Spondyloarthropathy Flashcards
Common features of all the spondyloarthropathies?
- Not a damn one of them involves rheumatoid factor
- All are associated with HLA B27
- Axial onvolvement with sacroilitis and spondylitis is common
- Large joint asymmettric oligoarthritis
- TNF alpha plays a crucial role
What are two other common features
Enthesitis- inflammation at the sites where tendons and ligaments attach
Dactylitis- Sausage digits
HLA B27 is an MHC class I molecule that binds antigenic peptides and presents them.
true
HLA-B27 is most common in who7
Pts with ankylosing spondylittis
Frequency of B27 in pts with reactive arthritis
75%
What does HLA-B27 confer
Increased disease severity and susceptibility
Pts with HLA B27 are more likely to develop
axial arthropathy`
Pathogenesis of ankylosing spondylitis
HLA-B27 plays a major role along with some other non MHC genes:
ARTS
IL1A
IL23
Cytokine dysregulation with OVEREXPRESSION of TNF-alpha
What is the primary target for th eabnormal immune response in ankylosing spondylitis?
Cartilage
AS features inflammation of the spinal joints leading to bony fusion.
Inflammation of the peripheral joints
Extra-articular disease
all true
AS tends to affect who?
Younger people (adolescence to age 35) Males moreso than females
What is ankylosing spondylitis associated with in the eyes?
Anterior Uveitis
PEripheral joint involvement is present in what percentage of AS pts
1/3
Involves hips shoulders knees and ankles
Oligoarticular, often asymetric
Cardiac complications of AS
aortic regurg, heart block
Pulmonary AS
apical lung fibrosis, thoracic cage restriction
