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Rheumatology International

, Volume 23, Issue 2, pp 61–66 | Cite as

Age at disease onset and diagnosis delay in HLA-B27 negative vs. positive patients with ankylosing spondylitis

  • Ernst Feldtkeller
  • Muhammad Khan
  • Désirée van der Heijde
  • Sjef van der Linden
  • Jürgen Braun
Original Article
  • 1.2k Downloads

Abstract

Objective. To investigate differences between HLA-B27 and HLA-B27+ patients with ankylosing spondylitis (AS).

Methods. A total of 1080 patients with AS responded to a questionnaire containing 30 questions; 945 (87.5%) knew their HLA-B27 status, 10% of them being B27.

Results. The average age at disease onset was 27.7 years in B27 and 24.8 years in B27+ AS (P<0.01). The average age at diagnosis was 39.1 and 33.2 years and the average diagnosis delay 11.4 and 8.5 years, respectively. The distribution in age at disease onset was significantly wider in B27 (standard deviation 10.0 years) than in B27+ AS (8.3 years). The percentages with childhood (age <16 years) disease onset did not differ significantly (7.6% vs. 6.2%, respectively), whereas the percentage of late onset (age >40 years) was significantly greater among B27 (13%) than among B27+ (5%) patients with AS. There is a difference in average age at disease onset between male (25.7 years) and female (24.2 years) AS patients, and no difference between patients with primary AS and AS associated with psoriasis, inflammatory bowel disease, or reactive arthritis. Acute anterior uveitis was significantly less frequent in B27 (26%) than in B27+ (41%) patients with AS.

Conclusions. This study of a much larger number of B27 AS patients than have been studied previously confirms earlier reports indicating a significantly older average age at disease onset and a less frequent prevalence of acute anterior uveitis in B27 than in B27+ AS. The frequency of late disease onset (after 40 years of age) is significantly higher in B27 AS. We provide the first report on significant differences in the distribution curves for the age at disease onset and for the age at diagnosis between B27and B27+ patients with AS. The average delay between the first spondyloarthritic symptoms and the diagnosis is significantly longer in B27 than in B27+ AS. The frequency of juvenile disease onset (before age 16 years) is nearly the same, irrespective of the B27 status.

Ankylosing spondylitis HLA-B27 Age at disease onset Age at diagnosis 

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Copyright information

© Springer-Verlag 2003

Authors and Affiliations

  • Ernst Feldtkeller
    • 1
  • Muhammad Khan
    • 2
  • Désirée van der Heijde
    • 3
  • Sjef van der Linden
    • 3
  • Jürgen Braun
    • 4
  1. 1.Ankylosing Spondylitis International Federation, Michaeliburgstraße 15, 81671 Munich, Germany
  2. 2.Case Western Reserve University, MetroHealth Medical Center, 2500 MetroHealth Drive, Cleveland, OH 44109-1998, USA
  3. 3.Department of Medicine, University Hospital Maastricht, Postbus 5800, 6202 AZ Maastricht, The Netherlands
  4. 4.Rheumazentrum Ruhrgebiet, St.-Josefs-Krankenhaus, Landgrafenstraße 15, 44652 Herne, Germany

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