Extrasceletal Manifestations in Patients with Ankylosing Spondylitis
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Abstract
Extraskeletal manifestations (EM) are often observed in ankylosing spondylitis (AS). The available data on the association of EM with inflammatory activity and other clinical parameters of AS are contradictory.
The purpose of the study was to evaluate the association of EM with inflammatory activity and other manifestations of AS.
Patients and methods. At the Tashkent state clinic hospital examined 100 patients (89 men and 11 women) diagnosed with AS according to the New York criteria (1984). The median age of patients was 31.5 years, the age of onset of the disease was 19.5 years and its duration - 11.5 years. 97 (97%) patients identified HLA-B27. In addition to the standard clinical, laboratory and instrumental examination, 52 patients underwent transthoracic echocardiography, ultrasound diagnostics of the kidneys, colonoscopy, consultations of an ophthalmologist, dermatologist, nephrologist, gastroenterologist. Uveitis, heart damage (impaired conduction, changes in the aorta and valves), inflammatory bowel disease (IBD) and psoriasis were considered as EMs. 18 (18%) of 100 patients had uveitis, 21 (21%) had cardiac conduction disorders, 17 (17%) had psoriasis, 6 (6%) had IBD, 41 (41%) out of 100 - changes in the aorta and heart valves. The I group of patients with EM (n=35) and II group without EM (n=65) were compared according to the age of onset of AS, the presence of HLA-B27, arthritis of the peripheral joints, coxitis, enthesitis, syndesmophytes, fever, anemia, and the need for gene- engineering therapy, biological drugs (GIBD) and / or systemic glucocorticoids (GC), the value of the BASDAI, BASMI, BASFI, ASDAS indices, VASc scale and ESR.
Results. The groups with and without EM were comparable in terms of gender, age, duration of AS, and the presence of HLA-B27. There were no significant differences in the ESR, BASDAI, frequency of coxitis, enthesitis, syndesmophytes in the spine.
In the group with EM peripheral arthritis was significantly more common than in the group without EM – in 29 (82.8%) of 35 and in 42 (65,6%) of 65 patients, respectively (p<0.0001) ; fever - in 4 (11,4%) of 35 and 8 (12,3%) of 65 patients, respectively (p<0.0001), anemia- in 9 (25,7%) of 35 and 16 (24,6%) of 65 patients, respectively (p<0.0001); use of GIBP and/or systemic GCs -in 18 (51,4%) of 35 and 26 (40,0%) of 65 patients, respectively (p<0.0001).
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References
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