强直性脊柱炎和白塞病共存：用乌帕替尼成功治疗。
Coexistence of ankylosing spondylitis and Behçet's disease: Successful treatment with upadacitinib.
机构信息
Department of Propaedeutics of Internal Diseases "Prof. Dr. Anton Mitov", Faculty of Medicine, Medical University of Plovdiv, Plovdiv, Bulgaria.
Department of Special Surgery, Faculty of Medicine, Medical University of Plovdiv, Plovdiv, Bulgaria.
出版信息
Immun Inflamm Dis. 2024 Apr;12(4):e1242. doi: 10.1002/iid3.1242.
BACKGROUND
Ankylosing spondylitis (AS) and Behçet's disease (BD) are distinct inflammatory disorders, but their coexistence is a rare clinical entity. This case sheds light on managing this complex scenario with Janus kinase (JAK) inhibitors.
CASE PRESENTATION
A 42-year-old woman presented with a decade-long history of lower back pain, nocturnal spinal discomfort, recurrent eye issues, oral and genital ulcers, hearing loss, pus formation in the left eye, and abdominal pain. Multidisciplinary consultations and diagnostic tests confirmed AS (HLA-B27 positivity and sacroiliitis) and BD (HLA-B51). Elevated acute-phase markers were observed.
CONCLUSION
This case fulfills diagnostic criteria for both AS and BD, emphasizing their coexistence. Notably, treatment with upadacitinib exhibited promising efficacy, underscoring its potential as a therapeutic option in patients with contraindications for conventional treatments. Our findings illuminate the intricate management of patients presenting with these two diverse systemic conditions and advocate for further exploration of JAK inhibitors in similar cases.
背景
强直性脊柱炎（AS）和贝赫切特病（BD）是两种不同的炎症性疾病，但它们同时存在是一种罕见的临床实体。本病例阐明了使用 Janus 激酶（JAK）抑制剂来管理这种复杂情况。
病例介绍
一名 42 岁女性，有长达十年的下腰痛、夜间脊柱不适、反复眼部问题、口腔和生殖器溃疡、听力损失、左眼脓液形成和腹痛病史。多学科会诊和诊断性检查确认了 AS（HLA-B27 阳性和骶髂关节炎）和 BD（HLA-B51）。观察到急性期标志物升高。
结论
本病例符合 AS 和 BD 的诊断标准，强调了它们的共存。值得注意的是，用 upadacitinib 治疗显示出有希望的疗效，强调了其在有传统治疗禁忌证的患者中的治疗选择潜力。我们的发现阐明了同时存在这两种不同系统性疾病的患者的复杂管理，并提倡在类似病例中进一步探索 JAK 抑制剂。
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