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)

A 35-week pregnant patient with ankylosing spondylitis and a known previous failed intubation required an elective caesarean section for intrauterine growth retardation. Regional anaesthesia was prevented by extensive spinal fusion. The anaesthetic management involved an awake oral fibreoptic intubation followed by induction and maintenance of general anaesthesia allowing delivery of a live infant without harm to the mother.
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PMID:Awake oral fibreoptic intubation for caesarean section. 1563 3

Pregnancy may occur in patients with ankylosing spondylitis, a chronic inflammatory joint disease. This disease, which is included in the group of seronegative spondylarthropathies, may be characterized by both intra- and extra-articular manifestations. Although most pregnant patients with ankylosing spondylitis experience normal spontaneous vaginal deliveries, manifestations of the disease may interfere with labor and delivery as well as the administration of general and regional anesthesia. Therefore, physicians caring for a pregnant patient with ankylosing spondylitis should be aware of the obstetric and anesthetic implications and the ramifications of active disease. These patients should be referred to an anesthesiologist early in pregnancy so that the obstetrician and anesthesiologist can together formulate a plan.
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PMID:Anesthetic management of the parturient with ankylosing spondylitis. 1563 18

Although rare, major complications after spinal and epidural anesthesia do occur. The safety of spinal and epidural anesthesia has been well established. This is a report of an epidural hematoma in a patient with ankylosing spondylitis who received aspirin for thromboprophylaxis after total hip replacement that was unrelated to the combined spinal-epidural anesthetic. Most epidural hematomas are spontaneous and idiopathic.
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PMID:Epidural hematoma unrelated to combined spinal-epidural anesthesia in a patient with ankylosing spondylitis receiving aspirin after total hip replacement. 1636 61

Laparoscopic cholecystectomy is the current gold standard for the management of cholelithiasis. As experience with laparoscopic cholecystectomy has increased, contraindications to the procedure have started decreasing. Kyphoscoliosis with fixed rigidity is considered as a relative contraindication to laparoscopic surgery. Ankylosing spondylitis is a challenge to the anaesthesiologist because it is associated with difficult intubation, restrictive ventilatory defects, and frequent cardiac involvement. The benefits of laparoscopic surgery can be extended to this group of patients with severe kyphoscoliosis due to advances in anesthesia and surgical expertise. We report a case of laparoscopic cholecystectomy performed in a patient with severe ankylosing spondylitis with fixed rigidity of the cervical spine and marked thoracolumbar kyphosis with severe restrictive lung disease. The purpose of this report is to describe the difficulties encountered in anesthesia and operative difficulties due to altered body habitus in terms of patient positioning and surgical access.
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PMID:Laparoscopic cholecystectomy in a patient with ankylosing spondylitis with severe spinal deformity. 1608 13

We describe a case of difficult intubation in a patient suffering from ankylosing spondylitis undergoing total hip replacement surgery. The anesthetic management of 42 year old patient with difficult airway is discussed. Failure of epidural anesthesia procedure necessitated general anesthesia. The problems of performing awake fibreoptic intubation and other alternative techniques to secure the airway are described. Cervical spine involvement in ankylosing spondylitis is of great concern for the anesthetist. Longstanding progressive course of this disease leads to fibrosis, ossification and ankylosis of entire spine and sacroiliac joints. Cervical spine mobility is decreased and in severe cases total fixity occurs in a flexed position. Patient may also have atlanto-occipital and temporo-mandibular joint involvement as well. Cricoarytenoid cartilages involvement may result in upper airway compromise. Furthermore cervical spine vertebrae are prone to fractures, especially on hyperextension and may lead to spinal cord transection and quadriplegia. In this case report we describe the airway management of such patient with fixed rigidity of cervical spine and thoracolumbar kyphosis.
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PMID:Management of difficult intubation in a patient with ankylosing spondylitis--a case report. 1643 12

Several techniques of airway management in ankylosing spondylitis (AS) have been reported. No study related specifically to the use of a lightwand-assisted intubation in AS has been previously described. The present case report demonstrates that an awake, nasotracheal intubation can be successfully performed to provide general anesthesia in a patient with AS. A 65-year-old Thai male was scheduled for exploratory surgery under general anesthesia. Past medical history consisted of hypertension and AS. The preoperative airway assessment showed limitation of mouth opening, an extremely anteriorly flexed and immobile cervical spine. An awake intubation under sedation and topical airway anesthesia were chosen. Multiple attempts at blind nasotracheal intubation and oral approach with lightwand were unsuccessful. Finally, intubation was successfully performed with lightwand by nasal route. This serves to show that an awake nasotracheal intubation with a lightwand may be a safe and useful alternative option for airway management in patients with severe ankylosing spondylitis.
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PMID:Lightwand-assisted nasotracheal intubation in awake ankylosing spondylitis. 1720 84

