Linssen A, Dekker-Saeys A J, Dijkstra P F, Rothova A, Kruit P J, Bakker M, Kijlstra A, Feltkamp T E
Doc Ophthalmol. 1986;64(2):217-23. doi: 10.1007/BF00159996.
Acute anterior uveitis (AAU) may be considered to be one manifestation of the seronegative spondylarthropathies of which ankylosing spondylitis (AS) is the prototype, especially when the patient is HLA-B27 positive. However, it is not yet clear under which circumstances a patient with AAU should be referred to the rheumatologist. In a retrospective study we evaluated the management of 68 consecutive HLA-B27+ AAU patients from a rheumatologic point of view. Although the majority (73%) showed rheumatic problems, only half (52%) of the patients was referred to a rheumatologist, due to problems in evaluation of clinical history and of x-ray reading of the sacroiliac (SI) joints. Because HLA-B27 typing will determine whether the AAU patients "at risk" have AS or a related arthropathy, we suggest using HLA-B27 typing in AAU patients as a diagnostic and prognostic aid. When the AAU patient is found to be HLA-B27 positive, the rheumatologist will be able to "split" these patients into those with AS and those without. Early diagnosis of AS in AAU patients is important as an early start of drug therapy and physiotherapy may prevent deformities and improve final rheumatologic outcome.
急性前葡萄膜炎（AAU）可被视为血清阴性脊柱关节病的一种表现形式，其中强直性脊柱炎（AS）是典型代表，尤其是当患者 HLA - B27 呈阳性时。然而，目前尚不清楚在何种情况下 AAU 患者应转诊给风湿病专科医生。在一项回顾性研究中，我们从风湿病学角度评估了 68 例连续的 HLA - B27 阳性 AAU 患者的治疗情况。尽管大多数（73%）患者存在风湿性问题，但由于在临床病史评估和骶髂关节 X 线读片方面存在问题，仅有一半（52%）的患者被转诊给了风湿病专科医生。由于 HLA - B27 分型将确定“有风险”的 AAU 患者是否患有 AS 或相关关节病，我们建议在 AAU 患者中使用 HLA - B27 分型作为诊断和预后的辅助手段。当发现 AAU 患者 HLA - B27 呈阳性时，并能够将这些患者分为患有 AS 和未患有 AS 的两类。在 AAU 患者中早期诊断 AS 很重要，因为早期开始药物治疗和物理治疗可能预防畸形并改善最终的风湿病学结局。
