Bilateral sacroiliitis and uveitis comorbidity: brucellosis? Ankylosing spondylitis?

Abstract

We present a rare case of a comorbidity of sacroiliitis and brucellosis infection. A 28-year-old woman received irregular medication due to ongoing backache and hip pain for 5 years. The patient presented to our hospital for evaluation of visual loss and was diagnosed with uveitis. Sacroiliac MRI was performed to investigate the inflammatory backache and hip pain, and the aetiology of the uveitis, revealing the presence of sacroiliitis. The patient's blood test results were as follows: positive brucellosis Rose Bengal test and positive tube agglutination test with a titre of 1/640. The patient was treated with doxycycline and rifampicin for 8 weeks for the brucellosis infection, and with acemetacin for the ankylosing spondylitis. The patient's back and hip pain decreased significantly 8 weeks later; however, the uveitis was not controlled by the treatment. Therefore, anti-tumour necrosis factor (infliximab) treatment was started.

Ankylosing spondylitis occurring in a patient with Behçet disease after chronic brucellosis infection: A case report and review of the literature

“…There are case reports in the literature on the coexistence of BD and AS 4,[6][7][8][9][10][11][12] as well as the coexistence of brucellosis infection and AS. [13][14][15] In this report, a patient with AS after brucellosis infection found while being followed up with the diagnosis of BD is mentioned.…”

“…They suggested that uveitis was due to reactivation of AS caused by brucellosis because the patient's inflammatory joint symptoms and eye symptoms had continued for about 4 years. 15 Behçet disease is thought to be a dysregulated immune after the onset of the disease. 18 In this case, it can be thought that the development of both BD and AS may be related to brucellosis.…”

Relationship of CARD8 Gene Polymorphisms with Susceptibility to Ankylosing Spondylitis: A Case-Control Study

“…In the later stage, it may appear as ankylosis of the spinal column and even loss of mobility [21,22]. So far, its exact etiology and pathogenesis is not clear; studies have shown that the occurrence of AS may be related to genetic background, chronic infection, autoimmune disorders, endocrine disorders, and so on [23][24][25][26]. A recent study suggests that AS is the result of the interaction of environmental and genetic factors [27]; environmental factors may be the causes of the disease, and genetic susceptibility the basis for AS pathogenesis.…”

Brucellar Uveitis in Eastern India

“…In most of the studies, it has been found that uveitis is the most common ocular manifestation of brucellosis and that posterior uveitis is the most common form of uveitis [7,8,11,12]. Ocular manifestations are mainly seen during the chronic phase of the disease [7,8,[13][14][15][16]. Several studies on brucellosis from Eastern India [17][18][19][20][21] indicated that it is prevalent ---2 30 Male 1⁄40 1⁄80 --------3 27 Female 1⁄20 1⁄40 --------4 29 Table 3.…”