Clinical Features in Juvenile-Onset Ankylosing Spondylitis Patients Carrying Different B27 Subtypes.
BACKGROUND
Ankylosing spondylitis (AS) is a common rheumatic disease and is characterized by inflammation of the axial skeleton. HLA-B27 is strongly associated with AS. Juvenile-onset AS (JAS) with disease onset before 16 years of age differs from adult-onset AS (AAS) in many respects.


OBJECTIVE
To compare the clinical features in JAS with different B27 subtypes and analyze the differences between JAS and AAS.


METHODS
145 JAS and 360 AAS patients were included. The demographic data, clinical manifestations, laboratory markers, Bath AS indices, and B27 subtypes were recorded.


RESULTS
Peripheral arthritis, enthesitis, BASDAI, ESR, and CRP were significantly higher in JAS patients with HLA-B(*)2704 than those with B27-negative. Enthesitis and ESR were significantly higher in patients with HLA-B(*)2705 than those with B27-negative. The onset age of HLA-B(*)2715 group was much earlier than the other groups. The peripheral arthritis, enthesitis, and hip joint involvement in JAS with HLA-B(*)2704 were significantly higher than those in AAS with HLA-B(*)2704.


CONCLUSIONS
JAS with different B27 subtypes had similar features in most of manifestations; JAS and AAS patients with the same subtype could have distinctive courses. Early diagnosis, hip detection, and control of systemic active inflammation in JAS patients will be helpful for improving the prognosis.
Department of Rheumatology, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, Guangdong 510630, China.
Yikun
Y
Mou
Department of Rheumatology, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, Guangdong 510630, China.
Pingping
P
Zhang
Department of Rheumatology, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, Guangdong 510630, China.
Qiuxia
Q
Li
Department of Rheumatology, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, Guangdong 510630, China.
Zhiming
Z
Lin
Department of Rheumatology, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, Guangdong 510630, China.
Zetao
Z
Liao
Department of Rheumatology, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, Guangdong 510630, China.
Qiujing
Q
Wei
Department of Rheumatology, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, Guangdong 510630, China.
Jieruo
J
Gu
D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D015415:Biomarkers / Q000097:blood; D002648:Child; D002681:China / Q000453:epidemiology; D005260:Female; D015796:HLA-B27 Antigen / Q000097:blood* / Q000276:immunology; D006801:Humans; D015995:Prevalence; D015203:Reproducibility of Results; D012307:Risk Factors; D012680:Sensitivity and Specificity; D017678:Sex Distribution; D013167:Spondylitis, Ankylosing / Q000097:blood / Q000175:diagnosis* / Q000453:epidemiology*; D063189:Symptom Assessment / Q000706:statistics & numerical data*; D055815:Young Adult
D015415:Biomarkers; D015796:HLA-B27 Antigen