Arthritis & Rheumatism, Volume 62,
November 2010 Abstract Supplement
Abstracts of the American College of
Rheumatology/Association of Rheumatology Health Professionals
Annual Scientific Meeting
Atlanta, Georgia November 6-11, 2010.
Ankylosing Spondylitis Associated with Takayasu Arteritis.
Yildirim, Süleyman, Hatemi, Gülen, Yurdakul, Sebahattin, Fresko, Izzet, Ozdogan, Huri
A number of case reports have been published on the association of Takayasu arteritis with ankylosing spondylitis. The aim of this study is to formally evaluate Takayasu patients for ankylosing spondylitis (AS).
All patients who were followed with a diagnosis of Takayasu arteritis in our clinic were evaluated. Apart from the 114 Takayasu patients who fulfill ACR criteria, 77 rheumatoid arthritis and 29 AS patients were included as controls. Patients were questionned for inflammatory back pain, arthritis and heel pain with a previously validated questionnaire for screening sero negative spondylarthropathies. Patients who gave an affirmative answer to at least one of the questions were further evaluated with physical examination and sacroiliac radiograms. Radiograms were evaluated twice on 2 seperate days by 3 rheumatologists blinded to each others observations and graded according to modified New York criteria. Patients who had bilateral grade 2 or unilateral grade 3 or 4 sacroiliitis on at least 3 of 6 observations were diagnosed as ankylosing spondylitis.
Among the 114 patients with Takayasu arteritis 14 had died. Two of these patients had been diagnosed as AS, and one of them also as Crohn's disease before they died. Among the remaining 100 patients 4 already had a diagnosis of AS, one of them with accompanying Crohn's disease. We were able to reach 75 of the remaining 96 patients. 36 gave an affirmative answer to at least one of the questions. 29 of these 36 patients agreed to come to the clinic for further evaluation. Two of these 29 patients had scaroiliitis. One of them had a diagnosis of Crohn's disease. Among the controls 2/77 RA (3%) patients and 28/29 (97%) AS patients had sacroiliitis. Among the 114 patients with Takayasu arteritis a total of 8 (7%) patients had ankylosing spondylitis. Three of them were known to have Crohn's disease. None of the remaining 5 patients had symptoms related to Crohn's disease. The inter and intra-observer reliability of reading the sacroiliac radiograms was good. (kappa: inter-observer 0.89, 0.89, 0.69 and intra-observer 0.93, 0.69, 0.71)
The frequency of ankylosing spondylitis is increased in Takayasu arteritis. The association seems to include Crohn's disease in at least some of the patients. The HLA B27 status and other features of spondylarthropathy in these patients remains to be studied.
To cite this abstract, please use the following information:
Yildirim, Süleyman, Hatemi, Gülen, Yurdakul, Sebahattin, Fresko, Izzet, Ozdogan, Huri; Ankylosing Spondylitis Associated with Takayasu Arteritis. [abstract]. Arthritis Rheum 2010;62 Suppl 10 :1279