Extraskeletal manifestations and the indicators of inflammatory activity and severity in ankylosing spondylitis

Autor: A. A. Godzenko, O. A. Rumyantseva, A. G. Bochkova, Yu. O. Korsakova, Sh. Erdes, V. V. Badokin
Jazyk: ruština
Rok vydání: 2018
Předmět:
Zdroj: Современная ревматология, Vol 12, Iss 1, Pp 13-19 (2018)
Druh dokumentu: article
ISSN: 1996-7012
2310-158X
DOI: 10.14412/1996-7012-2018-1-13-19
Popis: Extraskeletal manifestations (ESMs) are commonly observed in ankylosing spondylitis (AS). The available data on the association of ESMs with the inflammatory activity and other clinical parameters of AS are contradictory.Objective: to assess the association of ESMs with the inflammatory activity and other manifestations of AS.Patients and methods. The investigators of the V.A. Nasonova Research Institute of Rheumatology examined a total of 452 patients (363 men and 89 women) diagnosed with AS meeting the New-York criteria (1984). The patients' median age was 31.5 [24; 41] years; median disease onset age, 19.5 [15; 23] years; and disease duration, 11.5 [7; 18] years. HLA B27 was identified in 442 (97.7%) patients. In addition to standard laboratory and instrumental examinations, 172 patients underwent transthoracic echocardiography; Rehberg's test, if indicated; IgA test; histological examination of subcutaneous fat tissue or duodenal mucosa for amyloid; renal ultrasound; colonoscopy; and consultations by an ophthalmologist, a dermatologist, a nephrologist, an urologist, and a gastroenterologist. Uveitis, cardiac involvement (cardiac conduction disturbance, aortic and valvular changes), inflammatory bowel disease (IBD), glomerulonephritis, and psoriasis were considered to be ESMs. The latter were detected in 218 (48%) of the 452 patients; there was uveitis in 140 (30%), cardiac conduction disturbance in 61 (13.4%), psoriasis in 17 (3.7%), IBD in 16 (3.5%), nephritis in 16 (3.5%), and aortic and valvular changes in 71 (41.2%) of the 172 patients. The groups of patients with ESM (n = 218) and without ESM (n=234) were compared with regard to the onset age of AS, the presence of HLA- 27, peripheral arthritis, coxitis, enthesitis, syndesmophytis, fever, anemia, the need for biological agents (BAs) and/or systemic glucocorticoids (GCs), Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), and erythrocyte sedimentation rate (ESR). Results. The ESM and non-ESM groups were matched for gender, age, duration of AS, and the presence of HLA-В27. No significant differences were found in ESR, BASDAI, and the frequency of coxitis, enthesitis, and syndesmophytis in the spine. The ESM group versus non-ESM group was significantly more frequently observed to have peripheral arthritis in 148 (67.8%) of the 218 patients and in 70 (33.2%) of the 234 patients, respectively (p
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