title: Coexisting ankylosing spondylitis and rheumatoid arthritis: a case report with literature review.
abstract: A 30-year-old female patient with coexisting ankylosing spondylitis and rheumatoid arthritis was diagnosed and treated. The human leukocyte antigen (HLA)-B27 is a predisposing factor of ankylosing spondylitis and HLA-DR4 is a predisposing factor of rheumatoid arthritis. This patient was HLA-B27 and HLA-DR4 positive, and ankylosing spondylitis manifested before rheumatoid arthritis. After disease modifying anti-rheumatic drugs successfully arrested ankylosing spondylitis activity the patient conceived and delivered a healthy baby. One year later, she developed peripheral polyarthritis and was diagnosed with rheumatoid arthritis. We hypothesized that pregnancy may be one of the environmental factors that can activate rheumatoid arthritis, and that disease modifying anti-rheumatic drugs play an important role in keeping the disease under control.
authors.affiliation: Department of Rheumatology and Immunology, Shengjing Hospital of China Medical University, Shenyang, Liaoning 110004, China.
authors.forename: Ying-Ying
authors.initials: YY
authors.lastname: Guo
authors.forename: Li-Li
authors.initials: LL
authors.lastname: Yang
authors.forename: Hua-Dong
authors.initials: HD
authors.lastname: Cui
authors.forename: Shuai
authors.initials: S
authors.lastname: Zhao
authors.forename: Ning
authors.initials: N
authors.lastname: Zhang
mesh_terms: D000328:Adult; D001172:Arthritis, Rheumatoid / Q000175:diagnosis* / Q000378:metabolism; D005260:Female; D015796:HLA-B27 Antigen / Q000378:metabolism; D015804:HLA-DR4 Antigen / Q000378:metabolism; D006801:Humans; D013167:Spondylitis, Ankylosing / Q000175:diagnosis* / Q000378:metabolism
chemical_list: D015796:HLA-B27 Antigen; D015804:HLA-DR4 Antigen