Clinical diagnosis of ankylosing spondylitis in women and relation to presence of HLA-B27.

Hill, H F; Hill, Alan; Bodmer, JG

doi:10.1136/ard.35.3.267

Cited by 80 publications

(41 citation statements)

References 6 publications

(3 reference statements)

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“…Finally, HLA-B27 was present in all 47 of the patients tested for this antigen, thus confirming that the close association between definite AS and HLA-B27 also includes women with this disorder (19)(20)(21)(22). In regard to genetic susceptibility, 15 of our 50 patients had close relatives with definite AS, and 5 of those IS had more than I affected relative.…”

Section: Discussionsupporting

confidence: 74%

Ankylosing spondylitis and motherhood

Østensen¹,

Romberg²,

Husby³

1982

Arthritis & Rheumatism

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The influence of pregnancy on the course of ankylosing spondylitis (AS) was evaluated for 87 pregnancies of 50 patients. Remission of AS was recorded in 18 pregnancies, exacerbation in 21, and no change in 48. A short flareup of AS was noticed postpartum in 45% of the patients. Postpartum anterior uveitis occurred frequently (20%). The first symptoms of AS were often (20%) related to pregnancy. AS had no harmful effect on pregnancy, the fetus, or the newborn. Twelve percent of the offspring who were 18 years old or older have developed definite ankylosing spondylitis.

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Section: Discussionsupporting

confidence: 74%

Ankylosing spondylitis and motherhood

Østensen¹,

Romberg²,

Husby³

1982

Arthritis & Rheumatism

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“…This implies that patients have had medically unsolved disorders for a long time, have continued searching for a diagnosis and treatment, or are being erroneously diagnosed and managed 49 . One possible explanation is that dorsal/lumbar pain is a frequent symptom occurring in various conditions, and is one of the most common symptoms attributable to 6 The 1 2, 3, 6a), 14a), 14b), 15, 18, 20, 22 low STROBE: Strengthening The Reporting of OBservational studies in Epidemiology. Score quality: low quality < 50%; medium: 50% ≥ scoring < 70%; high: 70% ≥ scoring < 90%; excellent ≥ 90%.…”

Section: Discussionmentioning

confidence: 99%

“…Table 1 shows the main characteristics of the 42 studies on diagnostic delay in SpA included in this systematic review 1,2,3,[8][9][10][11][12][13][14][15][16][17][18]19,20,21,22,23,[26][27][28][29][30][31][32][33][34][35][36][37][38][39][40][41][42][43][44][45][46][47]48 . The review included 23,883 patients (67.6% men, 32.3% women).…”

Section: Methodsmentioning

confidence: 99%

“…Each of these was individually combined with: (delay OR delayed) AND (sex OR gender OR women OR woman) NOT (psoriatic arthritis). Complemen tary papers potentially eligible were included, a search through snowballing was performed by cross reference, and 16 studies were identified 1,3,[8][9][10][11][12][13][14][15][16][17][18][19][20][21] . Ultimately, 379 identified papers were consulted.…”

Section: Methodsmentioning

confidence: 99%

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Understanding How the Diagnostic Delay of Spondyloarthritis Differs Between Women and Men: A Systematic Review and Metaanalysis

Jovaní

Blasco-Blasco²,

Ruiz-Cantero³

et al. 2016

J Rheumatol

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Objective.To identify empirical evidence of diagnostic delay in spondyloarthritis (SpA), determine whether sex-related differences persist, and conduct an analysis from that perspective of the possible causes, including the influence of quality research, in this group of inflammatory rheumatic diseases.Methods.A systematic review was done of delay in diagnosis of SpA in MEDLINE and EMBASE and other sources. Study quality was determined in line with the Strengthening The Reporting of OBservational studies in Epidemiology (STROBE) statement. A metaanalysis of 13 papers reporting sex-disaggregated data was performed to evaluate sex-related differences in diagnostic delay. The global effect of diagnostic delay by sex was calculated using means difference (D) through a fixed effects model.Results.The review included 23,883 patients (32.3% women) from 42 papers. No significant differences between the sexes were detected for symptoms at disease onset or during evolution. However, the mean for delay in diagnosis of SpA showed sex-related differences, being 8.8 years (7.4–10.1) for women and 6.5 (5.6–7.4) for men (p = 0.01). Only 40% of papers had high quality. A metaanalysis included 12,073 participants (31.2% women). The mean global effect was D = 0.6 years (0.31–0.89), indicating that men were diagnosed 0.6 year (7 months) before women.Conclusion.Delay in diagnosis of SpA persists, and is longer in women than in men. There are no significant sex-related differences in symptoms that could explain sex-related differences in diagnostic delay. Methodological and possible publication bias could result in sex-biased medical practice.

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“…Female ankylosing spondylitis remains a possible alternative diagnosis (24, [33][34][35]. There is a growing awareness of peripheral joint disease, enthesopathy, and high incidence of HLA-B27 in this forme fruste of ankylosing spondylitis (23).…”

Section: Discussionmentioning

confidence: 99%

Reiter's disease in women

Smith

Bennett

Regan

1980

Arthritis & Rheumatism

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Reiter's disease in its classic form is defined by the triad of arthritis, conjunctivitis, and urethritis and occurs predominantly in men. Recent descriptions have emphasized other ancillary findings: mucocutaneous lesions, plantar fasciitis, Achilles tendinitis, sausage digits, asymmetrical sacroiliitis, and an association with HLA-B27. This study describes 29 women followed over the past 4 years who have a rheumatic disorder most consistent with Reiter's disease. All 29 patients were seronegative, 72% presenting with an asymmetrical pauciarticular arthritis, and the majority evidenced lower extremity involvement. During the course of their illness, 52% of the patients developed either eye and/or urinary tract involvement. Additional features were mucocutaneous lesions in 8 patients, heel pain or Achilles tendinitis in 15 patients, sausage digits in 20 patients, and clinical sacroiliitis in 20 patients. HLA-B27 was positive in 59% of patients, and radiographic bone and joint abnormalities were present in 52% of the patients. The recognition of this group of patients has both theraFrom the

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Clinical diagnosis of ankylosing spondylitis in women and relation to presence of HLA-B27.

Cited by 80 publications

References 6 publications

Ankylosing spondylitis and motherhood

Ankylosing spondylitis and motherhood

Understanding How the Diagnostic Delay of Spondyloarthritis Differs Between Women and Men: A Systematic Review and Metaanalysis

Reiter's disease in women

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