Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UNIPROT:P01889 (ankylosing spondylitis)
 5,717 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The administration of drugs constitutes an important component of the therapeutic programme in ankylosing spondylitis (AS). The main objective of initiating such therapy is to reduce pain, stiffness and discomfort. There are at present 3 groups of drugs available for the management of AS. The first group is represented by drugs thought to influence the disease process itself. In this group, sulfasalazine is the only drug which is controlled trials has been shown to suppress disease activity in AS. We recommend the use of sulfasalazine in patients with high disease activity, with peripheral arthritis and in those with AS of short duration. The second group of drugs includes nonsteroidal anti-inflammatory drugs (NSAIDs), which suppress inflammation without influencing the disease process. These drugs should be administered selectively during periods of high disease activity. Moreover, 1 drug should be used in appropriate dosage before it is assumed to be inefficient. High doses of NSAIDs may be prescribed before bedtime in patients suffering from severe pain and stiffness during the night. The toxicity profile of NSAIDs includes gastrointestinal and renal side effects. The third group comprises analgesics and muscle relaxants. Such drugs should be used rather frequently in patients with longstanding AS refractory to treatment with NSAIDs. Peripheral arthritis and enthesopathy are generally managed by local injections of corticosteroids, while AS complicated by psoriasis or inflammatory bowel disease is treated as primary AS. AS occurring in juveniles is best treated with aspirin and an NSAID, although careful observation is necessary for the development of Reye's syndrome (with aspirin) and gastric irritation (with NSAIDs). When patients with AS undergo surgery, the possibility of silent gastrointestinal bleeding due to the use of NSAIDs and salicylates should not be ignored. Patients treated with oral corticosteroids should receive a bolus injection of soluble corticosteroid prior to surgical intervention. NSAIDs may be administered pre- and postoperatively to relieve stiffness induced by immobility. Rapid treatment of intervening infections and use of NSAIDs is recommended in AS complicated by renal amyloidosis. During pregnancy and lactation, ibuprofen may be the preferred drug in AS.
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PMID:Ankylosing spondylitis. Current drug treatment. 128 Oct 74

In the Rheumatological Institute in Prague the authors made a retrospective investigation in patients with ankylosing spondylitis affecting the hip joints where one or two endoprostheses of the hip joints were made. In all these patients they evaluated the subjective complaints of the operated extremity, they made a clinical examination of the extent of mobility and evaluated X-ray pictures. The group of 20 patients was examined in this retrospective investigation approximately five years after operation. From the total of 32 endoprostheses 20 were cemented and 12 were without cement. From the total number of patients only four reported slight pain in the area of the operated hip joint without signs of loosening on the X-ray picture. The extent of mobility of all endoprostheses was very satisfactory, the mean abduction in men was 27.6 degrees, in women 30.7 degrees, flexion 84 degrees in men and 97 degrees in women. As revealed by X-ray, the hip joints were affected most frequently by coxitis, osteoplastic changes were detected in six patients. Enthesopathies of a small or medium extent were found in almost all patients. Heteroplastic bone was evaluated according to Brooker's criteria, in the investigated group only type I was found. It may be stated that the submitted group of results of endoprostheses in ankylosing spondylitis is a very satisfactory solution which improves the patient's mobility and thus restores the quality of life.
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PMID:[Replacement of hip joints with total endoprostheses in patients with ankylosing spondylitis]. 146 76

