Información de la revista
Vol. 1. Núm. 1.
Páginas 25-31 (mayo - junio 2005)
Compartir
Compartir
Descargar PDF
Más opciones de artículo
Vol. 1. Núm. 1.
Páginas 25-31 (mayo - junio 2005)
Revisión
Acceso a texto completo
Manifestaciones extraarticulares y complicaciones de la espondiloartritis anquilosante
Extra-articular manifestations and complications of ankylosing spondylitis
Visitas
47972
J. Gratacós
Autor para correspondencia
JGratacos@cspt.es

Correspondencia: Dr. J. Gratacós. Unidad de Reumatología. Hospital de Sabadell. Institut Universitari Parc Taulí. (UAB). Parc Taulí, s/n. 08208 Sabadell. Barcelona. España.
Unidad de Reumatología. Hospital de Sabadell. Institut Universitari Parc Taulí. Universidad Autónoma de Barcelona. Sabadell. Barcelona. España
Este artículo ha recibido
Información del artículo
Resumen
Bibliografía
Descargar PDF
Estadísticas

Como manifestaciones extraarticulares podrían entenderse todos aquellos signos y síntomas que, originándose en órganos y tejidos deferentes al aparato locomotor se hallan, al menos en parte, relacionados etiopatogénicamente con la espondilitis anquilosante (EA). Así, en este apartado se incluirían las manifestaciones oculares, intestinales y cardíacas communes a todas las enfermedades de la familia de las espondiloartritis a través de su asociación con el HLAB27. Las complicaciones por su parte incluirían aquellas manifestaciones clínicas que son más bien secuelas, fruto de la actividad espondilítica persistente y/o del tratamiento. En la tabla 1 se expone el listado y las principales características de todas ellas. Evidentemente, esta clasificación no es perfecta, pues entre otras cosas, el conocimiento que tenemos sobre la etiopatogenia de la EA es aún bastante limitado.

Palabras clave:
Manifestaciones extraarticulares
Espondilitis anquilosante
Espondiloartritis

Extra-articular manifestations can be defined as all symptoms and signs etiopathogenically related, at least in part, to ankylosing spondylitis (AS) that arise in the various organs and tissues of the locomotor apparatus. Thus, ocular, intestinal and cardiac manifestations, which are common to all spondylarthritides through their association with HLA-B27, are grouped under this heading. Complications include clinical manifestations that result from persistent spondylitic activity and/or treatment. Table 1 provides a list and the main characteristics of these manifestations. Obviously, this classification is far from perfect since, among other factors, knowledge of the etiopathogenesis of AS is still fairly limited.

