Cases reported "Spondylitis, Ankylosing"

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1/5. Sweet's syndrome in a patient with acute Crohn's colitis and longstanding ankylosing spondylitis.

    Acute neutrophilic dermatosis, also referred to as Sweet's syndrome according to the first description in 1964, occurs not only as an isolated phenomenon but also in the context of neoplastic and inflammatory diseases, occasionally including arthritides. Recently Sweet's syndrome has been reported in a small number of patients with chronic inflammatory bowel disease, mostly in advanced stages of the disease. Here, we describe the sudden outbreak of acute neutrophilic dermatosis in coincidence with the onset of severe Crohn's disease (CD) in a patient with long-standing ankylosing spondylitis (AS). This condition has not been described before and therefore Sweet's syndrome should be added to the spectrum of skin manifestations the rheumatologist has to think about in the context of the spondylarthropathies (SpA). Furthermore, this case report is of interest because the skin lesions of Sweet's syndrome are somewhat similar to psoriasis, which is a rather frequent feature of the spondylarthropathies. This article intends to clarify the clinical and histological differentiation between Sweet's syndrome, psoriatic skin lesions and erythema nodosum for the rheumatologist and stresses that these conditions must each be treated in a completely different manner.
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keywords = spondylarthropathies
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2/5. First manifestations of seronegative spondylarthropathy following autologous stem cell transplantation in HLA-B27-positive patients.

    Two male patients with non-Hodgkin's lymphoma (NHL, follicular NHL, diffuse large B cell NHL, both in 2nd complete remission) and one female patient with acute myeloid leukemia in 1st complete remission developed arthralgias and enthesopathy following autologous stem cell transplantation. In 2/3 patients, sacroiliitis could be demonstrated on X-ray. In both patients, the rheumatic symptoms were classified as manifestations of a spondylarthropathy. All three patients were subsequently shown to be HLA-B27-positive. The patients were successfully treated with non-steroidal anti-inflammatory drugs. The differential diagnosis of joint pain following autologous stem cell transplantation should include HLA-B27-associated spondylarthropathies in addition to the more commonly seen bone and joint pain due to immobilization and medication.
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ranking = 0.5
keywords = spondylarthropathies
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3/5. Two familial cases of malignant Reiter's syndrome.

    A Cambodian man and his son concomitantly developed malignant Reiter's syndrome soon after their arrival in france. In both cases generalized skin lesions of pustular psoriasis and systemic features were present. The son died after 2 years of unresponsive continuously progressive disease. The father received pulses of high dose immunosuppressants that worked rapidly and prevented a life threatening course. These 2 cases illustrate the pathophysiologic hypothesis of Reiter's syndrome, emphasizing the role of environmental triggering factors and the relationship between spondylarthropathies in B27 positive patients. Fatal cases of Reiter's syndrome are very rare in the review of the literature.
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keywords = spondylarthropathies
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4/5. IgA nephropathy associated with seronegative spondylarthropathies.

    Three patients with a seronegative spondylarthropathy were found to have IgA nephropathy. Two patients had ankylosing spondylitis (one with psoriasis), and one had incomplete Reiter's syndrome. All three had a focal proliferative glomerulonephritis with IgA-dominant mesangial immune deposits. One patient had a leukocytoclastic vasculitis. This association of IgA nephropathy with seronegative spondylarthropathies raises the possibility of a common or related pathogenesis. There is evidence to suggest that both diseases are mediated by genetically controlled immune responses to mucosal contact with etiologic antigens.
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ranking = 2.5
keywords = spondylarthropathies
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5/5. A multicase family with spondylarthropathies.

    Thirty six members of a family with symptoms and signs from the skin and/or the joints were examined clinically and radiologically and HLA typed. Fourteen were classified as having inflammatory joint disease, eight of them with more than one disease within the spondylarthropathy group (SpA). Four had psoriasis of the skin, two of whom had psoriatic arthritis. Ten (five males, five females) had radiological signs of sacroiliitis, eight of them fulfilled the criteria for SpA. Five (four males, one female) with sacroiliitis had radiological signs of spine involvement. One female member was classified as having rheumatoid arthritis. Seven with sacroiliitis were HLA-B27 positive, related to the same haplotype. Two with psoriasis were B27 positive and the other two had another haplotype in common. No single HLA antigen or haplotype was associated with the inflammatory joint manifestations or skin lesions. This suggests involvement of other gene loci or coincidence of multicases.
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ranking = 2
keywords = spondylarthropathies
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