In order to establish how many children with seronegative spondyloarthropathy (SpA) starting with peripheral arthritis and/or enthesitis will develop ankylosing spondylitis (AS), 13 consecutive Caucasian pediatric patients, (11 with the seronegative enthesopathy and arthropathy (SEA) syndrome and 2 with isolated B27 associated peripheral arthritis or enthesitis at entry), were followed prospectively with no loss for more than 5 years. Sacroiliac joint plain films obtained at the last visit were mixed with those of 14 control subjects and read blindly. The course of SpA was self-limiting in 6 patients and recurrent in the other 7. Six patients had episodes of inflammatory cervical and/or lumbar pain during followup. However, none showed any limitation of spinal movement in the asymptomatic periods. Only one patient (9.1%) of 11 with the SEA syndrome showed bilateral sacroiliitis and met New York criteria for AS after 5 years of disease. Our results suggest that the proportion of Caucasian children with the SEA syndrome developing AS is much lower than the 75% found in a similar study on Mexican children. Lack of evaluation of all patients after 5 years, the reading of pelvic plain films without reducing observer error, and the male predominance in the Mexican study, probably in addition to ethnic or environmental factors, may account for differences.
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PMID:Low frequency of axial involvement in Caucasian pediatric patients with seronegative enthesopathy and arthropathy syndrome after 5 years of disease. 157 64

Classification criteria for most of the disorders belonging to the spondylarthropathy group already exist. However, the spectrum of spondylarthropathy is wider than the sum of these disorders suggests. Seronegative oligoarthritis, dactylitis or polyarthritis of the lower extremities, heel pain due to enthesitis, and other undifferentiated cases of spondylarthropathy have been ignored in epidemiologic studies because of the inadequacy of existing criteria. In order to define classification criteria that also encompass patients with undifferentiated spondylarthropathy, we studied 403 patients with all forms of spondylarthropathy and 674 control patients with other rheumatic diseases. The diagnoses were based on the local clinical expert's opinion. The 403 patients included 168 with ankylosing spondylitis, 68 with psoriatic arthritis, 41 with reactive arthritis, 17 with inflammatory bowel disease and arthritis, and 109 with unclassified spondylarthropathy. Based on statistical analysis and clinical reasoning, we propose the following classification criteria for spondylarthropathy: inflammatory spinal pain or synovitis (asymmetric or predominantly in the lower limbs), together with at least 1 of the following: positive family history, psoriasis, inflammatory bowel disease, urethritis, or acute diarrhea, alternating buttock pain, enthesopathy, or sacroiliitis as determined from radiography of the pelvic region. These criteria resulted in a sensitivity of 87% and a specificity of 87%. The proposed classification criteria are easy to apply in clinical practice and performed well in all 7 participating centers. However, we regard them as preliminary until they have been further evaluated in other settings.
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PMID:The European Spondylarthropathy Study Group preliminary criteria for the classification of spondylarthropathy. 193 Mar 11

A 16-year-old black child with seronegative enthesopathy and arthropathy, who had the HLA-B27 antigen but no clinical or radiographic evidence of sacro-iliitis, is described. The patient did not fulfil the criteria for any of the seronegative spondylo-arthropathies. He was assessed as having the subtype of pauci-articular juvenile chronic arthritis, which occurs in older boys and is associated with HLA-B27, and he also had features of the seronegative enthesopathy and arthropathy syndrome, which has been reported in children. The HLA-B27-associated diseases, such as ankylosing spondylitis and Reiter's syndrome, are uncommon in black adults and there is very little data on their occurrence in black children. Suspicion of this entity in children will permit an accurate diagnosis and help to distinguish these children from those with other childhood rheumatic disorders.
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PMID:HLA-B27-associated seronegative enthesopathy and arthropathy in a black child. 229 14

The present study describes the profile of seronegative spondarthritides (SSA) in young servicemen. SSA was diagnosed in 63 patients from a prospective study on spondyloarthropathy. The SSA group consisted of ankylosing spondylitis (AS, 40 patients), Reiter's syndrome (RS, 6) and SSA undifferentiated (SSA-U, 17). The chief clinical and radiological features of the group were due to sacro-iliitis/spondylitis, peripheral arthritis and enthesopathy. Except for RS, extra-articular features were sparse. Mucosal lesions were not evident. Radiologically, sacro-iliitis varied from 24% in SSA-U to 100% in AS, and was disproportionately less when compared to its clinical extent. Dominant lower limb arthritis (poly and oligo) was seen in AS (40%), SSA-U (88.2%) and RS (100%). HLA A and B were typed in patients and controls. HLA AI had a significant negative association (p less than 0.05) with AS and the SSA group, and its relative risk (R) was consistently low (0.2-0.3). HLA B27 was present in 65.7%, 73%, 67%, 41% and 9% of the SSA group, AS, RS, SSA-U and controls respectively (p less than 0.05). Significant R values of A and B loci antigens in disease groups are presented. When compared with available Indian literature, this study highlights the variability and overlap in the disease. Disease markers currently available have limitations in defining the various subsets of SSA.
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PMID:Spectrum of seronegative spondarthritides (SSA) with special reference to HLA profiles. 238 18

