Journal List > J Korean Rheum Assoc > v.15(3) > 1003633

Kim, Lim, Kim, Kim, Kim, Seo, and Kim: A Case of Ankylosing Spondylitis in a Patient with Henoch-Schönlein Purpura

Abstract

Ankylosing spondylitis (AS) is a common inflammatory arthritis that affects the axial skeleton, causing characteristic inflammatory back pain, which can lead to structural and functional impairments and a decrease in quality of life. The disease can be accompanied by extraskeletal manifestations, such as acute anterior uveitis, inflammation in the colon or ileum, aortic insufficiency, cardiac conduction defects, fibrosis of the upper lobes of the lungs, neurologic involvement, or renal (secondary) amyloidosis. We report the case of a 19 year-old man who developed Henoch-Schönlein purpura (HSP) and subsequently AS. It has been recognized that AS may be associated with cutaneous vasculitis and IgA nephropathy, but the association of HSP with AS has not been reported. This association of IgA nephropathy or HSP with AS raises the possibility of a common or related pathogenesis.

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Fig. 1.
(A) Glomeruli show mild mesangiopathy with thin capillary walls. Tubules contain RBC casts (Jones' Silver stain, ×200). (B) There is mild mesangial proliferation with fuchsinophilic deposits (Masson's trichrome stain, ×400). (C) Immunofluorescence staining reveals diffuse mesangial deposits for IgA (×200).
jkra-15-268f1.tif
Fig. 2.
(A) Anteroposterior radiograph of the pelvis showing multiple periarticular erosions and sclerosis of both sacroiliac joints. (B) Radiograph of the lateral lumbar spine with squaring of vertebrae.
jkra-15-268f2.tif
Fig. 3.
99mTc MDP bone scan shows increased uptake in both sacroiliac joints, the region of right tibial tuberosity and right greater trochanter.
jkra-15-268f3.tif
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