We report a case of difficult airway management in a 41-year-old man with ankylosing spondylitis who was scheduled for total left hip replacement surgery. After several failed attempts to achieve regional anesthesia, we converted to general anesthesia with orotracheal intubation using a fiberoptic bronchoscope. Ankylosing spondylitis leads to fibrosis, ossification, and ankylosis along the spinal column and sacroiliac articulations. Cervical column and atlantooccipital articulation mobility are reduced and in severe cases the cervical vertebrae become fixed in a flexed position. This portion of the spine is also the most susceptible to fracture, particularly in hyperextension, an event that could lead to damage to the cervical spinal cord during maneuvers to manage the airway. Patients with this condition may also have temporomandibular joint involvement, further complicating airway management. We report the case of a patient with ankylosing spondylitis with fixation along the entire spine. The airway was managed by intubation with a fiberoptic bronchoscope. Spontaneous ventilation was maintained during the maneuver, and sedation was achieved with perfusion of remifentanil as the only anesthetic agent following failure of intradural anesthesia.
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PMID:[Airway management in a man with ankylosing spondylitis]. 1739 Jun 95

HIFU therapy is one of epoch-making, low-invasive treatments for prostate cancer. We investigated 71 patients who had undergone HIFU therapy from June 2004 through September 2005. We mainly gave a single spinal injection followed by epidural catheterization with a combined spinal-epidural anesthesia kit. Three patients received general anesthesia because of various problems such as allergy for local anesthetics, ankylosing spondylitis and severe spinal deformity causing difficulty in lumbar puncture. Spinal anesthesia was successfully achieved in most patients. Twelve patients with insufficient anesthetic levels required additional local anesthetics via epidural catheters. We found no serious perioperative complications.
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PMID:[Anesthetic management for high-intensity focused ultrasound (HIFU) therapy in prostate cancer patients]. 1744 57

Alkaptonuric ochronosis, caused by a deficiency of homogentisate 1,2-dioxygenase, is a rare, autosomal recessive, metabolic disorder. Accumulation of homogentisate acid (HGA) at the connective tissue destructs the spine and large joints, and cardiac valvular disease is prominent. In this report, we describe a case of alkaptonuric ochronosis for anesthetic management. A 75-year-old female patient with the disease was scheduled for a total-hip arthroplasty. We avoided applying general anesthesia for her valvular regurgitations. Spinal anesthesia was achieved successfully, and resulted in a hypesthesia level at T12. Although a epidural catheter was indwelled with no leak of cerebrospinal fluid, an accidental dural puncture appeared later during the surgery, suggesting a subdural catheterization. She had an uneventful perioperative course without any symptoms. In the patient of alkaptonuric ochronosis, the dura and arachnoid membrane could be damaged made vulnerable by HGA. In addition, since the clinical findings resemble ankylosing spondylitis, degenerative changes such as a narrowing of the disk space and spine fusion would make the regional technique unsuccessful. In term of anesthesia, alkaptonuric ochronosis requires ingenuity since there are a number of factors associated with prevention of untoward complications. Each case is to be evaluated individually and managed carefully.
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PMID:[Anesthesia in a patient with alkaptonuric ochronosis for total hip arthroplasty]. 1841 99

This case report presents a patient suffering acute fatal intracranial-intratumoral hemorrhage during a gamma knife treatment session. Acute hemorrhage during a radiosurgery session is extremely rare and a plausible cause for this case is discussed along with a literature review of previously reported incidents. The patient was a 71-year-old male presenting with three large intracranial lesions and an underlying primary renal cell carcinoma malignancy. Because of a severe kyphotic deformity resulting from ankylosing spondylitis, the patient was placed in a moderate Trendelenburg position to allow his head to fit into the gamma knife unit during the radiosurgery session. The two left-sided lesions were to be treated with 20 Gy to the 50% isodose line, and the right-sided lesion with 16 Gy to the 40% isodose line. Anesthesia was available throughout the treatment session to aid with pain control. The gamma knife treatment was aborted because the patient suffered a generalized seizure while in the unit. Immediate head CT of the patient revealed large acute hemorrhages into all three intracranial masses. This proved to be a fatal complication. It is likely that this positioning contributed to the hemorrhage. The clinical history of this patient is provided as well as a review of the literature on acute intracranial hemorrhage associated with radiosurgical therapy.
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PMID:Fatal case of intracerebral hemorrhage during gamma knife treatment for metastases. 1858 83


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