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Acute anterior uveitis and undiagnosed spondyloarthritis: usefulness of Berlin criteria

  • Inflammatory Disorders
  • Published:
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Abstract

Purpose

Inflammatory back pain, the main symptom in spondyloarthritis, is defined by the presence of two or more positive responses among the four items of Berlin Criteria. This study assesses the value of these criteria in detecting previously undiagnosed spondyloarthritis after an episode of acute anterior uveitis.

Methods

Records of patients addressed for etiological diagnosis after an acute anterior uveitis (April 2006 to November 2013) were retrospectively analysed. Patient characteristics, the presence of back pain, Berlin Criteria, the final diagnosis, and the ASAS classification criteria for spondyloarthritis were collected and analysed.

Results

The study included 102 patients (59.8 % women). The mean age was 44.5 years. Uveitis cases were mainly unilateral (73.5 %) and recurrent (58.8 %). Twenty-one patients had some type of spondyloarthritis, 20 fulfilling retrospectively the ASAS criteria. Back pain with at least two positive items from Berlin Criteria was 61.9 % sensitive and 97.5 % specific in diagnosing spondyloarthritis. Considering only one positive item increased the sensitivity (90.5 %) but decreased the specificity (91.4 %).

Conclusions

Acute anterior uveitis may be the key symptom that reveals a formerly undiagnosed spondyloarthritis. A referral to a rheumatologist should be considered in presence of back pain, even without fulfilment of the classical definition with Berlin Criteria.

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Competing interest

The authors declare no competing interests.

Financial support

Study performed at Hospices Civils de Lyon, Quai des Célestins, 69288 Lyon Cedex 02, France. No financial support.

Author information

Authors and Affiliations

  1. Université Claude Bernard Lyon I, Lyon, France

    Jean Wach, Delphine Maucort-Boulch, Laurent Kodjikian, Jean Iwaz, Christiane Broussolle & Pascal Sève

  2. Rheumatology Department, Centre Hospitalier Lyon-Sud, Hospices Civils de Lyon, Pierre-Bénite, France

    Jean Wach

  3. Service de Biostatistique, Hospices Civils de Lyon, Lyon, France

    Delphine Maucort-Boulch & Jean Iwaz

  4. CNRS, UMR5558, Laboratoire de Biométrie et Biologie Evolutive, Equipe Biostatistique-Santé, 69100, Villeurbanne, France

    Delphine Maucort-Boulch & Jean Iwaz

  5. Ophthalmology Department, Hôpital de la Croix-Rousse, Hospices Civils de Lyon, Lyon, France

    Laurent Kodjikian

  6. Internal Medicine Department, Hôpital de la Croix-Rousse, Hospices Civils de Lyon, 103 Grande Rue de la Croix-Rousse, 69317, Lyon, Cedex 04, France

    Christiane Broussolle & Pascal Sève

Authors
  1. Jean Wach
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  2. Delphine Maucort-Boulch
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  3. Laurent Kodjikian
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  4. Jean Iwaz
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  5. Christiane Broussolle
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  6. Pascal Sève
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Corresponding author

Correspondence to Pascal Sève.

Additional information

Preliminary results of this study were presented during the 66th congress of the French Society of Internal Medicine (Nice, December 2012) and during the 119th congress of the French Society of Ophthalmology (Paris, May 2013)

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Wach, J., Maucort-Boulch, D., Kodjikian, L. et al. Acute anterior uveitis and undiagnosed spondyloarthritis: usefulness of Berlin criteria. Graefes Arch Clin Exp Ophthalmol 253, 115–120 (2015). https://doi.org/10.1007/s00417-014-2772-6

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  • DOI: https://doi.org/10.1007/s00417-014-2772-6

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