Key words:
Extra-articular manifestations
Ankylosing spondylitis
Spondylarthritides
El Texto completo está disponible en PDF
Bibliografía
[1.]
A. Banares, C. Hernández-García, B. Fernández-Gutiérrez, J.A. Jover.
Eye involvement in the spondyloarthropathies.
Rheum Dis Clin North Am, 24 (1998), pp. 771-784
[2.]
S.M. Van der Linden, H.U. Rentsch, N. Gerber, A. Cats, H.A. Valkenburg.
The association between ankylosing spondylitis, acute anterior uveitis and HLA-B27: the results of a Swiss family study.
Br J Rheumatol, 27 (1988), pp. 39-41
[3.]
A.B. Beckingsale, J. Davies, J.M. Gibson, A.R. Rosenthal.
Acute anterior uveitis, ankylosing spondylitis, back pain, and HLA-B27.
Br J Ophthalmol, 68 (1984), pp. 741-745
[4.]
J.R. Smith.
HLA B-27 associated uveitis.
Ophtalmol Clin North AM, 15 (2002), pp. 297-307
[5.]
S. Muñoz-Fernández, V. Hidalgo, J. Fernández-Melón, A. Schlincker, G. Bonilla, D. Ruiz-Sancho, et al.
Sulfasalazine reduces the number of flares of acute anterior uveitis over a one-year period.
J Rheumatol, 30 (2003), pp. 1277-1279
[6.]
Y. El-Shabrawi, J. Hermann.
Anti-tumor necrosis factor-alpha therapy with infliximab as an alternative to corticosteroids in the treatment of human leukocyte antigen B27-associated acute anterior uveitis.
Ophthalmology, 109 (2002), pp. 2342-2346
[7.]
J.R. Smith, R.D. Levinson, G.N. Holland, D.A. Jabs, M.R. Robinson, S.M. Whitcup, et al.
Differential efficacy of tumor necrosis factor inhibition in the management of inflammatory eye disease and associated rheumatic disease.
[8.]
L. Bergfeldt.
HLA-B27-associated cardiac disease.
Ann Intern Med, 127 (1997), pp. 621-629
[9.]
P. Davidson, A.H. Baggenstoss, C.H. Slocumb, G.W. Daugherty.
Cardiac and aortic lesions in rheumatoid spondylitis.
Mayo Clin Proc, 38 (1963), pp. 427-435
[10.]
K.A. LaBresh, E.V. Lally, S.C. Sharma, G. Ho Jr.
Two-dimensional echocardiographic detection of preclinical aortic root abnormalities in rheumatoid variant diseases.
Am J Med, 78 (1985), pp. 908-912
[11.]
T.D. Kinsella, L.G. Johnson, R. Ian.
Cardiovascular manifestations of ankylosing spondylitis.
Can Med Assoc J, 111 (1974), pp. 1309-1311
[12.]
D.C. Graham, HA. Smythe.
The carditis and aortitis of ankylosing spondylitis.
Bull Rheum Dis, 9 (1958), pp. 171-174
[13.]
T. Stamato, R.M. Laxer, C. De Freitas, R. Gow, E.D. Silverman, L. Luy, et al.
Prevalence of cardiac manifestations of juvenile ankylosing spondylitis.
Am J Cardiol, 75 (1995), pp. 744-746
[14.]
C.L. Weed, B.G. Kulander, J.A. Massarella, J.L. Decker.
Heart block in ankylosing spondylitis.
Arch Intern Med, 117 (1966), pp. 800-806
[15.]
L. Bergfeldt.
HLA B27-associated rheumatic diseases with severe cardiac bradyarrhythmias. Clinical features and prevalence in 223 men with permanent pacemakers.
Am J Med, 75 (1983), pp. 210-215
[16.]
J.J. Crowley, S.M. Donnelly, M. Tobin, O. FitzGerald, B. Bresnihan, B.J. Maurer, et al.
Doppler echocardiographic evidence of left ventricular diastolic dysfunction in ankylosing spondylitis.
Am J Cardiol, 71 (1993), pp. 1337-1340
[17.]
D.A. Brewerton, D.G. Gibson, D.H. Goddard, T.J. Jones, R.B. Moore, C.T. Pease, et al.
The myocardium in ankylosing spondylitis. A clinical, echocardiographic, and histopathological study.
Lancet, 1 (1987), pp. 995-998
[18.]
C. Salvarani, I.G. Vlachonikolis, D.M. Van der Heijde, G. Fornaciari, P. Macchioni, M. Beltrami, et al.
Musculoskeletal manifestations in a population-based cohort of inflammatory bowel disease patients.
Scand J Gastroenterol, 36 (2001), pp. 1307-1313
[19.]
O. Palm, B. Moum, A. Ongre, J.T. Gran.
Prevalence of ankylosing spondylitis and other spondyloarthropathies among patients with inflammatory bowel disease: a population study (the IBSEN study).
J Rheumatol, 29 (2002), pp. 511-515
[20.]
H. Mielants, E.M. Veys, C. Cuvelier, M. De Vos.
Course of gut inflammation in spondylarthropathies and therapeutic consequences.
