RESUMEN
Analysis of five personal cases of the intravertebral vacuum cleft phenomenon and a close examination of the literature, suggest that it is rather more frequent than it first appears. Intravertebral vacuum cleft tends to occur more readily in the vertebrae of the dorsolumbar hinge and mainly in the elderly, slightly more common in women than men. The main factors, from the pathogenetic point of view, are osteoporosis, a history of trauma and frequent occurrence of rheumatic problems which are often complicated by vasculitis. The comparison between excessive uptake of calcium-mimetic technetium and uptake deficit of technetium phytate by the vertebra with a vacuum cleft, leads us to consider it as an expression of osteo and bone marrow necrosis.
Asunto(s)
Disco Intervertebral/diagnóstico por imagen , Enfermedades de la Columna Vertebral/diagnóstico por imagen , Anciano , Femenino , Gases , Humanos , Masculino , Persona de Mediana Edad , Osteoporosis/complicaciones , Radiografía , Cintigrafía , Enfermedades de la Columna Vertebral/complicacionesRESUMEN
Nine cases from among 64 patients with ankylosing spondylitis (AS) are described. In addition to bilateral sacroiliitis these cases had a peculiar type of spondylodiscitis characterised by quite diffuse and marked sclerosis of multiple vertebral bodies, with only minimal erosions of the adjacent vertebral plates while classical syndesmophytosis was absent. The antigen HLA-B27 was found only in 1 of these 9 cases. This type of spondylodiscitis could discriminate among all the patients with AS a subgroup with a peculiar clinical pattern and a probably distinctive pathological mechanism.
Asunto(s)
Antígenos HLA/análisis , Espondilitis Anquilosante/inmunología , Adulto , Prueba de Histocompatibilidad , Humanos , Disco Intervertebral , Masculino , Espondilitis Anquilosante/clasificaciónRESUMEN
Among 39 patients (23 males, 16 females) with sacroiliitis (SI) 17 were HLA-B27 positive. The female/male ratio in the B27-positive group was 2/15. Seventy-four first-degree relatives of 26 probands were also investigated. A high occurrence of SI (20%) was observed in the families of B27-positive probands compared with only 3.7% in the families of B27-negative probands. In the former families SI occurred only in B27-positive subjects with an earlier onset of symptoms and a male prevalence. In the latter, the disease showed a later onset and a lack of male preponderance. The nosological and prognostic relevance of the B27 typing is stressed.
Asunto(s)
Artritis/inmunología , Antígenos HLA/genética , Articulación Sacroiliaca , Adolescente , Adulto , Anciano , Artritis/genética , Femenino , Prueba de Histocompatibilidad , Humanos , Masculino , Persona de Mediana EdadAsunto(s)
Artritis/genética , Antígenos HLA , Antígenos de Histocompatibilidad , Articulación Sacroiliaca , Espondilitis Anquilosante/genética , Adolescente , Adulto , Anciano , Femenino , Antígenos HLA/análisis , Antígenos de Histocompatibilidad/análisis , Humanos , Italia , Masculino , Persona de Mediana Edad , Factores Sexuales , Enfermedades de la Columna Vertebral/genéticaRESUMEN
The families of 21 ankylosing spondylitis (AS) and 16 sacroiliitis (SI) patients were investigated and typed for HLA markers. The association of HLA B27 with AS was confirmed, but no strong evidence for the same or other HLA markers being associated with SI was found. Inheritance patterns in families were analyzed according to the multifactorial and monofactorial models. It is proposed that a major gene associated or interacting with the B27 product controls the susceptibility to AS, and that this gene behaves as a dominant with incomplete penetrance. The problem as to whether linkage disequilibrium maintained by selective pressure, or functional epistasis between the "disease gene" and the B27 antigen may be the acting mechanism of association, remains to be elucidated.
