Ankylosing spondylitis with systemic lupus erythematosus: A rare co-existence

Authors

  • Bhavya Chintala DNB Super speciality resident, Sir Gangaram Hospital, New Delhi
  • Neeraj Jain Senior consultant,Sir Gangaram Hospital, New Delhi
  • Lalit Duggal Senior Consultant,Sir Gangaram Hospital,New Delhi

DOI:

https://doi.org/10.15305/ijrci/v10i1/358

Keywords:

SLE, Discoid Lupus, Spondyloarthritis, HLA B 27

Abstract

Systemic lupus erythematosus (SLE) and ankylosing spondylitis (AS) are two distinct immunological disorders with different etiopathogenic profiles and their co-existence is very rare. The present study discusses two cases of co-existing AS with SLE. The first case, which fulfilled the criteria for lupus, had HLA-B27 arthritis with predominant peripheral involvement, bilateral hip disease associated with non-scarring alopecia, recurrent oral ulcers and positive immunological markers. The second case was of a 37-year-old male with lupus (predominantly musculoskeletal and cutaneous) who presented with inflammatory low backache. The patient had high titers of ANA and anti-dsDNA positivity and was on methotrexate treatment. On evaluation, he was found to have HLA B27 positivity and bilateral active sacroiliitis. The distinguishing feature of both the cases was that the time frame of presentation of the disorders was almost same, while second case had a significant time frame between the two disorders.

References

Nashel DJ, Leonard A, Mann DL, Guccion JG, Katz AL, Sliwinski AJ. Ankylosing spondylitis and systemic lupus erythematosus: a rare HLA combination. Arch Intern Med. 1982;142:1227–8.

Yılmaz N, Yazıcı A, Ozulu Turkmen B, Karalok I, Yavuz S. Sacroiliitis in Systemic Lupus Erythematosus Revisited. Arch Rheumatol 2020;35:254-258.

De Semet AA, Mahmood T, Robinson RG, Lindsley HB. Elevated sacroiliac joint uptake ratios in systemic lupus erythematosus. Am J Roentgenol. 1984;143:351–4.

Vivas J, Tiliakos NA. Sacroiliitis in male systemic lupus erythematous. Scan J Rheumatol. 1985;14:441.

Enginar AU, Nur H, Kacar C. Coexistence of ankylosing spondylitis and discoid lupus: A case report. North Clin Istanb. 2019;6(4):412-414.

Tarhan F, Argın M, Can G, Özmen M, Keser G. Coexistence of systemic lupus erythematosus and ankylosing spondylitis: another case report and review of the literature. Eur J Rheumatol. 2014;1(1):39-43.

Li D,Guo B,Wu H,Tan L,Chang C,Lu Q. Interleukin-17 in systemic lupus erythematosus: A comprehensive review. Autoimmunity 2015;48:353-61.

Jacob N, Yang H, Pricop L, Liu Y, Gao X, Zheng SG, et al. Accelerated pathological and clinical nephritis in systemic lupus erythematosus-prone New Zealand Mixed 2328 mice doubly deficient in TNF receptor 1 and TNF receptor 2 via a Th17-associated pathway. J Immunol 2009;182:2532-41.

Downloads

Additional Files

Published

14-03-2022

Issue

Section

Case Studies