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Rheumatoid spondylitis is also known as ankylosing spondylitis. It’s a condition in which there is a long-term inflammation which causes the vertebrae of the spine to attach together. This makes the spine very stiff and can change the posture of the affected individual. Other joints such as shoulder and the hip, can also be involved. In addition to this, ankylosing spondylitis may also affect other organ systems. An example is a gastrointestinal system and the eyes. The classic symptom of this inflammatory disease is a lower back pain, however, the pain usually resolves, and then comes back again. The rigidity of the joints usually worsens as time progresses. The exact cause of this disease is not known yet, however, research and studies have suggested that it could be a combination of some factors, such as genetics and environmental factors. It has been observed that over ninety percent of those affected by the disease have a particular Human leukocyte antigen, known as an HLA-B27 antigen. This has been attributed to be caused by some autoimmune reactions. Ankylosing spondylitis can be diagnosed based on the presenting symptoms, however, further evaluations can be done by undergoing some imaging tests, and blood evaluation. This disease belongs to the seronegative spondyloarthropathy group of diseases. These type of diseases do not show the presence of rheumatoid factor when screened. This disease has no cure, although there are treatments that could improve the well-being of the patient, and reduce the pain they experience. Autologous transplantation is one of the most effective and non-surgical methods of treating this disease.

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What Are The Signs And Symptoms Of Ankylosing Spondylitis?

The initial signs and symptoms of this disease include

Pain and stiffness of the joints: Patients might experience pain and rigidity of the joints of the lower back and the hips. This usually occurs in the morning. Patients might lose the ability to move their spine and also have a reduced chest expansion, as the disease progresses.

Other symptoms that can be seen include

  • Loss of weight, tiredness, and fever. The pain is always greatest when the affected person is at rest but may become better with physical activities. Ankylosing spondylitis can affect any part of the spine. Pain can also be referred from the affected part to the buttocks, or to the posterior part of the thigh from the sacroiliac joint. Up to fifty percent of affected people might also experience inflammation of the chambers of the eyes, which would eventually lead to eye redness and pain. The patient’s eye might also become overly sensitive to light.
  • Ankylosing spondylitis can lead to the inflammation of the prostate gland.
  • It can also cause some heart-related Some of the heart disorders that could occur as a result of ankylosing spondylitis include aortitis, aortic valve insufficiency, and the alteration of the electrical conduction system of the heart.

What Are The Causes Of Ankylosing Spondylitis?

The exact cause of ankylosing spondylitis is not known, however, some factors have been identified to contribute significantly to the development of the disease. These factors include genetic and environmental factors. The majority of people affected by this disease usually possess the Human leukocyte antigen- B27, also known as B27.  People that possess this gene have a higher chance of being affected by this disease.

How Is Ankylosing Spondylitis Diagnosed?

This medical condition can be diagnosed based on different factors. Some of these factors include the following:

  1. Symptoms
  2. Results of the physical examination
  3. The result of the X-rays
  4. Lab test results.

What Are The Risk Factors For This Disease?

  1. Gender: It has been observed that this disease is more predominant among the male gender. In other words, there have been more cases of this disease in males than in females.
  2. Age: Ankylosing spondylitis usually starts when people are still adolescents or when they are young adults.
  3. Genetics: This disease predominantly affects those people with the HLA-B27 gene. However, there are people that possess this gene and do not have ankylosing spondylitis.

What Are The Complications Of Ankylosing Spondylitis?

In the severe form of ankylosing spondylitis, there is the formation of new bone structures. This is done in an attempt of the body to heal.  The new bone grows and eventually joins bridges the space between the vertebrae. This would also lead to the fusion of the vertebrae. The parts that fused together would become very rigid, and immovable. This can also affect other parts of the body, such as the ribs, which would subsequently reduce the movements of the rib cage, especially during respiration, leading to the reduction of the lung capacity and function. Other complications of ankylosing spondylitis include:

  1. Cardiovascular-related disorders: This disease is capable of causing some disorders in the cardiovascular system. Some of these disorders include the inflammation of the aorta. In addition, the disease might lead to the alteration of the aortic valve. This inhibits its function, and would eventually lead to murmurs, and a reduced heart function.
  2. Visual disorders: This is one of the most common complications of ankylosing spondylitis. The eyes usually become red, and painful. Some patients do present with oversensitivity to light.
  3. Compression fractures: The bones of some individuals affected by this disease thin, especially in the initial stages. This makes their vertebrae prone to fracture, and other mechanical injuries. In addition, this worsens the already stooped posture of the affected persons. The injuries and fracture of the vertebrae, due to its weakening can cause damage to the spinal cord, and also the nerves that exit the spine.

How Is Ankylosing Spondylitis Currently Treated?

There is no cure for this disease, however, treatment is focused on improving the well-being of the patient, and also reducing the pain and rigidity of the affected joints. Below are some of the treatments:

  1. Surgery: This is usually done in severe cases of ankylosing spondylitis. The affected joints can be replaced, which is usually in the hips and knees.
  2. Physical therapy: This includes activities such as low-intensity aerobic exercise, thermotherapy, home supervised exercise, group exercises and so on.
  3. Physiotherapy: This is usually done to restore and maintain the functions of the joints. It also reduces the progression of the deformity. A physiotherapist is usually employed to do this.
  4. Medications: Some drugs are used to reduce inflammatory processes and pain associated with this disease. They include corticosteroids and analgesics.

Stem Cell Therapy Of Ankylosing Spondylitis.

Stem cell transplantation is one of the most reliable and effective treatments for this disease. Autologous transplantation is usually done to patients. This is a process in which the patient’s stem cells are extracted and then re-infused back into the patient. The stem cells reduce and can stop the progression of the disease. In addition, it’s also capable of repairing and replacing dead and injured tissues and cells.

References

034 Predictors of Employment Loss in Ankylosing Spondylitis: Results from the Scotland Registry for Ankylosing Spondylitis. (2016). Rheumatology.

Jantunen, E. (2000). Autologous stem cell transplantation in a lymphoma patient with a long history of ankylosing spondylitis. Rheumatology, 39(5), pp.563-564.

Mohammadi, H., Hemmatzadeh, M., Babaie, F., Shabgah, A., Azizi, G., Hosseini, F., Majidi, J. and Baradaran, B. (2018). MicroRNA implications in the etiopathogenesis of ankylosing spondylitis. Journal of Cellular Physiology.

Ramiro, S., van Tubergen, A., Stolwijk, C., Landewé, R., van de Bosch, F., Dougados, M. and van der Heijde, D. (2013). Scoring radiographic progression in ankylosing spondylitis: should we use the modified Stoke Ankylosing Spondylitis Spine Score (mSASSS) or the Radiographic Ankylosing Spondylitis Spinal Score (RASSS)?. Arthritis Research & Therapy, 15(1), p.R14.

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