ICF). In addition, suggestions for ways in which nurses can offer patients choices in physical functional therapy and psychosocial aspects of coping with the chronicity of RA are discussed. Understanding how RA relates to the holistic management of the patient will allow nurses to modify and suggest additional measures to enhance the outcomes of patient-centered care. Many degrees of disability exist that affect the physical and psychosocial domains of RA. Nurses should identify the primary issues influencing disability and assemble supporting resources or a multidisciplinary team to manage a person's disabilities. As nurses develop and maintain relationships with patients, they are able to follow through with the care plan continuum and recognize when modifications are needed. PMID:20306616

Barker, Tara L; Puckett, Theresa L

2010-01-01

413

Painful feet in rheumatoid arthritis  

PubMed Central

Pain in the feet is an important diagnostic feature and a major management problem of rheumatoid arthritis. Of 50 hospitalized patients, 28% recalled painful feet as the sole presenting symptom of their disease. Rheumatoid disease commonly affects the feet: 90% of the patients studied complained of foot pain at some time during the course of their disease, 86% had clinical involvement and 92% had radiological changes in their feet. The forefoot is most frequently involved. Midfoot involvement was noted in 68% but was symptomatic in only 22%. Changes in the ankle were least common but always symptomatic. ImagesFIG. 1AFIG. 1BFIG. 2AFIG. 2BFIG. 3FIG. 4FIG. 5 PMID:4746132

Minaker, K.; Little, H.

1973-01-01

414

Sialochemistry in juvenile chronic arthritis.  

PubMed

Stimulated parotid gland secretions collected from 16 patients with juvenile chronic arthritis (JCA) were analysed and the results compared with those obtained from 83 healthy sex-, age-, and socioeconomic status-matched children. Parotid salivary flow rate was measured and the saliva samples were assayed for calcium, phosphorus, potassium, chloride, sodium, urea, lysozyme, amylase and immunoglobulin levels (IgA, Ig, IgM). Our results showed that parotid flow rate (PFR) values in JCA patients were not statistically different from those in healthy controls. However, the mean salivary concentrations of calcium, phosphorus, potassium, lysozyme and IgA were significantly lower in the patients. These data could provide an explanation for the increased incidence of caries and gingivitis observed in JCA. PMID:2477107

Siamopoulou, A; Mavridis, A K; Vasakos, S; Benecos, P; Tzioufas, A G; Andonopoulos, A P

1989-10-01

415

Can Rheumatoid Arthritis Be Prevented?  

PubMed Central

The discovery of elevations of rheumatoid arthritis (RA)-related biomarkers prior to the onset of clinically apparent RA raises hopes that individuals who are at risk for future RA can be identified in a preclinical phase of disease that is defined as abnormalities of RA-related immune activity prior to the clinically apparent onset of joint disease. Additionally, there is a growing understanding of the immunologic processes that are occurring in preclinical RA, as well as a growing understanding of risk factors that may be mechanistically related to RA development. Furthermore, there are data supporting that treatment of early RA can lead to drug free remission. Taken as a whole, these findings suggest that it may be possible to use biomarkers and other factors to accurately identify the likelihood and timing of onset of future RA, and intervene with immunomodulatory therapies and/or risk factor modification to prevent the future onset of RA in at-risk individuals. Importantly, several clinical prevention trials for RA have already been tried, and one is underway. However, while our understanding of the growing understanding of the mechanisms and natural history of RA development may be leading us to the implementation of prevention strategies for RA, there are still several challenges to be met. These include developing sufficiently accurate methods of predicting those at high risk for future RA so that clinical trials can be developed based on accurate rates of development of arthritis and subjects can be adequately informed of their risk for disease, identifying the appropriate interventions and biologic targets for optimal prevention, and addressing the psychosocial and economic aspects that are crucial to developing broadly applicable prevention measures for RA. These issues notwithstanding, prevention of RA may be within reach in the near future. PMID:24315049

Deane, Kevin

2013-01-01

416

Arthritis  

MedlinePLUS Videos and Cool Tools

... include the ones: • between the palm of the hands and the fingers • between the vertebrae • in the ... For example, an unresponsive wrist can cause the hand to be almost useless. If an unresponsive wrist ...

