Prevalence, Clinical Features, and Radiological Features of Iraqi Patients with Ankylosing Spondylitis

Abstract

Objective: To estimate  prevalence, clinical feature, radiological feature  of Iraqi patients with ankylosing spondylitis (AS) and  its  possible correlation with the disease activity and eye involvement.Patients and Method: A cross sectional study was conducted on 318 Iraqi patients with AS diagnosed according to the modified New York criteria. Clinical  evaluation (age , gender, symptom of AS, duration of the disease , presence of eye symptoms ,family history of AS, clinical assessment scoring of disease activity by bath ankylosing spondylitis disease activity Index  (BASDAI) as well as function by Bath ankylosing spondylitis functional index (BASFI) and radiological evaluation (Plain x-ray of sacroiliac joint , pelvic, dorso-lumbar spine and cervical spine as well as magnetic resonance imaging (MRI)   for  sacroiliac joint and spine were recorded for each patients, and  laboratory investigation (complete blood count , erythrocyte sedimentation rate(ESR) C-reactive protein (CRP), and human leucocyte antigen B 27 (HLA-B27) status were  tested using the standard serological method .Results: The prevalence rate of AS in the sample studied was 0.9 %, male was 90.6% with male to female ratio 9:1. The percentage of enthesiopathy   was 80.5% , axial arthritis was 68.2% and the peripheral arthritis was 13.8% . HLA-B27 was positive in 55%. Eye involvement was 23.6% and uveitis (all of the patients unilateral) 18.9%. There was significant association between eye manifestation with peripheral arthritis, high function class and severe disease activity but not with the sex, age, disease duration, family history of AS , HLA-B27 positive and extent  axial involvement  .Conclusions: Prevalence of AS in the sample studied was 0.9 % with male predominance, enthesiopathy was 80.5% , axial spondylitis 68.2%, peripheral arthritis 13.8%,  Eye involvement was 23.6%. .HLA-B27 was positive in 55%.There was significant association between eye manifestation with peripheral arthritis, high function class and severe disease activity.

Keywords:-Iraq, Ankylosing spondylitis, Clinical feature, Radiological feature, HLA-B27.