title: Coexistence of axial spondyloarthritis and thromboangiitis obliterans in a young woman.
abstract: A peculiar coexistence of axial spondyloarthritis and ischemia of the feet and the fourth finger of the left hand in a young woman, who was a heavy smoker, is discussed in this report. This picture was considered within the context of thromboangiitis obliterans. Positivity of anti-nuclear antibodies and mild elevation of inflammatory parameters were noted. Computed tomography angiograms of upper and lower limbs showed luminal narrowing and occlusion of the left humeral, left anterior/posterior tibial and right anterior tibial arteries. Daily iloprost perfusions were started, and smoking cessation was strongly recommended. Coldness and rest pain in the distal extremities improved within a few weeks. The possibility that spondyloarthritis might precede the clinical picture of thromboangiitis obliterans should be considered in heavy smokers.
authors.affiliation: Interdisciplinary Department of Medicine, Rheumatology Unit, Policlinico of Bari. glopalco@hotmail.it.
authors.forename: G
authors.initials: G
authors.lastname: Lopalco
authors.forename: F
authors.initials: F
authors.lastname: Iannone
authors.forename: D
authors.initials: D
authors.lastname: Rigante
authors.forename: A
authors.initials: A
authors.lastname: Vitale
authors.forename: M E
authors.initials: ME
authors.lastname: Mancini
authors.forename: M
authors.initials: M
authors.lastname: Covelli
authors.forename: G
authors.initials: G
authors.lastname: Lapadula
authors.forename: L
authors.initials: L
authors.lastname: Cantarini
mesh_terms: D000974:Antibodies, Antinuclear / Q000097:blood; D015415:Biomarkers / Q000097:blood; D001916:Brachial Artery / Q000000981:diagnostic imaging; D000072226:Computed Tomography Angiography / Q000379:methods; D005260:Female; D006801:Humans; D016285:Iloprost / Q000008:administration & dosage; D007262:Infusions, Intravenous; D008279:Magnetic Resonance Imaging / Q000379:methods; D008875:Middle Aged; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects; D025241:Spondylarthritis / Q000097:blood / Q000150:complications* / Q000175:diagnosis*; D013919:Thromboangiitis Obliterans / Q000097:blood / Q000150:complications* / Q000175:diagnosis* / Q000188:drug therapy; D016909:Tibial Arteries / Q000000981:diagnostic imaging; D016896:Treatment Outcome; D014665:Vasodilator Agents / Q000008:administration & dosage
chemical_list: D000974:Antibodies, Antinuclear; D015415:Biomarkers; D014665:Vasodilator Agents; D016285:Iloprost