Juvenile Ankylosing Spondylitis (Literature Review and Own Findings)

O.Ye. Chernyshova, T.R. Polesova, Ye.D. Yehudina, O.V. Syniachenko


We present a review of current literature and findings of our own surveys of 35 children and 182 adults with ankylosing spondylitis. Compared with the disease in adults, juvenile ankylosing spondylitis has a number of clinical features, which occurs only in boys, manifests by a more frequent lesion of axial joints (shoulder, hip), development of systemic bone deficiency (osteopenia, osteoporosis), enthesitis (in particular, of the femoral condyles and the vertebral joints, but not achillodynia), uveitis, and cardiopathy, proliferation (and not destruction) of bone sections during the onset of spondylopathy and a rare involvement in the process of the lumbar spine and the formation of epiphyseal osteoporosis, higher blood concentrations of interleukin-8 and -17, but lower values of interleukin-1β, circulating immune complexes, fibrinogen, immunoglobulins А and G. It may be desirable to separate ankylosing spondylitis as a nosological form, such as juvenile idiopathic arthritis (in the recent past, juvenile rheumatoid arthritis).


ankylosing spondylitis; children; adults; course; pathogenesis


Agarwal NN, Patil D, Nagendra S, Jadhav SM. Bilateral hip pain in a young man? It may be worth considering juvenile-onset ankylosing spondylitis (JAS). BMJ Case Rep 2015;28(10):2015. doi: 10.1136/bcr-2015-212097.

Bao J, Chen Y, Bao YX. Prevalence and risk factors of low bone mineral density in juvenile onset ankylosing spondylitis. Calcif Tissue Int 2014;95(2):108-11. doi: 10.1007/s00223-014-9867-2.

Barber CE, Marshall DA, Mosher DP, Akhavan P, Tucker L, Houghton K, Batthish M, Levy DM, Schmeling H, Ellsworth J, Tibollo H, Grant S, Khodyakov D, Lacaille D. Development of system-level performance measures for evaluation of models of care for inflammatory arthritis in Canada. J Rheumatol 2016;43(3):530-40. doi: 10.3899/jrheum.150839.

Berard RA, Laxer RM. Paediatric rheumatology: A disease activity index for juvenile SpA-a welcome addition. Nat Rev Rheumatol 2014;10(11):642-4. doi: 10.1038/nrrheum.2014.150.

Boonen A, van der Linden SM. The burden of ankylosing spondylitis. J Rheumatol Suppl 2016;78:4-11. doi: 10.1016/j.semarthrit.2015.10.009.

Braun J, Sieper J. Ankylosing spondylitis: Target treatment criteria. Z Rheumatol 2009;68(1):30-6. doi: 10.1007/s00393-008-0361-y.

Burgos-Vargas R, Peláez-Ballestas I. Epidemiology of spondyloarthritis in México. Am J Med Sci 2011;341(4):298-300. doi: 10.1097/MAJ.0b013e31820f8d0a.

Chee MM, Sturrock RD. Ankylosing spondylitis. Scott Med J 2012;52(4):32-5.

Colbert RA. Classification of juvenile spondyloarthritis: Enthesitis-related arthritis and beyond. Nat Rev Rheumatol 2010:6(8):477-85. doi: 10.1038/nrrheum.2010.103.

Conway R, O'Shea FD. Juvenile versus adult-onset ankylosing spondylitis: are we comparing apples and oranges? J Rheumatol 2012;39(5):887-9. doi: 10.3899/jrheum.120164.

Duarte AP, Marques CD, Bortoluzzo AB, Gonçalves CR, da Silva JA, Ximenes AC, Bértolo MB, Ribeiro SL, Keiserman M, Skare TL, Carneiro S, Menin R, Azevedo VF, Vieira WP. Epidemiologic profile of juvenile-onset compared to adult-onset spondyloarthritis in a large Brazilian cohort. Rev Bras Reumatol 2014;54(6):424-30. doi: 10.1016/j.rbr.2014.06.005.

Geusens P, Vosse D, Van der Linden S. Osteoporosis and vertebral fractures in ankylosing spondylitis. Curr Opin Rheumatol 2007;19(4):335-9.

Goldring SR. Inflammatory signaling induced bone loss. Bone 2015;80(11):143-9. doi: 10.1016/j.bone.2015.05.024.

Guan M, Wang J, Zhu Z, Xiao J, Zhao L, Li Z, Shi Z. Comparison in clinical features and life impact between juvenile-onset and adult-onset ankylosing spondylitis. Turk J Med Sci 2014;44(4):601-5.

