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)

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

A 56-year-old man was admitted because of diarrhea, cough, weight loss, and disturbance of consciousness. He had been diagnosed as having ankylosing spondylitis at 18-years old. The spondylitis progressed until there was complete rigidity of the spine including the neck, hip and knee joints. Human leukocyte antigen (HLA) B27, which has been characteristic of ankylosing spondylitis, was also present in this case. A chest radiograph showed pleural thickness and a cavity in the right upper lobe; and a soft tissue mass and fluid level was found in the cavity. Aspergillus fumigatus was detected in the sputum and pulmonary aspergillosis was diagnosed. Biopsy of the colon revealed that a large interstitial amyloidosis. Despite the treatment of the patient's malnutrition and lung aspergillosis using amphotericin B, the clinical course was rapidly progressive and the patient died of respiratory failure due to lung aspergillosis. It is important to be aware of these rare complications, which are correlated with the prognosis in cases of ankylosing spondylitis.
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PMID:[A case of ankylosing spondylitis associated with pulmonary aspergillosis and amyloidosis]. 1185 83

We present a 26-year-old man with edema, ascites and bloody diarrhea that later proved to be due to gastrointestinal and renal amyloidosis. Interestingly, he was also diagnosed as having ankylosing spondylitis,-possibly after a delay of 12 years. The obscure diagnosis and challenging treatment of secondary amyloidosis are further discussed.
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PMID:The burden of amyloidosis on the gastrointestinal tract of an ankylosing spondylitis patient. 1467 23

Nabumetone is a nonsteroidal anti-inflammatory prodrug, which exerts its pharmacological effects via the metabolite 6-methoxy-2-naphthylacetic acid (6-MNA). Nabumetone itself is non-acidic and, following absorption, it undergoes extensive first-pass metabolism to form the main circulating active metabolite (6-MNA) which is a much more potent inhibitor of preferentially cyclo-oxygenase (COX)-2. The three major metabolic pathways of nabumetone are O-demethylation, reduction of the ketone to an alcohol, and an oxidative cleavage of the side-chain occurs to yield acetic acid derivatives. Essentially no unchanged nabumetone and < 1% of the major 6-MNA metabolite are excreted unchanged in the urine from which 80% of the dose can be recovered and another 10% in faeces. Nabumetone is clinically used mainly for the management of patients with osteoarthritis (OA) or rheumatoid arthritis (RA) to reduce pain and inflammation. The clinical efficacy of nabumetone has also been evaluated in patients with ankylosing spondylitis, soft tissue injuries and juvenile RA. The optimum oral dosage of nabumetone for OA patients is 1 g once daily, which is well tolerated. The therapeutic response is superior to placebo and similar to nonselective COX inhibitors. In RA patients, nabumetone 1 g at bedtime is optimal, but an additional 0.5-1 g can be administered in the morning for patients with persistent symptoms. In RA, nabumetone has shown a comparable clinical efficacy to aspirin (acetylsalicylic acid), diclofenac, piroxicam, ibuprofen and naproxen. Clinical trials and a decade of worldwide safety data and long-term postmarketing surveillance studies show that nabumetone is generally well tolerated. The most frequent adverse effects are those commonly seen with COX inhibitors, which include diarrhoea, dyspepsia, headache, abdominal pain and nausea. In common with other COX inhibitors, nabumetone may increase the risk of GI perforations, ulcerations and bleedings (PUBs). However, several studies show a low incidence of PUBs, and on a par with the numbers reported from studies with COX-2 selective inhibitors and considerably lower than for nonselective COX inhibitors. This has been attributed mainly to the non-acidic chemical properties of nabumetone but also to its COX-1/COX-2 inhibitor profile. Through its metabolite 6-MNA, nabumetone has a dose-related effect on platelet aggregation, but no effect on bleeding time in clinical studies. Furthermore, several short-term studies have shown little to no effect on renal function. Compared with COX-2 selective inhibitors, nabumetone exhibits similar anti-inflammatory and analgesic properties in patients with arthritis and there is no evidence of excess GI or other forms of complications to date.
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PMID:Nabumetone: therapeutic use and safety profile in the management of osteoarthritis and rheumatoid arthritis. 1545 29

Inflammatory bowel disease (IBD) is a disorder driven by immune dysregulation, characterized by a relapsing-remitting pattern which is punctuated by flares associated with abdominal pain and bloody diarrhea. Management in general is guided by potent immunosuppressive regimens, often with equally potent associated toxicities. Treatment of refractory disease has been revolutionized by biologic therapies. Surgery remains an important part of the overall treatment plan, especially in patients presenting with acute mechanical complications and for prophylactic total colectomy in certain patients at high risk for colorectal cancer (CRC). IBD is associated with a host of intestinal disease-related complications such as intestinal stricture and fistula formation, small bowel obstruction, toxic megacolon, CRC and malnutrition. In addition to these complications there exist a myriad of extraintestinal manifestations that affect almost every organ system, such as primary sclerosing cholangitis, ankylosing spondylitis, pyoderma gangrenosum and uveitis.
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PMID:Inflammatory bowel disease: complications and extraintestinal manifestations. 1943 44

