Factors predicting axial spondyloarthritis among first-degree relatives of probands with ankylosing spondylitis: a family study spanning 35 years

Autor:	Sjef M van der Linden, Muhammad Asim Khan, Zhixiu Li, Heinz Baumberger, Hermine van Zandwijk, Kazim Khan, Peter M Villiger, Matthew A Brown
Rok vydání:	2022
Předmět:	Rheumatology Back Pain Spondylarthritis Immunology Humans Immunology and Allergy Spondylitis Ankylosing Sacroiliitis 610 Medicine & health Uveitis Anterior Axial Spondyloarthritis HLA-B27 Antigen General Biochemistry Genetics and Molecular Biology
Zdroj:	Annals of the Rheumatic Diseases. 81:831-837
ISSN:	1468-2060 0003-4967
DOI:	10.1136/annrheumdis-2021-222083
Popis:	ObjectiveFactors predicting axial spondyloarthritis (axSpA) among first-degree relatives (FDRs) of ankylosing spondylitis (AS) patients need to be defined. We investigated the predictive value of the probands’ HLA-B27 and radiographic sacroiliitis status on disease occurrence among their FDR. We also assessed the predictive value of features of the clinical history, including chronic inflammatory back pain (CIBP) and acute anterior uveitis (AAU), among the FDR and how they can be used to improve classification and diagnosis of axSpA.MethodsIn 1985, we studied 363 AS probands and 806 FDR who underwent rheumatologic examination, completed questionnaires, provided blood samples for HLA-typing and underwent radiography of sacroiliac joints. At follow-up in 2018–2019, 125 patients and 360 FDR were available for study, and completed a postal questionnaire about axSpA features. FDRs were asked to report whether after 1985 they had been diagnosed by Swiss rheumatologists as having axSpA.ResultsAmong HLA-B27(+) FDR, axSpA occurred in 25.4%–26.3%, independent of the radiographic sacroiliitis status of the proband. AAU occurred in 13/34 (38.2%) FDR with axSpA vs 29/251 (11.6%) FDR without axSpA (p=0.00004, OR=4.74 95% CI 2.15 to 10.47). The presence of CIBP at baseline did not predict later occurrence of axSpA but combining CIBP and pain/discomfort at the thoracic spineandat anterior (ventral) chest wall ever, assessed at follow-up in 2018–2019, provided 83.1% sensitivity and 87.2% specificity for current axSpA.ConclusionOccurrence of AAU among FDR of axSpA probands should prompt screening for axSpA. Moreover, co-occurrence of CIBP and pain/discomfort in the thoracic spine and at anterior chest wall as a three-question tool may further enhance clinical suspicion of axSpA among these FDR.
Databáze:	OpenAIRE
Externí odkaz:	https://explore.openaire.eu/search/publication?articleId=doi_dedup___::7a81e9211f92dbbe19902f6b7221ebd2 https://doi.org/10.1136/annrheumdis-2021-222083 Zobrazit plný text záznamu