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Coexistence of Behcet's Disease and Ankylosing Spondylitis

Although the prevalence of coexistent Bechcet's disease (BD) and ankylosing spondylitis (AS) is much debated, it occurs in two patients described in a case report by N. Kotevoglu, MD, Sisli Etfal Teaching Hospital, Istanbul, Turkey.

One patient, a 45-year old man, presented with symptoms of fatigue, weight loss, arthralgias, and hip and back pain that had lasted for many years, as well as episodes of painful genital and oral ulcerations and disseminated papulopustular skin lesions. Laboratory results showed severe anaemia (haemoglobin level 6.4 g/dL, normal white cell count 7.4x10/l , and increased platelet count 504,000/mm. The results also demonstrated a high sedimentation rate (110 mm/hr, erythrocyte sedimentation rate) and impaired renal function (2.3 gr/dl serum creatinine, 60 ml/min creatinine clearance, and 0.5 gr proteinuria with microscopic haematuria). A pathergy test was positive, and the patient was found to have tissue type Human Leukocyte Antigen (HLA)-B27. He was diagnosed with BD with AS, accompanied by amyloidosis and end-stage renal failure.

The second patient was a 40-year-old woman with severe neck pain as the presenting symptom. The patient had experienced recurrent oral and genital ulcers, along with papulopustular skin lesions on her trunk and limbs over the past 3 years. Radiography of the cervical spine showed signs of AS; laboratory results were normal. The patient's pathergy test was positive, and her tissue type was positive for HLA-B5 (but negative for HLA-B27). The patient was diagnosed with BD and AS, with subsequent development of anterior uveitis.

This article describes the presentation of two patients with coexistent BD and AS, and discusses the process of diagnosis based on presenting symptoms, radiological studies, and laboratory results.
Scand J Rhematol 2003;32:3:184-185. "Coexistence of ankylosing spondylitis and Behcet's disease. Two cases with atypical presentation and course"

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