Abstract

KOKUINA, Elena et al. Primary ankylosing spondylitis: clinical patterns in Cuban patients. Rev cubana med [online]. 2007, vol.46, n.1. ISSN 0034-7523.

70 patients with diagnosis of primary ankylosing spondylitis, according to the modified criteria of New York, were retrospectively studied aimed at investigating its clinical patterns in Cuban patients. The demographic, clinical and radiological data were compared by sex , race, age at the onset of AS, and status of the HLA-B27 antigen. There was a predominance of males (80.0 %), of individuals of the Caucasian race (82.90 %), of onset of the ankylosing spondylitis at adulthood (90.0 %), and of positive HLA-B27 (90.0 %). The familiy histories of AS were registered in 17.1 % of the patients. The pure axial affection was observed in 4.3 %, enthesopathy in 81.4 %, and peripheral arthritis in 58.6 %. The anterior severe uveitis was the most frequent extraarticular manifestation (17.1 %). The male sex was associated with aortic failure and the female sex with fibromyalgia (p=0.11). Sex was also associated with the location of the patients. Males came from urban areas, and females from rural areas (p=0.001). The non-Caucasian race differently from the Caucasian, was subjected to total hip replacement (p=0.027). Those patients with AS of juvenile onset presented peripheral arthirits more frequently (p=0.019), and needed total hip replacement (p =0.003). Bilateral grade 3 and 4 sacro-illitis (p = 0,009), low back pain (p=0.023), and enthesopathy were more common in the patients positive for HLA-B27 than in the patients negative for this allele. The time of duration of AS was also longer (8.1 y 3.6 years, p=0.021). It was concluded that the male sex marked differences in the extraarticular manifestations of AS, the Caucasian and the non-Caucasian races presented similar clinical manifestations, the juvenile onset of AS was characterized by peripheral arthritis, and that the presence of HLA-B27 antigen was associated with axial manifestations and enthesopathy.

Keywords : Ankylosing spondylitis; clinical patterns; HLA-B27 antigen..