Ultrasonographic Assessment of Enthesitis in HLA-B27 Positive Patients with Rheumatoid Arthritis, a Matched Case-Only Study

Varela, A. Mera; Ferreiro-Iglesias, Aida; Pérez‐Pampín, Eva; Porto-Silva, Marisol; Gómez-Reino, Juan J.; González, Antonio

doi:10.1371/journal.pone.0058616

Cited by 14 publications

(4 citation statements)

References 42 publications

(73 reference statements)

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“…Certain types of HLA antigens are more frequent in some diseases. Studies on patients with rheumatic diseases can be given as examples (12,13). Osteoarticular involvement is a frequent and treatable complication of brucellosis.…”

Section: Discussionmentioning

confidence: 99%

Investigation of human leukocyte antigen in osteoarticular brucellosis

Gönen¹,

Dizbay²,

Söylemezoğlu³

2017

Turk J Med Sci

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Background/aim: To determine the relationship between human leukocyte antigen (HLA) antigens and osteoarticular brucellosis by evaluating HLA Class I and II antigens in control subjects and patients developing osteoarticular brucellosis in Turkey. Materials and methods:The study included 28 patients with osteoarticular involvement diagnosed with brucellosis and 100 controls. The HLA Class I and II antigens were studied in isolated DNA samples using sequence-specific oligonucleotide procedure. Results:The mean age of the 28 patients and 100 controls was 42.3 ± 20.2 years and 50.1 ± 16.3 years, respectively. When the frequency of HLA Class I was examined, HLA-A*02 and HLA-B*27 antigens were detected in 50% and 28.57% of the patients, respectively. However, there was no significant difference when compared to the control group. Among the HLA Class I antigens, HLA-Cw*10 was determined in 35.71% of the patients and 17% of the controls; the difference was significant (P = 0.039). Conclusion:In the development of brucellosis, the frequency of HLA-Cw*10 among HLA Class I antigens was observed to be increased, and HLA-Cw*10 was considered likely to cause predisposition to brucellosis. Further studies to be performed on a higher number of patients and controls could demonstrate that genetic factors play a role in the diagnosis of osteoarticular brucellosis.

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Section: Discussionmentioning

confidence: 99%

Investigation of human leukocyte antigen in osteoarticular brucellosis

Gönen¹,

Dizbay²,

Söylemezoğlu³

2017

Turk J Med Sci

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“…The research by Toussirot et al [ 4 ] shows that 6.6% of patients with RA may have positive HLA-B27, which is comparable to the general population, wherein the expression of this antigen is 5–8%. The presence of HLA-B27 in patients with RA does not increase the incidence of enthesitis or sacroiliac joint inflammation [ 4 , 8 , 9 ]. The percentage of people with positive HLA-B27 who can develop AS did not exceed 5%, whereas this antigen is detected in up to 90–95% of Caucasians suffering from AS [ 1 ].…”

Section: Discussionmentioning

confidence: 99%

Coexistence of rheumatoid arthritis and ankylosing spondylitis

Barczyńska¹,

Węgierska²,

Żuchowski

et al. 2015

Reumatologia

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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.

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“…Subsequent studies by other investigators regarding the specificity of these imaging findings, reviewed recently by Paramarta, et al 10 , yielded conflicting results. Additional support for the importance of enthesitis in SpA pathology indicated that HLA-B27+ patients with plantar fasciitis demonstrated more severe bone pathology (bone marrow edema) than HLA-B27-negative patients 11 ; and in an ultrasound assessment of patients with established RA, the presence of HLA-B27 alleles was not associated with increased prevalence of enthesitis, suggesting that additional factors, not observed in this population, are required for the enthesis phenotype to be expressed 12 .…”

Section: Enthesitis: a Cardinal Event In Psoriatic Arthritis?mentioning

confidence: 95%

Psoriatic Enthesitis: An Update from the GRAPPA 2013 Annual Meeting

Ritchlin

2014

J Rheumatol

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The enthesis, attachment site of ligaments, tendons, and joint capsules to bone, has emerged as a complex structure or entheseal organ that dissipates stress to maintain homeostasis. Entheses are also anatomically and functionally integrated with adjacent bursa, fibrocartilage, and synovium in a synovial entheseal complex that may trigger inflammation in response to biomechanical stress. Recent studies have suggested that inflammation in psoriatic arthritis (PsA) arises in the enthesis based on imaging and anatomical data. In this review, the anatomy of the enthesis from a functional perspective is discussed, and the data that support a central role for enthesitis in PsA are outlined. In addition, new animal models that implicate Th17 and tumor necrosis factor pathways in enthesitis are highlighted along with new data that question the primacy of the enthesis in the early stages of PsA. Finally, future studies that incorporate new technologies are outlined. Those studies may address the contribution of entheseal inflammation to initiation and perpetuation of key pathophysiologic pathways in the psoriatic joint.

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Ultrasonographic Assessment of Enthesitis in HLA-B27 Positive Patients with Rheumatoid Arthritis, a Matched Case-Only Study

Cited by 14 publications

References 42 publications

Investigation of human leukocyte antigen in osteoarticular brucellosis

Investigation of human leukocyte antigen in osteoarticular brucellosis

Coexistence of rheumatoid arthritis and ankylosing spondylitis

Psoriatic Enthesitis: An Update from the GRAPPA 2013 Annual Meeting

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