scholarly journals Uveitis – Possible adverse reaction to secukinumab in a patient with rehabilitation treatment for ankylosing spondylitis (case report)

2020 ◽  
pp. 561-565
Author(s):  
Doinița OPREA ◽  
Diana JIMBU ◽  
Elena Valentina IONESCU ◽  
Mădălina Gabriela ILIESCU ◽  
Liliana Elena STANCIU ◽  
...  
Keyword(s):  
Adverse Reaction ◽  
Ankylosing Spondylitis ◽  
Human Monoclonal Antibody ◽  
Biological Response ◽  
Chronic Inflammatory Disease ◽  
Common Side Effect ◽  
Rehabilitation Treatment ◽  
Ocular Disorders ◽  
Axial Form ◽  
The Right

Introduction. Ankylosing spondylitis (AS) is a chronic inflammatory disease that predominantly affects the spine, but also peripheral joints, the major characteristic of the disease being the early involvement of the sacroiliac joint. The most common extra skeletal manifestations are ocular disorders and appear to 25-30% of the patients, being more frequent to HLA B27 positive patients. Episodes of previous acute uveitis, known as iridocyclitis, may precede or may occur during or after inflammatory joint manifestations. Materials and Methods. We present a 41-year-old patient diagnosed 11 years ago with Ankylosing spondylitis, on its axial form, without extra-articular manifestations, periodically treated with anti-inflammatory drugs and balneary treatment, but with inefficient clinic and biological response. Since November 2019, his treatment with Secukinumab, started to improve the clinic and paraclinical symptoms. Secukinumab is a fully human monoclonal antibody, the first care that selectively targets IL-17A, an essential cytokine treatment that produces inflammation, and bone remodeling, characteristic of AS. Results. In January 2020, the patient presents increased pain and redness in the right eye area, subsequently diagnosed as anterior acute uveitis. Conclusions. This anterior acute uveitis, may be an extra-articular manifestation in the context of the natural evolution of the disease insufficiently controlled by the recently introduced therapy, or it may be an adverse reaction to Secukinumab, being known that the optic malfunction is a less common side effect. Keywords: Ankylosing Spondylitis, Uveitis, Secukinumab, extra-articular manifestations, rehabilitation, treatment,

scholarly journals TYPE III CAWLEY ANDERSSON LESION IN A CASE OF ANKYLOSING SPONDYLITIS

2014 ◽  
Vol 04 (02) ◽  
pp. 136-139
Author(s):  
Deepak Hegde ◽  
Ballal Arjun ◽  
Vinay Kumar C. ◽  
H. Ravindranath Rai
Keyword(s):  
Back Pain ◽  
Ankylosing Spondylitis ◽  
Morning Stiffness ◽  
Posterior Spinal Fusion ◽  
Chronic Inflammatory Disease ◽  
Inflammatory Back Pain ◽  
Type Iii ◽  
Lesion Type ◽  
Andersson Lesion ◽  
Spinal Ligament

Abstract:Ankylosing spondylitis (AS) is a chronic inflammatory disease that affects especially males in the second and third decades of life.1 The main clinical symptom is inflammatory back pain typically occurring at night and morning stiffness improving after exercise.1 Apart from syndesmophytes and ankylosis of the spine resulting in rigidity, in longstanding ankylosing spondylitis, also focal destructive 1 discovertebral lesions (Andersson lesions) can occur.1 The case we present here is of a 35 year old male patient who presented to us with the symptoms of pain of upper back and both shoulders for 6 years. Pain was followed with stiffness of the neck and shoulder. Radiography of the dorsolumbar spine revealed squaring of the vertebra, syndesmophytes, calcification of the anterior spinal ligament, end plate irregularity at D10-D11 level, ill defined sclerosis with fracture of the ankylosed spine, features consistent with Andersson lesion type III. He underwent posterior spinal fusion with good functional outcome.

scholarly journals Expression analysis of HLA-E and NKG2A and NKG2C receptors points at a role for natural killer function in ankylosing spondylitis

