Summary
We have experienced six patients of juvenile ankylosing spondylitis. Their chief complaints were polyarthralgia or coxalgia, however, any pain or stiffness in lumbar regions was absent. These clinical features were atypical for those of ankylosing spondylitis, and much more like those of a peripheral arthropathy such as juvenile rheumatoid arthritis. After a long-term follow-up, all the patients showed definite clinical features of ankylosing spondylitis. HLA-B27 was found in 4 out of 6 cases. This frequency is almost equal to that of adult ankylosing spondylitis patients. HLA typing was very important in the early diagnosis.
Zusammenfassung
6 jugendliche Patienten mit ankylosierender Spondylitis werden untersucht. Die klinischen Beschwerden bestanden hauptsächlich in einer Polyarthralgie bzw. Coxalgie, aber ohne Schmerzen und Einsteifung im Bereich der Lendenwirbelsäule. Diese klinischen Bilder waren atypisch für ankylosierende Spondylitis und wiesen eher auf eine periphere Arthropathie im Sinne einer juvenilen rheumatoiden Arthritis hin. Nach langfristiger Beobachtung ergaben sich jedoch bei all diesen Patienten eindeutige Hinweise auf ankylosierende Spondylitis. Die HLA-B27 Antigene waren in 4 von 6 Fällen positiv. Diese Häufigkeit entspricht in etwa der bei den Erwachsenen ankylosierenden Spondylitis. HLA-Bestimmung erscheint daher für die Frühdiagnose sehr wichtig.
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Mitsui, H., Juji, T. & Sonozaki, H. Juvenile ankylosing spondylitis, its clinical features and HLA-B27. Arch orthop Unfall-Chir 87, 31–37 (1977). https://doi.org/10.1007/BF00416137
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DOI: https://doi.org/10.1007/BF00416137