Early diagnosis in ankylosing spondylitis in women

Abstract

Introduction: In ankylosing spondylitis, it is difficult to start treatment early because of delayed diagnosis in men about 8.4 years, and in women 9.8 years from the onset of the disease. This is related to a number of subjective and objective factors. Purpose: early diagnosis in ankylosing spondylitis in women. Material and methods: In order to perform the study and satisfy the proposed objectives, 40 patients with the diagnosis established by AS, aged between 18-60 years, disease duration 7.2 ± 0.3 years were investigated. It was assessed for joint pain syndrome by analog visual scale, evaluation of inflammation indices: Creactive protein, fibrinogen, ESR, HLA-B27, sacroiliac joint radiograph and HAQ index. Results: When analyzing the visual analog scale of the disease, the joint pain syndrome is much stronger in women with HLA B27 positive. Among the laboratory indices of inflammation, the mean value of ESR in the HLA B27-positive group was 28 mm / h compared with 17 in those with HLA B27 negative, the C-reactive protein values in the HLA B27-positive group were 43 mg / dl with HLA B 27 negative 21 mg / dl. The BASFI index had a prevalence in the group of patients with HLA B27 positive. HLA-B27 was present in 36 (90%) cases. In all evaluated patients sacroiliitis was present in 100% of cases, of which st Rg II in patients with HLA B27 negative compared to St Rg II in those with HLA B27 positive. The HAQ index was on average 15-40 in women with HLA B27 positive, compared with 12-30 in those with HLA B27 negative. Conclusions: For women with HLA B27 positive at the onset of the disease, it is characterized by a faster progression of sacroiliac joint damage, and a much more pronounced pain syndrome and a lower functional capacity compared to patients with HLA B27 negative. Highlighting the presence of HLA B-27 antigen in the blood at the early stages of the disease would allow the diagnosis of ankylosing spondylitis to be established, early initiation of background treatment and stopping the progression of the process.