Abstract
Background: Ankylosing spondylitis (AS) is the most severe form of the spondyloarthritis (SpA) group. In western Algeria, we have very little epidemiological data on the characteristics of patients with AS.
Objective: To determine the clinical, biological and radiological characteristics of patients with ankylosing spondylitis in the wilaya of Tlemcen.
Material and methods: descriptive cross-sectional study of patients with AS not associated with psoriasis and chronic inflammatory bowel disease, meeting the modified New York criteria, residing in the wilaya of Tlemcen over a three-year period from 2020 to 2022.
Results: 235 AS patients were included in the study, 153(65.1%) were male, mean age 39.83±11.72 years, mean age of onset 30.39±11.04 years. Juvenile onset was observed in 21 (8.9%) cases. The mean time to diagnosis was 5.7±5.54 years. HLAB27 antigen was present in 99(65.5%) of cases. Spinal deformity was common in 59(25.1%) of cases, coxitis in 82(34.9%), restrictive pulmonary syndrome in 57(24.3%) and uveitis in 35(14.9%). Radiographic structural damage was severe: mean BASRI spine 6.02±3.4, m SASSS 17.52±19.9, sacroiliac 2.74±0.86 and BASRI hip 2.76±1.025. More than half the patients 136 (58%) and 142 (60%) respectively had impaired functional status and poor quality of life.
Conclusion: Ankylosing spondylitis in the wilaya of Tlemcen predominates in young males. It has a severe clinical and radiological phenotype which could be explained by genetic factors: given the high frequency of the HLAB27 antigen, familial forms and the delay in diagnosis and treatment.
References
Claudepierre P, Wendling D, Breban M, Goupillle P, Dougados M. Ankylosing spondylitis, spondyloarthropathy, spondyloarthritis, or spondylarthritis: what's in a name? 2012. p. 534-5.
Proft F, Poddubnyy D. Ankylosing spondylitis and axial spondyloarthritis: recent insights and impact of new classification criteria. Therapeutic advances in musculoskeletal disease. 2018;10(5-6):129-39.
Baraliakos X, Braun J. Non-radiographic axial spondyloarthritis and ankylosing spondylitis: what are the similarities and differences? RMD open. 2015;1(Suppl 1):e000053.
Poddubnyy D, Sieper J. Similarities and differences between nonradiographic and radiographic axial spondyloarthritis: a clinical, epidemiological and therapeutic assessment. Current opinion in rheumatology. 2014;26(4):377-83.
Djoudi H. Etude du systéme HLA dans la population. Alger: Alger; 1985.
Benbouaziz M. La spondylarthrite ankylosante: perspective de dépistage. Alger: Université d'Alger; 1984.
Bayou M. Coxites de la pelvi-spondylite rhumatismale. Alger: Université d'Alger; 1968.
Ibn Yacoub Y, Amine B, Laatiris A, Bensabbah R, Hajjaj-Hassouni N. Relationship between diagnosis delay and disease features in Moroccan patients with ankylosing spondylitis. Rheumatology international. 2012;32(2):357-60.
El Mansouri L, Bahiri R, Abourazzak FE, Abouqal R, Hajjaj-Hassouni N. Two distinct patterns of ankylosing spondylitis in Moroccan patients. Rheumatol Int. 2009;29(12):1423-9.
Maghraoui AE, Bensabbah R, Bahiri R, Bezza A, Guedira N, Hajjaj-Hassouni N. Cervical spine involvement in ankylosing spondylitis. Clinical rheumatology. 2003;22(2):94-8.
Amroun H. Facteurs de prédisposition génétique aux spondylarthropathies à Alger. Alger: Université d'Alger; 2009.
Allat R. Particularités des spondyloarthrites Algeriennes Revue du rhumatisme. 2015(82S: A363).
Casals-Sánchez JL, Prous MJGDY, Gallego MÁD, Olmos JMB, Ortells LC, García CH, et al. Characteristics of patients with spondyloarthritis followed in rheumatology units in Spain. emAR II study. Reumatología Clínica (English Edition). 2012;8(3):107-13.
Allat R. Qualité de vie des spondyloarthrites Algeriennes. Algerie: Université Saad Dahlab Blida; 2021.
Younsi R, Azrib S, Aitouazar M, Harifi G, El Hassani S. Evaluation de l'incidence du gène HLA B-27 chez le patient atteint de spondylarthrite ankylosante au Maroc. Revue du rhumatisme. 2007;10(74):1013.
Onen F, Akar S, Birlik M, Sari I, Khan MA, Gurler O, et al. Prevalence of ankylosing spondylitis and related spondyloarthritides in an urban area of Izmir, Turkey. The Journal of rheumatology. 2008;35(2):305-9.
