RT Journal Article
SR Electronic
T1 Clinical Features of Late-onset Ankylosing Spondylitis: Comparison with Early-onset Disease
JF The Journal of Rheumatology
JO J Rheumatol
FD The Journal of Rheumatology
SP jrheum.111082
DO 10.3899/jrheum.111082
A1 Carlos Montilla
A1 Javier Del Pino-Montes
A1 Eduardo Collantes-Estevez
A1 Pilar Font
A1 Pedro Zarco
A1 Juan Mulero
A1 Jordi Gratacós
A1 Carlos Rodríguez
A1 Xavier Juanola
A1 Jose Luis Fernández-Sueiro
A1 Raquel Almodovar
YR 2012
UL http://www.jrheum.org/content/early/2012/03/10/jrheum.111082.abstract
AB Objective Ankylosing spondylitis (AS) is generally observed in young patients but can occur later in life or in persons ≥ 50 years of age. Our objective was to characterize the clinical features of late-onset AS in a large multicenter national cohort. Methods We studied late-onset AS in the National Registry of Spondyloarthritis of the Spanish Society of Rheumatology (REGISPONSER database) cohort (n = 1257), of whom 3.5% had onset at age ≥ 50 years versus a control group with onset at < 50 years. Results There were no differences between late-onset and early-onset AS according to sex and family history of spondyloarthropathies. Patients in the late-onset group more often showed involvement of the cervical spine (22.7% vs 9.7%; p = 0.03) and arthritis of the upper (13.6% vs 3.0%; p = 0.002) and lower limbs (27.3% vs 15.2%; p = 0.03) as first manifestations than did patients in the early-onset group. A higher percentage of mixed forms (axial and peripheral joint disease) during the course of the disease was also recorded in the late-onset group (50% vs 24%; p = 0.0001). Conclusion Our study suggests that age at onset of AS affects the patients’ presenting clinical form. Arthritis of the upper limbs requires a differential diagnosis with other conditions frequent in patients over 50 years of age, such as rheumatoid arthritis or crystal-induced arthropathy.