Flores-Robles Bryan-Josué, Labrador-Sánchez Eztizen, Andrés-Trasahedo Estíbaliz, Pinillos-Aransay Valvanera, Joven-Zapata María-Yasmina, Torrecilla Lerena Laura, Salazar-Asencio Osman-Alberto, López-Martín Juan-Antonio
San Pedro Hospital, Logroño, La Rioja, Spain Rheumatology Department.
San Pedro Hospital, Logroño, La Rioja, Spain Nursing Department.
Case Rep Rheumatol. 2022 May 28;2022:8500567. doi: 10.1155/2022/8500567. eCollection 2022.
The association of rheumatoid arthritis (RA) and ankylosing spondylitis (AS) in a single patient is a rarely described phenomenon. AS and RA are conditions that can have a high impact on the morbidity and mortality of patients.
We described the clinical, epidemiological, analytical, and radiological characteristics of 81 patients with concomitant diagnosis of rheumatoid arthritis (RA) and ankylosing spondylitis (AS). Of these patients, seven were diagnosed at our hospital. A literature review was carried out using Medline, Embase, Scopus, and virtual hospital libraries, including the period from January 1950 to April 2020.
Regarding the results, 71% of the patients were men, with a mean age of 53 years (±14.83). RA was the first disease diagnosed in 52% of the cases. Approximately 53% of the patients had rheumatoid nodules, and 83% reported inflammatory lumbar pain during their evaluation. Erosions were observed on radiographs of the hands and/or feet in 85% of the cases, and almost all the patients (80/81) had sacroiliitis on imaging studies. Approximately 92% of the cases were rheumatoid factor (RF) positive and 90% HLA B-27 positive.
The coexistence of RA and AS is highly uncommon. With the data obtained in this review, it seems that there exist erosive radiological patterns, positivity for RF, involvement of the axial skeleton, and rheumatoid nodules at a higher frequency than those patients with a single diagnosis of the two entities. More data are needed to corroborate this association.
类风湿关节炎（RA）和强直性脊柱炎（AS）在同一患者中并存是一种鲜有描述的现象。AS和RA是对患者发病率和死亡率有重大影响的疾病。
我们描述了81例同时诊断为类风湿关节炎（RA）和强直性脊柱炎（AS）患者的临床、流行病学、分析及放射学特征。其中7例患者在我院确诊。利用Medline、Embase、Scopus和虚拟医院图书馆进行文献综述，涵盖1950年1月至2020年4月期间。
在结果方面，71%的患者为男性，平均年龄53岁（±14.83）。52%的病例中RA是首个被诊断出的疾病。约53%的患者有类风湿结节，83%的患者在评估期间报告有炎性腰背痛。85%的病例在手部和/或足部X线片上观察到侵蚀，几乎所有患者（80/81）在影像学检查中有骶髂关节炎。约92%的病例类风湿因子（RF）呈阳性，90%的患者HLA B - 27呈阳性。
RA和AS并存极为罕见。根据本综述获得的数据，似乎存在侵蚀性放射学模式、RF阳性、中轴骨骼受累以及类风湿结节，其出现频率高于单一诊断这两种疾病的患者。需要更多数据来证实这种关联。
