RESUMO
A pair of identical twins suffering from ankylosing spondylitis is reported. One brother developed an earlier-onset disease and showed ossification of the posterior longitudinal ligament and the flavum ligament in his cervical spine.
Assuntos
Doenças em Gêmeos , Ossificação Heterotópica/complicações , Ligamento Cruzado Posterior , Espondilite Anquilosante/complicações , Espondilite Anquilosante/genética , Adulto , Humanos , Masculino , Ossificação Heterotópica/diagnóstico por imagem , Ligamento Cruzado Posterior/diagnóstico por imagem , Radiografia , Espondilite Anquilosante/diagnóstico por imagem , Gêmeos MonozigóticosRESUMO
Two more cases of late onset peripheral seronegative spondyloarthropathy (SpA) are reported. Like the patients reported by Dubost and Sauvezie, they had extensive pitting edema of the lower limbs, constitutional symptoms, elevated erythrocyte sedimentation rate and minimal involvement of the axial skeleton with marked signs of diffuse idiopathic skeletal hyperstosis.
Assuntos
Espondilite Anquilosante/diagnóstico , Idoso , Sedimentação Sanguínea , Edema/complicações , Humanos , Hiperostose Esquelética Difusa Idiopática/complicações , Masculino , Pessoa de Meia-Idade , Radiografia , Testes Sorológicos , Espondilite Anquilosante/complicações , Espondilite Anquilosante/diagnóstico por imagem , SíndromeRESUMO
In order to establish how many children with seronegative spondyloarthropathy (SpA) starting with peripheral arthritis and/or enthesitis will develop ankylosing spondylitis (AS), 13 consecutive Caucasian pediatric patients, (11 with the seronegative enthesopathy and arthropathy (SEA) syndrome and 2 with isolated B27 associated peripheral arthritis or enthesitis at entry), were followed prospectively with no loss for more than 5 years. Sacroiliac joint plain films obtained at the last visit were mixed with those of 14 control subjects and read blindly. The course of SpA was self-limiting in 6 patients and recurrent in the other 7. Six patients had episodes of inflammatory cervical and/or lumbar pain during followup. However, none showed any limitation of spinal movement in the asymptomatic periods. Only one patient (9.1%) of 11 with the SEA syndrome showed bilateral sacroiliitis and met New York criteria for AS after 5 years of disease. Our results suggest that the proportion of Caucasian children with the SEA syndrome developing AS is much lower than the 75% found in a similar study on Mexican children. Lack of evaluation of all patients after 5 years, the reading of pelvic plain films without reducing observer error, and the male predominance in the Mexican study, probably in addition to ethnic or environmental factors, may account for differences.