[Two faces of an illness: rheumatoid arthritis followed by ankylosing spondylitis]

Author presents the clinical history of a 35 years old female patient, who suffered from seronegative rheumatoid arthritis at the age of 29. Remission of the illness was followed by successful gravidity. Almost two years later spondylarthritis was diagnosed, showing only axial symptoms. The major histocompatibility complex analyzed by normal serological methods revealed the HLA B27 haplotype, typical for ankylosing spondylitis, and the HLA DR1 haplotype, typical for rheumatoid arthritis. During the examination of HLA DRB polymorphism, presence of DR B1 0101 allele was found, that plays role in the pathophysiology of rheumatoid arthritis. This case proves that a combination of HLA alleles typical for ankylosing spondylitis and rheumatoid arthritis can be found in the same patient.