Karaarslan Ahmet, Yilmaz Hatice, Aycan Hakan, Orman Mehmet, Kobak Senol
Sifa University Faculty of Medicine Department of Ortopedics.
Bosn J Basic Med Sci. 2015 Jul 22;15(3):64-7. doi: 10.17305/bjbms.2015.511.
Ankylosing spondylitis (AS) is a chronic inflammatory disease, which typically begins in early decades of life with primarily axial joints involvement. This disease rarely affects patients older than 50 years of age. The aim of this study was to compare and evaluate the demographic, clinical, and laboratory features of late onset and early onset AS patients who were followed up in a single rheumatology center. A total of 339 patients who have been diagnosed with AS according to modified New York criteria were included in the study. The patients whose initial symptoms were observed after 50 years of age were accepted as late onset AS. Out of 339 patients, 27 (7.9%) were diagnosed as late onset AS and 312 (92.3%) patients were evaluated as early onset AS. Of 27 late onset patients, 10 were male and 17 were female. Delay in the diagnosis was 5.8 years for early onset AS, while it was 3.8 years for late onset AS (p = 0.001). Higher levels of acute phase reactants and more methotrexate (MTX) use were detected in early onset AS patients compared to late onset AS (p = 0.001, p = 0.007, respectively). Statistically, there was no difference between these two groups, with regard to disease clinical activity indexes, anthropometric measurement parameters, uveitis and peripheral joint involvement. In this study, we showed that early and late onset AS patients may present with different clinical, genetic, and laboratory features. Late onset AS patients are characterized with lower human leukocyte antigen-B27 sequence, less inflammatory sign, delayed diagnosis, and less MTX and anti-tumor necrosis factor alpha drug usage.
强直性脊柱炎(AS)是一种慢性炎症性疾病,通常始于生命的最初几十年,主要累及中轴关节。这种疾病很少影响50岁以上的患者。本研究的目的是比较和评估在单一风湿病中心接受随访的晚发性和早发性AS患者的人口统计学、临床和实验室特征。根据改良纽约标准诊断为AS的339例患者纳入本研究。初始症状在50岁以后出现的患者被视为晚发性AS。在339例患者中,27例(7.9%)被诊断为晚发性AS,312例(92.3%)患者被评估为早发性AS。在27例晚发性患者中,10例为男性,17例为女性。早发性AS的诊断延迟为5.8年,而晚发性AS为3.8年(p = 0.001)。与晚发性AS相比,早发性AS患者的急性期反应物水平更高,使用甲氨蝶呤(MTX)更多(分别为p = 0.001,p = 0.007)。在疾病临床活动指数、人体测量参数、葡萄膜炎和外周关节受累方面,两组之间在统计学上没有差异。在本研究中,我们表明早发性和晚发性AS患者可能表现出不同的临床、遗传和实验室特征。晚发性AS患者的特征是人类白细胞抗原-B27序列较低、炎症迹象较少、诊断延迟以及MTX和抗肿瘤坏死因子α药物使用较少。