The Korean Journal of Medicine

The Korean Association of Internal Medicine (대한내과학회)
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Systemic Sclerosis and Pleural Effusion in a Patient with Ankylosing Spondylitis

강직척추염 발병 이후 전신경화증과 흉수가 동반된 1예

  • Koo, Bon San (Department of Internal Medicine, Inje University Seoul Paik Hospital, Inje University College of Medicine) ;
  • Song, Yoonah (Department of Radiology, Hanyang University Hospital for Rheumatic Diseases) ;
  • Lee, Seunghun (Department of Radiology, Hanyang University Hospital for Rheumatic Diseases) ;
  • Kim, Tae-Hwan (Department of Rheumatology, Hanyang University Hospital for Rheumatic Diseases) ;
  • Jun, Jae-Bum (Department of Rheumatology, Hanyang University Hospital for Rheumatic Diseases)
  • 구본산 (인제대학교 의과대학 서울백병원 내과) ;
  • 송윤아 (한양대학교 류마티스병원 영상의학과) ;
  • 이승훈 (한양대학교 류마티스병원 영상의학과) ;
  • 김태환 (한양대학교 류마티스병원 류마티스내과) ;
  • 전재범 (한양대학교 류마티스병원 류마티스내과)
  • Received : 2017.12.05
  • Accepted : 2018.03.01
  • Published : 2018.10.01
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Abstract

Systemic sclerosis (SSc) is a chronic autoimmune disorder characterized by endothelial and fibroblast dysfunction, resulting in progressive fibrosis of the skin and internal organs. Ankylosing spondylitis (AS) is an arthritic condition affecting the axial skeleton and peripheral joints. An association between SSc and AS is relatively rare, as the two diseases share few characteristics. Here, we present a case of limited SSc in a 44-year-old man who exhibited low-grade AS, and discuss several cases of coexisting SSc and AS in the literature. Patients with both diseases showed several common features, including male predominance, middle age, and combined interstitial lung disease. However, unlike our case, the patients reported in the literature had advanced ankylosis and diffuse SSc.

Keywords

References

  1. LeRoy EC, Black C, Fleischmajer R, et al. Scleroderma (systemic sclerosis): classification, subsets and pathogenesis. J Rheumatol 1988;15:202-205.
  2. Park H, Bourla AB, Kastner DL, Colbert RA, Siegel RM. Lighting the fires within: the cell biology of autoinflammatory diseases. Nat Rev Immunol 2012;12:570-580. https://doi.org/10.1038/nri3261
  3. Dean LE, Jones GT, MacDonald AG, Downham C, Sturrock RD, Macfarlane GJ. Global prevalence of ankylosing spondylitis. Rheumatology (Oxford) 2014;53:650-657. https://doi.org/10.1093/rheumatology/ket387
  4. Barnes J, Mayes MD. Epidemiology of systemic sclerosis: incidence, prevalence, survival, risk factors, malignancy, and environmental triggers. Curr Opin Rheumatol 2012;24:165-170. https://doi.org/10.1097/BOR.0b013e32834ff2e8
  5. Arslan Tas D, Yildiz F, Sakalli H, Kelle B, Balli T, Erken E. Sacroiliac joint involvement in systemic sclerosis. Int J Rheum Dis 2015;18:84-90. https://doi.org/10.1111/1756-185X.12379
  6. Witt P, Thomas E. Transfer dysphagia in a patient with the rare combination of scleroderma and ankylosing spondylitis. J Natl Med Assoc 1987;79:993-994, 996.
  7. Pham T, Daumen-Legre V, Lafforgue P. Concomitant spondylarthropathy and CREST syndrome. Clin Exp Rheumatol 1999;17:754.
  8. Kayser C, Alvarenga MC, Neves AS, Gerbase-De Lima M, Andrade LE. Severe ankylosing spondylitis and diffuse systemic sclerosis: case report of a genetic trap. Scand J Rheumatol 2005;34:145-147. https://doi.org/10.1080/03009740510026346
  9. Soledade CS, Sampaio-Barros PD, Samara AM, Marques-Neto JF. Unusual association of systemic sclerosis and ankylosing spondylitis. Clin Rheumatol 2005;24:652-654. https://doi.org/10.1007/s10067-004-0980-x
  10. Ouedraogo DD, Palazzo E, Nlome-Nze M, Somogyi-Demerjian N, Meyer O. Ankylosing spondylitis and systemic sclerosis: a rare combination. Joint Bone Spine 2009;76:290-292. https://doi.org/10.1016/j.jbspin.2006.07.008
  11. Rudwaleit M, van der Heijde D, Landewe R, et al. The development of assessment of spondyloarthritis international society classification criteria for axial spondyloarthritis (part II): validation and final selection. Ann Rheum Dis 2009;68:777-783. https://doi.org/10.1136/ard.2009.108233
  12. van den Hoogen F, Khanna D, Fransen J, et al. 2013 classification criteria for systemic sclerosis: an American college of rheumatology/European league against rheumatism collaborative initiative. Arthritis Rheum 2013;65:2737-2747. https://doi.org/10.1002/art.38098
  13. Olivieri I, Gemignani G, Balagi M, Pasquariello A, Gremignai G, Pasero G. Concomitant systemic lupus erythematosus and ankylosing spondylitis. Ann Rheum Dis 1990;49:323-324. https://doi.org/10.1136/ard.49.5.323
  14. Rabin BS, Rodnan GP, Bassion S, Gill TJ 3rd. Letter: HL-A antigens in progressive systemic sclerosis (scleroderma). Arthritis Rheum 1975;18:381-382. https://doi.org/10.1002/art.1780180418
  15. Thompson AE, Pope JE. A study of the frequency of pericardial and pleural effusions in scleroderma. Br J Rheumatol 1998;37:1320-1323. https://doi.org/10.1093/rheumatology/37.12.1320
  16. Luo YF, Robbins IM, Karatas M, Brixey AG, Rice TW, Light RW. Frequency of pleural effusions in patients with pulmonary arterial hypertension associated with connective tissue diseases. Chest 2011;140:42-47. https://doi.org/10.1378/chest.10-0227
  17. Rosenow E, Strimlan CV, Muhm JR, Ferguson RH. Pleuropulmonary manifestations of ankylosing spondylitis. Mayo Clin Proc 1977;52:641-649.