417

Arthritis and pain. Psychosocial aspects in the management of arthritis pain  

Microsoft Academic Search

The purpose of this review is to summarize psychosocial factors associated with arthritis pain and highlight recent evidence for psychosocial approaches to managing arthritis pain. By definition, psychosocial factors refer to two dimensions of experience: the psychological (cognitive, affective) and social (interacting with others, engaging in life activities). Psychosocial factors influence the perception of pain and the presence of pain

Catherine L Backman

2006-01-01

418

Paralysis Developing as a Paradoxical Response During the Treatment for Tuberculous Spondylitis: A Case Report  

PubMed Central

It can be difficult for clinicians to distinguish a paradoxical response to antituberculous therapy, worsening of an existing lesion despite adequate treatment, treatment failure, and drug resistance. We report a case of a 69-year-old woman who experienced bilateral lower extremity paralysis secondary to a paradoxical response. She had been suffering for 1 month from low back pain, due to tuberculous spondylitis. Her low back pain improved after antituberculous therapy. The low back pain, however, reappeared 2 months after treatment, accompanied by newly developed lower extremity weakness. Imaging studies showed an increased extent of her previous lesions. Consequently, the patient underwent a vertebral corpectomy with interbody fusion of the thoracolumbar spine. Histopathological examination showed chronic inflamed granulation tissue with no microorganisms. Although the antituberculous medication was not changed, the patient's symptoms and signs, including the paralysis, resolved after surgery. PMID:25024967

Park, Jae Hyeon; Kim, Yeo Hyung; Kwon, Chan Hyuk

2014-01-01

419

Spondylitis in a humpback whale (Megaptera novaeangliae) from the southeast Pacific.  

PubMed

A 7.25 m long male humpback whale (Megaptera novaeangliae) with spondylitis was found beached on August 13, 1994 at Ancon, Ecuador (2 degrees 23' S, 80 degrees 47' W). The condition involved at least 11 vertebrae, 7 lumbar (L4 to L11) and 4 caudal (Ca1 to Ca4). Partial fusion of vertebrae was observed as a result of intervertebral bony proliferation, likely impeding full motion. The relatively young age of this specimen and the severity of the deformities suggest an infectious, rather than degenerative, process. The gross findings are most consistent with some type of spondyloarthritis. Although this condition has previously been identified in a number of cetacean species, the pathogenesis, population impact and ecologic implications have not been fully assessed. This is the third case described for humpback whales and the first for a humpback whale from the SE Pacific. PMID:17629121

Félix, Fernando; Haase, Ben; Aguirre, Windsor E

2007-05-01

420

The Spondyloarthropathies  

SciTech Connect

This book contains several chapters on advances in inflammation research. Some of the chapter titles are: Genetic Analysis of Ankylosing Spondylitis, Pathological Specificity of Ankylosing Spondylitis: Is it yet established., Acute Anterior Uveitis and the Fourteenth Chromosome, and Patterns of Spondyloarthropathies.

Ziff, M.; Cohen, S.B.

1985-01-01

421

The Extended Posterior Circumferential Decompression Technique in the Management of Tubercular Spondylitis with and without Paraplegia  

PubMed Central

Study Design Retrospective clinical series. Purpose To study the clinical, functional and radiological results of patients with tuberculous spondylitis with and without paraplegia, treated surgically using the "Extended Posterior Circumferential Decompression (EPCD)" technique. Overview of Literature With the increasing possibility of addressing all three columns by a single approach, posterior and posterolateral approaches are gaining acceptance. A single exposure for cases with neurological deficit and kyphotic deformity requiring circumferential decompression, anterior column reconstruction and posterior instrumentation is helpful. Methods Forty-one patients with dorsal/dorsolumbar/lumbar tubercular spondylitis who were operated using the EPCD approach between 2006 to 2009 were included. Postoperatively, patients were started on nine-month anti-tuberculous treatment. They were serially followed up to thirty-six months and both clinical measures (including pain, neurological status and ambulatory status) and radiological measures (including kyphotic angle correction, loss of correction and healing status) were used for assessment. Results Disease-healing with bony fusion (interbody fusion) was seen in 97.5% of cases. Average deformity (kyphosis) correction was 54.6% in dorsal spine and 207.3% in lumbar spine. Corresponding loss of correction was 3.6 degrees in dorsal spine and 1.9 degrees in the lumbar spine. Neurological recovery in Frankel B and C paraplegia was 85.7% and 62.5%, respectively. Conclusions The EPCD approach permits all the advantages of a single or dual session anterior and posterior surgery, with significant benefits in terms of decreased operative time, reduced hospital stay and better kyphotic angle correction.

Rathinavelu, Barani; Krishnan, Venkatesh; Amritanand, Rohit; Sundararaj, Gabriel David

2014-01-01

422

Treat-to-target in spondyloarthritis: implications for clinical trial designs.  

