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Query: UNIPROT:P01889 (ankylosing spondylitis)
 5,717 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Inflammation of one or both sacroiliac joints is a characteristic feature of patients with spondyloarthropathies (SpA). Sacroiliitis often leads to inflammatory back pain (IBP). IBP and asymmetric peripheral arthritis of the lower limbs are the main clinical symptoms and criteria for classification and diagnosis of SpA in which sacroiliac joints are uni- or bilaterally affected with an intensity ranging from mild to very severe inflammation resulting in partial or complete ankylosis Sacroiliitis is a very frequent feature of undifferntiated SpA. In ankylosing spondylitis (AS) inflammation in the axial skeleton occurs rarely in the absence of sacroiliitis. Objective evidence of sacroiliitis obtained by imaging procedures, especially x-rays, has always been part of diagnostic and classification criteria for AS. This is in contrast to spinal radiography which, however, has been recently included in a core set of outcome items to be assessed in clinical studies. In early and acute stages of sacroiliitis the diagnosis can be difficult because conventional radiographs -- which are known to have considerable intra- and interobserver variability -- may be normal. Since IBP is not a specific indicator of sacroiliitis there is need for valuable imaging techniques. Scintigraphy lacks specificity. Computed tomography (CT) is a very good method to demonstrate already established bony changes and magnetic resonance imaging (MRI) has the advantage of combining a good visualisation of the complicated anatomy of the sacroiliac joint with the ability to localise different degrees of inflammation and oedema and prove a possible spread to muscles as it occurs in septic sacroiliitis, an important differential diagnosis.
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PMID:Imaging of sacroiliitis. 1075

Secondary amyloidosis is an occasional complication of ankylosing spondylitis (AS) and in most cases renal amyloidosis presents with proteinuria, nephrotic syndrome and decreased renal function. We describe a 32-year-old male patient with AS manifested by frequent diarrhea, intermittent abdominal pain and low serum albumin levels. He has suffered from severe inflammatory back pain for 14 years with multiple peripheral joint involvement. Protein-losing enteropathy due to gastrointestinal amyloidosis was diagnosed with 99mTc-human albumin scintigraphy, fecal alpha-1 antitrypsin clearance and colonoscopic biopsy with Congo red staining. Somatostatin analogue octreotide and prednisolone were introduced with successful result.
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PMID:Successful treatment of protein-losing enteropathy due to AA amyloidosis with somatostatin analogue and high dose steroid in ankylosing spondylitis. 1107 6

Ankylosing spondylitis is not an uncommon disease worldwide, yet is relatively rare in Bahrain. There is a typical pattern of joint involvement in cases of ankylosing spondylitis, but the presentation of discitis is rare. We present a case of a patient presenting with backache and was diagnosed to have discitis. The diagnosis of ankylosing spondylitis was made only after he was found to be Human Leukocyte Antigen-B27 positive. This is the first case report of ankylosing spondylitis presenting as discitis in Bahrain.
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PMID:Ankylosing spondylitis presenting with discitis. 1137 71

The cauda equina syndrome in ankylosing spondylitis (the CES-AS syndrome) is marked by slow, insidious progression and a high incidence of dural ectasia in the lumbosacral spine. A high index of suspicion for this problem must be maintained when evaluating the patient with ankylosing spondylitis with a history of incontinence and neurologic deficit on examination. There has been disagreement in the literature as to whether surgical treatment is warranted for this condition. A meta-analysis was thus performed comparing outcomes with treatment regimens. Our results suggest that leaving these patients untreated or treating with steroids alone is inappropriate. Nonsteroidal antiinflammatory drugs may improve back pain but do not improve neurologic deficit. Surgical treatment of the dural ectasia, either by lumboperitoneal shunting or laminectomy, may improve neurologic dysfunction or halt the progression of neurologic deficit.
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PMID:Cauda equina syndrome in ankylosing spondylitis (the CES-AS syndrome): meta-analysis of outcomes after medical and surgical treatments. 1158 43

