Department of Internal Medicine, Gazi University Faculty of Medicine, Ankara, Turkey.
Division of Rheumatology, Department of Internal Medicine, Hacettepe University Faculty of Medicine, Ankara, Turkey.
Joint Bone Spine. 2019 Jul;86(4):497-501. doi: 10.1016/j.jbspin.2019.01.020. Epub 2019 Feb 6.
Takayasu arteritis and Spondyloarthritis are two distinct inflammatory diseases that affect the same age periods. Increasing number of reports on co-incident Takayasu arteritis-spondyloarthritis cases in literature raised the hypotheses about their association. The purpose of this study is to evaluate the incidence of spondyloarthropathy spectrum diseases in Takayasu arteritis patients.
Detailed clinical and demographic features of Takayasu arteritis patients were recorded and all were screened meticulously for the presence of spondyloarthropathy features following recommendations of Assessment of SpondyloArthritis international Society. Patients were questioned for inflammatory back pain, enthesitis, uveitis, inflammatory bowel disease, peripheral arthritis, and investigated accordingly with HLA-B27, plain X-rays and sacroiliac magnetic resonance imaging.
A total of 69 Takayasu arteritis patients (65 female, 94.2%) were enrolled. After detailed investigation, 14 (20.3%) Takayasu arteritis patients fulfilled the Assessment of SpondyloArthritis international Society criteria for Spondyloarthropathy. Two of 14 (14.2%) spondyloarthropathy patients were positive for HLA-B27. Type 1 and type 2 Takayasu arteritis were more common in patients with diagnosis of both Takayasu arteritis and spondyloarthropathy than those without spondyloarthropathy. Most of patients with diagnosis of both these diseases required biologic therapies than patients with diagnosis of Takayasu arteritis alone (64.3% vs 29.1%, P = 0.014) due to refractory Takayasu arteritis.
Our results suggest a significant association between Takayasu arteritis and spondyloarthropathy. Possible shared genetic or immunopathogenic processes may explain this association, which merits further investigations.
大动脉炎和脊柱关节炎是两种不同的炎症性疾病，它们影响相同的年龄段。越来越多的文献报道表明，大动脉炎和脊柱关节炎同时发生的病例增多，这就提出了它们之间存在关联的假说。本研究旨在评估大动脉炎患者中脊柱关节病谱疾病的发病率。
详细记录大动脉炎患者的临床和人口统计学特征，并按照评估脊柱关节炎国际学会的建议，对所有患者进行细致的脊柱关节病特征筛查。询问患者是否存在炎症性背痛、肌腱附着点炎、葡萄膜炎、炎症性肠病、外周关节炎，并相应进行 HLA-B27 检测、普通 X 线片和骶髂磁共振成像检查。
共纳入 69 例大动脉炎患者（65 例女性，94.2%）。经过详细调查，14 例（20.3%）大动脉炎患者符合评估脊柱关节炎国际学会的脊柱关节病标准。14 例脊柱关节病患者中有 2 例（14.2%）HLA-B27 阳性。1 型和 2 型大动脉炎在同时诊断为大动脉炎和脊柱关节病的患者中比没有脊柱关节病的患者更为常见。由于大动脉炎难治性，同时诊断出这两种疾病的患者比仅诊断出大动脉炎的患者更需要生物治疗（64.3% vs 29.1%，P=0.014）。
我们的结果表明大动脉炎和脊柱关节病之间存在显著关联。可能存在共同的遗传或免疫发病机制可以解释这种关联，值得进一步研究。
