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)

Despite the early description of painless spinal ankylosis, the existence of a clinical subset of ankylosing spondylitis with silent axial disease has largely been overlooked. Of 45 patients who met Rome diagnostic criteria for ankylosing spondylitis, five denied ever having back pain either as an initial symptom or during the subsequent course of their illness. All had decreased lumbar spine motion and bilateral radiographic sacroiliitis of at least grade III severity. Chest expansion was decreased in four, and radiographic involvement of the cervical and lumbar spine was observed in three and two patients, respectively. There were no differences observed in sex or race distribution, or frequencies of peripheral arthritis, heel pain, acute uveitis, genito-urinary infection or HLA-B27 positivity when these patients were compared with the remaining patients with back pain. These patients support the existence of a "latent" form of ankylosing spondylitis with silent axial disease.
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PMID:The absence of back pain in classical ankylosing spondylitis. 15 20

Seronegative spondyloarthritides (Reiter's syndrome, ankylosing spondylitis, or psoriatic arthritis) was diagnosed in 24 of 30 patients with severe heel pain. Most of the patients were carriers of the antigen HLA B27. Talalgia was frequently the first symptom of disease. Heel surgery is contra-indicated during the inflammation phase, since it may cause local aggravation and risk of ankylosis of the talocalcaneal articulation. Other causes of heel pain include tendon chondrocalcinosis, local tuberculous infection, and nodular tendinitis caused by a partial rupture of the tendon. On the other hand, severe talagia was rarely found in rheumatoid arthritis, and no case was related to the presence of tophi or xanthomas of the Achilles tendon.
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PMID:Talalgia. A review of 30 severe cases. 67 39

Forestier disease, or ankylosing hyperostosis, is a common disorder of middle-aged and elderly persons. Characteristic clinical and radiographic features enable the physician to distinguish between this disease and ankylosing spondylitis. The principal clinical features include aching spinal stiffness with relative preservation of function and minimal evidence of spinal immobility. Many patients have elbow and heel pain and dysphagia. Typical radiographic findings are ligament ossification, para-articular osteophytosis, and bone production at sites of tendon and ligment attachment in spinal and extraspinal locations. The extraspinal roentgenographic manifestations are so characteristic that when present, they allow the diagnosis of spinal ankylosing hyperostosis to be suggested, even in the absence of axial radiographs.
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PMID:Diffuse skeletal abnormalities in Forestier disease. 93 66

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

One hundred and two patients from South India with primary ankylosing spondylitis (AS) were analysed clinically and radiologically. The mean age of onset was 26 years, with a male to female ratio of 16:1. Eleven patients presented as juvenile ankylosing spondylitis. The mode of presentation of AS included axial involvement in 59, peripheral arthritis in 38, heel pain in 18 and acute anterior uveitis (AAU) in 11. The overall incidence of extra axial features was high (90 patients). These included subjects with peripheral arthritis (49), heel pain (35), AAU (14), rib pain (11), aortic regurgitation (8), apical pulmonary fibrosis (5), mitral regurgitation (2) and conduction defects (2). Peripheral arthritis was characteristically asymmetrical and oligo articular, and involved lower limb joints. No renal involvement was noticed. Radiologically, bilateral sacroilitis was seen in 80% of cases.
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PMID:Pattern of rheumatic diseases in south India. V. Ankylosing spondylitis. A clinical and radiological study. 208 81

As in other diseases of undetermined etiology, the diagnosis of ankylosing spondylitis (AS) and related spondyloarthropathies (SpA) is based on clinical and roentgenographic features. The current criteria for diagnosis of some of these diseases are too restricted, and do not recognize the existence of a much wider disease spectrum. For example, radiographically detected sacroiliitis is extremely frequent in AS, but may not be an obligate manifestation, especially in early or atypical forms of the disease. Arthritis involving the axial skeleton, including the sacroiliac joints, can be present in some patients without evidence of erosive disease roentgenographically. The disease spectrum of Reiter's syndrome has also been broadened considerably, and "incomplete" forms of Reiter's syndrome are observed much more commonly than the classical triad of arthritis, conjunctivitis, and urethritis. The term "B27-associated reactive arthritis" has been used in recent years to refer to SpA following enteric or urogenital infections, and the disease spectrum includes the clinical picture of typical Reiter's syndrome. The clinical spectrum of psoriatic SpA has been better clarified. Some of the less well defined B27-associated clinical syndromes include seronegative oligoarthritis, polyarthritis, or dactylitis ("sausagelike" toes) of the lower extremities, and heel pain caused by calcaneal (and tarsal) periostitis. These and other undifferentiated SpA have been ignored in previous epidemiological studies because of the inadequacy of the existing classification criteria. The European Spondylarthropathy Study Group (ESSG) has completed a study aimed at developing preliminary classification criteria for the whole group of SpA patients, with the specific intention of encompassing patients with undifferentiated SpA.
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PMID:A wider spectrum of spondyloarthropathies. 225 5

