1/24. A case of coexisting Behcet's disease and ankylosing spondylitis.Behcet's disease (BD) is a chronic inflammatory condition involving several organs, such as skin, mucous membrane, eye, joint, intestine, lung and central nervous system. Ankylosing spondylitis (AS) is a prototype of seronegative spondyloarthropathy, and a chronic systemic inflammatory disorder of the axial skeleton, mainly affecting the sacroiliac joint and spine. In the latter, systemic complications may develop in addition to joint involvement. The coexistence of BD and AS has been rarely reported in the literature. The inclusion of BD among seronegative spondyloarthritides and whether sacroiliitis (SI) develops in BD are still being debated. We describe a 28-year-old man who has fulfilled the diagnostic criteria for BD and AS as well.- - - - - - - - - - ranking = 1keywords = organ (Clic here for more details about this article) |
2/24. Hypoglycaemic neuropathy: a case report.A 53 years old male, a known case of ankylosing spondylitis having recurrent attacks of hypoglycaemia, developed symmetrical distal sensorimotor neuropathy. The neuropathy was axonal with secondary demyelination. Evidence of vasculopathy was also noted on histopathology of the nerve. serum c-peptide level was low, a feature reported with autoimmune hypoglycaemia with antireceptor antibodies. The patient showed spontaneous recovery.- - - - - - - - - - ranking = 1.7066364870982keywords = nerve (Clic here for more details about this article) |
3/24. Transverse myelitis in a patient with long-standing ankylosing spondylitis.Ankylosing spondylitis is reported to involve not only the joints but other organs as well. Among these extra-articular involvements, uncommon complications associated with nervous system such as single root lesions, compression of the myelum and cauda equina syndrome have also been documented. Here we present a patient with long-standing ankylosing spondylitis who developed spastic paraparesis. Extensive study to find the cause of a spastic paraparesis failed and therefore led to the conclusion that this patient was suffering from transverse myelitis. Similar reports in the past have been attributed to an association with multiple sclerosis; however, we suggest that the findings support the diagnosis of a rare complication of ankylosing spondylitis with an unknown etiology.- - - - - - - - - - ranking = 1keywords = organ (Clic here for more details about this article) |
4/24. An absence of changes in kidney tissues after an enormous number of shock waves.Repeated sessions of unilateral extracorporeal shock wave lithotripsy (ESWL) were performed in a patient with multiple bilateral calycolithiasis who suffered from Crohn's disease of long duration and from recurrent gastric ulcers. To achieve complete clearance of stones from the left kidney it was necessary to apply 10,000 shock waves during seven sessions within five weeks. This number is exceedingly high compared to average total doses which were applied to other patients of our group (920 SW per one session). For the treatment was used an electrohydraulic lithotripter (Medipo). A surgical reconstruction of the abdominal wall which had been planned long before was made six weeks after the last ESWL session. The postoperative course was complicated by bleeding gastric ulcer of which the patient died despite an intensive treatment. The autopsy and histology revealed no damage of kidney tissue or adjacent organs caused by ESWL.- - - - - - - - - - ranking = 1keywords = organ (Clic here for more details about this article) |
5/24. Ankylosing spondylitis and central core disease: case report.Ankylosing spondylitis (AS) is an inflammatory disorder of unknown cause that primarily affects the axial skeleton. Neurological manifestations of AS are usually related to spinal deformities. Previous studies of the paraspinal muscles of AS patients showed muscle fiber atrophy, and core fibers. On the other hand, central core disease (CCD) is a genetic condition that primarily involves the skeletal muscles, but can present articular deformities secondary to muscular weakness. We report the case of a 45-year-old man with clinical and radiological diagnosis of AS and proximal muscular weakness in the lower limbs. Needle electromyography showed myopathic features and nerve conduction study was normal. Muscle biopsy disclosed almost complete predominance of type-1 fibers, and fibers with central cores. This is the first report of AS and CCD. Whether central core myopathy is coincidental or a new association with AS is discussed.- - - - - - - - - - ranking = 1.7066364870982keywords = nerve (Clic here for more details about this article) |
