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

Typing for histocompatibility antigen (HLA)-B27 has been suggested as a clinically valuable diagnostic test for ankylosing spondylitis and Reiter's syndrome, although some decry its use for this purpose. Diagnoses can be made in most patients with these diseases on the basis of the history, physical examination, and roentgenographic findings. The B27 test cannot be used to screen an asymptomatic population to detect these diseases and should not be thought of as a routine diagnostic test. We present probability graphs derived from Bayes' theorem, which show that for certain patients the B27 test, when used properly, is of clinical value as an aid to diagnosis. Proper application of the B27 test in clinical medicine is discussed. The test result does not absolutely confirm or exclude the presence of these diseases; it merely provides a probability statement on their existence in the patient. The test is therefore most useful to physicians who understand the use of probability reasoning in clinical decision making.
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PMID:Diagnostic value of HLA-B27 testing ankylosing spondylitis and Reiter's syndrome. 705 11

Thirty-nine children with a syndrome of seronegative enthesopathy and arthropathy were evaluated. The group included 25 patients with no apparent underlying primary disease and 13 with either ankylosing spondylitis, inflammatory bowel disease, reactive arthritis, or Reiter's syndrome. Significant distinguishing characteristics of the group included male predominance, late age at onset, positive family histories of arthritis, oligoarthropathy, axial skeleton involvement, and the presence of the B27 histocompatibility antigen. This syndrome is distinguishable from other childhood rheumatic disorders, including juvenile rheumatoid arthritis. Its recognition may reliably identify children with the prodromal manifestations of seronegative spondylarthropathies.
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PMID:A syndrome of seronegative enthesopathy and arthropathy in children. 712 88

The association between the histocompatibility antigen HLA-B27 and the seronegative spondylarthritides such as ankylosing spondylitis and Reiter's syndrome is dramatic. A question that arises in practice is, when should a clinician request HLA-B27 typing in the assessment of a patient with a rheumatologic complaint? Generally, diagnosis of these spondylarthropathies depends on history, clinical and radiologic examination, and, occasionally, confirmatory laboratory tests. This paper reviews the criteria for the diagnosis of the spondylarthritides, discusses the sensitivity and specificity of HLA-B27 typing in these conditions, analyzes the relation between HLA-B27 status and prognosis, and defines the role of genetic counseling. It is concluded th,t knowledge of the patient's HLA-B27 status provides only minimal help to the physician. Indiscriminate typing is to be deprecated.
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PMID:HLA-B27: to type of not to type? 735 29

We report a 50-year-old male patient with hereditary multiple exostoses (HME) and ankylosing spondylitis (AS). This is the first case reporting the coexistence of HME and AS. Our patient has multiple exostoses around the knee, elbow and wrist joints. At the age of 40 years, pain in the lower back associated with morning stiffness lasting about an hour and improving with exercise began. His son also has hereditary multiple exostoses but has no sign of AS. HME is an autosomal dominant disorder. AS has a remarkably strong association with the histocompatibility antigen HLA-B27. Owing to the different genetic mechanisms, it is not possible to differentiate between coincidence and association. Coexistence of HME and AS in our patient probably represents a coincidence rather than a real association.
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PMID:Coexistence of hereditary multiple exostoses and ankylosing spondylitis. 1063 74

Seronegative inflammatory spondyloarthropathies include ankylosing spondylitis, psoriatic arthritis, Reiter syndrome, juvenile chronic arthritis and colitic arthritis. These diseases share some characteristics among which the most important is the presence of the histocompatibility antigen HLA B27; moreover the frequent overlapping of the various inflammation patterns have accounted for their classification in a single group. Diagnostic imaging can differentiate among the different forms only if the diagnostic algorithm, based on clinical history and laboratory findings is followed, considering the advantages and limitations of each method. In this respect, it should be kept in mind that the findings relative to the spine and sacroiliac joints allow to establish a definitive diagnosis.
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PMID:The lumbar spine: imaging in rheumatic disease. 1096 34