RMD Open ◽  
2018 ◽  
Vol 4 (2) ◽  
pp. e000597 ◽  
Author(s):  
Alberto Cauli ◽  
Grazia Dessole ◽  
Matteo Piga ◽  
Maria Maddalena Angioni ◽  
Silvia Pinna ◽  
...  
Keyword(s):  
Ankylosing Spondylitis ◽  
Nk Cells ◽  
Natural Killer ◽  
Surface Density ◽  
Surface Expression ◽  
Chronic Inflammatory Disease ◽  
Hla B27 ◽  
Peripheral Blood Mononuclear ◽  
Histocompatibility Complex ◽  
Natural Killer Receptors

BackgroundAnkylosing spondylitis (AS) is a complex chronic inflammatory disease strongly associated with the majority of human leucocyte antigen (HLA)-B27 alleles. HLA-E molecules are non-classical major histocompatibility complex (MHC) class I molecules that specifically interact with the natural killer receptors NKG2A (inhibitory) and NKG2C (activating), and have been recently proposed to be involved in AS pathogenesis.‘’ObjectiveTo analyse the expression of HLA-E and the CD94/NKG2 pair of receptors in HLA-B27-positive patients with AS and healthy controls (HC) bearing the AS-associated B*2705 and the non-AS-associated B*2709 alleles.MethodsThe level of surface expression of HLA-E molecules on CD14+ peripheral blood mononuclear cell was evaluated in 21 HLA-B*2705 patients with AS, 12 HLA-B*2705 HC, 12 HLA-B*2709 HC and 6 HLA-B27-negative HC using the monoclonal antibody MEM-E/08 by quantitative cytofluorimetric analysis. The percentage and density of expression of HLA-E ligands NKG2A and NKG2C were also measured on CD3−CD56+ NK cells.ResultsHLA-E expression in CD14+ cells was significantly higher in patients with AS (587.0, IQR 424–830) compared with B*2705 HC (389, IQR 251.3–440.5; p=0.0007), B*2709 HC (294.5, IQR 209.5–422; p=0.0004) and HLA-B27-negative HC (380, IQR 197.3–515.0; p=0.01). A higher number of NK cells expressing NKG2A compared with NKG2C were found in all cohorts analysed, as well as a higher cell surface density.ConclusionThe higher surface level of HLA-E molecules in patients with AS compared with HC, concurrently with a prevalent expression of NKG2A, suggests that the crosstalk between these two molecules might play a role in AS pathogenesis, accounting for the previously reported association between HLA-E and AS.

scholarly journals Epidural hematoma in patients with ankylosing spondylitis requiring surgical stabilization: a single-institution retrospective review with literature analysis

2021 ◽  
Vol 51 (4) ◽  
pp. E5
Author(s):  
George Hanna ◽  
Syed-Abdullah Uddin ◽  
Andrew Trontis ◽  
Lindsey Ross ◽  
Doniel Drazin ◽  
...  
Keyword(s):  
Ankylosing Spondylitis ◽  
Spine Surgery ◽  
Retrospective Review ◽  
Epidural Hematoma ◽  
Early Recognition ◽  
Chronic Inflammatory Disease ◽  
Spine Fractures ◽  
Single Institution ◽  
Record System ◽  
Increased Risk

OBJECTIVE Ankylosing spondylitis (AS) is a chronic inflammatory disease affecting the sacroiliac joints and axial spine that is closely linked with human leukocyte antigen–B27. There appears to be an increased frequency of associated epidural hematomas in spine fractures in patients with AS. The objective was to review the incidence within the literature and a single-institution experience of the occurrence of epidural hematoma in the context of patients with AS requiring spine surgery. METHODS Deep 6 AI software was used to search the entire database of patients at a single level I trauma center (since the advent of the institution’s modern electronic health record system) to look at all patients with AS who underwent spinal surgery and who had a diagnosis of epidural hematoma. Additionally, a systemic literature review was performed of all papers evaluating the incidence of epidural hematoma in patients with spine fractures. RESULTS A single-institution, retrospective review of records from 2009 to 2020 yielded a total of 164 patients with AS who underwent spine surgery. Of those patients, 17 (10.4%) had epidural hematomas on imaging, with the majority requiring surgical decompression. These spine fractures occurred close to the cervicothoracic or thoracolumbar junction. The patients ranged in age from 51 to 88 years, and there were 14 males and 3 females in the cohort. Eight patients were administered an antiplatelet and/or anticoagulant agent, and the rest were not. All patients required surgical stabilization, with 64.7% of patients also requiring decompressive laminectomies for evacuation of the hematoma and spinal cord decompression. Only 1 death was reported in the series. There was a tendency toward neurological improvement after surgical intervention. CONCLUSIONS AS has been a well-described pathologic process that leads to an increased risk of three-column injury in spine fracture, with an increased incidence of symptomatic epidural hematoma compared with patients without AS. Early recognition of this entity is important to ensure that appropriate surgical management includes addressing compression of the neural elements in addition to surgical stabilization.

