Raouf Rahim Merza; Lawen Jamal Mustafa
Abstract
Background: Ankylosing spondylitis (AS) is a chronic, progressive, and disabling disease among rheumatological diseases.Objectives: Current study aimed to investigate the Time lag between the onset of symptoms and final diagnosis of AS, and also identify the factors that contribute to that delay in Sulaymaniyah ...
Read More
Background: Ankylosing spondylitis (AS) is a chronic, progressive, and disabling disease among rheumatological diseases.Objectives: Current study aimed to investigate the Time lag between the onset of symptoms and final diagnosis of AS, and also identify the factors that contribute to that delay in Sulaymaniyah province.Methods: In this cross-sectional study, 104 (AS) patients who satisfied the modified New York 1984 criteria were enlisted. The time lag was defined as the diagnosis delay (DD) between the appearance of the first symptoms and the correct diagnosis of AS. Spearman correlation analysis was used to detect correlations between variables.Results: The higher percentage of variables with DD ≥ 6 years were urban 32 (74.4%), housewife 15(34.9%), had no family history 42 (97.7%), with high diploma 33 (76.7%), and positive HLAB27 31 (72.1%), the first specialist consulted orthopedics 21(48.8%) then GP 6 (14.9). Moreover, the higher percentage of variables with DD < 6 years were diagnosis years between 2000 to 2020, rural 55 (90.2), 39 (63.9%) respectively, higher education 47 (77%), employee and worker 22 (36.1%), positive family history 44 (72.1%), positive human leukocyte antigen (HLAB27-61) (100%), inflammatory back pain 47 (77%), rheumatologist 29 (47.5%). The average year’s DD is 6.48. A statistically significant positive correlation was detected between the DD and age, age at diagnosis but, a negative correlation was found between the DD time and, age at symptom onset.Conclusion: The Time lag between the onset of symptoms of AS and the final diagnosis in Sulaymaniyah was 6.48 years. (HLA-B27), age, age at diagnosis, education level, occupation, 1st specialist, 1st symptom at onset of disease and family history are the factors that affect delayed diagnosis in Sulaymaniyah patients with AS.
Gholam Hossein Alishiri; Ehsan Rahmanian; Mahsa Ramezanpour
Abstract
Introduction: A case of pulmonary sarcoidosis is reported because of difficulties in diagnosis and treatment, including the co-existence of ankylosing spondylitis (AS) and severe corticosteroid dependence. Case Presentation: A 48-year-old nonsmoking woman referred to the hospital because of chronic nonproductive ...
Read More
Introduction: A case of pulmonary sarcoidosis is reported because of difficulties in diagnosis and treatment, including the co-existence of ankylosing spondylitis (AS) and severe corticosteroid dependence. Case Presentation: A 48-year-old nonsmoking woman referred to the hospital because of chronic nonproductive cough and dyspnea with a 10-year history of AS. Bilateral rhonchi was detected in lung auscultation. There was a significant limitation in lumbar activity and range of motion in flexion (positive Schober’s test), extension, and lateral bending. In lumbosacral magnetic resonance imaging (MRI), irregularities in the sacroiliac joint and bilateral sacroiliitis were evident. The angiotensin-converting enzyme level was elevated. Biopsy in hilar lymphadenopathy by transbronchial lung biopsy was done, and the histopathological findings showed chronic non-necrotizing granulomatosis inflammation compatible with sarcoidosis. Anti-tumor necrosis factor drugs was effective on steroid-dependent coexisting of sarcoidosis and AS. The symptoms were absent in regular follow up. Conclusion: Pulmonary fibrosis due to sarcoidosis can be prevented by suitable treatment. Clinical trials are needed to confirm the impact of treatments with monoclonal antibodies against tumor necrosis factor (TNF), for curing sarcoidosis.