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Background: Secondary AA-amyloidosis is one of the most serious complications of ankylosing spondylitis (AS). Better knowledge of specific to secondary AA-amyloidosis clinical features is important for improving further management of these patients.
Objectives: To conduct a comparative analysis of AS patients with and without secondary AA-amyloidosis.
Methods: The study included 220 AS patients (according to modified New York criteria) without amyloidosis - Group 1, and 9 AS patients with histologically confirmed secondary AA-amyloidosis – Group 2.
Results: Table 1 presents the comparative characteristics of Group 1 and Group 2 patients. Both groups were comparable in terms of patients’ age, rates of HLA B27 positivity, presence of enthesitis, uveitis, inflammatory bowel diseases (IBD), and psoriasis on assessment. Group 2 patients tended to be younger at AS onset, while shorter disease duration and fewer male patients were established for Group 1. Group 2 had higher rates of extra-spinal AS manifestations, such as arthritis and coxitis. It should be noted that all AS patients with secondary AA-amyloidosis were males, with clinically manifest arthritis, involving hip joints, and AS onset in the childhood in 8 out of 9 cases.
Comparative characteristics of Group 1 and Group 2 AS patients.
| Group 1 (n=220) | Group 2 (n=9) | р | |
|---|---|---|---|
| Mean age, M±α, y. | 35,1±9,5 | 40,1±8,6 | >0.05 |
| Mean age at the onset, M±α, y. | 29,9±9,6 | 13,4±7,5 | <0.05 |
| Mean disease duration, M±α, y. | 6,9±5,6 | 26,3±6,5 | <0.05 |
| Men, n (%) | 162 (73,6%) | 9 (100%) | <0.05 |
| HLA B27, n (%) | 202 (91,8%) | 9 (100%) | >0.05 |
| Arthritis, n (%) | 182 (82,7%) | 9 (100%) | <0.05 |
| Coxitis, n (%) | 119 (54,0%) | 9 (100%) | <0.05 |
| Enthesitis, n (%) | 105 (47,7%) | 7 (78%) | >0.05 |
| Uveitis, n (%) | 52 (23,6%) | 4 (44,4%) | >0.05 |
| IBD, n (%) | 5 (2,2%) | 0 | >0.05 |
| Psoriasis, n (%) | 24 (10,9%) | 0 | >0.05 |
Conclusion: Patients with AS and secondary AA amyloidosis are predominantly of male gender, who usually get sick in childhood, have 100% HLA-B27 positivity, peripheral arthritis, and coxitis.
Disclosure of Interests: None declared