scholarly journals The New Perceptions on Life of Iranian Patients with Ankylosing Spondylitis: A Qualitative Study

2021 ◽  
Author(s):  
Sara Shahba ◽  
Reza Jafari-Shakib ◽  
Mahdi Mahmoudi ◽  
Ahmadreza Jamshidi ◽  
Mahdi Vojdanian ◽  
...  
Keyword(s):  
Ankylosing Spondylitis ◽  
Life Experience ◽  
Chronic Inflammatory Disease ◽  
Qualitative Studies ◽  
Structured Interviews ◽  
Quantitative Studies ◽  
Research Findings ◽  
First Time ◽  
Insight Into ◽  
Gaining Insight

Various studies suggest that ankylosing spondylitis (AS) as a chronic inflammatory disease with many disabilities can have impacts on different aspects of patients’ life. Despite many quantitative studies, only few qualitative studies have thus far been published on this subject. For the first time, the present study aims at gaining insight into the life experience of Iranian AS patients. We performed a content analysis through semi-structured interviews with twenty-eight patients diagnosed with AS, including three females and twenty-five males with an average age of 38.5 years, to gain insight into their experiences. Whatever the patients expressed was written and transcribed verbatim. Then, we did analysis of the results after each interview. The detailed information completely extracted from the interviews was classified as sub-themes and main themes. Three main themes were identified by the analysis: (i) “Always with pain” describing the effects were found in regard to pain on patients’ life, (ii) “The perceived limitation” describing many difficulties that people may face in the society as a result of their disease, and (iii) “Fearing the unknown future” which implies to both patients and their families have concerns about the future and what will happen. Our research findings in line with other qualitative studies showed that AS disease puts a heavy and intolerable burden on patients and their family. It seems that the experiences of people living with AS can be useful to meet challenges caused by the disease and it can enhance their coping with the disease.

Prevalence of Vertebral Fractures by Semiautomated Morphometry in Patients with Ankylosing Spondylitis

2011 ◽  
Vol 38 (5) ◽  
pp. 893-897 ◽  
Author(s):  
NURIA MONTALA ◽  
XAVIER JUANOLA ◽  
EDUARDO COLLANTES ◽  
ELISA MUÑOZ-GOMARIZ ◽  
CARLOS GONZALEZ ◽  
...  
Keyword(s):  
New York ◽  
Ankylosing Spondylitis ◽  
Vertebral Fractures ◽  
Axial Skeleton ◽  
Chronic Inflammatory Disease ◽  
National Registry ◽  
Prevalent Vertebral Fracture ◽  
High Prevalence ◽  
Prevalent Fracture ◽  
Semiquantitative Method

Objective.Ankylosing spondylitis (AS) is a chronic inflammatory disease mainly affecting the axial skeleton and characterized by ossification of the spinal disc, joints, and ligaments leading to progressive ankylosis. Vertebral osteoporosis is a recognized feature of AS. Studies have confirmed a moderate to high prevalence of vertebral fractures with extremely varying ranges in patients with AS. Our objective was to estimate the prevalence of vertebral fractures in a representative Spanish population of patients with AS using a validated semiquantitative method, MorphoXpress®.Methods.Patients were randomly selected from the 10 initial participating centers of the Spanish National Registry of Spondyloarthropathies (REGISPONSER) by consecutive sampling. All patients fulfilled the New York modified criteria for AS and had a baseline thoracolumbar radiograph. A prevalent vertebral fracture was defined according to the Genant classification criteria.Results.The estimated prevalence of vertebral fractures was 32.4% (95% CI 25.5%–39.3%). The majority of fractures were localized in the thoracic segment (n = 100; 82.%) and were mild (n = 79; 64.8%). In logistic regression analysis, age (odds ratio per year 1.05, 95% CI 1.03–1.08, p < 0.001), disease duration (OR per year 1.03, 95% CI 1.01–1.06, p = 0.011), Bath Ankylosing Spondylitis Functional Index score (OR per score 1.16, 95% CI 1.03–1.30, p = 0.015), Bath Ankylosing Spondylitis Radiographic Index-TS (OR per score 1.25, 95% CI 1.12–1.39, p < 0.001), and wall-occiput distance (OR per cm 1.15, 95% CI 1.08–1.23, p < 0.001) were all associated with prevalent fracture.Conclusion.Semiquantitative methods are needed to improve the diagnosis of vertebral fractures in AS in order to start early treatment and to avoid complications arising from osteoporosis.

