Coexistence of rheumatoid arthritis and ankylosing spondylitis

Abstract

Rheumatoid arthritis (RA) and ankylosing spondylitis (AS) are chronic progressive inflammatory diseases, leading to joint damage and reducing the physical fitness of patients. They are among the most common rheumatic diseases. However, their etiology and symptomatology are different. Formerly, AS was often wrongly diagnosed as RA. Today there are no major diagnostic difficulties in differentiation between these diseases, thanks to modern laboratory tests and imaging. However, a problem may arise when the patient has symptoms typical for both diseases simultaneously. Cases of coexistence of RA with AS – according to our best knowledge – are rare. This study aims to compare our experience in diagnosis and treatment of concomitant RA and AS with the experience of other researchers. Implementation of the proper diagnostic algorithm, allowing for correct diagnosis of both diseases in one patient, may be useful for differential diagnosis of similar cases in the future.

Proteomic analysis of synovial fluid from rheumatic arthritis and spondyloarthritis patients

“…In SpA, MHC class I type HLA-B27 is present in up to 90% of the patients [11] and with less than 5% of the patients being RF or ACPA positive [12]. The two diseases can thereby be differentiated, but in rare cases the two diseases can co-exist [13]. In both diseases C-reactive protein (CRP) can be increased during active disease.…”

A rare co-occurrence of anti CCP-positive rheumatoid arthritis with sacroiliitis

“…8 There are literature findings reporting the association of seronegative RA with spondyloarthropathy conditions such as ankylosing spondylitis. 3,9,10 Since the possibility for spondyloarthritis has been excluded in the current patient, the presence of sacroiliitis can be considered as an atypical joint involvement of RA.…”

Commentary: A rare co-occurrence of anti CCP-positive rheumatoid arthritis with sacroiliitis

“…7 However, the true co-existence of two or even more inflammatory joint diseases in the same patient can result in modification of the clinical image and an inadequate response to the treatment. 7 In RA, synthetic disease-modifying antirheumatic drugs (DMARD) should be applied as soon as possible, while in the axial form of AS without peripheral joint inflammation, drugs from this group do not apply. 8 While in both diseases, high efficacy of biological DMARD such as TNF inhibitors has been confirmed.…”

“…8 While in both diseases, high efficacy of biological DMARD such as TNF inhibitors has been confirmed. 7 . It may be possible that the rarely observed RA and SpA co-existence may be more prevalent than it was thought and is actually missed and/or unrecognized.…”