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

Abstract

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.

Coexistence of Juvenile Systemic Lupus Erythematosus and Juvenile Spondyloarthropathy: A Case Report and Review of the Literature

“…Previously, 10 adult patients with SLE and SpA have been reported (Table 1). [5][6][7][8][9][10][11][12][13] Among them, eight patients (80%) had malar rash, seven (70%) had hematologic involvement, four (40%) had renal involvement and three (30%) had discoid rash revealing SLE. [5][6][7][8][9][10][11][12][13] All patients fulfilled the American Collage of Disease criteria for SLE.…”

“…Up to date, only 10 adult patients with SLE and SpA have been described (Table 1). [5][6][7][8][9][10][11][12][13]…”

Spondyloarthritis in SLE-Therapeutic Challenge!

“…Overall improvements in medical care including the availability of antibiotics, anti-hypertensive's, and renal replacement therapy coupled with the judicious use of glucocorticoid, antimalarial, and immunosuppressive drugs have led to improved survival of SLE patients in the past 50 years [6]. Despite the improvements in care, patients often suffer long-term morbidity that can adversely affect their quality of life and their ability to work, resulting in substantial direct and indirect costs.…”

Co-existence of Systemic Lupus Erythematosus and Ankylosing Spondylitis - A Case Report

“…*Nakarmi S 1 , Ahmed S 2 , Shahin MA 3 , Shazzad MN 4 , Mahmood 5 , Haq SA 6 peculiarities of sacroilitis in SLE are absence of typical back pain and HLA B27. 4 So far, only 9 cases of coexistence of SLE and AS have been reported.…”

“…4 So far, only 9 cases of coexistence of SLE and AS have been reported. [5][6][7][8][9][10][11][12][13] In this report, we describe another case of such coexistence.…”