We report magnetic resonance imaging findings of diskovertebral lesions in a case of ankylosing spondylitis mimicking metastatic and/or infectious disease. Multiple hypointense areas were seen on T1-weighted images corresponding to hyperintense areas on T2-weighted images in dorsal, lumbar, and sacral vertebral bodies and the manubriosternal joint, with accompanying soft tissue masses. Diagnosis was achieved through biopsy, regression of the paravertebral soft tissue masses, later detection of bilateral sacroiliitis on computed tomography, and presence of histocompatibility antigen HLA-B27.
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PMID:Destructive diskovertebral lesions in ankylosing spondylitis: appearance on magnetic resonance imaging. 1154 99

Reiter's syndrome (RS) is uncommon in children, and the classic triad manifestations of RS usually do not occur simultaneously in children. It is often clinically confused with other childhood illnesses. We report a case of RS in a 7-year-old boy with a family history of ankylosing spondylitis. He had developed intermittent arthralgia of the right knee for about 6 months and occasional bilateral eye pain for several months prior to admission. In the 5 days before admission, he developed multiple oral ulcers, weight loss from 25 to 22 kg and fever. Physical examination showed injected bilateral conjunctivae and the right knee joint with swelling, local warmth, and tenderness over the patellar ligament. Laboratory results revealed positive histocompatibility antigen-B27 (HLA-B27), negative rheumatoid factor (RF) and antinuclear antibody (ANA) and normal urinalysis. RS was diagnosed based on the findings of both arthritis and conjunctivitis. The arthritis was treated with acetaminophen and naproxen. In conclusion, juvenile RS should be considered in children with arthritis and conjunctivitis, positive HLA-B27, negative RF and ANA and a family history of related diseases.
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PMID:Juvenile Reiter's syndrome: a case report. 1559 72

Inflammatory processes are accompanied by the posttranslational modification of certain arginine residues within proteins to yield citrulline, although it is largely unknown how this modification influences antigen presentation. We employed crystallographic and functional studies to investigate whether the exchange of arginine to citrulline affects the display of a peptide by two human major histocompatibility antigen class I subtypes, HLA-B(*)2705 and HLA-B(*)2709. Both differ only in residue 116 within the peptide binding groove despite their differential association with ankylosing spondylitis, an inflammatory rheumatic disorder. The crystal structures described here show that a modified self-peptide, pVIPR-U5 (RRKWURWHL; U = citrulline), is presented by the two HLA-B27 molecules in distinct conformations. These binding modes differ not only drastically from each other but also from the conformations exhibited by the non-citrullinated peptide in a given subtype. The differential reactivity of HLA-B27-restricted cytotoxic T cells with modified or unmodified pVIPR supports the structural findings and shows that the presentation of citrullinated peptides has the potential to influence immune responses.
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PMID:Citrullination-dependent differential presentation of a self-peptide by HLA-B27 subtypes. 1865 Apr 41

Recent studies have outlined the clinical and epidemiological profile of the spondyloarthritides in Ibero-American countries. The objective of this study was to compare the data collected in a Brazilian epidemiological study with the data obtained from other Ibero-American countries that used the same protocol of investigation. The Brazilian series presented a higher frequency of patients with ankylosing spondylitis (72.3% Brazilian vs. 57.7% Ibero-American), being associated with the male gender (73.6% vs. 66.0%) and histocompatibility antigen positive HLA-B27 (65.9% vs. 51.8%). Regarding the treatment, hormonal anti-inflammatory drugs - NSAIDS were more frequently prescribed to Brazilian patients (77.0% vs. 71.2%) and less often, corticosteroids (7.5% vs. 18.5%).
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PMID:Spondyloarthritis: analysis of a Brazilian series compared with a large Ibero-American registry (RESPONDIA group). 2112 92

The idea that ankylosing spondylitis is a separate entity from rheumatoid arthritis has recently been strengthened by the discovery that the majority of individuals suffering from ankylosing spondylitis exhibit the histocompatibility antigen HLA B27. Inflammation of the sacroiliacs must be present for a diagnosis of ankylosing spondylitis to be made. Radiological interpretation of sacroiliac films may be difficult. In patients with normal or equivocal X-rays of the sacroiliacs, radioisotope scanning of the sacroiliac joint may confirm diagnosis. Although the articular features of ankylosing spondylitis are well known, a variety of systemic complications may be attributed to some other cause. The principles of management require a precise diagnosis, control of pain and maintenance of a good functional state by means of physiotherapy. The majority of patients with ankylosing spondylitis respond well to therapy.
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PMID:Diagnosis and management of ankylosing spondylitis. 2130 77


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