PubMed

Spondyloarthritis (SpA) is a chronic inflammatory disease involving the spine and peripheral joints, and extra-articular manifestations such as uveitis, psoriasis and bowel inflammation. The treatment goals for SpA are maintenance of physical function, control of disease activity and prevention of radiographic progression. However, unlike the well-established treat-to-target (T2T) guidance in rheumatoid arthritis, the T2T concept for treating SpA is still immature. Clinical evidence of T2T in SpA is still lacking. To develop evidence of T2T in SpA, several research agendas need to be accomplished. Firstly, a well-accepted measureable treatment target needs to be defined through expert consensus. Secondly, a T2T treatment algorithm for monitoring disease activity and adjusting therapies needs to be generated. Finally, well-designed comparative clinical trials to compare this T2T strategy with the current standard of treatment should be conducted to demonstrate long-term benefits and risks. In SpA clinical trials, T2T comparative studies should have a clear disease definition for enrollment of patients with ankylosing spondylitis (AS), psoriatic arthritis, axial SpA or non-radiographic axial SpA. Endpoints should be assessment with AS International Working Group criteria for 20% improvement (ASAS20), ASAS40, and the Ankylosing Spondylitis Disease Activity Score (ASDAS) with inactive and moderate disease activity at month 3. Long-term efficacy endpoints such as the modified Stoke Ankylosing Spondylitis Spinal Score (mSASSS) of radiographic progression and magnetic resonance imaging (MRI) score at 2 years are encouraged. More sensitive assessment tools to detect structural damage and new bone formation, such as low-radiation computerized tomography (CT), are promising. PMID:24969316

Wei, James Cheng-Chung

2014-07-01

423

The Impact of Arthritis on Canadian Women  

PubMed Central

Health Issue Arthritis is one of the most prevalent chronic conditions in Canada and a leading cause of long-term disability, pain, and increased health care utilization. It is also a far more prevalent condition among women than men. Information was obtained primarily from the 1998–99 National Population Health Survey and the Canadian Joint Replacement Registry. Key Findings In 1998, the overall prevalence of self-reported arthritis or rheumatism in Canadian women was 20.0%. This rate increased to 55.6% among women over 75 years of age. Compared to women with chronic conditions, women with arthritis were more likely to experience long-term disability; report worse health; experience more pain; be dependent upon others and consult general practitioners, specialists, and physiotherapists more frequently. While men and women with arthritis under-utilize total joint replacement surgery, the degree of under-use was over three times greater for women. Data Gaps and Recommendations There is a lack of detailed information on the use of health care services by women with arthritis. There are also no systematic data available on the prescribing of medications, access to services such as assistive devices or exercise programs, or use of community support, self-management strategies, or rehabilitation services. The burden of arthritis both on women and on society is expected to increase as the population ages. A comprehensive health strategy to reduce the impact of arthritis is required to ensure that health and support services are available in a timely manner and provided in such a way to meet the needs of Canadian women. PMID:15345081

Badley, Elizabeth M; Kasman, Naomi M

2004-01-01

424

Common Therapy for Rheumatoid Arthritis Reduces Risk of Death  

MedlinePLUS

... Common Therapy for Rheumatoid Arthritis Reduces Risk of Death Taking methotrexate—a commonly prescribed anti-inflammatory medication—may reduce the risk of death among patients with rheumatoid arthritis (RA), according to ...

425

Orthodontic treatment of an ankylosed maxillary central incisor through single-tooth osteotomy by using interdental space regained from microimplant anchorage.  

PubMed

This case report describes the treatment of a boy, aged 13.6 years, whose ankylosed maxillary left central incisor had been avulsed and replanted 2.5 years earlier. Ankylosis of the tooth and adjacent alveolar process led to the development of infraocclusion, migration of adjacent teeth, midline deviation, and a vertical alveolar bone defect. Initially, distal tooth movement in the maxillary arch was performed with microimplant anchorage to gain space for repositioning the ankylosed tooth. Then a single-tooth osteotomy was performed in 1 surgical stage to allow for inferior repositioning of the tooth and bone. The ankylosed tooth was successfully leveled in the maxillary arch with a harmonic gingival margin. The total treatment period was 18 months, and the results were acceptable at 14 months after debonding. PMID:22284297

Chae, Jong-Moon; Paeng, Jun-Young

2012-02-01

426

Optimizing Long-Term Treatment of Rheumatoid Arthritis  

E-print Network

Optimizing Long-Term Treatment of Rheumatoid Arthritis with Systematic Documentation K. M. Simonic OF RHEUMATOID ARTHRITIS The whole body is plagued with pains. They ravage the joints in particular, so that foot Baillou, Liber de rheumatismo et pleuritide (1642) Rheumatoid arthritis [1] is an inflammatory systemic

