Coexistence of Takayasu’s arteritis and ankylosing spondylitis may not be accidental – Is there a need for a new subgroup in the spondyloarthritis family?

Abstract

Aortitis of ascending aorta is a recognized complication of ankylosing spondylitis (AS). There are a few published cases of diffuse aortitis and aorta collaterals inflammation that fulfill Takayasu's arteritis (TA) criteria coexisting with AS. We have reviewed published cases from literature and present three new cases of such coexistence. We identified three patients who fulfilled definite AS New York criteria in our Takayasu's vasculitis cohort of eight patients. One of this patients had been diagnosed with Crohn's disease before AS and TA diagnosis. Additionally, two other patients had an inflammatory back pain and suffered of chronic uveitis. One of them had increased sacroiliac uptake of isotope in scintigraphy. Those two patients did not fulfil spondyloarthritis criteria. In this paper, we debate if TA type arteritis might be one of the AS cardiovascular complications.

A case of ankylosing spondylitis with concurrent Takayasu arteritis

“…Although relatively rare, in patients in whom both diseases coexist, AS most commonly precedes TA and the age at TA onset is somewhat advanced. In their investigation of 23 concurrent cases of SpA, including AP and TA, Mielnik et al 25 determined that most patients were male (male:female ratio, 14:9), 8 of 17 patients (47%) who underwent testing were positive for HLA-B27, and concomitant inflammatory bowel disease was diagnosed in 2 patients (8.7%). In 22 of the 23 patients, SpA preceded TA (mean duration, 6 years), and a glucocorticoid was administered to all patients except one in whom tumor necrosis factor blockers were administered before TA onset.…”

Takayasu Arteritis

“…Spondyloarthritis (SpA) is not commonly associated with TA, but several case reports are evident in the literature. 8,9 The majority saw patients with SpA later developing signs of TA. Although aortitis is a known association of anklylosing spondylitis, these cases demonstrate more widespread large vessel disease.…”

“…Spondyloarthritis (SpA) is not commonly associated with TA, but several case reports are evident in the literature 8,9 . The majority saw patients with SpA later developing signs of TA.…”

Response to: ‘Comment on ‘Successful remission with tofacitinib in a patient with refractory Takayasu arteritis complicated by ulcerative colitis’ by Kuwabaraet al’ by Rios Rodriguezet al

“…3 As Rios Rodriguez et al mentioned, some population of TAK has the overlapped features with spondyloarthritis. 4 It is not unexpected if JAK inhibitors are effective in the population of TAK. But, it is unclear if JAK inhibitors are broadly useful in patients with TAK due to the heterogeneity of the disease.…”