The objective of this paper is to study the macroscopic and microscopic aspects of colonic mucosa in patients with ankylosing spondylitis (AS) and in controls without colonic symptoms in Bangladesh. This observational study was done in a tertiary care center of Dhaka. Twenty-eight consecutive cases of AS were included, fulfilling modified New York Criteria with pure axial form or combined axial and peripheral joint involvement. Ten controls were enrolled in the study from people in whom endoscopy of upper gastrointestinal tract (GI) tract was performed and who had no musculoskeletal complaints and no colonic symptoms. Short colonoscopy (up to 60 cm) and colonoscopic biopsy were done in all. Histological features were evaluated following Cuvelier grading and Rubio and Kock scoring system. Demographic data including age and sex were similar in the AS and control groups. Out of 28 patients, ten had axial and 18 combined axial and peripheral joint disease, mostly pauciarticular. In the AS group, macroscopic and microscopic lesions were found in four and 14 subjects, respectively. Out of 22 subjects without diarrhea, seven had stage II and two had stage I changes. Six subjects in the AS group gave a history of diarrhea, of them three had stage I and two had stage II changes. In the control group, no macroscopic abnormalities were found. On histological examination, the mean diameter of transversely cut rectal glands, interglandular linear distances, number of glands per area, and total digital scores varied between 45-90 microm, 4.6-27 microm, 5-25, and 17-18 respectively. In eight of the ten controls, eosinophilic infiltration was found. Subclinical inflammatory lesions in the colonic mucosa are common in patients with ankylosing spondylitis. Colonic mucosa in normal individuals does not differ from that found in western studies, except for the presence of frequent mild eosinophilic infiltration in the lamina propria.
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PMID:The colon in patients with ankylosing spondylitis and in normal controls in Bangladesh: a macroscopic and microscopic study. 1984 57

Secondary (AA) amyloidosis is a disease that is caused by systemic deposition of amyloid fibrils. Circulating serum amyloid A protein is an acute phase reactant and levels are therefore high during inflammatory states. Chronic elevation of serum amyloid A levels results in accumulation and deposition in various organs, leading to organ dysfunction. Unless the inciting inflammatory state can be controlled, the subsequent development of amyloidosis diminishes patient survival. We report a case of systemic amyloidosis that presented primarily as chronic diarrhea in a patient with ankylosing spondylitis. Unfortunately for the patient, the diagnosis of amyloidosis was delayed for years despite encounters with multiple physicians. Early medical intervention to control chronic inflammation is imperative and could prevent morbidity and mortality related to the development of secondary amyloidosis. Consideration of amyloidosis as a diagnosis in patients who have chronic uncontrolled inflammatory conditions is also important in preventing poor outcomes related to this disease.
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PMID:Systemic amyloidosis presenting as chronic diarrhea in a patient with ankylosing spondylitis. 2005 51

Multiple extraintestinal diseases are present in 0.3- 4.5 % of inflammatory bowel disease patients. A 39-year-old woman was admitted with a 3 months history of cervicalgia with functional incapacity, asthenia, tibio-tarsal bilateral arthritis and bloody diarrhoea. She had ferropenic anemia, SR-120 mm, creatinine clearance-42 mL/min, proteinuria-1.2 g/24h. Colonoscopy with biopsy showed active ulcerative rectossigmoiditis. She had bilateral sacroileitis more pronounced at the right side which was suggestive of ankylosing spondylitis. HLA B27 was positive. Because of colestasis, colangio-MRI and CPRE were done and were suggestive of primary sclerosing colangitis. Renal disease was interpreted as an analgesic nephropathy versus glomerulonephritis associated with ulcerative colitis. Cardiac ecodoppler showed pericardial thickening with a thin pericardial effusion. Full improvement of gastrointestinal complaints was observed with 5-ASA topic enemas, sulfassalazine, corticosteroids and azathioprine and full remission of ankylosing spondylitis with adalimumab. This case illustrates extraintestinal wide involvement as the initial presentation of ulcerative colitis, remarking its systemic nature.
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PMID:[Ulcerative colitis initial presentation with multiple extra-intestinal manifestations]. 2068 1

Cryptosporidiosis is a parasitic disease caused by a protozoan called Cryptosporidium sp. An increased number of diagnoses were made in the last 20 years, especially in patients with immunodeficiency like the acquired human immunodeficiency syndrome and induced immunodeficiency, such as in transplant patients and those who need frequent hemodialysis, has been observed. We report the case of a young patient with ankylosing spondylitis treated with adalimumab who developed chronic diarrhea secondary to cryptosporidiosis.
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PMID:Cryptosporidiosis in a patient with ankylosing spondylitis treated with adalimumab. 2112 68

A 27-year-old male with a 2 year history of ankylosing spondylitis (AS) was investigated for intermittent episodes of diarrhea and found to have granulomatous ileitis. Differential diagnosis, discussions regarding similarities in immune alterations in both AS and Crohn's disease and therapeutic options are presented in this paper.
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PMID:Ankylosing spondylitis or Crohn's disease? Case report and review of the literature. 2152 64


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