scholarly journals Non-uremic Calciphylaxis: A Rare and Late Adverse Reaction of Warfarin

2019 ◽  
Vol 14 (3) ◽  
pp. 246-248 ◽  
Author(s):  
Dhruvkumar M. Patel ◽  
Mukundkumar V. Patel ◽  
Akash D. Patel ◽  
Jignesh C. Kaklotar ◽  
Greshaben R. Patel ◽  
...  
Keyword(s):  
Adverse Reaction ◽  
Inflammatory Markers ◽  
Metabolic Profile ◽  
Connective Tissue Diseases ◽  
Skin Ulcer ◽  
Wound Treatment ◽  
History Of ◽  
The Right ◽  
Work Up ◽  
Late Adverse Reaction

Background:Calciphylaxis is a complex dermatological lesion of micro vascular calcification that is typically presented as panniculitis with gangrenous painful lesions having uremic and non-uremic causes.Case Report:We present a case of a 48-year old male with a history of paroxysmal atrial fibrillation and hypertension taking amlodipine 5 mg and warfarin 5 mg daily for the last 26 months. The patient had a 6- months history of painful swelling followed by necrotic skin ulcer over the right leg. His remarkable examination findings were right leg tender ulcer with surrounding erythema and secondary sepsis. His hemogram, metabolic profile and connective tissue diseases work up were unremarkable except leucocytosis and raised inflammatory markers. His local part radiological and skin biopsy findings were suggestive of calciphylaxis.Results and Conclusion:In our case, warfarin and amlodipine were culprit drugs for the lesion, but Naranjo score (warfarin 7and amlodipine 1) speculate warfarin as a probable adverse reaction of warfarin. The lesion was cured with local wound treatment after discontinuation of warfarin. The physician should be aware of this rare cutaneous disorder of systemic origin for proper management.

scholarly journals A giant fibrinoid pericardial mass in a patient with rheumatoid arthritis: a case report

2019 ◽  
Vol 3 (2) ◽  
Author(s):  
Felipe Cañas ◽  
Juan David Lopez Ponce de León ◽  
Juan Esteban Gomez ◽  
Carlos Alberto Cañas
Keyword(s):  
Rheumatoid Arthritis ◽  
Right Ventricle ◽  
Chronic Inflammatory Disease ◽  
Pericardial Disease ◽  
Prognostic Features ◽  
Cardiac Manifestation ◽  
Histopathological Studies ◽  
The Right ◽  
Pericardial Mass ◽  
Pericardial Thickening

Abstract Background  Rheumatoid arthritis (RA) is a chronic inflammatory disease of the joints, which may extend to extra-articular organs. Extra-articular manifestations have been considered as prognostic features in RA, and pericardial disease is one of the most frequent occurrences. Rheumatoid arthritis pericarditis is usually asymptomatic and is frequently found on echocardiography as pericardial thickening with or without mild effusion. Severe and symptomatic cases are rare, but pericardial masses are even rarer. We report a patient with erosive, nodular seropositive RA, and progressive functional deterioration owing to a giant pericardial mass compressing the right cardiac chambers. Case summary The patient was a 79-year-old man. Cardiac magnetic resonance imaging revealed a pericardial lesion measuring 10 × 9 × 6 cm with complex structures in its interior, which had compressive effects on the right atrium and right ventricle, severely limiting diastole. Late gadolinium enhancement of the lesion walls and pericardium suggested pericarditis. Surgical resection was performed, and a soft mass with liquid content was extracted. The patient recovered well with improvements in symptoms and the functional status. Histopathological studies ruled out neoplasm, vasculitis, and infection, and the entire mass showed fibrinoid material associated with fibrinoid pericarditis. Discussion Symptomatic RA pericarditis is a rare cardiac manifestation of RA, whilst associated significant haemodynamic compromise is even rarer. The condition could manifest with a giant compressive pericardial mass composed of fibrinous material, with particular involvement of the right ventricle. Exclusion of other conditions, such as neoplasms and infections, is necessary.

