Abstract
This retrospective study analyzed 350 patients with the diagnosis of spondyloarthropathies (SPA) (207 with ankylosing spondylitis (AS), 80 with undifferentiated spondyloarthropathies (USPA) and 63 with psoriatic arthritis (PsA)) attended at a tertiary referral hospital for a minimum period of 5 years. All the patients presented complete clinical (axial and peripheral involvement, heel enthesopathies, extra-articular manifestations) and radiologic (sacroiliac, lumbar, dorsal and cervical spine) evaluation. HLA-B27 and respective alleles were searched. These data were compared with the occurrence of uveitis during the follow-up of the SPA patients. Thirty AS patients (14.5%) presented 55 episodes of acute anterior uveitis; there was statistical association between uveitis and juvenile-onset AS (P = 0.0094) and achillean (P = 0.0003) and plantar (P = 0.0067) enthesopathies; one AS patient presented a single episode of posterior uveitis, associated to tuberculosis. Seven USPA patients (8.8%) presented 13 episodes of acute anterior uveitis; it was not observed statistical association with any variable; one patient presented a single episode of posterior uveitis, associated to toxoplasmosis. Five HLA-B27 positive PsA patients (8%) presented 13 episodes of acute anterior uveitis. All the 26 positive HLA-B27 SPA patients with anterior uveitis tested for the HLA-B27 alleles were HLA-B*2705. No patient presented ophthalmologic severe sequelae of the anterior uveitis. Concluding, anterior uveitis was associated to the juvenile onset of the disease and to the enthesophatic involvement of the lower limbs in AS patients. The HLA-B*2705 allele was predominant in the anterior uveitis patients, whilst posterior uveitis was rare and associated to infectious disease.
Similar content being viewed by others
References
Hamideh F, Prete PE (2001) Ophthalmologic manifestations of rheumatic diseases. Semin Arthritis Rheum 30:217–241
Rosenbaum JT (1990) An algorithm for the systemic evaluation of patients with uveitis: guidelines for the consultant. Semin Arthritis Rheum 19:248–257
Rothova A, Buitenhuis HJ, Meenken C, et al (1992) Uveitis and systemic disease. Br J Ophthalmol 76:137–141
McCannel CA, Holland GN, Helm CJ, et al (1996) Causes of uveitis in the general practice of ophthalmology. Am J Ophthalmol 121:35–46
Tay-Kearney ML, Schwam BL, Lowder C, et al (1996) Clinical features and associated systemic diseases of HLA-B27 uveitis. Am J Ophthalmol 121:47–56
Bañares A, Jover JA, Fernández-Gutiérrez B, et al (1997) Patterns of uveitis as a guide in making rheumatologic and immunologic diagnoses. Arthritis Rheum 40:358–370
Kotaniemi K, Aho K, Kotaniemi A (2001) Uveitis as a cause of visual loss in arthritides and comparable conditions. J Rheumatol 28:309–312
Bañares A, Hernández-Garcia C, Fernández-Gutiérrez B, Jover JA (1998) Eye involvement in the spondyloarthropathies. Rheum Dis Clin North Am 24:771–784
Khan MA (1998) Ankylosing spondylitis: clinical aspects. In: Calin A, Taurog JD (eds) The spondylarthritides. Oxford University Press, Oxford, pp 27–40
Rosenbaum JT (1992) Acute anterior uveitis and spondyloarthropathies. Rheum Dis Clin North Am 18:143–151
Martin TM, Smith JR, Rosenbaum JT (2002) Anterior uveitis: current concepts of pathogenesis and interactions with the spondyloarthropathies. Curr Opin Rheumatol 14:337–431
Linssen A, Meenken C (1995) Outcomes of HLA-B27-positive and HLA-B27-negative acute anterior uveitis. Am J Ophthalmol 120:351–361
Konno Y, Numaga J, Tsuchiya N, et al (1999) HLA-B27 subtypes and HLA class II alleles in Japanese patients with anterior uveitis. Invest Ophthalmol Vis Sci 40:1838–1844
Islam SMM, Numaga J, Fujino Y, et al (1995) HLA-DR8 and acute anterior uveitis in ankylosing spondylitis. Arthritis Rheum 38:547–550
Paiva ES, Macaluso DC, Edwards A, Rosenbaum JT (2000) Characterisation of uveitis in patients with psoriatic arthritis. Ann Rheum Dis 59:67–70
Queiro R, Torre JC, Belzunegui J, et al (2002) Clinical features and predictive factors in psoriatic arthritis-related uveitis. Semin Arthritis Rheum 31:264–270
