Scarpa Raffaele, Cosentini Elena, Manguso Francesco, Oriente Alfonso, Peluso Rosario, Atteno Mariangela, Ayala Fabio, D'Arienzo Agesilao, Oriente Pasquale
Department of Clinical and Experimental Medicine, University Federico II, via Sergio Pansini 5, 80131 Naples, Italy.
J Rheumatol. 2003 Dec;30(12):2638-40.
To characterize the clinical pattern of psoriatic arthritis (PsA) sine psoriasis.
Fifty-seven patients (31 men, 26 women, mean age 46.32 +/- 14.12 yrs) with undifferentiated spondyloarthropathy (SpA) were studied. Two subsets were defined: (1) 21 patients with familial psoriasis (12 men, 9 women, mean age 49.29 +/- 14.17 yrs); (2) 36 patients without familial psoriasis (19 men, 17 women, mean age 44.58 +/- 14.00 yrs). The prevalence of the following clinical variables was evaluated: low back pain, enthesopathy, dactylitis, distal interphalangeal (DIP) arthritis, spinal involvement, and discitis. In all patients the following HLA haplotypes were tested: B7, B13, B17, B18, B27, B38, Cw6, and DR7.
Dactylitis and DIP arthritis were markedly present in the articular subset with familial psoriasis (p < 0.0001) that also showed a high frequency rate of HLA-Cw6 (p < 0.0001 vs controls and patients without familial psoriasis). HLA-B27 was markedly frequent in patients without familial psoriasis (p < 0.0001 vs controls and p = 0.019 vs patients with familial psoriasis). In addition, in patients with familial psoriasis the log-linear model showed that the presence of HLA-Cw6 was related to the presence of DIP arthritis as well as dactylitis (likelihood ratio chi-square change of 5.891 and p = 0.015).
A subset of patients with PsA "sine psoriasis" is identified by the occurrence of a SpA with dactylitis and/or DIP arthritis, presence of HLA-Cw6, and familial psoriasis in first or second-degree relatives.
描述无银屑病的银屑病关节炎（PsA）的临床特征。
对57例未分化脊柱关节炎（SpA）患者（31例男性，26例女性，平均年龄46.32±14.12岁）进行研究。定义了两个亚组：（1）21例有家族性银屑病的患者（12例男性，9例女性，平均年龄49.29±14.17岁）；（2）36例无家族性银屑病的患者（19例男性，17例女性，平均年龄44.58±14.00岁）。评估以下临床变量的患病率：腰背痛、附着点炎、指（趾）炎、远端指间关节（DIP）关节炎、脊柱受累和椎间盘炎。对所有患者检测以下HLA单倍型：B7、B13、B17、B18、B27、B38、Cw6和DR7。
指（趾）炎和DIP关节炎在有家族性银屑病的关节亚组中明显存在（p<0.0001），该亚组还显示HLA-Cw6的频率较高（与对照组和无家族性银屑病的患者相比，p<0.0001）。HLA-B27在无家族性银屑病的患者中明显常见（与对照组相比，p<0.0001；与有家族性银屑病的患者相比，p=0.019）。此外，在有家族性银屑病的患者中，对数线性模型显示HLA-Cw6的存在与DIP关节炎以及指（趾）炎的存在有关（似然比卡方变化为5.891，p=0.015）。
无银屑病的PsA患者亚组可通过以下特征识别：出现伴有指（趾）炎和/或DIP关节炎的SpA、存在HLA-Cw6以及一级或二级亲属中有家族性银屑病。
