Ankylosing spondylitis and other spondyloarthropathies: extra-articular manifestations and their management

摘要

The spondylarthropathies (SpA) are a group of rheumatic inflammatory inter-related diseases that share common etiopathogenesis, clinical, genetic and radiological features, in which ankylosing spondylitis is the prototype of the family. All SpA are, to some extent, associated with human leukocyte antigen-B27, but the frequency varies among the several diseases. Extra-articular involvement is a frequent feature of the SpA. By the way they relate with the SpA concept, two different categories of extra-articular manifestations may be identified. First, is the extra-articular manifestation concept-associated, which has eye, bowel and skin involvement. This category may be present in all groups of the SpA family; they share common etiopathogenesis with the disease itself and can be present at any moment during disease evolution. Second, is the extra-articular manifestations non-concept associated, which involve cardiac, pulmonary, renal and neurologic manifestations, as well as osteoporosis and amyloidosis. This category is most frequently described in relation to ankylosing spondylitis, and often occurs in long-standing uncontrolled disease. In this article, we review the clinical features and therapeutic approach to the main extra-articular involvement of the SpA, paying special attention to ankylosing spondylitis.