Ankylosing spondylitis presenting as PUO.

Kinsella, Paolo; Ebringer, R.; Hooker, Jeffrey D.; Corbett, Mary; Cox, N. R.; Parry, C. B. Wynn

doi:10.1136/bmj.2.6129.19-a

Cited by 11 publications

(6 citation statements)

References 1 publication

Supporting

Mentioning

Contrasting

Order By: Relevance

“…AS is a chronic inflammatory disorder, and most patients experiencing generalised flare have already been diagnosed with AS. Thus, AS presenting as FUO is rare,5–7 and difficult to diagnose for primary care physicians. In one prospective study on the causes of FUO in Turkey, only one of 87 (1.2%) patients with FUO was diagnosed with AS 6.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Ankylosing spondylitis presenting with enthesitis at an uncommon site and fever of unknown origin

Kanda¹,

Takeda

Hatakeyama

et al. 2019

BMJ Case Rep

View full text Add to dashboard Cite

A 58-year-old man presented with a 2-month history of arthralgia and bilateral temporal region pain, and a 1-month history of fever. He had had refractory neck pain since his 20s. Reduced cervical and lumbar mobility was observed. Radiographs of cervical and thoracic vertebrae disclosed syndesmophytes. Pelvic radiographs showed sclerosis in the right sacroiliac joint and ankylosis in the left sacroiliac joint. MRI with contrast enhancement showed enthesitis in the upper extremities and enhancement in the bilateral temporal muscle, which indicated enthesitis of temporal muscle. He was diagnosed with ankylosing spondylitis based on the limitation in mobility of the lumbar spine and radiographic findings. To the best of our knowledge, this is the first report describing enthesitis of the temporal muscle. This case highlights that ankylosing spondylitis can be accompanied with enthesitis at the temporal muscle and fever of unknown origin at the initial presentation.

show abstract

Section: Discussionmentioning

confidence: 99%

“…AS can present miscellaneous extra-articular symptoms including uveitis or inflammatory bowel disease 4. On the other hand, fever is rarely associated with AS, and AS presenting as fever of unknown origin (FUO) would be atypical 5–7…”

Section: Introductionmentioning

confidence: 99%

Ankylosing spondylitis presenting with enthesitis at an uncommon site and fever of unknown origin

Kanda¹,

Takeda

Hatakeyama

et al. 2019

BMJ Case Rep

View full text Add to dashboard Cite

show abstract

“…Fever in such patient is absent or slight, but sometimes can be high. 35) The fever was once attributed to the presence of Klebsiella infection and human leukocyte antigen B27. 35) The diagnosis of ankylosing spondylitis is based on radiography and (or) laboratory tests of C-reactive protein or human leukocyte antigen B27.…”

Section: Aortitismentioning

confidence: 99%

“…35) The fever was once attributed to the presence of Klebsiella infection and human leukocyte antigen B27. 35) The diagnosis of ankylosing spondylitis is based on radiography and (or) laboratory tests of C-reactive protein or human leukocyte antigen B27. 36) The pathology of the aortitis due to ankylosing spondylitis is characterized by local medial elastic destruction, intimal thickening, and endarteritis obliterans of the adventitia, similar to luetic aortitis.…”

Section: Aortitismentioning

confidence: 99%

Aortitis Presenting as Fever of Unknown Origin

Yuan

Lin

2018

ATCS

View full text Add to dashboard Cite

Patients with aortitis often present with nonspecific constitutional symptoms. Due to the fact that aortitis is associated with inflammatory or infectious courses, patients may manifest fever or fever of unknown origin. Such clinical characteristics of aortitis are unavoidably brought about diagnostic dilemmas and might lead to a series of unnecessary work-ups and maltreatment. Therefore, it is important for the clinical physicians and surgeons to understand aortitis presenting with fever of unknown origin to avoid delayed diagnosis and treatment. In this article, clinical and pathological features of aortitis (giant cell arteritis, Takayasu arteritis and infective aortitis, etc.) with fever of unknown origin are described and the differential diagnosis and management policy are discussed.

show abstract

“…There is evidence of more widespread inflammatory changes occurring in AS apart from the well known pulmonary and cardiac involvement, namely, in paraspinal muscles,'9 gastrointestinal tract,20 presacral and paravertebral lymph nodes,2' and occasionally generalised severe constitutional disturbances such as fever. 22 We would modify Von Bechterew's early observation and suggest that the peridural tissue can be a target organ for what is generally believed to be a genetically mediated immune response.23 It is clearly desirable to treat this condition positively during its active stage. Intrathecal steroids have been proposed,6 but radiotherapy may be more effective.…”

Section: Discussionmentioning

confidence: 99%