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Rheumatology Advance Access published online on March 1, 2005
Rheumatology, doi:10.1093/rheumatology/keh577
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© British Society for Rheumatology 2005; all rights reserved
Received October 13, 2004
Accepted January 14, 2005

Original Papers

Study of undifferentiated spondyloarthropathy among first-degree relatives of ankylosing spondylitis probands

C. T. Chou 1*, K. J. Lin 2, J. C. C. Wei 3, W. C. Tsai 4, H. H. Ho 5, C. M. Hwang 6, J. M. Cherng 7, C. M. Hsu 8, and D. T. Y. Yu 9

1 Veterans General Hospital, Taipei
2 National Taipei College of Nursing, Taipei
3 Chung Shan Medical University, Taichung, Taiwan
4 Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
5 Chang Gung Memorial Hospital, Lin-Ko, Taiwan
6 China Medical College Hospital, Taichung, Taiwan
7 Buddhist Tzu Chi General Hospital, Hualien, Taiwan
8 Ping-Tung Christian Hospital, Ping-Tung, Taiwan
9 University of California, Los Angeles, CA, USA

* To whom correspondence should be addressed.
C. T. Chou, E-mail: ctchou{at}vghtpe.gov.tw


  Abstract

Objective. To estimate in a Chinese population the prevalence of undifferentiated spondyloarthropathy (USpA) among first-degree relatives (FDRs) of ankylosing spondylitis (AS) probands, and to compare the clinical features of familial USpA with those of sporadic USpA.

Methods. The FDRs of two separate cohorts of consecutive AS probands were evaluated for the prevalence of USpA, using the Modified New York criteria and the European Spondylitis Study Group criteria for AS and SpA, respectively. Sporadic USpA and FDRs of non-SpA rheumatic patient probands served as separate controls.

Results. Among the 301 FDRs of 102 AS probands, 7.0% were USpA. This was 1000 times higher than the 147 FDRs of 40 non-SpA probands (P=0.00230). Within the AS families, USpA was less male-dominated than AS (33.3 vs 72.5%) (P=0.006). The only feature distinguishing familial from sporadic USpA was that the percentages of HLA B27 were 100 and 50%, respectively (P<0.001).

Conclusion. USpA and AS coexist in the same Chinese families, both being predisposed by HLA B27. In these families, a female gender favours the development of USpA rather than AS. A significant subset of sporadic USpA (HLA B27-negative group) has a different genetic predisposition compared with familial USpA.

Keywords: Undifferentiated spondyloarthropathy; Ankylosing spondylitis; First-degree relatives; HLA B27.
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