Alkylosing Spondylitis

Alkylosing Spondylitis, Reiter s Disease, Psoriasis, Crohn s Syndrome, and Multiple Sclerosis 

Alkylosing spondylids is an inflammatory autoimmune reac-dve arthrids wdth a primary end organ target of the intervertebral Joints and the sacroiliac joint at the hip. The characterisdc features are a bowled spine and inflamed joints. Compared wdth 8% of Caucasians as a w hole, 95% of people wdth alkylosing spondylids have the HLA B27 allele. Unlike many autoimmune diseases, alkylosing spondylids is more common in men and has an early onset betw een 20 and 40 m years of age. 

Muld System Involvement wdth Emphasis on Neurologic Symptoms 

Multi System Involvement with Emphasis on Neurologic Symptoms 

the HLA allele proposed to be involved in alkylosing spondylitis, shares an epitope with an enzyme from Klebsiella pneumoniae, a common intestinal Gram negative bacterium. Molecular mimicry is thought to result in cross-reactive antibody formation, joint inflammation and spinal damage. Along with many of the immunotherapies described for other similar arthritic autoimmune disorders, alkylosing spondylitis is treated with anti-inflammatory medications and a low carbohydrate diet to reduce intestinal K. pneumoniae levels. 

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Keywords Alkylosing spondylitis Crohn s disease HLA B27 Keratinocytes Molecular mi mi cry Sjogren s syndrome Subluxation Thalidomide... 

Psoriasis generally appears at the joints, limbs and scalp but may appear anywhere on the body. At least 10% those with psoriasis develop psoriatic arthritis, a degenerative disease of the joints and connective tissue. Approximately 1 million people in the U.S. have psoriatic arthritis. Psoriatic arthritis usually develops between the ages of 30 and 50 but can develop without the lesions characteristic of psoriasis (Natl Psoriasis Foundation, 2005, Specific forms of psoriasis, psoriasis.org). Of those with psoriatic arthritis, about 20% will develop spinal involvement. The inflammation associated with spinal involvement can lead to vertebral fusion as in alkylosing spondylitis. 

Compare the gender distribution of those diagnosed with Multiple Sclerosis, Crohn s disease and Alkylosing Spondylitis... 

Discuss the postulated role of molecular mimicry in Alkylosing Spondylitis. 

Alkylosing spondylitis Intervertebral joints and sacroiliac joint Eye inflammations and caudae equinae related neuropathies... 

Reiter s Disease (reactive arthritis) Vertebral joints >15% develop alkylosing spondylitis or severe arthritis with neurologic sequelae... 

The exact cause is unknown, but there appears to be a genetic link. About 75% of those with the tendency to develop Reiter s syndrome have the same gene marker, HLA-B27, described in the previous description of alkylosing spondylitis. There is also an environmental or infectious component. Reiter s disease can develop in at risk individuals following an infection in the intestines, genital or urinary tract. Bacteria implicated as potential causes of Reiter s syndrome include Chlamydia,... 

Those patients who develop psoriatic arthritis with spinal involvement are most likely to test positive for the HLA-B27 genetic marker also implicated in alkylosing spondylitis and Reiter s syndrome. 

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