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Ankylosing spondylitis lung disease--an underdiagnosed entity?
European Journal of Respiratory Diseases
|August 1, 1983
Summary
Ankylosing spondylitis (AS) can affect the lungs, often going undiagnosed. Early recognition of upper lobe changes and symptoms is crucial for timely diagnosis and management of this condition.
Area of Science:
- Pulmonology
- Rheumatology
- Radiology
Background:
- Ankylosing spondylitis (AS) is a chronic inflammatory disease primarily affecting the spine.
- Pulmonary involvement in AS, particularly upper lobe changes, is an under-recognized complication.
- Diagnosis of AS can be challenging, leading to delayed or missed identification of associated conditions.
Observation:
- Over the last decade, 14 cases of ankylosing spondylitis with upper lobe lung changes were identified.
- Two recent cases were initially undiagnosed despite being HLA B27 positive with typical sacroiliac joint X-ray findings.
- A literature review identified 160 previously published cases of AS with pulmonary involvement.
Findings:
- AS-related lung lesions can be complicated by superinfections.
- Fungal, non-tuberculous mycobacterial, and tuberculous infections are potential complications.
- Specific questioning and careful evaluation are necessary to diagnose missed AS cases.
Implications:
- Increased awareness of pulmonary manifestations in AS is needed among clinicians.
- Prompt diagnosis of AS-related lung disease can prevent serious complications.
- Further research into the pathogenesis and management of AS pulmonary involvement is warranted.