Angiopathy in ankylosing spondylitis

Background. Ankylosing spondylitis is a chro­nic progressive systemic autoimmune rheumatic disease of the spine, peripheral joints, sacroiliac joints, enthesis, ligamentous apparatus and internal organs, and related to risk factors of severe vascular disease. The purpose of our work was to study clinical and instrumental course of angiopathy, find pathogenetic connection with immune parameters in ankylosing spondylitis. Materials and methods. The study included 79 patients aged 15 to 66 years (mean 38 years old), among whom there were 95 % of men and 5 % of women. The duration of the disease from its first manifestation was 11 years, I degree of activity occurred in 32 % of cases, II — in 39 % and III — in 29 %, and the ratio of slow-progressive to the rapidly progressive course of the pathological process was 4 : 1. Peripheral monooligoartritis was ascertained in 47 % of patients, polyarthritis — in 53%. Patients underwent echocardiography, vascular doppler ultrasound, biomicroscopy of vessels of the conjunctiva. Results. Angiopathy occurs in 85 % of patients with ankylosing spondylitis, the development of which is linear related to the degree of activity of pathological process and inversely to the seropositivity by rheumatoid factor. Cutaneous vasculitis depends on the age of patients; uveitis, scleritis, Raynaud’s syndrome, damage of the central and peripheral nervous system depend on the peculiarities of articular syndrome clinical course. Integrated clinical and instrumental vascular indices significantly correlated with immune parameters (levels of rheumatoid factor, C-reactive protein, circulating immune complexes, values of immunoglobulinemia) and vascular damage occurs with increased pulmonary artery pressure and vascular resistance in genesis of which C-reactive protein is involved that could be a prognostic value.