Skip to main content
Log in

HLA-B27 positive ankylosing spondylitis and polyarteritis nodosa: a case report

  • Case Report
  • Published:
Clinical Rheumatology Aims and scope Submit manuscript

Summary

A35-year-old man, with positive HBV and HCV markers, showed clinical and histopathological features of polyarteritis nodosa (PAN), in the course of HLA-B27 positive ankylosing spondylitis (AS). The possible occurrence of both diseases in genetically susceptible subjects is discussed.

Although the role of HBV surface antigen in the pathogenesis of PAN is well established, there is still a large proportion of PAN patients with no evidence of HBV infection. In the present case, the coexistence of HCV infection led us to speculate about a possible role of this virus in the pathogenesis of PAN.

In our case we were able to verify the sensitivity of single photon emission computed tomography (SPECT) in the diagnosis and the clinical evaluation of the ischaemic cerebral lesions.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Brewerton, D.A., Caffrey, M., Hart, F.D., James, D.C.O., Nicholls, A., Sturroch, R.D. Ankylosing spondylitis and HLAB27. Lancet 1973,1, 904–7.

    Article  PubMed  Google Scholar 

  2. Gezy, A.F., Alexander, K., Bashir, H.V. A factor(s) in klebsiella filtrates specifically modifies an HLA-B27-associated cell surface component. Nature 1980, 283, 782–84.

    Article  PubMed  Google Scholar 

  3. Schwimmbeck, P.L., Yu, D.T.Y., Oldstone, M.B.A. Autoantibodies to HLA-B27 in the sera of HLAB27 patients with ankylosing spondylitis and Reiter's syndrome; molecular mimicry with klebsiella pneumoniae as potential mechanism of autoimmune disease. J Exp Med 1987, 166, 173–81.

    Article  PubMed  Google Scholar 

  4. Conn, L.D., Hunder, G.G., O'Duffy, J.D. Vasculitis and related disorders. In: Textbook of Rheumatology IVth. edition. Eds.: Kelley, W.N., Harris, E.D., Ruddy, S.S., Sledge, C.B. WB Saunders Company 1993, 1077–202.

  5. Leib, E.S., Restivo, C., Paulus, H.E. Immunosuppressive and corticosteroid therapy of periarteritis nodosa. Am J Med 1979, 67, 941–7.

    Article  PubMed  Google Scholar 

  6. Adu, D., Luqmani, R.A., Bacon, P.A. Polyarteritis, Wegener's granulomatosis and Churg-Strauss syndrome. In: Oxford Textbook of Rheumathology. Eds.: Maddisson, P.J., Isemberg, D.A., Woo, P., Glass, D.N. Oxford University Press 1993, 846–59.

  7. Sattar, M.A. Coexisting HLA-B27 positive spondyloarthritis and polyarteritis nodosa. Ann Rheum Dis 1992, 51, 1338–39.

    PubMed  Google Scholar 

  8. Ball, G.V., Hathaway, B. Ankylosing spondylitis with widespread arteritis. Arthritis Rheum 1966, 9, 1014–27.

    Google Scholar 

  9. Van der Linden, S.M., Valkemburg, H.A., Cats, A. Evaluation of diagnostic criteria for ankylosing spondylitis. A proposal for modifications of the New York criteria. Arthritis Rheum 1984, 27, 361

    PubMed  Google Scholar 

  10. Lightfoot, R.W., Mikel, B.A., Bloch, D.A. et al. The American College of Rheumatology 1990 Criteria for the classification of polyarteritis nodosa. Athritis Rheum 1990, 33, 1088–93.

    Google Scholar 

  11. Ferri, C., Greco, F., Longobardo, G. et al. Hepatitis C virus antibodies in mixed cryoglobulinemia patients. Arthritis Rheum 1991, 34, 1606–10.

    PubMed  Google Scholar 

  12. Disdier, P., Harlé, J.R., Vailler, P.J. Cryoglobulinemia and hepatitis C infection. Lancet 1991, 338, 1151–2.

    Article  Google Scholar 

  13. Szer, I.S., Miller, J.H., Rawling, D., Shaham, B., Bernstein, B. Cerebral perfusion abnormalities in children with central nervous system manifestations of lupus detected by single photon emission computed tomography. J Rheumatol 1993, 20, 2143–8.

    PubMed  Google Scholar 

  14. Nossent, J.C., Hovestadt, A., Schonfeld, D.H.V., Swaak, A.J.G. SPECT of the brain in the evaluation of cerebral lupus. Arthritis Rheum 1991, 34, 1397–403

    PubMed  Google Scholar 

  15. Carbotte, R.M., Denburg, S.D., Garnett, S., Nahmias, C., Firnau, G., Denburg, J.A. Positron emission tomography of the brain and neurocognitive function in SLE. Arthritis Rheum 1988, (suppl 4) 31, S56.

Download references

Author information

Authors and Affiliations

Authors

Rights and permissions

Reprints and permissions

About this article

Cite this article

Galeazzi, M., Fioravanti, A., Minari, C. et al. HLA-B27 positive ankylosing spondylitis and polyarteritis nodosa: a case report. Clin Rheumatol 15, 204–206 (1996). https://doi.org/10.1007/BF02230343

Download citation

  • Received:

  • Accepted:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF02230343

Key words

Navigation