Haibel H, Sieper J. Enthesitis in connection with spondyloarthritides. Orthopade 2015;44(5):395-406. doi: 10.1007/s00132-015-3114-z.

Healey EL, Haywood KL, Jordan KP, Garratt A. Impact of ankylosing spondylitis on work in patients across the UK. Scand J Rheumatol 2011;40(1):34-40. doi: 10.3109/03009742.2010.487838.

Heuft-Dorenbosch L, Spoorenberg A, van Tubergen A, van ver Tempel H. Assessment of enthesitis in ankylosing spondylitis. Ann Rheum Dis 2009;62(2):127-32.

Ho HH, Chen JY. Ankylosing spondylitis: Chinese perspective, clinical phenotypes, and associated extra-articular systemic features. Curr Rheumatol Rep 2013;15(8):344-54. doi: 10.1007/s11926-013-0344-0.

Howe HS, Zhao L, Song YW, Springer L. Seronegative spondyloarthropathy – studies from the Asia Pacific region. Ann Acad Med Singapore 2010;36(2):135-41.

Jadon DR, Ramanan AV, Sengupta R. Juvenile versus adult-onset ankylosing spondylitis – clinical, radiographic, and social outcomes; a systematic review. J Rheumatol 2013;40(11):1797-805. doi: 10.3899/jrheum.130542.

Jamshidi AR, Shahlaee A, Farhadi E, Fallahi S, Nicknam MH, Bidad K, Barghamadi M, Mahmoudi M. Clinical characteristics and medical management of Iranian patients with ankylosing spondylitis. Mod Rheumatol 2014;24(3):499-504. doi: 10.3109/14397595.2013.844302.

Jang JH, Ward MM,, Rucker AN, Reveille JD. Ankylosing spondylitis: patterns of radiographic involvement – a re-examination of accepted principles in a cohort of 769 patients. Radiology 2011;258(1):192-8. doi: 10.1148/radiol.10100426.

Jaremko JL, Liu L, Winn NJ, Ellsworth JE, Lambert RG. Diagnostic utility of magnetic resonance imaging and radiography in juvenile spondyloarthritis: evaluation of the sacroiliac joints in controls and affected subjects. J Rheumatol 2014;41(5):963-70. doi: 10.3899/jrheum.131064.

Katsicas MM, Russo R. Biologic agents in juvenile spondyloarthropathies. Pediatr Rheumatol Online J 2016;14(1):17-27. doi: 10.1186/s12969-016-0076-6.

Kim HW, Choe HR, Lee SB, Chang WI, Chae HJ, Moon JY, Kang J, Lee S, Song YW, Lee EY. Phenotype difference between familial and sporadic ankylosing spondylitis in Korean patients. J Korean Med Sci 2014;29(6):782-7. doi: 10.3346/jkms.2014.29.6.782.

Kim TJ, Shin JH, Sung IH, Lee S, Song Y, Kim TH. Comparison on radiographic progression for 5 years between juvenile onset ankylosing spondylitis and adult onset ankylosing spondylitis: an observational study of the Korean SpondyloArthropathy Registry (OSKAR) data. Clin Exp Rheumatol 2016;66(4):162-8.

Layh-Schmitt G, Colbert RA. The interleukin-23/interleukin-17 axis in spondyloarthritis. Curr Opin Rheumatol 2008;20(4):392-7. doi: 10.1097/BOR.0b013e328303204b.

Lin C, Milojevic D. Diagnosis and treatment of juvenile spondyloarthropathy and related diseases. Pediatr Ann 2012;41(11):172-8. doi: 10.3928/00904481-20121022-11.

Malaviya AN, Sawhney S, Mehra NK, Kanga U. Seronegative arthritis in South Asia: an up-to-date review. Curr Rheumatol Rep 2014;16(4):413-23. doi: 10.1007/s11926-014-0413-z.

Mou Y, Zhang P, Li Q, Lin Z, Liao Z, Wei Q, Gu J. Clinical features in juvenile-onset ankylosing spondylitis patients carrying different B27 subtypes. Biomed Res Int 2015;20(15):594878. doi: 10.1155/2015/594878.

Pacheco-Tena C, Pérez-Tamayo R, Pineda C, González-Chávez SA, Quiñonez-Flores C, Ugalde Vitelly A, Inman RD, Aubin JE, Vázquez-Mellado J, Burgos-Vargas R. Bone lineage proteins in the entheses of the midfoot in patients with spondyloarthritis. J Rheumatol 2015;42(4):630-7. doi: 10.3899/jrheum.140218.

