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Seronegative spondyloarthropathies

Last updated: December 19, 2020

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Seronegative spondyloarthropathies include several chronic inflammatory arthritic diseases that affect the vertebral column. The most important diseases in this group are ankylosing spondylitis, reactive arthritis, and psoriatic arthritis. Common features include the absence of rheumatoid factor (RF) and a strong genetic association with HLA-B27. Spondyloarthropathies disproportionately affect men, with symptom onset generally occurring before the age of 45. The cardinal sign is slowly progressive pain in the lower back and sacroiliac joints (especially at night). Asymmetrical oligoarthritis and enthesopathy are also common. The diseases differ in the involvement of other organs, such as the eyes, the genitourinary tract (particularly in reactive arthritis) or the skin (particularly in psoriatic arthritis). Seronegative spondyloarthropathies usually respond well to NSAID therapy.

The different types of seronegative spondyloarthropathy do not necessarily represent distinct diseases but may overlap significantly in etiology, pathology, clinical features, and treatment.

A-PAIR of conditions is commonly associated with HLA-B27: Ankylosing spondylitis, Psoriasis, Acute anterior uveitis, Inflammatory bowel disease, Reactive arthritis.

  1. Harper BE, Reveille JD. Spondyloarthritis. Curr Sports Med Rep. 2009; 8 (1): p.29-34. doi: 10.1249/jsr.0b013e3181967ac6 . | Open in Read by QxMD
  2. N. J. Sheehan. HLA-B27: what's new?. Rheumatology (Oxford). 2010; 49 (4): p.621-631. doi: 10.1093/rheumatology/kep450 . | Open in Read by QxMD
  3. Akassou A, Bakri Y. Does HLA-B27 Status Influence Ankylosing Spondylitis Phenotype?. Clinical medicine insights. Arthritis and musculoskeletal disorders. 2018; 11 : p.1179544117751627. doi: 10.1177/1179544117751627 . | Open in Read by QxMD
  4. Ruiz DG, Azevedo MN, Lupi O. HLA-B27 frequency in a group of patients with psoriatic arthritis.. An Bras Dermatol. undefined; 87 (6): p.847-50. doi: 10.1590/s0365-05962012000600004 . | Open in Read by QxMD
  5. Wakefield D, Chang JH, Amjadi S, Maconochie Z, el-Asrar AA, McCluskey P. What Is New HLA-B27 Acute Anterior Uveitis?. Ocul Immunol Inflamm. 2011; 19 (2): p.139-144. doi: 10.3109/09273948.2010.542269 . | Open in Read by QxMD
  6. Martin TM, Rosenbaum JT. An update on the genetics of HLA B27-associated acute anterior uveitis.. Ocul Immunol Inflamm. 2011; 19 (2): p.108-14. doi: 10.3109/09273948.2011.559302 . | Open in Read by QxMD
  7. Fragoulis GE, Liava C, Daoussis D, Akriviadis E, Garyfallos A, Dimitroulas T. Inflammatory bowel diseases and spondyloarthropathies: From pathogenesis to treatment.. World journal of gastroenterology. 2019; 25 (18): p.2162-2176. doi: 10.3748/wjg.v25.i18.2162 . | Open in Read by QxMD
  8. Ritchlin CT, FitzGerald O. Psoriatic and Reactive Arthritis. Elsevier Health Sciences ; 2007
  9. Bennett JE, Dolin R, Blaser MJ. Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases. Elsevier Saunders ; 2015
  10. Herold G. Internal Medicine. Herold G ; 2014