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

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...

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Main Authors: A. A. Godzenko, O. A. Rumyantseva, A. G. Bochkova, Yu. O. Korsakova, Sh. Erdes, V. V. Badokin
Format: Article
Language:Russian
Published: IMA-PRESS LLC 2018-04-01
Series:Современная ревматология
Subjects:
Online Access:https://mrj.ima-press.net/mrj/article/view/803
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author A. A. Godzenko
O. A. Rumyantseva
A. G. Bochkova
Yu. O. Korsakova
Sh. Erdes
V. V. Badokin
author_facet A. A. Godzenko
O. A. Rumyantseva
A. G. Bochkova
Yu. O. Korsakova
Sh. Erdes
V. V. Badokin
author_sort A. A. Godzenko
collection DOAJ
description 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<0.0001); fever in 34  (15.6%) and 12 (5.1%), respectively (p<0.0001), anemia in 58  (26.6%) and 26 (11.1%), respectively (p<0.0001); GAs and/or  systemic GCs were taken by 121 (55.5%) and 58 (24.8%) patients, respectively (p<0.0001). Conclusion. ESMs in patients with AS are associated with peripheral arthritis and inflammatory activity indicators.
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spelling doaj.art-caef4d10230143d9a5f67e68c022acfd2023-03-13T08:39:25ZrusIMA-PRESS LLCСовременная ревматология1996-70122310-158X2018-04-01121131910.14412/1996-7012-2018-1-13-192074Extraskeletal manifestations and the indicators of inflammatory activity and severity in ankylosing spondylitisA. A. Godzenko0O. A. Rumyantseva1A. G. Bochkova2Yu. O. Korsakova3Sh. Erdes4V. V. Badokin5ФГБОУ ДПО «Российская медицинская академия непрерывного профессионального образования» Минздрава России ФГБНУ «Научно-исследовательский институт ревматологии им. В.А. Насоновой»ФГБНУ «Научно-исследовательский институт ревматологии им. В.А. Насоновой»ФГБНУ «Научно-исследовательский институт ревматологии им. В.А. Насоновой»ФГБНУ «Научно-исследовательский институт ревматологии им. В.А. Насоновой»ФГБНУ «Научно-исследовательский институт ревматологии им. В.А. Насоновой»ФГБОУ ДПО «Российская медицинская академия непрерывного профессионального образования» Минздрава России ФГБНУ «Научно-исследовательский институт ревматологии им. В.А. Насоновой»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<0.0001); fever in 34  (15.6%) and 12 (5.1%), respectively (p<0.0001), anemia in 58  (26.6%) and 26 (11.1%), respectively (p<0.0001); GAs and/or  systemic GCs were taken by 121 (55.5%) and 58 (24.8%) patients, respectively (p<0.0001). Conclusion. ESMs in patients with AS are associated with peripheral arthritis and inflammatory activity indicators.https://mrj.ima-press.net/mrj/article/view/803анкилозирующий спондилитвнескелетные проявлениявоспалительная активностьпериферический артрит
spellingShingle A. A. Godzenko
O. A. Rumyantseva
A. G. Bochkova
Yu. O. Korsakova
Sh. Erdes
V. V. Badokin
Extraskeletal manifestations and the indicators of inflammatory activity and severity in ankylosing spondylitis
Современная ревматология
анкилозирующий спондилит
внескелетные проявления
воспалительная активность
периферический артрит
title Extraskeletal manifestations and the indicators of inflammatory activity and severity in ankylosing spondylitis
title_full Extraskeletal manifestations and the indicators of inflammatory activity and severity in ankylosing spondylitis
title_fullStr Extraskeletal manifestations and the indicators of inflammatory activity and severity in ankylosing spondylitis
title_full_unstemmed Extraskeletal manifestations and the indicators of inflammatory activity and severity in ankylosing spondylitis
title_short Extraskeletal manifestations and the indicators of inflammatory activity and severity in ankylosing spondylitis
title_sort extraskeletal manifestations and the indicators of inflammatory activity and severity in ankylosing spondylitis
topic анкилозирующий спондилит
внескелетные проявления
воспалительная активность
периферический артрит
url https://mrj.ima-press.net/mrj/article/view/803
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