Coexisting ankylosing spondylitis and gouty arthritis

Area of Science:

• Rheumatology
• Clinical Medicine
• Immunogenetics

Background:

• Ankylosing spondylitis (AS) is a chronic inflammatory disease primarily affecting the axial skeleton.
• Gout is a form of inflammatory arthritis caused by monosodium urate crystal deposition.
• Coexistence of AS and gout presents unique diagnostic and management challenges.

Purpose of the Study:

• To investigate the clinical characteristics of patients with coexisting ankylosing spondylitis and gout.
• To analyze the demographic, clinical, and comorbidity profiles of this patient cohort.

Main Methods:

• Retrospective study of 65 patients with coexisting AS and gout.
• Data collection on patient demographics, age at onset of both conditions, clinical manifestations, and associated medical conditions.
• Review of medication use and complications.

Main Results:

• The study included 65 patients (93.8% male), predominantly Han Chinese.
• Mean age at onset for AS was 29.3 years and for gout was 42.2 years.
• Common manifestations included acute peripheral arthritis (100%), chronic peripheral arthritis (67.7%), and heel pain/enthesopathy (50.8%). HLA-B27 positivity was high (93.9%).
• Associated conditions included hyperlipidemia (52.3%), hypertension (32.3%), and urolithiasis (26.2%).
• Six patients (9.2%) developed iatrogenic Cushing syndrome.

Conclusions:

• Coexisting ankylosing spondylitis and gout are not uncommon.
• Clinical differentiation between AS and gout manifestations, especially peripheral arthritis and enthesopathies, is essential for accurate diagnosis and treatment.
• The high prevalence of certain comorbidities and potential drug-induced complications warrants careful monitoring.