Baillieres Clin Rheumatol, 10 (1996), pp. 147-164
[21.]
J.C. Alonso, F.J. López-Longo, J.L. Lampreave, C.M. González, M. González, I. Almoguera, et al.
Different abdominal scintigraphy pattern in patients with ulcerative colitis, Crohn's disease and seronegative spondylarthropathies.
Br J Rheumatol, 34 (1995), pp. 946-950
[22.]
D. Lamarque, J.T. Nhieu, M. Breban, C. Bernardeau, N. Martín-García, Z. Szepes, et al.
Lymphocytic infiltration and expression of inducible nitric oxide synthase in human duodenal and colonic mucosa is a characteristic feature of ankylosing spondylitis.
J Rheumatol, 30 (2003), pp. 2428-2436
[23.]
I. Bjarnason, K.O. Helgason, A.J. Geirsson, G. Sigthorsson, I. Reynisdottir, D. Gudbjartsson, et al.
Subclinical intestinal inflammation and sacroiliac changes in relatives of patients with ankylosing spondylitis.
Gastroenterology, 125 (2003), pp. 1598-1605
[24.]
F. De Keyser, D. Baeten, F. Van den Bosch, M. De Vos, C. Cuvelier, H. Mielants, et al.
Gut inflammation and spondyloarthropathies.
Curr Rheumatol Rep, 4 (2002), pp. 525-532
[25.]
U. Seckin, N. Bolukbasi, G. Gursel, S. Eroz, V. Sepici, N. Ekim.
Relationship between pulmonary function and exercise tolerance in patients with ankylosing spondylitis.
Clin Exp Rheumatol, 18 (2000), pp. 503-506
[26.]
D.K. Boushea, W.R. Sundstrom.
The pleuropulmonary manifestations of ankylosing spondylitis.
Semin Arthritis Rheum, 18 (1989), pp. 277-281
[27.]
K. Turetschek, W. Ebner, D. Fleischmann, P. Wunderbaldinger, L. Erlacher, T. Zontsich, et al.
Early pulmonary involvement in ankylosing spondylitis: assessment with thin-section CT.
Clin Radiol, 55 (2000), pp. 632-636
[28.]
I.P. Casserly, H.M. Fenlon, E. Breatnach, S.M. Sant.
Lung findings on highresolution computed tomography in idiopathic ankylosing spondylitis-correlation with clinical findings, pulmonary function testing and plain radiography.
Br J Rheumatol, 36 (1997), pp. 677-682
[29.]
E.S. Strobel, E. Fritschka.
Renal diseases in ankylosing spondylitis: review of the literature illustrated by case reports.
Clin Rheumatol, 17 (1998), pp. 524-530
[30.]
M.L. Orme.
Non-steroidal anti-inflammatory drugs and the kidney.
Br Med J (Clin Res Ed), 292 (1986), pp. 1621-1622
[31.]
M.A. Gertz, R.A. Kyle.
Secondary systemic amyloidosis: response and survival in 64 patients.
Medicine (Baltimore), 70 (1991), pp. 246-256
[32.]
J. Gratacòs, C. Orellana, R. Sanmartí, M. Solé, A. Collado, E. Gómez-Casanovas, et al.
Secondary amyloidosis in ankylosing spondylitis. A systematic survey of 137 patients using abdominal fat aspiration.
J Rheumatol, 24 (1997), pp. 912-915
[33.]
C. Geffriaud, L.H. Noel, P. Blanche, D. Ganeval, C. Barbanel, P. Jungers, et al.
Ankylosing spondylitis with type AA amyloidosis. 6 cases.
Presse Med, 17 (1988), pp. 2344-2347
[34.]
Y. Sasatomi, Y. Kiyoshi, N. Uesugi, S. Hisano, S. Takebayashi.
Prognosis of renal amyloidosis: a clinicopathological study using cluster analysis.
Nephron, 87 (2001), pp. 42-49
[35.]
H. Shiiki, T. Shimokama, Y. Yoshikawa, H. Toyoshima, T. Kitamoto, T. Watanabe.
Renal amyloidosis. Correlations between morphology, chemical types of amyloid protein and clinical features.
Virchows Arch A Pathol Anat Histopathol, 412 (1988), pp. 197-204
[36.]
K. Berglund, C. Keller, H. Thysell.
Alkylating cytostatic treatment in renal amyloidosis secondary to rheumatic disease.
Ann Rheum Dis, 46 (1987), pp. 757-762
[37.]
J.E. Gottenberg, F. Merle-Vincent, F. Bentaberry, Y. Allanore, F. Berenbaum, B. Fautrel, et al.
Anti-tumor necrosis factor alpha therapy in fifteen patients with AA amyloidosis secondary to inflammatory arthritides: a followup report of tolerability and efficacy.
Arthritis Rheum, 48 (2003), pp. 2019-2024
[38.]
K.N. Lai, P.K. Li, B. Hawkins, F.M. Lai.
IgA nephropathy associated with ankylosing spondylitis: occurrence in women as well as in men.
Ann Rheum Dis, 48 (1989), pp. 435-437
[39.]