Hammerton, James

427

Management of Rheumatoid Arthritis: Defining the Role of Leflunomide  

Microsoft Academic Search

Rheumatoid arthritis is a progressive, disabling disease which can lead to long-term deformity and disability. Leflunomide is a disease-modifying antirheumatic drug (DMARD) approved to reduce signs and symptoms, inhibit structural damage and improve physical function in adults with active rheumatoid arthritis. In clinical trials in patients with active rheumatoid arthritis, leflunomide had a more rapid onset of action than methotrexate,

Christopher I. Carswell; Caroline M. Perry; Tim Ibbotson

2003-01-01

428

38 CFR 4.58 - Arthritis due to strain.  

Code of Federal Regulations, 2013 CFR

...2013-07-01 2013-07-01 false Arthritis due to strain. 4.58 Section 4...The Musculoskeletal System § 4.58 Arthritis due to strain. With service incurred...amputation or shortening, a disabling arthritis, developing in the same...

2013-07-01

429

ARTHRITIS & RHEUMATISM Vol. 60, No. 8, August 2009, pp 22422247  

E-print Network

ARTHRITIS & RHEUMATISM Vol. 60, No. 8, August 2009, pp 2242­2247 DOI 10.1002/art.24721 © 2009 of Joint Destruction in Rheumatoid Arthritis Michael P. M. van der Linden,1 Anouk L. Feitsma,1 Saskia le of joint destruction in rheumatoid arthritis (RA) is highly variable from pa- tient to patient

Raychaudhuri, Soumya

430

38 CFR 4.58 - Arthritis due to strain.  

...2014-07-01 2014-07-01 false Arthritis due to strain. 4.58 Section 4...The Musculoskeletal System § 4.58 Arthritis due to strain. With service incurred...amputation or shortening, a disabling arthritis, developing in the same...

2014-07-01

431

Study of a prevention programme for caprine arthritis-encephalitis  

E-print Network

Study of a prevention programme for caprine arthritis-encephalitis G Péretz F Bugnard D Calavas; A prevention programme for caprine viral arthritis-encephalitis was monitored in 363 goat herds between 1988 transmission. goat / caprine arthritis-encephalitis virus / prevention Résumé ― Ã?tude d'un programme de

Paris-Sud XI, Université de

432

38 CFR 4.58 - Arthritis due to strain.  

Code of Federal Regulations, 2012 CFR

...2012-07-01 2012-07-01 false Arthritis due to strain. 4.58 Section 4...The Musculoskeletal System § 4.58 Arthritis due to strain. With service incurred...amputation or shortening, a disabling arthritis, developing in the same...

2012-07-01

433

Arthritis associated with inflammatory bowel disease in children  

Microsoft Academic Search

The records of 102 children with inflammatory bowel disease (44 with ulcerative colitis, 58 with Crohn's disease) were reviewed for evidence of joint disease unassociated with erythema nodosum. Thirteen children had arthritis, four had ulcerative colitis, and nine had Crohn's disease. Arthritis tended to be pauciarticular; ankles, knees, elbows and hips were most commonly affected. In three patients arthritis preceded

Murray H. Passo; Joseph F. Fitzgerald; Kenneth D. Brandt

1986-01-01

434

Pemetrexed ameliorates experimental arthritis in rats.  

PubMed

Pemetrexed (PMTX) is an anti-folate drug as methotrexate. The purpose of this study was to assess the efficacy of PMTX on collagen-induced arthritis (CIA). Forty Wistar albino rats were randomized into four groups. Arthritis was induced by intradermal injection of chicken type II collagen combined with incomplete Freund's adjuvant. Animals were sacrificed at the 15th day after the onset of arthritis. Tumor necrosis factor alpha (TNF-?), interleukin (IL)-17, and malondialdehyde (MDA) levels were increased, and superoxide dismutase (SOD), catalase (CAT), and glutathione peroxidase (GPx) activities and the expressions of nuclear factor erythroid 2-related factor 2 (Nrf2) and heme oxygenase-1 (HO-1) were decreased in the arthritis group. In the PMTX-treated (0.2 and 1 mg/kg/week i.p.) groups, the levels of TNF-?, IL-17, and MDA were decreased; the activities of SOD, CAT, and GPx and the expressions of Nrf2 and HO-1 were restored, and perisynovial inflammation and cartilage-bone destruction were decreased. PMTX has anti-arthritic potential in the CIA model and may be a therapeutic agent for rheumatoid arthritis. PMID:25129058

Karatas, Ahmet; Koca, Suleyman Serdar; Ozgen, Metin; Dagli, Adile Ferda; Erman, Fazilet; Sahin, Nuran; Sahin, Kazim; Isik, Ahmet

2015-02-01

435

[Osteoscintigraphy in the diagnosis of psoriatic arthritis].  