scholarly journals Patients with Ankylosing Spondylitis and Low Disease Activity because of Anti-TNF-Alpha Therapy Have Higher TRAIL Levels Than Controls: A Potential Compensatory Effect

2014 ◽  
Vol 2014 ◽  
pp. 1-6 ◽  
Author(s):  
Fernanda Genre ◽  
Raquel López-Mejías ◽  
Javier Rueda-Gotor ◽  
José A. Miranda-Filloy ◽  
Begoña Ubilla ◽  
...  
Keyword(s):  
Ankylosing Spondylitis ◽  
Disease Activity ◽  
Systemic Inflammation ◽  
Inverse Correlation ◽  
Chronic Inflammatory Disease ◽  
Compensatory Mechanism ◽  
Infliximab Infusion ◽  
Potential Biomarker ◽  
Marginal Association ◽  
Cv Disease

Objective. TRAIL is a potential biomarker of cardiovascular (CV) disease. Ankylosing spondylitis (AS) is a chronic inflammatory disease associated with metabolic syndrome (MeS) and accelerated atherosclerosis. We assessed whether disease activity, systemic inflammation, and MeS features were associated with circulating TRAIL levels in AS patients undergoing TNF-αantagonist infliximab therapy and if infliximab infusion modified TRAIL levels.Methods. We measured TRAIL serum levels in 30 nondiabetic AS patients without CV disease undergoing anti-TNF-αtherapy, immediately before and after an infliximab infusion, and in 48 matched controls. Correlations of TRAIL levels with disease activity, systemic inflammation and MeS features, adipokines, and biomarkers of endothelial activation were evaluated. Changes in TRAIL levels following anti-TNF-αinfusion were analyzed.Results. TRAIL levels were higher in AS patients than controls. TRAIL levels displayed an inverse correlation with total and LDL cholesterol. We observed an inverse correlation with QUICKI and a marginal association with HOMA-IR. We also found an inverse correlation with resistin and a marginal association with apelin and OPN. Anti-TNF-αinfusion did not change TRAIL levels after 120′.Conclusion. Elevated TRAIL levels in AS patients may be the result of a compensatory mechanism to reduce CV risk in these patients.

Audiological findings in patients with ankylosing spondylitis

2005 ◽  
Vol 119 (7) ◽  
pp. 534-539 ◽  
Author(s):  
Necat Alatas ◽  
Pelin Yazgan ◽  
Adil Oztürk ◽  
Imran San ◽  
Ismail Iynen
Keyword(s):  
Hearing Loss ◽  
Ankylosing Spondylitis ◽  
Auditory Brainstem ◽  
Chronic Inflammatory Disease ◽  
Control Group ◽  
Acoustic Reflex ◽  
Neck Movement ◽  
Significant Difference ◽  
Brainstem Response ◽  
Interpeak Latency

Ankylosing spondylitis (AS) is a chronic inflammatory disease. The aim of this investigation was to study the relationship between AS and hearing loss. This study compared 28 patients with AS with 23 age-matched controls. All subjects underwent ENT examination, audiological and acoustic immittance measurements, and auditory brainstem response (ABR) tests. Sensorineural hearing loss was found in 28.6 per cent of the AS patients and in 4.35 per cent of the control group. For hearing levels at 250–500 Hz and 4000–8000 Hz, there was a statistically significant difference between the two groups. Acoustic reflex was not obtained in both ears of four patients and the left ear of one patient. There was a correlation between increase of tympanic volume and limitation in neck movement, between extension of 1–3 interpeak latency and limitation in the neck movement. In conclusion, AS affects the inner ear more than the middle ear.

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