S.G. Satko, S.S. Iskandar, R.G. Appel.
IgA nephropathy and Reiter's syndrome. Report of two cases and review of the literature.
Nephron, 84 (2000), pp. 177-182
[40.]
Forestier J, Jacqueline F, Rotes-Querol J. Ankylosing spondylitis. En: Thomas, editor. Springfield, IL; 1956.
[41.]
C. Ramos-Remus, A. Gómez-Vargas, J.L. Guzmán-Guzmán, F. Jiménez-Gil, J.I. Gámez-Nava, L. González-López, et al.
Frequency of atlantoaxial subluxation and neurologic involvement in patients with ankylosing spondylitis.
J Rheumatol, 22 (1995), pp. 2120-2125
[42.]
J.R. Harding, I.W. McCall, W.M. Park, B.F. Jones.
Fracture of the cervical spine in ankylosing spondylitis.
Br J Radiol, 58 (1985), pp. 3-7
[43.]
J.D. Bartleson, M.D. Cohen, T.M. Harrington, N.P. Goldstein, W.W. Ginsburg.
Cauda equina syndrome secondary to long-standing ankylosing spondylitis.
Ann Neurol, 14 (1983), pp. 662-669
[44.]
B. Cruickshank.
Pathology of ankylosing spondylitis.
Bull Rheum Dis, 10 (1960), pp. 211-214
[45.]
M.I. Jayson, P.R. Salmon, W. Harrison.
Amyloidosis in ankylosing spondylitis.
Rheumatol Phys Med, 11 (1971), pp. 78-82
[46.]
J. Villiaumey, E. Lejeune, B. Avouac, P. Horreard.
Ankylosing spondylarthritis and amyloidosis.
Ann Med Interne (Paris), 129 (1978), pp. 67-71
[47.]
J.M. Martínez Vázquez, C. Pigrau, I. Ocaña, R. Muniz, J.A. Capdevila, E. Ribera.
Clinical evaluation of 66 cases of secondary amyloidosis.
Med Clin (Barc), 85 (1985), pp. 350-355
[48.]
M.A. Gertz, C.Y. Li, T. Shirahama, R.A. Kyle.
Utility of subcutaneous fat aspiration for the diagnosis of systemic amyloidosis (immunoglobulin light chain).
Arch Intern Med, 148 (1988), pp. 929-933
[49.]
C.A. Libbey, M. Skinner, A.S. Cohen.
Use of abdominal fat tissue aspirate in the diagnosis of systemic amyloidosis.
Arch Intern Med, 143 (1983), pp. 1549-1552
[50.]
Gratacòs J., A. Collado, F. Pons, M. Osaba, R. Sanmartí, M. Roque, et al.
Significant loss of bone mass in patients with early, active ankylosing spondylitis: a followup study.
[51.]
S. Donnelly, D.V. Doyle, A. Denton, I. Rolfe, E.V. McCloskey, T.D. Spector.
Bone mineral density and vertebral compression fracture rates in ankylosing spondylitis.
Ann Rheum Dis, 53 (1994), pp. 117-121
[52.]
R. Will, R. Palmer, A.K. Bhalla, F. Ring, A. Calin.
Osteoporosis in early ankylosing spondylitis: a primary pathological event?.
Lancet, 2 (1989), pp. 1483-1485
[53.]
S.H. Ralston, G.D. Urquhart, M. Brzeski, R.D. Sturrock.
Prevalence of vertebral compression fractures due to osteoporosis in ankylosing spondylitis.
BMJ, 300 (1990), pp. 563-565
[54.]
D. Mitra, D.M. Elvins, D.J. Speden, A.J. Collins.
The prevalence of vertebral fractures in mild ankylosing spondylitis and their relationship to bone mineral density.
Rheumatology (Oxford), 39 (2000), pp. 85-89
[55.]
C. Cooper, L. Carbone, C.J. Michet, E.J. Atkinson, W.M. O’Fallon, Lj. Melton 3rd.
Fracture risk in patients with ankylosing spondylitis: a population based study.
J Rheumatol, 21 (1994), pp. 1877-1882
[56.]
R. Bessant, C. Harris, A. Keat.
Audit of the diagnosis, assessment, and treatment of osteoporosis in patients with ankylosing spondylitis.
J Rheumatol, 30 (2003), pp. 779-782
[57.]
E. Demis, C. Roux, M. Breban, M. Dougados.
Infliximab in spondylarthropathy —influence on bone density.
Clin Exp Rheumatol, 20 (2002), pp. S185-S186
[58.]
H. Marzo-Ortega, D. McGonagle, G. Haugeberg, M.J. Green, S.P. Stewart, P. Emery.
Bone mineral density improvement in spondyloarthropathy after treatment with etanercept.
Ann Rheum Dis, 62 (2003), pp. 1020-1021
[59.]
MA. Khan.
Clinical features of ankylosing spondylitis.
Rheumatology, pp. 1161-1181
Copyright © 2005. Elsevier España S.L. Barcelona
Descargar PDF
Idiomas
Reumatología Clínica
Opciones de artículo
Herramientas
es en

¿Es usted profesional sanitario apto para prescribir o dispensar medicamentos?

Are you a health professional able to prescribe or dispense drugs?