Rheumatology International

, Volume 32, Issue 2, pp 357–360 | Cite as

Relationship between diagnosis delay and disease features in Moroccan patients with ankylosing spondylitis

  • Yousra Ibn Yacoub
  • Bouchra Amine
  • Assia Laatiris
  • Rachida Bensabbah
  • Najia Hajjaj-Hassouni
Original Article

Abstract

We aimed to evaluate diagnosis delay and its impact on disease in terms of activity, functional disability, and radiographic damage in Moroccan patients with ankylosing spondylitis (AS). We recruited 100 Moroccan patients who fulfilled New York Classification criteria for AS. Diagnosis delay was defined as the interval between the first symptom of AS and the moment of a correct diagnosis. Disease activity was evaluated by the bath ankylosing spondylitis disease activity index (BASDAI), functional status by the bath ankylosing spondylitis functional index (BASFI), and radiographic damage by the bath ankylosing spondylitis radiologic index (BASRI). Measurements of spinal mobility were assessed. The average age at disease onset was 28.56 ± 10.9 years. Of the patients, 16% had juvenile-onset AS. Disease duration was 9.5 ± 6.8 years, and the average of diagnosis delay was 4.12 ± 3.99 years. There were no differences in diagnosis delay according to the age at onset, educational level, or the presence of extra-articular involvement. Our patients had altered functional ability. Patients with late diagnosis (>5 years) had statistically significant higher structural damage (BASRI) and severe limited spinal mobility. There was no correlation between diagnosis delay and the activity of disease. Few studies focused on diagnostic delay and its impact in patients with AS. It is necessary in our context to establish an early diagnosis taking into account the high frequency of severe functional disability in Moroccan AS.

Keywords

Diagnosis delay Ankylosing spondylitis Function Activity Mobility Radiographic damage 

References

  1. 1.
    Dincer U, Cakar E, Kiralp MZ, Dursun H (2008) Diagnosis delay in patients with ankylosing spondylitis: possible reasons and proposals for new diagnostic criteria. Clin Rheumatol 27(4):457–462PubMedCrossRefGoogle Scholar
  2. 2.
    Khan MA (2002) Ankylosing spondylitis: introductory comments on its diagnosis and treatment. Ann Rheum Dis 61(3):3–7Google Scholar
  3. 3.
    Davis JC, Dougados M, Braun J, Sieper J, van der Heijde D, van der Linden S (2006) Definition of disease duration in ankylosing spondylitis: reassessing the concept. Ann Rheum Dis 65(11):1518–1520PubMedCrossRefGoogle Scholar
  4. 4.
    Van Den Bosch F, Kruithof E, Baeten D, Herssens A, de Keyser F, Het Mielants et al (2002) Randomized double-blind comparison of chimeric monoclonal antibody to tumor necrosis factor alpha (infliximab) versus placebo in active spondylarthropathy. Arthritis Rheum 46(3):755–765CrossRefGoogle Scholar
  5. 5.
    Brandt J, Khariouzov A, Listing J, Haibel H, Sorensen H (2003) Grassnickel Letal. Six-month results of a double-blind, placebo-controlled trial of etanercept treatment in patients with active ankylosing spondylitis. Arthritis Rheum 48(6):1667–1675PubMedCrossRefGoogle Scholar
  6. 6.
    Aggarwal R, Malaviya AN (2009) Diagnosis delay in patients with ankylosing spondylitis: factors and outcomes–an Indian perspective. Clin Rheumatol 28(3):327–331PubMedCrossRefGoogle Scholar
  7. 7.
    El Mansouri L, Bahiri R, Abourazzak FZ, Abouqal R, Hajjaj-Hassouni N (2009) Two distinct patterns of ankylosing spondylitis in Moroccan patients. Rheumatol Int 29:1423–1429PubMedCrossRefGoogle Scholar
  8. 8.
    Moll JM (1987) New criteria for the diagnosis of ankylosing spondylitis. Scand J Rheumatol Suppl 65:12–24PubMedCrossRefGoogle Scholar
  9. 9.
    Rostom S, Benbouazza K, Amine B, Bahiri R, Lazrak N, Abouqal R, Guillemin F, Hajjaj-Hassouni N (2009) Psychometric evaluation of the Moroccan version of the Bath ankylosing spondylitis functional index (BASFI) and Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) for use in patients with ankylosing spondylitis. Clin Rheumatol (in press)Google Scholar
  10. 10.
    Haywood KL, Garratt AM, Jordan K, Dziedzic K, Dawes PT (2004) Spinal mobility in ankylosing spondylitis: reliability, validity and responsiveness. Rheumatol 43:750–757CrossRefGoogle Scholar
  11. 11.
    Kaya T, Gelal F, Gunaydin R (2006) The relationship between severity and extent of spinal involvement and spinal mobility and physical functioning in patients with ankylosing spondylitis. Clin Rheumatol 25:835–839PubMedCrossRefGoogle Scholar
  12. 12.
    Dernis-Labous E, Messow M, Dougados M (2003) Assessment of fatigue in the management of patients with ankylosing spondylitis. Rheumatology 42:1523–1528PubMedCrossRefGoogle Scholar
  13. 13.
    Kidd BL, Cawley MI (1988) Delay in diagnosis of spondarthritis. Br J Rheumatol 27(3):230–232PubMedCrossRefGoogle Scholar
  14. 14.
    Feldtkeller E, Erlendsson J (2008) Definition of disease duration in ankylosing spondylitis. Rheumatol Int 28(7):693–696PubMedCrossRefGoogle Scholar
  15. 15.
    Liao Z, Gu J, Huang F, Lin Z, Zhao L, Yu B (2009) Verification of Berlin algorithm for diagnosing undifferentiated spondyloarthropathy patients in Chinese population. Joint Bone Spine 76(2):146–149PubMedCrossRefGoogle Scholar
  16. 16.
    Rudwaleit M, van der Heijde D, Khan MA et al (2004) How to diagnose axial spondyloarthropathies early. Ann Rheum Dis 63:535–543PubMedCrossRefGoogle Scholar
  17. 17.
    Stone M, Warren RW, Bruckel J, Cooper D, Cortinovis D, Inman RD (2005) Juvenile-onset ankylosing spondylitis is associated with worse functional outcomes than adult-onset ankylosing spondylitis. Arthritis Rheum 53(3):445–451PubMedCrossRefGoogle Scholar
  18. 18.
    Rudwaleit M, Listing J, Brandt J, Braun J, Sieper J (2004) Prediction of a major clinical response (BASDAI 50) to tumour necrosis factor alpha blockers in ankylosing spondylitis. Ann Rheum Dis 63(6):665–670PubMedCrossRefGoogle Scholar
  19. 19.
    Gorman JD, SackK E, Davis JC Jr (2002) Treatment of ankylosing spondylitis by inhibition of tumor necrosis factor alpha. N Engl J Med 346(18):1349–1356PubMedCrossRefGoogle Scholar
  20. 20.
    Ward MM, Reveille JD, Learch TJ, Davis JC Jr, Weisman MH (2008) Occupational physical activities and long-term functional and radiographic outcomes in patients with ankylosing spondylitis. Arthritis Rheum 59(6):822–832PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag 2010

Authors and Affiliations

  • Yousra Ibn Yacoub
    • 1
  • Bouchra Amine
    • 1
  • Assia Laatiris
    • 1
  • Rachida Bensabbah
    • 1
  • Najia Hajjaj-Hassouni
    • 1
  1. 1.Department of Rheumatology (Pr N. Hajjaj-Hassouni), El Ayachi HospitalUniversity Hospital of Rabat-SaleSaleMorocco

Personalised recommendations