Paroli MP, Teodori C, D'Alessandro M, Mariani P. Increased vascular endothelial growth factor levels in aqueous humor and serum of patients with quiescent uveitis. Eur J Ophthalmol 2007;17(6):938-42.

Ramanathan A, Srinivasalu H, Colbert RA. Update on juvenile spondyloarthritis. Rheum Dis Clin North Am 2013;39(4):767-88. doi: 10.1016/j.rdc.2013.06.002.

Reikerys O, Helle A, Krohn CD, Brox JI. Systemic and local cytokine kinetics in musculoskeletal injury: a prospective study in patients with ankylosing spondylitis. Scand J Clin Lab Invest 2008;22:1-6. doi: 10.1080/00365510802471588.

Rohekar S, Chan J, Tse SM, Haroon N, Chandran V, Bessette L, Mosher D, Flanagan C, Keen KJ, Adams K, Mallinson M, Thorne C, Rahman P, Gladman DD, Inman RD. Update of the Canadian Rheumatology Association/spondyloarthritis research consortium of Canada treatment recommendations for the management of spondyloarthritis. Part I: principles of the management of spondyloarthritis in Canada. J Rheumatol 2015;42(4):654-64. doi: 10.3899/jrheum.141000.

Sandhya P, Danda D, Jeyaseelan L. Are Indian patients with juvenile-onset ankylosing spondylitis taller than reference population? Indian J Med Res 2015;141(4):446-453. doi: 10.4103/0971-5916.159295.

Shahlaee A, Mahmoudi M, Nicknam MH, Farhadi E, Fallahi S, Jamshidi AR. Gender differences in Iranian patients with ankylosing spondylitis. Clin Rheumatol 2015;34(2):285-93. doi: 10.1007/s10067-013-2439-4.

Shaw AT, Gravallese EM. Mediators of inflammation and bone remodeling in rheumatic disease. Semin Cell Dev Biol 2016;49(1):2-10. doi: 10.1016/j.semcdb.2015.10.013.

Siddiq MA, Al Hasan S, Rasker JJ. Persistent enthesitis and spondyloarthropathy: a case series of 71 Bangladeshi people. J Back Musculoskelet Rehabil 2015;28(3):463-71. doi: 10.3233/BMR-140541.

Sivas F, Mermerci Bazkan B, Erkol Inal E, Akbulut Aktekin L. The relationship between enthesitis indices and disease activity parameters in patients with ankylosing spondylitis. Clin Rheumatol 2009;28(3):259-64. doi: 10.1007/s10067-008-1027-5.

Sonkar GK, Usha SS. Is HLA-B27 a useful test in the diagnosis of juvenile spondyloarthropathies? Singapore Med J 2013;49(10):795-9.

Srivastava R, Agnihotry S, Aggarwal R, Bajpai P, Aggarwal A. HLA-B27 subtypes in enthesitis-related arthritis category of juvenile idiopathic arthritis and ankylosing spondylitis in northern India. Clin Exp Rheumatol 2015; 33(6):931-5.

Torres TM, Ferraz MB, Ciconelli RM. Resource utilisation and cost of ankylosing spondylitis in Brazil. Clin Exp Rheumatol 2016;28(4):490-7.

Tse SM, Laxer RM. New advances in juvenile spondyloarthritis. Nat Rev Rheumatol 2012;8(5):269-79. doi: 10.1038/nrrheum.2012.37.

Tseng ST, Yao TC, Huang JL, Yeh KW, Hwang YS. Clinical manifestations in uveitis patients with and without rheumatic disease in a Chinese population in Taiwan. J Microbiol Immunol Infect 2015;17(11):1684. doi: 10.1016/j.jmii.2015.10.007.

Usenbo A, Kramer V, Young T, Musekiwa A. Prevalence of arthritis in Africa: A systematic review and meta-analysis. PLoS One 2015;10(8):0133858. doi: 10.1371/journal.pone.0133858.

Wang DM, Zeng QY, Chen SB, Gong Y, Hou ZD, Xiao ZY. Prevalence and risk factors of osteoporosis in patients with ankylosing spondylitis: a 5-year follow-up study of 504 cases. Clin Exp Rheumatol 2015;33(4):465-70.

Weiss PF. Diagnosis and treatment of enthesitis-related arthritis. Adolesc Health Med Ther 2012;12(3):67-74.

DOI: https://doi.org/10.22141/2224-0551.4.72.2016.76591


  • There are currently no refbacks.

Copyright (c) 2016 CHILD`S HEALTH

Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 International License.


© Publishing House Zaslavsky, 1997-2018


   Seo анализ сайта