Low frequency of axial involvement in Caucasian pediatric patients with seronegative enthesopathy and arthropathy syndrome after 5 years of disease.
In order to establish how many children with seronegative spondyloarthropathy (SpA) starting with peripheral arthritis and/or enthesitis will develop ankylosing spondylitis (AS), 13 consecutive Caucasian pediatric patients, (11 with the seronegative enthesopathy and arthropathy (SEA) syndrome and 2 with isolated B27 associated peripheral arthritis or enthesitis at entry), were followed prospectively with no loss for more than 5 years. Sacroiliac joint plain films obtained at the last visit were mixed with those of 14 control subjects and read blindly. The course of SpA was self-limiting in 6 patients and recurrent in the other 7. Six patients had episodes of inflammatory cervical and/or lumbar pain during followup. However, none showed any limitation of spinal movement in the asymptomatic periods. Only one patient (9.1%) of 11 with the SEA syndrome showed bilateral sacroiliitis and met New York criteria for AS after 5 years of disease. Our results suggest that the proportion of Caucasian children with the SEA syndrome developing AS is much lower than the 75% found in a similar study on Mexican children. Lack of evaluation of all patients after 5 years, the reading of pelvic plain films without reducing observer error, and the male predominance in the Mexican study, probably in addition to ethnic or environmental factors, may account for differences.
Olivieri
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I
Rheumatic Disease Unit, Institute of Medical Pathology 1, University of Pisa, Italy.
Foto
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Ruju
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Gemignani
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Giustarini
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Pasero
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G
D000293:Adolescent; D015796:HLA-B27 Antigen / Q000032:analysis; D006801:Humans; D007592:Joint Diseases / Q000000981:diagnostic imaging / Q000208:ethnology / Q000503:physiopathology*; D009140:Musculoskeletal Diseases / Q000000981:diagnostic imaging / Q000208:ethnology / Q000503:physiopathology*; D010146:Pain; D011446:Prospective Studies; D013122:Spinal Diseases / Q000503:physiopathology; D013131:Spine / Q000503:physiopathology; D013577:Syndrome; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D044465:White People
D015796:HLA-B27 Antigen