Clinical diagnosis of ankylosing spondylitis in women and relation to presence of HLA-B27.

Abstract

. (1976). Annals ofthe Rheumatic Diseases, 35,[267][268][269][270]. Clinical diagnosis of ankylosing spondylitis in women and relation to presence ofHLA-B27. Thirty-nine Caucasian women with definite or probable ankylosing spondylitis were tissue typed and the radiographic and clinical features were correlated with the presence of B27 (formerly W27). This investigation showed that the same strong positive correlation observed in men obtains in women between B27 and unequivocal radiographic changes. As such changes develop slowly in women, clinical and laboratory features were identified which were sufficiently characteristic to enable the diagnosis to be reached in advance of decreased spinal mobility. Immobility pain and stiffness and bilateral sacroiliac pain are the most characteristic features, but additional support is provided by the presence of any of the following: onset by age 30, a raised sedimentation rate, peripheral joint involvement, circumthoracic pain, family history, and iritis.

Ankylosing spondylitis and motherhood

“…Finally, HLA-B27 was present in all 47 of the patients tested for this antigen, thus confirming that the close association between definite AS and HLA-B27 also includes women with this disorder (19)(20)(21)(22). In regard to genetic susceptibility, 15 of our 50 patients had close relatives with definite AS, and 5 of those IS had more than I affected relative.…”

Understanding How the Diagnostic Delay of Spondyloarthritis Differs Between Women and Men: A Systematic Review and Metaanalysis

“…This implies that patients have had medically unsolved disorders for a long time, have continued searching for a diagnosis and treatment, or are being erroneously diagnosed and managed 49 . One possible explanation is that dorsal/lumbar pain is a frequent symptom occurring in various conditions, and is one of the most common symptoms attributable to 6 The 1 2, 3, 6a), 14a), 14b), 15, 18, 20, 22 low STROBE: Strengthening The Reporting of OBservational studies in Epidemiology. Score quality: low quality < 50%; medium: 50% ≥ scoring < 70%; high: 70% ≥ scoring < 90%; excellent ≥ 90%.…”

“…Table 1 shows the main characteristics of the 42 studies on diagnostic delay in SpA included in this systematic review 1,2,3,[8][9][10][11][12][13][14][15][16][17][18]19,20,21,22,23,[26][27][28][29][30][31][32][33][34][35][36][37][38][39][40][41][42][43][44][45][46][47]48 . The review included 23,883 patients (67.6% men, 32.3% women).…”

“…Each of these was individually combined with: (delay OR delayed) AND (sex OR gender OR women OR woman) NOT (psoriatic arthritis). Complemen tary papers potentially eligible were included, a search through snowballing was performed by cross reference, and 16 studies were identified 1,3,[8][9][10][11][12][13][14][15][16][17][18][19][20][21] . Ultimately, 379 identified papers were consulted.…”

Reiter's disease in women

“…Female ankylosing spondylitis remains a possible alternative diagnosis (24, [33][34][35]. There is a growing awareness of peripheral joint disease, enthesopathy, and high incidence of HLA-B27 in this forme fruste of ankylosing spondylitis (23).…”