Here we report the case of a previously healthy 32-year-old HLA B27 positive male who developed completely reversible acute oliguric renal failure in the course of nonfulminant hepatitis A infection. This is a rare complication of uncertain etiology. B27 positive individuals are prone to a number of immune system derangements including overreacting in interactions with some microbiologic agents. We made our consideration on the basis of some experimental models and the presumed pathogenesis of reactive arthritis in these individuals. As a result here we postulate a hepatitis A virus-triggered, immune mediated mechanism of renal injury restricted to genetically susceptible (i.e. B27 positive) individuals. In regard to this hypothesis we warrant additional HLA-profiles and future similar cases for further confirms and conclusions.
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http://dx.doi.org/10.1081/jdi-100100904 | DOI Listing |
J Rheumatol
January 2025
Clementina López-Medina, MD, PhD, Department of Rheumatology, Reina Sofia University Hospital; GC-05 Group, Maimonides Institute for Biomedical Research of Cordoba, IMIBIC; Medical and Surgical Sciences, University of Cordoba, Cordoba, Spain.
Objective: To compare the clinical and sociodemographic characteristics of Ibero-American patients with radiographic axial spondyloarthritis (r-axSpA) to those of European patients, with a particular focus on the influence of HLA-B27.
Methods: This was an observational, cross-sectional, and multicentre study of patients who fulfilled the European Spondyloarthropathy Study Group (ESSG) criteria for SpA from the REGISPONSER and RESPONDIA registries. Univariate and multivariate analyses between European and Ibero-American populations stratified by HLA-B27 status were conducted.
J Orthop Case Rep
January 2025
Department of Orthopaedics, Saveetha Institute of Medical and Technical Sciences, Chennai, Tamil Nadu, India.
Introduction: Ankylosing spondylitis (AS) is a chronic inflammatory disorder that primarily affects the spine and sacroiliac joints, leading to pain, stiffness, and progressive thoracolumbar kyphotic deformity. A key complication in advanced AS is the development of Andersson lesions (AL), degenerative vertebral lesions resulting from the disease's progression. These lesions can cause significant mechanical pain, often mistaken for the chronic discomfort associated with AS.
View Article and Find Full Text PDFLancet
January 2025
Rheumazentrum Ruhrgebiet Herne, Ruhr-University Bochum, Germany.
Axial spondyloarthritis manifests as a chronic inflammatory disease primarily affecting the sacroiliac joints and spine. Although chronic back pain and spinal stiffness are typical initial symptoms, peripheral (ie, enthesitis, arthritis, and dactylitis) and extra-musculoskeletal (ie, uveitis, inflammatory bowel disease, and psoriasis) manifestations are also common. Timely and accurate diagnosis is challenging and relies on identifying a clinical pattern with a combination of clinical, laboratory (HLA-B27 positivity), and imaging findings (eg, structural damage on pelvic radiographs and bone marrow oedema on MRI of the sacroiliac joints).
View Article and Find Full Text PDFActa Med Philipp
November 2024
Department of Medicine, Makati Medical Center.
Axial Spondyloarthritis (SpA) is a chronic inflammatory disease of the spine associated with the gene HLA-B27. Non-radiographic spondyloarthritis (nr-SpA), an early stage of axial SpA often goes unrecognized in many settings including the Philippines. We describe five Filipinos from a tertiary health care facility who fulfill the Assessment of SpondyloArthritis International Society (ASAS) 2009 criteria for non-radiographic SpA with the aim of increasing awareness of this disease in the Philippines.
View Article and Find Full Text PDFCalcif Tissue Int
January 2025
Internal Medicine Division, Federal University of Parana (UFPR), Curitiba, PR, Brazil.
Patients with radiographic axial spondyloarthritis (r-axSpA) experience a higher prevalence of fragility fractures, though the pathophysiology of osteoporosis associated with this disease remains poorly understood. The objective of this study was to evaluate the histomorphometric data in r-axSpA patients. Male r-axSpA patients up to 55 years old were enrolled in this cross-sectional study.
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