RISK FACTORS FOR EXTRA-ARTICULAR SIGNS IN SPONDYLOARTHRITIS

Sa？etak Background: There are data that development of different extra articular symptoms in seronegative spondyloarthropathies (SpA) is connected with elevated levels of different markers of inflammatory process Objectives: The aim the study was to assess risk factors of different extra-articular symptoms in SpA. Methods: We studied 287 SpA patients: 131 had AS, 110 had PsA, and 46 had SAPHO. We assessed extra-articular symptoms in all cases. In 191 SpA patients, we measured serum interleukin–6 (IL-6), interleukin–18 (IL-18), interleukin–23 (IL-23), endothelin-1 (ET-1) Results: In SpA patients as compared to healthy controls: 1. Increased serum levels of IL-6 (P=0.02), IL-23 (P=0.03), and Il-18 (P=0.0006) were associated with increased risk of acute anterior uveitis (AAU). 2. Increased serum levels IL-18 (P=0.03) were associated with an increased risk of inflammatory bowel disease (IBD). 3. Increased serum levels of IL-18 (P=0.0002) and decreased serum levels of ET-1 (P=0.006) were associated with increased risk of skin psoriasis. 4. Increased serum levels of IL-18 (P=0.0002) and decreased serum levels of ET-1 (P=0.008) were associated with increased risk of psoriatic onychopathy. 5. Increased serum levels of IL-18 (P=0.01) was associated with increased risk of palmo-plantar pustulosis. SpA patients with AAU (P=0.0008) and IBD (P=0.03) had higher VAS. SpA patients with skin psoriasis (P=0.001) and psoriatic onychopathy(P=0.006) had lower VAS. Conclusions: In SpA patients, increased serum IL-18 and decreased serum ET-1 were associated with an increased risk of extra-articular symptoms. Increased VAS was connected with AAU and IBD, decreased VAS – with skin psoriasis and psoriatic onychopathy