Coexistence of spondyloarthritis, Takayasu arteritis may not be coincidental
The association of spondyloarthritis (SpA) with Takayasu arteritis (TA) in a single patient is unusual but probably not coincidental, a recent study suggests.
In patients with SpA, the first indicators of TA are peripheral pulse palpation and vascular auscultation, which should be systematic. In addition, elevated acute-phase reactants during SpA follow-up must lead to search for TA.
“Finally, there are therapeutic implications because anti-tumour necrosis factor (TNF) is efficient in SpA and might be efficient in TA,” researchers said.
In this French multicentre retrospective survey, the investigators established a standardized questionnaire to describe clinical features of patients having SpA associated with TA and to identify some characteristics of the types of patients with SpA associated with TA. Treatments used in this context were also assessed.
The participants included 14 patients (median age at SpA diagnosis 43.5 years; range, 19 to 63 years; 10 women). Subtypes of SpA included ankylosing spondylitis (n=11), psoriatic arthritis (n=2), and synovitis, acne, pustulosis, hyperostosis and osteitis syndrome (n=1).
There were three positive cases of HLA-B27, nine negative and two unknown. SpA was detected before TA in 13 cases. Imaging findings compatible with the diagnosis of TA were discovered using computed tomography (11/14) and/or Doppler ultrasound (10/14).
Laboratory tests exhibited increased acute-phase reactants in all cases (C-reactive protein ≥25 mg/l in 71 percent of the cases). There were 13 patients who received corticosteroids and seven administered with anti-TNF.
SpA and TA are chronic inflammatory diseases that may coexist in a single patients, although such coexistence is rare, according to researchers.