6/24. Thoracic aortic pseudoaneurysm after spine trauma in ankylosing spondylitis. Case report.Ankylosing spondylitis (AS) is a rheumatic disease characterized by consolidation of the articulating surfaces and inflammation of the vertebral column. Because of its associated spine stiffness and secondary osteoporosis, patients with this disorder are at increased risk of vertebral fractures. Ankylosing spondylitis presents a significant challenge to spine surgeons because of its complex effects on the spine, extraarticular organ manifestations, and potential neurological and functional sequelae. Traumatic thoracic and lumbar spine injuries in this patient population may be associated with injury to the aorta either due to direct mechanical trauma or to blunt forces associated with the spine fracture. This complication and association is thought to be the result of pathophysiological changes that cause the aorta to become firmly adherent to the anterior longitudinal ligament. The authors present a case of AS in a patient with a thoracic spine fracture and in whom a delayed thoracic aortic pseudoaneurysm ruptured. To the best of the authors' knowledge, only five cases of this complex condition have been reported since 1980. Recognition of the potential for aortic injury in patients with AS should prompt early investigation of the aorta in cases involving numerous fractures and assist in surgical planning to avoid this lethal injury.- - - - - - - - - - ranking = 1keywords = organ (Clic here for more details about this article) |
7/24. Transverse myelitis after lumbar steroid injection in a patient with Behcet's disease.STUDY DESIGN: Case report. OBJECTIVE: We describe a patient who developed transverse myelitis (TM) following a nerve root injection of steroids and anesthetic at L2 for radicular pain. SETTING: baltimore, MD, USA. CLINICAL PRESENTATION: A 42-year-old woman developed progressive lower extremity weakness and paresthesias, a T12 sensory level and urinary urgency 8 h following the injection of Marcaine and Celestone into the left L2 nerve root. magnetic resonance imaging showed T2 signal abnormality with gadolinium enhancement from T12 to the conus medullaris and there was no evidence of traumatic injury to the spinal cord. The patient had undiagnosed Behcet's disease (BD) and had experienced multiple episodes of pathergy: hyper-responsiveness of the skin to local trauma, resulting in inflammation and edema. Intravenous steroids were initiated and the patient experienced a near total clinical resolution and a complete radiologic resolution. CONCLUSION: Since the spinal cord inflammation developed after and immediately adjacent to local spinal trauma, we suggest that the TM in this patient was related to BD and was a pathergy response in the spinal cord.- - - - - - - - - - ranking = 3.4132729741965keywords = nerve (Clic here for more details about this article) |
8/24. Correction osteotomy of flexion deformity of cervical spine in ankylosing spondylitis--a case report.It is well known that severe flexion deformities of the spine may occur in patients suffering from ankylosing spondylitis. The prevention of these deformities by early recognition of the disease process should be the main aim of the medical profession in handling patients with specific spinal involvements. Yet, we still see all too often patients with advanced kyphotic deformities of the trunk who are very grossly disabled and thus present a major problem to definitive surgical correction of their deformities. Correction of rigid kyphosis by establishing a compensatory lordosis can be carried out in the lumbar or cervical area. Surgical intervention in the cervical region enables the chin to be lifted off the sternum, but great care has to be taken of the relatively bulky spinal cord, which practically fills the spinal canal. Excessive correction runs the risks of fatally damaging the nerves and vertebral vessels. Therefore, most centers perform correction osteotomies of the cervical spine progressively, with day-by-day adjustment of the external fixators. We present a case of cervical osteotomy in which, under local anesthesia and with the aid of S.S.E.P., cervical kyphosis was corrected by a one-stage procedure. The results and difficulties are described here-in.- - - - - - - - - - ranking = 1.7066364870982keywords = nerve (Clic here for more details about this article) |
9/24. cauda equina syndrome associated with multiple lumbar arachnoid cysts in ankylosing spondylitis: improvement following surgical therapy.A case of cauda equina syndrome with multiple lumbar arachnoid cysts complicating ankylosing spondylitis (AS) is described. The value of computerised tomography (CT) and magnetic resonance imaging (MRI) as a non-invasive means of establishing the diagnosis is emphasised. In contrast to previously reported cases the patient showed neurological improvement following surgical therapy. Surgery may be indicated in some patients, particularly when there is nerve root compression by the arachnoid cysts and when the patient is seen early before irreversible damage to the cauda equina has occurred.- - - - - - - - - - ranking = 1.7066364870982keywords = nerve (Clic here for more details about this article) |
10/24. Abnormal scintigraphic evolution in AA hepatic amyloidosis.A patient with AA amyloidosis secondary to ankylosing spondylitis showed intense liver uptake of Tc-99m MDP on bone imaging. The biopsy showed hepatic amyloid deposition. A repeat bone scan with Tc-99m MDP 1 year later was negative, although the clinical signs and liver function tests of the patient had not changed. A mechanism might exist, other than the affinity of amyloid to calcium, which would explain the extraosseous uptake of pyrophosphates and diphosphonates in organs and soft tissues affected by systemic amyloidosis.- - - - - - - - - - ranking = 1keywords = organ (Clic here for more details about this article) |
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