Concomitant systemic lupus erythematosus and ankylosing spondylitis.

Olivieri, Ignazio; Gemignani, G; Balagi, Michela; Pasquariello, Antonio; Gremignai, G; Pasero, G

doi:10.1136/ard.49.5.323

Cited by 23 publications

(22 citation statements)

References 10 publications

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“…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: 88%

“…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: Discussionmentioning

confidence: 88%

Section: Introductionmentioning

confidence: 79%

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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“…Studies of haplotype frequency in white subjects have shown that the combination of the B27 antigen with the DR2 and/or DR3 antigens is quite rare [12]. Nashel et al [3] and Olivieri et al [5] each described the coexistence in a single patient of ankylosing spondylitis and SLE. In both cases, HLA typing showed the B27 antigen in combination with the DR2 and/or DR3 antigens [3,5].…”

Section: Discussionmentioning

confidence: 98%

“…Nashel et al [3] and Olivieri et al [5] each described the coexistence in a single patient of ankylosing spondylitis and SLE. In both cases, HLA typing showed the B27 antigen in combination with the DR2 and/or DR3 antigens [3,5]. The authors suggest that SLE and spondyloarthropathy may coexist only when this rare combination of genetically determined markers occurs.…”

Section: Discussionmentioning

confidence: 98%

“…The concomitant presence of ankylosing spondylitis and connective tissue disease is very rare and only a few cases have been reported in the literature [1][2][3][4][5]. Nashel et al in 1982 [3] and Olivieri et al in 1989 [5] each described the coexistence in a single patient of ankylosing spondylitis and systemic lupus erythematosus (SLE), and hypothesised that SLE and spondyloarthropathy may appear together only when a specific association of genetically determined markers occurs.…”

Section: Introductionmentioning

confidence: 98%

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Coexistence of ankylosing spondylitis and undifferentiated connective tissue disease

et al. 1998

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We report the case of a 45-year-old Caucasian woman suffering from ankylosing spondylitis and undifferentiated connective tissue disease in whom the prevailing clinical features were retinal vasculitis and inflammatory low back pain. HLA typing revealed the concomitant presence of B27 and DR2 antigens. We hypothesise that the uncommon coexistence of ankylosing spondylitis and connective tissue disease in the same patient could be due to the exceptional association of HLA- B27 with the DR2 antigen.

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