Pattern of ankylosing spondylitis in an Iranian population of 98 patients

Abstract

The prevalence and pattern of ankylosing spondylitis (AS) can vary from country to country, according to genetic and environmental factors. This study aims to analyze the patterns of disease in a population of Iranian patients with AS. We performed a prospective study (2002-2007) analyzing 98 patients with diagnosis of AS according to the modified New York criteria. Selected patients underwent complete clinical (initial symptom, axial and peripheral involvement, heel enthesitis, extra-articular manifestations) and radiological (sacroiliac, lumbar, thoracic, and cervical spine) investigations, and these data were compared with sex, age at onset, and HLA-B27. There was predominance of men (71.4%), adult onset (>16 years, 90.8%), and positive HLA-B27 (73.4%). Family history of AS was noted in 14.3% of the patients. The predominant initial symptoms were inflammatory low back pain (44.2%). Radiological findings included syndesmophytes in 34.7% and "bamboo spine" in 16.3% of patients. Acute anterior uveitis was noted in 44.9% of patients. Male sex was associated with involvement of shoulder (P = 0.001). Female sex and juvenile-onset AS were associated with extra-articular involvement. Positive HLA-B27 was associated with hip involvement (P = 0.042) and adult-onset AS (P = 0.035). Analysis of the patterns of disease in this population of 98 southern Iranian patients with AS revealed that female sex and juvenile-onset AS were associated with extensive extra-axial involvement; and HLA-B27 was associated with hip involvement.

Characterization of ankylosing spondylitis in Upper Egypt

“…The diagnostic delay in the current study (9.9 years) was much higher than that reported previously for other Middle Eastern populations [14,15,[23][24][25]. However, an Italian study [26] reported a diagnostic delay of approximately 9 years, and another recent study from North This delay in our study can be explained by the lack of rheumatologists, and the lack of awareness among general practitioners and orthopedists about AS, as most of the patients in this series were diagnosed by rheumatologists (84.3%).…”

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

“…Delay in diagnosis of SpA has been described in women 5,9,10 and in both sexes 6,7,[11][12][13][14][15][16]20,26,27,29,30,32,33,35,38,39,40,44,45,46 , and although Bandinelli 23 observed less diagnostic delay in women than in men, in most of the papers where delay was compared between men and women, it was greater in women 8,17,18,19,21,22,28,31,34,37,41,42,43,47,48 . 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 .…”

“…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.…”

“…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).…”

Improvement in pain intensity, spine stiffness, and mobility during a controlled individualized physiotherapy program in ankylosing spondylitis

“…Pathologic alterations occur in synovial and cartilaginous joint and in sites of tendon and ligament attachment to bone [1,2].The most common and characteristic initial symptom of AS is chronic low back pain of insidious onset [3]. Most structures and tissues found in the low back, hip and pelvic areas are capable of producing symptoms.…”