Sixty-one Thai patients with ankylosing spondylitis (AS), diagnosed in accordance with Rome and New York criteria for AS, were studied. The cases includes idiopathic AS (46 cases), Reiter's syndrome AS (8 cases) and psoriatic spondylitis (7 cases). The vast majority of patients were male (Male:Female = 11.2:1), and in over three-fourths the age of onset was between 10 and 39. Low back pain and peripheral arthritis as the initial manifestations were observed in 78.68 and 55.73% of patients respectively. Peripheral arthritis was evident during the course of illness in 72.13% of cases, oligoarticular arthritis being predominant (68.97%). Heel pain, tendonitis and plantar pain were noted in 19.67, 4.92 and 3.28% respectively. Most patients had lumbosacral and thoracic spine involvements, and only 49.18% showed involvement of the cervical spine. Bilateral sacroiliitis was noted in 98.36%. Uveitis was evident in 11.47% while evidence of aortic insufficiency was noted in 3.28%. An association with HLA-B27 was encountered in 91.07% of all cases. In general, the clinical features of AS in Thai patients are similar to those reported elsewhere, but an association with inflammatory bowel disease and Behcet's disease are notably absent.
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PMID:Clinical study of Thai patients with ankylosing spondylitis. 315 30

Reiter's Syndrome (RS) is not common in children and adolescents. From 1982 to 1987 we have seen 13 pediatric patients (8 male and 5 female) with clinical manifestations that characterized RS. Age of onset was 13 years. Clinical findings have been arthritis (100%) involving the knee and ankle joints, heel pain (84%), lumbosacral pain (38%). One to three weeks before joint involvement, six patients (46%) complained of urethritis, 5 (38%) had enteritis and two patients had both. 46% of the patients had HLA-B27 antigen. Radiologic findings were sacroileitis in five patients and calcaneal spurs. All patients were treated with non-steroidal antiinflammatory therapy and, in general, there was a clinical remission in 1-3 months. Nevertheless, after 4 years of follow up, 2 patients had acute relapsing arthritis and 4 had chronic arthropathy. Three patients have developed secondary ankylosing spondylitis. RS is not all that infrequent in pediatric patients with joint involvements if one looks for urethritis, enteritis, eye involvement and cutaneous manifestations. The clinical course is favorable, but there might be some chronic or relapsing cases. Some patients can developed secondary ankylosing spondylitis. For that reason a prolonged follow up of these patients is necessary.
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PMID:[Reiter's syndrome: considerations on the frequency and mid-term course of its juvenile form]. 323 76

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 age of onset of disease was 21.4 years and 60% of them had mono- or oligoarthritis; 60% had arthritis of only lower limb joints. Knee, ankle, and hip joints were most commonly involved, often asymmetrically (mean degree of asymmetry = 0.28). Minimal radiographic sacroiliitis was present in 4 patients, though 13 had low back pain. HLA B27 antigen was detected in 21 (84%) of these patients and only 5.9% of 118 controls (relative risk 83). In addition to these 25 patients there were 4 others whose only symptom was severe bilateral heel pain: 3 of them were positive for HLA B27.
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PMID:HLA B27 related 'unclassifiable' seronegative spondyloarthropathies. 660

Fifty-one North Indian patients with ankylosing spondylitis (AS) are described with mean age of onset 21.2 years and male to female ratio of 16:1. AS began with peripheral arthritis in 47%, low back pain in 41%, acute anterior uveitis in 10%, and heel pain in 2% of the patients. 76% of 51 patients had one of the extra-axial features of AS: peripheral arthritis (61%), heel pain (24%), anterior uveitis (22%), urethritis (12%), kidney disease (10%), mucosal ulcerations (6%), aortic incompetence (4%), and apical pulmonary fibrosis (4%). A majority (71%) of the patients with peripheral arthritis had mono- or oligoarthritis affecting mainly the lower limb joints. Two patients had coexistent rheumatoid arthritis also. HLA-B27 antigen was detected in 48 (94%) of 51 patients compared with 7 (6%) of 118 controls (relative risk 254; Fisher's exact p = 3.49(-29]. On comparing patients with juvenile onset AS and patients with adult onset disease we found peripheral arthritis to be more frequent at the beginning and during the course of disease in the former.
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PMID:Ankylosing spondylitis in North India: a clinical and immunogenetic study. 661 Nov 38


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