The importance of early diagnosis and treatment in patients with ankylosing spondylitis - case report

Abstract

Introduction. Ankylosing spondylitis is a common, chronic musculoskeletal condition associated with substantial functional limitations. Inflammation in later phases of the disease may lead to fibrosis and calcification of the spine, causing poor quality of life. This case report emphasizes the importance of early diagnosis of ankylosing spondylitis as one of the major factors in further course of the disease. Case report. A 27-yearold man was diagnosed with ankylosing spondylitis in 2019. He was first time examined in 2005 because of joint pain which was then characterized as growing pains. Symptoms of joint pain reappeared approximately 10 years later, and were present in lumbar and thoracic spine accompanied by morning stiffness. New pain spots also appeared, as well as positive laboratory results regarding inflammation. Despite the lasting diarrhea, additional tests such as anti-smooth muscle and anti-mitochondrial antibody, Hepatitis B surface Antigen and anti-Hepatitis C virus antibody test as well as stool test results all turned out to be negative. The magnetic resonance imaging showed edema of lower edges of the lumbosacral corpus, most likely as part of spondylitis, changes to the sacroiliac joints in terms of chronic phase of sacroiliitis with discrete activity, and right shoulder active synovitis. The human lymphocyte antigen B27 testing showed positive results. Despite the prescribed medical therapy, the disease activity remained high with positive clinical presentation. This patient may be a candidate for biological therapy. Conclusion. Early diagnosis and effective treatment provide reduction of pain, fatigue and disease activity and also prevent functional limitations, therefore improving the quality of life.