Fallahi S, Jamshidi AR. Diagnostic delay in ankylosing spondylitis: related factors and prognostic outcomes. Archives of rheumatology. 2016;31(1):024-30.
Webers C, Essers I, Ramiro S, Stolwijk C, Landewe R, van der Heijde D, et al. Gender-attributable differences in outcome of ankylosing spondylitis: long-term results from the Outcome in Ankylosing Spondylitis International Study. Rheumatology. 2016;55(3):419-28.
Kim T-J, Kim T-H. Aspect clinique de la spondylarthrite ankylosante en Corée. Revue du rhumatisme. 2010;77(3):273-8.
Schlosstein L, Terasaki PI, Bluestone R, Pearson CM. High association of an HL-A antigen, W27, with ankylosing spondylitis. N Engl J Med. 1973;288(14):704-6.
Tbini H, Slouma M, Rahmouni S, Abdennadher A, Amri K, Mallat Y, et al. Hip involvement in spondyloarthritis: analysis of associated factors. BMJ Publishing Group Ltd; 2022.
Pertuiset E. Diagnostic précoce des spondylarthropathies. La Revue de médecine interne. 2008;29(7):596-605.
Hammoudeh M, Abdulaziz S, Alosaimi H, Al-Rayes H, Aldeen Sarakbi H, Baamer M, et al. Challenges of diagnosis and management of axial spondyloarthritis in North Africa and the Middle East: an expert consensus. Journal of International Medical Research. 2016;44(2):216-30.
Allat R. Qualité de vie des spondyloarthrites Algeriennes. Blida: Université Saad Dahlab Blida; 2021.
Cansu DÜ, Çalışır C, Savaş Yavaş U, Kaşifoğlu T, Korkmaz C. Predictors of radiographic severity and functional disability in Turkish patients with ankylosing spondylitis. Clinical rheumatology. 2011;30(4):557-62.
Claudepierre P, Gueguen A, Ladjouze A, Hajjaj-Hassouni N, Sellami S, Amor B, et al. Predictive factors of severity of spondyloarthropathy in North Africa. Rheumatology. 1995;34(12):1139-45.
Moshrif A, Mosallam A, Rayan M, Khalifa H, Sobhy A. Characterization of ankylosing spondylitis in Upper Egypt. Int J Clin Rheumatol. 2018;13(1).
Rkain H, Allali F, Bentalha A, Lazrak N, Abouqal R, Hajjaj-Hassouni N. Socioeconomic impact of ankylosing spondylitis in Morocco. Clinical rheumatology. 2007;26(12):2081-8.
Claudepierre P, Wendling D. Spondylarthrite ankylosante. EMC, appareil locomoteur. Paris: Elsevier Masson SAS; 2019.
Haid S, Rahal S, Teniou A, Gasmi A, Megateli I, Abdessemed A. Les coxites dans la spondyloarthrite. Rev Rhum. 2015;82(Suppl. 1):A358.
López-Medina C, Molto A, Sieper J, Duruöz T, Kiltz U, Elzorkany B, et al. Prevalence and distribution of peripheral musculoskeletal manifestations in spondyloarthritis including psoriatic arthritis: results of the worldwide, cross-sectional ASAS-PerSpA study. RMD open. 2021;7(1):e001450.
Vander Cruyssen B, Munoz-Gomariz E, Font P, Mulero J, De Vlam K, Boonen A, et al. Hip involvement in ankylosing spondylitis: epidemiology and risk factors associated with hip replacement surgery. Rheumatology. 2010;49(1):73-81.
Casserly I, Fenlon H, Breatnach E, Sant S. Lung findings on high-resolution computed tomography in idiopathic ankylosing spondylitis--correlation with clinical findings, pulmonary function testing and plain radiography. British journal of rheumatology. 1997;36(6):677-82.
El Maghraoui A, Chaouir S, Bezza A, Tabache F, Abouzahir A, Ghafir D, et al. Thoracic high resolution computed tomography in patients with ankylosing spondylitis and without respiratory symptoms. Annals of the rheumatic diseases. 2003;62(2):185-6.
Şenocak Ö, Manisalı M, Özaksoy D, Sevinç C, Akalın E. Lung parenchyma changes in ankylosing spondylitis: demonstration with high resolution CT and correlation with disease duration. European journal of radiology. 2003;45(2):117-22.
Bodur H, Ataman Ş, Rezvani A, Buğdaycı DS, Çevik R, Birtane M, et al. Quality of life and related variables in patients with ankylosing spondylitis. Quality of Life Research. 2011;20(4):543-9.