PubMed

The authors presented the results of clinical, x-ray and osteoscintigraphic investigations of 133 psoriatic arthritis patients and 72 patients with common psoriasis. Osteoscintigraphy was performed using a routine method with 99mTc-pyrophos (USSR) and 99mTc-phosphone (Hungary) on gamma-camera LFOV (Nuclear-Chicago, USA). X-ray signs of the involvement of the osteoarticular system were noted in 69 (51%) patients with psoriatic arthritis and in 16 (22%) patients with common psoriasis. The method permitted the detection of the foci of RP hyperfixation in 129 (97%) patients with psoriatic arthritis and in 51 (70.8%) patients with common psoriasis. They were observed mostly in large and small limb joints, less frequently--in the vertebral column, cranial bones, thorax, and ribs. Thus, osteoscintigraphy is a highly sensitive method for the detection of active inflammatory foci of the osteoarticular system in psoriasis at all stages of arthritis development. It makes it possible to detect the spreading of arthritis and its preclinical forms. PMID:2537452

Milevskaia, S G; Borodulin, V G

1989-02-01

436

The microbiome and rheumatoid arthritis  

PubMed Central

Humans are not (and have never been) alone. From the moment we are born, millions of micro-organisms populate our bodies and coexist with us rather peacefully for the rest of our lives. This microbiome represents the totality of micro-organisms (and their genomes) that we necessarily acquire from the environment. Micro-organisms living in or on us have evolved to extract the energy they require to survive, and in exchange they support the physiological, metabolic and immune capacities that have contributed to our evolutionary success. Although currently categorized as an autoimmune disorder and regarded as a complex genetic disease, the ultimate cause of rheumatoid arthritis (RA) remains elusive. It seems that interplay between predisposing genetic factors and environmental triggers is required for disease manifestation. New insights from DNA sequence-based analyses of gut microbial communities and a renewed interest in mucosal immunology suggest that the microbiome represents an important environmental factor that can influence autoimmune disease manifestation. This Review summarizes the historical clues that suggest a possible role for the microbiota in the pathogenesis of RA, and will focus on new technologies that might provide scientific evidence to support this hypothesis. PMID:21862983

Scher, Jose U.; Abramson, Steven B.

2012-01-01

437

HLA-linked rheumatoid arthritis.  

PubMed Central

Twenty-eight pedigrees were ascertained through pairs of first-degree relatives diagnosed with rheumatoid arthritis (RA). RA was confirmed in 77 pedigree members including probands; the absence of disease was verified in an additional 261 pedigree members. Pedigree members were serologically typed for HLA. We used likelihood analysis to statistically characterize the HLA-linked RA susceptibility locus. The genetic model assumed tight linkage to HLA. The analysis supported the existence of an HLA-linked RA susceptibility locus, estimated the susceptibility allele frequency as 2.16%, and estimated the lifetime penetrance as 41% in male homozygotes and as 48% in female homozygotes. Inheritance was recessive in males and was nearly recessive in females. In addition, the analysis attributed 78% of the variance within genotypes to genetic or environmental effects shared by siblings. The genetic model inferred in this analysis is consistent with previous association, linkage, and familial aggregation studies of RA. The inferred HLA-linked RA susceptibility locus accounts for approximately one-half of familial RA, although it accounts for only approximately one-fifth of the RA in the population. Although other genes may account for the remaining familial RA, a large portion of RA cases may occur sporadically. PMID:7942852

Hasstedt, S. J.; Clegg, D. O.; Ingles, L.; Ward, R. H.

1994-01-01

438

HLA-linked rheumatoid arthritis  

SciTech Connect

Twenty-eight pedigrees were ascertained through pairs of first-degree relatives diagnosed with rheumatoid arthritis (RA). RA was confirmed in 77 pedigree members including probands; the absence of disease was verified in an additional 261 pedigree members. Pedigree members were serologically typed for HLA. We used likelihood analysis to statistically characterize the HLA-linked RA susceptibility locus. The genetic model assumed tight linkage to HLA. The analysis supported the existence of an HLA-linked RA susceptibility locus, estimated the lifetime penetrance as 41% in male homozygotes and as 48% in female homozygotes. Inheritance was recessive in males and was nearly recessive in females. In addition, the analysis attributed 78% of the variance wit