spondarthritis

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It is shown that the concept of "seronegative HLA B 27 associated spondarthritis," which is unsatisfactory even as a name, cannot be accepted as a new overgroup in a logically constructed classification. HLA B 27 occurs in certain of these illnesses almost inevitably as a predisposing antigen; in others it is merely a factor modifying the pattern of disease. The illnesses thus are obviously different. In any case, the concept itself is not a diagnosis, in spite of the fact that it is at present often employed as a diagnostic term...

Immunological parameters including the serum levels of major classes of immunoglobulins and complement C3, screening of six commonly encountered autoantibodies (including rheumatoid factor) and screening for circulating immune complexes were carried out in patients with different presentations of seronegative spondyloarthropathies. Compared with 27 controls, the mean serum levels of IgG were significantly elevated (p less than 0.001) in 19 patients with ankylosing spondylitis (AS), 15 with Reiter's disease (RD) and nine with 'unclassified' seronegative spondarthritis...

The term seronegative arthritis (alternately labelled seronegative spondarthritis or spondyloarthritis) includes ankylosing spondylitis; Reiter's syndrome; psoriatic arthritis; enteropathic arthritis; and some forms of juvenile chronic arthritis.

Cytotoxic studies indicate cross-reactivity between some enteric organisms and cells obtained from the majority of patients with ankylosing spondylitis. Preliminary studies suggest that the factor responsible for cross-reactivity may be generated by a bacterial plasmid. However, the mechanism mediating the interaction between the HLA-B27 positive cell and the bacterial antigen is at present unknown.

The concept of seronegative spondarthritis, linking several diseases around ankylosing spondylitis, has received considerable clinical and genetic support, especially through the discovery of a high frequency of HLA-B27 in these disorders. Exogenous factors would appear to be responsible for some manifestations of the disease, but the role of Klebsiella micro-organisms is equivocal, and dietary control does not affect clinical manifestations. Increased serum and salivary IgA antibodies in active ankylosing spondylitis patients tend to suggest that IgA may act as an acute-phase reactant...

A 15-fold increase in the prevalence of ankylosing spondylitis in a group of 223 men with permanent cardiac pacemakers has recently been demonstrated. In this study of the same patient group, the prevalence of other related rheumatic syndromes was investigated by clinical examination and HLA typing. The clinical picture and electrocardiographic features of all patients with HLA B27-associated rheumatic disease (seronegative spondarthritis) were analyzed. Altogether 28 patients, 12.6 percent (95 percent confidence limits: 8...

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During the last 50 years there has been an obvious change in the relationship between Reiter's syndrome and spondarthritis, probably due to the introduction of antibiotics. Postgonorrhoeic prostatovesiculitis was formerly common: Romanus' spondylitics in the 1940s had a history of gonorrhoea in 35% of cases and 50% of my patients with chronic uro-arthritis in the 1950s had had gonorrhoea. Urogenital syndromes nowadays rarely develop into ankylosing spondylitis; on the other hand, sacroiliitis is still a rather common late sequela, especially in females, however often asymptomatic...

The T-cell mediated immunity in 21 patients with seronegative spondarthritis was tested with mitogens PHA, PWM, Con-A and MLC, and found to be reduced except when tested with Con-A. The patients were then treated with levamisole or placebo for 12 weeks in a double-blind trial. During treatment the T-cell responses normalized in both groups, and it is concluded that the enhanced response is independent of levamisole. Earlier we reported clinical improvement in levamisole treated patients and the data of the present study suggest that the effect of levamisole occurs locally in the inflamed tissues...

In accordance with the prevailing trends of the development of science in rheumatology Wright, Moll and Haslock inaugurated the integrative conception of the seronegative spondarthritides in the middle of the seventies. The diseases which belong to the seronegative spondarthritides are the ankylosing spondylitis, the psoriasis-arthritis, the Reiter syndrome, the Behçet syndrome, the ulcerous colitis, Crohn's disease and Whipple's disease. Object of the representation is the determination of the notion of seronegative spondarthritis and its presence among the dwelling population...

The group of seronegative rheumatic spondylarthropathies (spondarthritis) includes different diseases with common features. The common characteristics of these diseases are sacroiliitis and/or spondylitis, usually oligoarticular arthritis, distinct extraarticular manifestations of the skin, mucous membranes, eyes and internal organs, and a common genetic disposition. To differentiate the diseases within this group, of which spondylitis ankylosans counts as the prototype, allowance must be made for radiomorphological changes of the spine, the various joints involved and the type of extraarticular symptoms...

Septic arthritis is a recognised complication of rheumatoid arthritis but has not been well described in sero-negative spondarthritis. We report 3 patients with sero-negative inflammatory joint disease who developed joint sepsis early in the course of the disease. In none was there a recognisable source of infection. Two cases were complicated by osteomyelitis and in one the sepsis has been recurrent over thirty years.

No abstract text is available yet for this article.

No abstract text is available yet for this article.

The pathogenesis of the nonsuppurative sequelae of bacterial infections, e.g. rheumatic fever (RF) following A-streptococcal infection and seronegative spondarthritis (SS) following enterobacterial infection, is thought to be related to 1. an unusual persistence of infection, and/or 2. direct toxic effects of bacterial toxins, and/or 3. an abnormal immune response to the inital infection. Additionally, modern working hypothesis center around more recent findings concerning the genetic predisposition (for which there are now markers in both diseases) and the various immunologically active biostructures of the bacteria...

The St. Mary's Hospital Sleep Questionnaire was used to investigate sleep in 439 hospitalized rheumatic and non-rheumatic patients. This questionnaire enabled an evaluation of both the level of sleep disturbance and the causes of such disturbance. The findings from this study indicated that there was little difference in the level of sleep disturbance between rheumatic and non-rheumatic patients. The sleep problem most frequently cited by rheumatic patients was pain. Noise appeared to be the worst environmental sleep problem in these patients...

A long-term follow-up of 119 patients with the descriptive diagnosis of B27-positive oligoarthritis showed that after a time between months to several years about half of the patients with this condition develop a definite disease of the seronegative spondarthritis group, especially ankylosing spondylitis. Another great part of the patients go into a complete and presumably persistent remission of their arthritis. After a follow-up time of 8 to 12 years, about 10% present a recurrent B27-associated oligoarthritis with some special clinical features...

71 patients with juvenile spondarthritis were studied retrospectively. Age at onset of disease varied between 4 and 16 years. 94% of patients were HLA-B27 positive. Relatives with symptoms of spondarthritis were found in the families of 23 children. All patients developed radiographic sacroiliitis. Prominent disease symptom was a peripheral arthritis, which was mostly pauciarticular and asymmetric, involving big joints of the lower limbs. 41 patients suffered from heel pains, 33 complained of back or sacroiliac pains...

It has been seen that involvement of the foot in the seronegative arthropathies forms a regular and varied part of the clinical picture. This is often quite different from that seen in rheumatoid arthritis; its components, whether in joints, periarticular structures, or as surface manifestations, may be characteristic enough to raise the diagnosis of 'spondarthritis'. The features described, though characteristic of the spondarthritides, are, however, not pathognomonic. Thus, the osteolysis in psoriatic arthritis also occurs in neuropathic arthritis (e...