Durrani K, Foster CS (2005) Psoriatic uveitis: a distinct clinical entity? Am J Ophthalm 139:106–111
Pato E, Bañares A, Jover JA, et al (2000) Undiagnosed spondyloarthropathy in patients presenting with anterior uveitis. J Rheumatol 27:2198–2202
Fernández-Melón J, Muñoz-Fernández S, Hidalgo V, et al (2004) Uveitis as the initial clinical manifestation in patients with spondyloarthropathies. J Rheumatol 31:524–527
Linder R, Hoffmann A, Brunner R (2004) Prevalence of the spondyloarthritides in patients with uveitis. J Rheumatol 31:2226–2229
Van der Linden S, Valkenburg HA, Cats A (1984) Evaluation of diagnostic criteria for ankylosing spondylitis: a proposal for modification of the New York criteria. Arthritis Rheum 27:361–368
Moll JMH, Wright V (1973) Psoriatic arthritis. Semin Arthritis Rheum 3:55–78
Dougados M, van der Linden S, Juhlin R, et al (1991) The European spondylarthropathy study group preliminary criteria for the classification of spondylarthropathy. Arthritis Rheum 34:1218–1217
Amor B, Dougados M, Mijiyawa M (1990) Criteria of the classification of spondylarthropathies [French]. Rev Rhum 57:85–89
Sampaio-Barros PD, Bértolo MB, Kraemer MHS, Marques Neto JF, Samara AM (2001) Primary ankylosing spondylitis: patterns of disease in a group of 147 Brazilian patients. J Rheumatol 28:560–565
Khan MA (2002) Update on spondyloarthropathies. Ann Intern Med 136:896–907
Reveille JD, Ball EJ, Khan MA (2001) HLA-B27 and genetic predisposing factors in spondyloarthropathies. Curr Opin Rheumatol 13:265–272
Gonzalez S, Garcia-Fernandez S, Martinez-Borra J, et al (2002) High variability of HLA-B27 alleles in ankylosing spondylitis and related spondyloarthropathies in the population of northern Spain. Hum Immunol 63:673–676
Conde RA, Sampaio-Barros PD, Donadi EA, et al (2003) Frequency of the HLA-B27 alleles in Brazilian patients with ankylosing spondylitis. J Rheumatol 30:2611–2612
Zeidler H, Mau W, Khan MA (1992) Undifferentiated spondyloarthropathies. Rheum Dis Clin North Am 18:187–202
Sampaio-Barros PD, Bertolo MB, Kraemer MHS, Marques Neto JF, Samara AM (2001) Undifferentiated spondyloarthropathies: a 2-year follow-up. Clin Rheumatol 20:201–206
Smith JR, Rosenbaum JT (2002) Management of uveitis. A rheumatologic perspective. Arthritis Rheum 46:309–318
Dougados M, Berenbaum F, Maetzel A, Amor B (1993) Prévention des épisodes d’úvéite antérieure aigue des spondylarthropathies par la salazosulfapyridine. Rev Rhum 60:81–83
Benitez-del-Castillo JM, Garcia-Sanchez J, Iradier T, Bañares A (2000) Sulfasalazine in the prevention of anterior uveitis associated with ankylosing spondylitis. Eye 14:340–343
Muñoz-Fernández S, Hidalgo V, Fernández-Melón J, et al (2003) Sulfasalazine reduces the number of flares of acute anterior uveitis over a one-year period. J Rheumatol 30:1277–1279
Sampaio-Barros PD, Costallat LTL, Bertolo MB, Marques Neto JF, Samara AM (2000) Methotrexate in the treatment of ankylosing spondylitis. Scand J Rheumatol 29:160–162
Reiff A, Takei S, Sadeghi S, et al (2001) Etanercept therapy in children with treatment-resistant uveitis. Arthritis Rheum 44:1411–1415
Smith JA, Thompson DJS, Whitcup SM, et al (2005) A randomized, placebo-controlled, double-masked clinical trial of etanercept for the treatment of uveitis associated with juvenile idiopathic arthritis. Arthritis Rheum 53:18–23
Braun J, Baraliakos X, Listing J, Sieper J (2005) Decreased incidence of anterior uveitis in patients with ankylosing spondylitis treated with the anti-tumor necrosis factor agents infliximab and etanercept. Arthritis Rheum 52:2447–2451
Acknowledgment
The authors would like to thank Andréia Semolini and Helymar Costa Machado for the statistical analysis of the present study.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Sampaio-Barros, P.D., Conde, R.A., Bonfiglioli, R. et al. Characterization and outcome of uveitis in 350 patients with spondyloarthropathies. Rheumatol Int 26, 1143–1146 (2006). https://doi.org/10.1007/s00296-006-0203-7
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00296-006-0203-7