Younes M, Jalled A, Aydi Z, Younes K, Jguirim M, Zrour S, et al. Qualité de vie au cours de la spondylarthrite ankylosante. LA TUNISIE MEDICALE. 2011;89(04):374-8.
Hamdi W, Haouel M, Ghannouchi MM, Mansour A, Kchir MM. Validation de la version dialectale tunisienne de l'ankylosing spondylitis quality of life (ASQoL). La Tunisie medicale. 2012;90(n°07):564-70.
Hamdi W, Chelli-Bouaziz M, Ahmed MS, Ghannouchi MM, Kaffel D, Ladeb MF, et al. Correlations among clinical, radiographic, and sonographic scores for enthesitis in ankylosing spondylitis. Joint Bone Spine. 2011;78(3):270-4.
Claudepierre P, Wendling D, Breban M, Goupillle P, Dougados M. Ankylosing spondylitis, spondyloarthropathy, spondyloarthritis, or spondylarthritis: what's in a name? 2012. p. 534-5.
Proft F, Poddubnyy D. Ankylosing spondylitis and axial spondyloarthritis: recent insights and impact of new classification criteria. Therapeutic advances in musculoskeletal disease. 2018;10(5-6):129-39.
Baraliakos X, Braun J. Non-radiographic axial spondyloarthritis and ankylosing spondylitis: what are the similarities and differences? RMD open. 2015;1(Suppl 1):e000053.
Poddubnyy D, Sieper J. Similarities and differences between nonradiographic and radiographic axial spondyloarthritis: a clinical, epidemiological and therapeutic assessment. Current opinion in rheumatology. 2014;26(4):377-83.
Djoudi H. Etude du systéme HLA dans la population. Alger: Alger; 1985.
Benbouaziz M. La spondylarthrite ankylosante: perspective de dépistage. Alger: Université d'Alger; 1984.
Bayou M. Coxites de la pelvi-spondylite rhumatismale. Alger: Université d'Alger; 1968.
Ibn Yacoub Y, Amine B, Laatiris A, Bensabbah R, Hajjaj-Hassouni N. Relationship between diagnosis delay and disease features in Moroccan patients with ankylosing spondylitis. Rheumatology international. 2012;32(2):357-60.
El Mansouri L, Bahiri R, Abourazzak FE, Abouqal R, Hajjaj-Hassouni N. Two distinct patterns of ankylosing spondylitis in Moroccan patients. Rheumatol Int. 2009;29(12):1423-9.
Maghraoui AE, Bensabbah R, Bahiri R, Bezza A, Guedira N, Hajjaj-Hassouni N. Cervical spine involvement in ankylosing spondylitis. Clinical rheumatology. 2003;22(2):94-8.
Amroun H. Facteurs de prédisposition génétique aux spondylarthropathies à Alger. Alger: Université d'Alger; 2009.
Allat R. Particularités des spondyloarthrites Algeriennes Revue du rhumatisme. 2015(82S: A363).
Casals-Sánchez JL, Prous MJGDY, Gallego MÁD, Olmos JMB, Ortells LC, García CH, et al. Characteristics of patients with spondyloarthritis followed in rheumatology units in Spain. emAR II study. Reumatología Clínica (English Edition). 2012;8(3):107-13.
Allat R. Qualité de vie des spondyloarthrites Algeriennes. Algerie: Université Saad Dahlab Blida; 2021.
Younsi R, Azrib S, Aitouazar M, Harifi G, El Hassani S. Evaluation de l'incidence du gène HLA B-27 chez le patient atteint de spondylarthrite ankylosante au Maroc. Revue du rhumatisme. 2007;10(74):1013.
Onen F, Akar S, Birlik M, Sari I, Khan MA, Gurler O, et al. Prevalence of ankylosing spondylitis and related spondyloarthritides in an urban area of Izmir, Turkey. The Journal of rheumatology. 2008;35(2):305-9.
Fallahi S, Jamshidi AR. Diagnostic delay in ankylosing spondylitis: related factors and prognostic outcomes. Archives of rheumatology. 2016;31(1):024-30.
Webers C, Essers I, Ramiro S, Stolwijk C, Landewe R, van der Heijde D, et al. Gender-attributable differences in outcome of ankylosing spondylitis: long-term results from the Outcome in Ankylosing Spondylitis International Study. Rheumatology. 2016;55(3):419-28.
Kim T-J, Kim T-H. Aspect clinique de la spondylarthrite ankylosante en Corée. Revue du rhumatisme. 2010;77(3):273-8.
Schlosstein L, Terasaki PI, Bluestone R, Pearson CM. High association of an HL-A antigen, W27, with ankylosing spondylitis. N Engl J Med. 1973;288(14):704-6.
