Ankylosing spondylitis in a patient with myelodysplastic syndrome: an association with HLA-B27 or coincidence?
The authors report an unusual case of myelodysplastic syndrome (MDS) associated with ankylosing spondylitis (AS). A 40-year-old-man with MDS presented with chronic low back pain for 6 years. Four years ago, MDS was diagnosed during routine blood analysis for the work-up of his articular complaints. His initial articular complaints were attributed to extramedullary manifestations of MDS. Persistent low back pain with increasing intensity finally led the patient to seek medical attention. Radiograph of the pelvis showed bilateral asymmetric sacroiliitis. A diagnosis of AS was established on the basis of modified New York criteria. Although various autoimmune phenomena associated with MDS have been described, this is the first report of AS in the setting of MDS. Causal relationship between these two disorders is currently unknown. Increased risk of hematological diseases as well as AS in individuals with a positive HLA-B27 provides a feasible explanation for this rare observation.
Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Irwon-dong, Gangnam-gu, Seoul, 135-710, Republic of Korea.
Jaejoon
J
Lee
Hyungjin
H
Kim
Joong Kyong
JK
Ahn
Ji Won
JW
Hwang
Jun Ho
JH
Jang
Eun-Mi
EM
Koh
Hoon-Suk
HS
Cha
D000328:Adult; D015796:HLA-B27 Antigen / Q000276:immunology*; D006801:Humans; D017116:Low Back Pain / Q000175:diagnosis / Q000000981:diagnostic imaging; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging; D008297:Male; D009190:Myelodysplastic Syndromes / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000276:immunology*; D011859:Radiography; D013167:Spondylitis, Ankylosing / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000276:immunology*
D015796:HLA-B27 Antigen