Ankylosing spondylitis in female systemic lupus erythematosus: a rare combination

Mrabet, Dalila; Rekik, S.; Sahli, H.; Trojet, S.; Cheour, Ilhem; Eleuch, M.; Osmane, A. Ben; Meddeb, N.; Sellami, Slaheddine

doi:10.1177/0961203310392420

Cited by 10 publications

(15 citation statements)

References 10 publications

(13 reference statements)

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“…On the other hand, the association between HLA-B27 and AS is well known, and the HLA-B27 molecule plays a role in the pathogenesis of AS. HLA-B27 was positive in four of the previously reported cases (3,7,8,9), as seen in the present case.…”

Section: Discussionsupporting

confidence: 73%

“…Interestingly, most of the reported patients with the coexistence of SLE and AS, including the present case, are female (F/M: 6/3). In most cases, including the present case, SLE symptoms preceded those of AS (F/M: 5/4) (4,5,6,9). On the other hand, the association between HLA-B27 and AS is well known, and the HLA-B27 molecule plays a role in the pathogenesis of AS.…”

Section: Discussionmentioning

confidence: 87%

“…These two autoimmune rheumatologic diseases, which have a different aetiopathogenesis as well as diverse clinical and genetic characteristics, are rarely seen together. To the best of our knowledge, there are only 8 reported cases of the coexistence of SLE and AS in the English literature (3)(4)(5)(6)(7)(8)(9)(10). Here, we report another case with the coexistence of these two diseases.…”

Section: Introductionmentioning

confidence: 79%

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Coexistence of systemic lupus erythematosus and ankylosing spondylitis: another case report and review of the literature

Tarhan¹,

Argın²,

Can³

et al. 2014

Eur J Rheum

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The coexistence of systemic lupus erythematosus (SLE) and ankylosing spondylitis (AS) is very rare, and, to the best of our knowledge, there are only 8 reported cases in the English literature. Here, we present another case with the coexistence of these two diseases, and review the clinical and laboratory features of the previously reported cases. A 55 year-old female patient, with a diagnosis of SLE with locomotor, skin, renal and hematopoietic system involvement, which had been confirmed by relevant autoantibody positivity, and hypocomplementemia and biopsyproven membranous lupus nephritis, was referred to our clinic suffered from typical inflammatory low-back pain after eight years of follow-up. Sacroiliac magnetic resonance imaging (MRI) confirmed the presence of bilateral active sacroiliitis with bone marrow oedema. HLA-B27 was positive and bilateral calcaneal spurs were also detected by conventional radiography. Therefore, the additional diagnosis of AS was made, eight years after the diagnosis of SLE. Inflammatory low-back pain typically responded to treatment with non-steroidal anti-inflammatory drugs. Including the present case, most of the reported cases of the coexistence of SLE and AS are female, and SLE generally precedes the occurrence of AS. The present case is also notable as the patient had both MRI confirmation of bilateral active sacroiliitis and HLA-B27 positivity. The coexistence of these two diseases with different genetic backgrounds in the same patient is much lower than expected based upon their prevalence in the general population. Although it has been suggested that the very rare combination of the susceptibility genes of each disease may explain the rarity of coexistence, epidemiological data concerning the genetic risks for the coexistence of SLE and AS are not available.

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Section: Discussionsupporting

confidence: 73%

Section: Discussionmentioning

confidence: 87%

Section: Introductionmentioning

confidence: 79%

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Coexistence of systemic lupus erythematosus and ankylosing spondylitis: another case report and review of the literature

Tarhan¹,

Argın²,

Can³

et al. 2014

Eur J Rheum

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“…Concerning SLE, coexistence of AS is very rare, and this association has been suggested to occur in patients who carry one or two susceptibility alleles for both diseases [30]. Furthermore, shared environmental factors that remain to be identified may also contribute to triggering both diseases [30].…”

Section: Discussionmentioning

confidence: 99%

“…Furthermore, shared environmental factors that remain to be identified may also contribute to triggering both diseases [30]. The recently published cases of the coexistence of SLE and AS corresponded to drug-induced SLE or lupus-like syndrome associated with anti TNF treatment in SpA patients [31–33].…”

Section: Discussionmentioning

confidence: 99%

Spondyloarthropathies in Autoimmune Diseases and Vice Versa

Perez-Fernandez

Mantilla

Cruz‐Tapias

et al. 2012

Autoimmune Diseases

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Polyautoimmunity is one of the major clinical characteristics of autoimmune diseases (ADs). The aim of this study was to investigate the prevalence of ADs in spondyloarthropathies (SpAs) and vice versa. This was a two-phase cross-sectional study. First, we examined the presence of ADs in a cohort of patients with SpAs (N = 148). Second, we searched for the presence of SpAs in a well-defined group of patients with ADs (N = 1077) including rheumatoid arthritis (RA), systemic lupus erythematosus (SLE), and Sjögren's syndrome (SS). Among patients with SpAs, ankylosing spondylitis was observed in the majority of them (55.6%). There were two patients presenting with SS in the SpA group (1.4%) and 5 patients with autoimmune thyroiditis (3.5%). The global prevalence of ADs in SpAs was 4.86%. In the ADs group, there were 5 patients with SpAs (0.46%). Our results suggest a lack of association between SpAs and ADs. Accordingly, SpAs might correspond more to autoinflammatory diseases rather than to ADs.

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