While cardiovascular disease develops in up to 50% of adult patients with ankylosing spondylitis, it is very uncommon in its juvenile counterpart. Regarding the early stage of the disease, before onset of sacroiliac joint changes, only two cases with aortic incompetence have been published while reports of mitral valve involvement are not available. A 13 year old boy is described with an HLA-B27 positive asymmetric oligoarthritis and enthesitis, without back pain or radiographic evidence of sacroiliitis. Echocardiography showed an echogenic structure measuring 8 x 11 x 20 mm at the fibrous continuity between the aortic and mitral valves extending through a false tendon into an echogenic thickened posterior papillary muscle, causing a grade II aortic and grade I/II mitral regurgitation. Short term corticosteroid and long term non-steroidal anti-inflammatory drug and disease modifying antirheumatic drug treatments efficiently controlled the symptoms. The cardiac findings remained unchanged during a follow up of 20 months. Careful cardiac evaluation appears to be mandatory even in these young patients.
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PMID:HLA-B27 positive juvenile arthritis with cardiac involvement preceding sacroiliac joint changes. 1171 84

Spondyloarthropathies are important and common inflammatory arthropathies that occur in approximately 2% of the population. They are often underrecognized. The diagnosis features the presence of asymmetrical, predominately lower limb arthritis and/or inflammatory back pain. The spondyloarthropathies can be subdivided into several disease subcategories, including ankylosing spondylitis, Reiter's/reactive arthritis, psoriatic arthritis, inflammatory bowel disease-associated arthritis and a large group of undifferentiated spondyloarthritis. The interactions between infectious agents and the individual's genetic background are important aetiological factors. Therapies for these conditions include physical therapy, non-steroidal anti-inflammatories and disease-modifying drugs.
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PMID:Spondyloarthropathies: an overview. 1178 74

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.
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PMID:Conventional treatments for ankylosing spondylitis. 1238 10

The onset of ankylosing spondylitis is usually characterized by lower back pain and stiffness in young adults; early diagnosis is not easy, but the disease is generally identified within a few years of onset. Anterior atlantoaxial subluxation may occur in the late stage of ankylosing spondylitis, but early spontaneous subluxation is rarely seen. We present a case of ankylosing spondylitis with an initial symptom of neck pain, rather than lower back pain, due to spontaneous anterior atlantoaxial subluxation. After medical and surgical intervention, except for limited range of motion, the patient experienced neither neck pain nor weakness of his left limbs during the next 8 mo of follow-up.
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PMID:Ankylosing spondylitis manifested by spontaneous anterior atlantoaxial subluxation. 1244 95

The prevelance of ankylosing spondylitis or sacroiliitis in Behcet's disease has been the subject of debate for some time. Two cases with atypical presentation and course are discussed. The first patient was a young woman with Behcet's disease whose primary complaint was neck pain. X-ray examination showed severe cervical involvement, characteristic of the type seen in women with ankylosing spondylitis. She subsequently developed anterior uveitis. The second patient was a man suffering from back pain and limited movement of his neck and back. When he was referred to our outpatient clinic, his severe anemia became the subject of the whole investigation. He was diagnosed with Behcet's disease with ankylosing spondylitis accompanied with amyloidosis and an end-stage renal failure.
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PMID:Coexistence of ankylosing spondylitis and Behcet's disease. Two cases with atypical presentation and course. 1289 58

Aceclofenac (Almirall Prodesfarma SA) is an oral NSAID that is effective in the treatment of painful inflammatory diseases and has been used to treat > 75 million patients worldwide. It has proved as effective as diclofenac, naproxen and piroxicam in patients with osteoarthritis, diclofenac, ketorolac, tenoxicam and indomethacin in patients with rheumatoid arthritis and tenoxicam, naproxen and indomethacin in patients with ankylosing spondylitis. It also provides effective analgesia in other indications, such as dental or gynaecological pain, lower back pain and ear, nose and throat indications. Aceclofenac appears to be particularly well-tolerated amongst the NSAIDs, with a lower incidence of gastrointestinal adverse effects. This good tolerability profile results in a reduced withdrawal rate and hence greater compliance with treatment.
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PMID:Aceclofenac in the management of inflammatory pain. 1516 79


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