Langevitz P, Livneh A, Zemer D, Shemer J, Pras M
Heller Institute of Medical Research, Sheba Medical Center, Tel-Hashomer, Israel.
Semin Arthritis Rheum. 1997 Oct;27(2):67-72. doi: 10.1016/s0049-0172(97)80007-8.
To define a possible association between familial Mediterranean fever (FMF) and seronegative spondyloarthropathy (SNSA) and to study features of SNSA in FMF patients, we screened for the presence and manifestations of SNSA in 3,000 FMF patients attending the National Center for FMF in our institution. This population included 160 patients with chronic arthritis, most who suffered from SNSA. Patients were considered to suffer from SNSA if they had chronic arthritis, inflammatory back/neck pain, and sacroiliitis. Patients who had other diseases associated with SNSA were excluded. Eleven patients, nine men and two women, with chronic monoarthritis or oligoarthritis, grade 2 (four patients) or grades 3 to 4 (seven patients), sacroiliitis, and inflammatory back pain met the criteria for diagnosis of SNSA of FMF. These patients were rheumatoid factor (RF) and HLA-B27 negative. In seven patients, spondyloarthropathy developed while they received colchicine, and in four before colchicine. Most patients responded to treatment with nonsteroidal antiinflammatory drugs, but three required second-line agents. These findings suggest that SNSA is one of the musculoskeletal manifestations of FMF that may occur despite colchicine therapy and requires specific treatment.
为了确定家族性地中海热（FMF）与血清阴性脊柱关节病（SNSA）之间可能存在的关联，并研究FMF患者中SNSA的特征，我们在我院国家FMF中心就诊的3000例FMF患者中筛查了SNSA的存在情况和表现。该人群包括160例慢性关节炎患者，其中大多数患有SNSA。如果患者患有慢性关节炎、炎性背痛/颈痛和骶髂关节炎，则被认为患有SNSA。患有与SNSA相关的其他疾病的患者被排除。11例患者（9例男性和2例女性）患有慢性单关节炎或寡关节炎，2级（4例患者）或3至4级（7例患者），骶髂关节炎和炎性背痛，符合FMF的SNSA诊断标准。这些患者类风湿因子（RF）和HLA - B27均为阴性。7例患者在接受秋水仙碱治疗时出现脊柱关节病，4例在使用秋水仙碱之前出现。大多数患者对非甾体抗炎药治疗有反应，但3例需要二线药物。这些发现表明，SNSA是FMF的肌肉骨骼表现之一，尽管进行了秋水仙碱治疗仍可能发生，并且需要特定治疗。
