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Abstract
The spondyloarthropathies are a group of inflammatory rheumatic diseases including ankylosing spondylitis, reactive arthritis, psoriatic arthritis, arthritis associated with inflammatory bowel disease, and undifferentiated spondyloarthropathy. It usually begins in young or middle aged adults, but sometimes presents with atypical symptoms in the older patients. Late onset spondyloarthropathies are characterized by severe disease, marked elevation of laboratory parameters of inflammation, oligoarthritis involving the lower limbs with edema of the extremities. We described a 66-year-old patient who presented with asymmetric polyarthritis mainly involving lower extremities with fever, marked elevation of laboratory inflammatory markers, and was successfully treated with mini-pulse corticosteroids with disease modifying antirheumatic drugs.
REFERENCES
1). Dubost JJ., Sauveize B. Late onset peripheral spondyloarthropathy. J Rheumatol. 1989. 16:1214–7.
2). Caplanne D., Tubach F., Parc JM. Late onset spondyloarthropathy: clinical and biologic comparison with early onset patients. Ann Rheum Dis. 1997. 56:176–9.
3). Toussirot E., Wendiling D. Late onset ankylosing spondylitis and related spondyloarthropathies: clinical and radiological characteristics and pharmacological treatment options. Drugs Aging. 2005. 22:451–69.
4). 이ivieri I., Salvarani C., Cantini F., Ciancio G., Padula A. Ankylosing spondylitis and undifferentiated spondyloarthropathies: a clinical review and description of a disease subset with older age at onset. Curr Opin Rheumatol. 2001. 13:280–4.
5). Amor B., Dougados M., Mijiyawa M. Criteria of the classification of spondylarthropathies. Rev Rhum Mal Osteoartic. 1990. 57:85–9.
6). Dougados M., Van der Linden S., Juhlin R. The European Spondyloarthropathy Study Group preliminary criteria for the classification of spondyloarthropathy. Arthritis Rheum. 1991. 34:1218–27.
7). Dubost JJ., Sauveizie B. Current aspects of inflammatory rheumatic diseases in elderly patients. Rev Rhum Mal Osteoartic. 1992. 59:37–42.
8). Benedek TG. Neoplastic associations of rheumatic diseases and rheumatic manifestations of cancer. Clin Geraitr Med. 1988. 4:333–55.
9). Olive A., Blanco J., Pons M., Vaquero M., Tena X. The clinical spectrum of remitting seronegative symmetrical synovitis with pitting edema. J Rheumatol. 1997. 24:333–6.
10). Salvarani C., Gabriel S., Hunter GG. Distal extremity swelling with pitting edema in polymyalgia rheumatica: report on nineteen cases. Arthritis Rheum. 1996. 39:73–80.
11). Salvarani C., Cantini F., Macchinoni L., 이ivieri I., Niccoli L., Padula A, et al. Distal musculoskeletal manifestations in polymyalgia rheumatica: a prospective follow up study. Arthritis Rheum. 1998. 41:1221–26.
12). Buffum M., Buffum JC. Non-steroidal anti-inflammatory drugs in the elderly. Pain Manag Nurs. 2000. 1:40–50.
13). Dougados M., vam der Linden S., Leirisalo-Repo M., Huitfeldt B., Juhlin R., Veys E, et al. Sulfasalazine in the treatment of spondyloarthropathy: a randomized, multicenter, double blind, placebo-controlled study. Arthritis Rheum. 1995. 38:618–27.
14). Clegg DO., Reda DJ., Abdellatif M. Comparison of sulfasalazine and placebo for the treatment of axial and peripheral articular manifestations of the seronegative spondyloarthropathies: a Department of Veterans Affairs cooperative study. Arthritis Rheum. 1999. 42:2325–9.
15). Toussirot E., Wendling D. Bone mass in ankylosing spondylitis. Clin Exp Rheumatol. 2000. 18((Suppl 21):):S16–20.
Fig. 2.
Pelvis X-ray images revealed subtle small erosion and sclerosis at both sacroiliac joint with poststatus of total hip replacement surgery at both hip joints.
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