We studied prospectively the clinical and radiographic features of sacroiliac and spinal involvement in 20 patients with seronegative enthesopathy and arthropathy. This group was compared with 25 patients with a polyarticular onset form of juvenile rheumatoid arthritis (JRA) and 28 with definite ankylosing spondylitis (AS) of juvenile onset. A significant increasing proportion of patients with seronegative enthesopathy and arthropathy developed back complaints and radiographic sacroiliitis fulfilling the diagnostic criteria for AS from the 3rd-5th year of disease (47.1-75.0%) and thereafter (92.3%). Back complaints were rarely seen in JRA and, furthermore, sacroiliitis of the AS type nerve occurring in this group. There were no significant differences between the group with seronegative enthesopathy and arthropathy and juvenile AS, either at onset or through the years. Clinical and radiographic assessment of axial involvement in children at risk should include a careful analysis of symptoms, periodical measurements of the spinal flexion and, starting from the 3rd year, radiographs of the pelvis.
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PMID:Axial involvement in the seronegative enthesopathy and arthropathy syndrome and its progression to ankylosing spondylitis. 234 41

We studied 87 Mexican mestizo patients (82 men and 5 women) with definite ankylosing spondylitis (AS) with particular reference to juvenile and adult onset types. HLA-B27 was present in 32 of 38. Forty-seven patients (54.0%) had onset before the age of 16 years and 40 (46.0%) thereafter. By the end of the 1st year of disease, main features included spinal involvement in 44 (50.6%), peripheral arthropathy in 57 (65.5%) and enthesopathy in 41 (47.1%). Frequency of these increased up to 100.0, 79.3 and 64.4%, respectively, through the course of the disease. Peripheral arthritis and/or enthesopathy occurred in 89.4 and 63.1% of juveniles and 37.5 and 27.5% of adults, respectively, while lumbar pain and/or stiffness occurred in 23.4% of the former and 82.5% of the latter during the first year of disease. Additional findings were high erythrocyte sedimentation rate, anemia and hypergammaglobulinemia. Uveitis was the commonest extraarticular manifestation occurring in 20.6%. Our data suggest that the clinical pattern of AS in our patients was influenced by both age at onset and sex distribution of the disease.
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PMID:Ankylosing spondylitis in the Mexican mestizo: patterns of disease according to age at onset. 278 4

A number of conditions have been found to be associated with the HLA-B27 locus including ankylosing spondylitis, psoriatic spondylitis, Reiter's syndrome, juvenile arthritis, and others. An unusual clinical syndrome of "sausage-like" toe, or dactylitis, associated with an oligoarthritis involving the lower extremities has been reported in adults, as has HLA-B27 associated spondyloarthritis and enthesopathy in children. We describe 3 children with dactylitis of the toe who carry HLA-B27. Their course and treatment are presented, and the importance of establishing this diagnostic entity is discussed.
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PMID:HLA-B27 associated dactylitis in children. 326 63

A middle-aged man presented with a 10-year history of intermittent low back pain. Radiological examination of the spine disclosed findings of both ankylosing spondylitis and diffuse idiopathic skeletal hyperostosis (DISH). Radiography of the hands showed the typical enthesopathy of DISH. To our knowledge this is the 2nd published case on the coexistence of the two diseases.
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PMID:Coexistence of ankylosing spondylitis and diffuse idiopathic skeletal hyperostosis: another report. 350 68


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