Tbini H, Slouma M, Rahmouni S, Abdennadher A, Amri K, Mallat Y, et al. Hip involvement in spondyloarthritis: analysis of associated factors. BMJ Publishing Group Ltd; 2022.
Pertuiset E. Diagnostic précoce des spondylarthropathies. La Revue de médecine interne. 2008;29(7):596-605.
Hammoudeh M, Abdulaziz S, Alosaimi H, Al-Rayes H, Aldeen Sarakbi H, Baamer M, et al. Challenges of diagnosis and management of axial spondyloarthritis in North Africa and the Middle East: an expert consensus. Journal of International Medical Research. 2016;44(2):216-30.
Allat R. Qualité de vie des spondyloarthrites Algeriennes. Blida: Université Saad Dahlab Blida; 2021.
Cansu DÜ, Çalışır C, Savaş Yavaş U, Kaşifoğlu T, Korkmaz C. Predictors of radiographic severity and functional disability in Turkish patients with ankylosing spondylitis. Clinical rheumatology. 2011;30(4):557-62.
Claudepierre P, Gueguen A, Ladjouze A, Hajjaj-Hassouni N, Sellami S, Amor B, et al. Predictive factors of severity of spondyloarthropathy in North Africa. Rheumatology. 1995;34(12):1139-45.
Moshrif A, Mosallam A, Rayan M, Khalifa H, Sobhy A. Characterization of ankylosing spondylitis in Upper Egypt. Int J Clin Rheumatol. 2018;13(1).
Rkain H, Allali F, Bentalha A, Lazrak N, Abouqal R, Hajjaj-Hassouni N. Socioeconomic impact of ankylosing spondylitis in Morocco. Clinical rheumatology. 2007;26(12):2081-8.
Claudepierre P, Wendling D. Spondylarthrite ankylosante. EMC, appareil locomoteur. Paris: Elsevier Masson SAS; 2019.
Haid S, Rahal S, Teniou A, Gasmi A, Megateli I, Abdessemed A. Les coxites dans la spondyloarthrite. Rev Rhum. 2015;82(Suppl. 1):A358.
López-Medina C, Molto A, Sieper J, Duruöz T, Kiltz U, Elzorkany B, et al. Prevalence and distribution of peripheral musculoskeletal manifestations in spondyloarthritis including psoriatic arthritis: results of the worldwide, cross-sectional ASAS-PerSpA study. RMD open. 2021;7(1):e001450.
Vander Cruyssen B, Munoz-Gomariz E, Font P, Mulero J, De Vlam K, Boonen A, et al. Hip involvement in ankylosing spondylitis: epidemiology and risk factors associated with hip replacement surgery. Rheumatology. 2010;49(1):73-81.
Casserly I, Fenlon H, Breatnach E, Sant S. Lung findings on high-resolution computed tomography in idiopathic ankylosing spondylitis--correlation with clinical findings, pulmonary function testing and plain radiography. British journal of rheumatology. 1997;36(6):677-82.
El Maghraoui A, Chaouir S, Bezza A, Tabache F, Abouzahir A, Ghafir D, et al. Thoracic high resolution computed tomography in patients with ankylosing spondylitis and without respiratory symptoms. Annals of the rheumatic diseases. 2003;62(2):185-6.
Şenocak Ö, Manisalı M, Özaksoy D, Sevinç C, Akalın E. Lung parenchyma changes in ankylosing spondylitis: demonstration with high resolution CT and correlation with disease duration. European journal of radiology. 2003;45(2):117-22.
Bodur H, Ataman Ş, Rezvani A, Buğdaycı DS, Çevik R, Birtane M, et al. Quality of life and related variables in patients with ankylosing spondylitis. Quality of Life Research. 2011;20(4):543-9.
Younes M, Jalled A, Aydi Z, Younes K, Jguirim M, Zrour S, et al. Qualité de vie au cours de la spondylarthrite ankylosante. LA TUNISIE MEDICALE. 2011;89(04):374-8.
Hamdi W, Haouel M, Ghannouchi MM, Mansour A, Kchir MM. Validation de la version dialectale tunisienne de l'ankylosing spondylitis quality of life (ASQoL). La Tunisie medicale. 2012;90(n°07):564-70.
Hamdi W, Chelli-Bouaziz M, Ahmed MS, Ghannouchi MM, Kaffel D, Ladeb MF, et al. Correlations among clinical, radiographic, and sonographic scores for enthesitis in ankylosing spondylitis. Joint Bone Spine. 2011;78(3):270-4.
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
Copyright (c) 2024 Medical Focus Journal