Introduction: The coexistence of ankylosing spondylitis and connective tissue diseases is rarely described in sub-Saharan Africa. Objective: To describe the epidemiological, diagnostic and prognostic profile of this association. Methods: A cross-sectional, descriptive study was conducted between January 2021 and March 2025 in the Rheumatology Department of CHU Aristide Le Dantec of Dakar, relocated to the C.O.U.D hospital. We collected data from patients presenting both ankylosing spondylitis and a connective tissue disease. Results: A total of 25 patients (80% women) were included. The mean age was 46 ± 16.9 years. The average diagnostic delay was 12.2 years. Ankylosing spondylitis and connective tissue disease were diagnosed concomitantly in 92% of cases. Axial involvement was noted in 87% of cases, and peripheral manifestations were constant. Mean CRP was 14.4 ± 11.9 mg/L. HLA B27 antigen was positive in 56.25% of cases. Associated systemic autoimmune diseases included Sj？gren’s syndrome (20 cases), rheumatoid arthritis (4 cases), and systemic lupus erythematosus (2 cases). One patient had both lupus and rheumatoid arthritis. Mean BASDAI and BASFI scores were 25.07 and 21.34 respectively. The SF-36 indicated impaired quality of life across all domains. Conclusion: Our study demonstrates the coexistence of ankylosing spondylitis and connective tissue diseases in clinical practice. This association should be considered in any case of axial and peripheral polyarthritis.
References
[1]
Jamilloux, Y., Sève, P. and Henry, T. (2014) Les inflammasomes et les maladies humaines. La Revue de Médecine Interne, 35, 730-741. https://doi.org/10.1016/j.revmed.2014.04.017
[2]
Wendling, D., Hecquet, S., Fogel, O., Letarouilly, J., Verhoeven, F., Pham, T., et al. (2022) Actualisation 2022 des recommandations de la Société française de rhumatologie (SFR) pour la prise en charge en pratique courante des malades atteints de spondyloarthrite, incluant le rhumatisme psoriasique. Revue du Rhumatisme, 89, 210-222. https://doi.org/10.1016/j.rhum.2021.11.010
[3]
Sibilia, J. (2007) Comment définir et classer les maladies inflammatoires? Revue du Rhumatisme, 74, 714-725. https://doi.org/10.1016/j.rhum.2007.07.003
[4]
Hachulla, E. (2018) Connectivites: Quel bilan initial et quel suivi? JMV-Journal de MédecineVasculaire, 43, 75-76. https://doi.org/10.1016/j.jdmv.2017.12.006
[5]
Rudwaleit, M., van der Heijde, D., Landewé, R., Listing, J., Akkoc, N., Brandt, J., et al. (2009) The Development of Assessment of Spondyloarthritis International Society Classification Criteria for Axial Spondyloarthritis (Part II): Validation and Final Selection. Annals of the Rheumatic Diseases, 68, 777-783. https://doi.org/10.1136/ard.2009.108233
[6]
Van der Linden, S., Valkenburg, H.A. and Cats, A. (1984) Evaluation of Diagnostic Criteria for Ankylosing Spondylitis. A Proposal for Modification of the New York Criteria. Arthritis & Rheumatism, 27, 361-368. https://doi.org/10.1002/art.1780270401
[7]
Aletaha, D., Neogi, T., Silman, A.J., Funovits, J., Felson, D.T., Bingham, C.O., et al. (2010) 2010 Rheumatoid Arthritis Classification Criteria: An American College of Rheumatology/European League against Rheumatism Collaborative Initiative. Arthritis & Rheumatism, 62, 2569-2581. https://doi.org/10.1002/art.27584
[8]
Shiboski, C.H., Shiboski, S.C., Seror, R., Criswell, L.A., Labetoulle, M., Lietman, T.M., et al. (2017) 2016 American College of Rheumatology/European League against Rheumatism Classification Criteria for Primary Sjögren’s Syndrome: A Consensus and Data-Driven Methodology Involving Three International Patient Cohorts. Annals of the Rheumatic Diseases, 76, 9-16. https://doi.org/10.1136/annrheumdis-2016-210571
[9]
Aringer, M., Costenbader, K., Daikh, D., Brinks, R., Mosca, M., Ramsey‐Goldman, R., et al. (2019) 2019 European League against Rheumatism/American College of Rheumatology Classification Criteria for Systemic Lupus Erythematosus. Arthritis & Rheumatology, 71, 1400-1412. https://doi.org/10.1002/art.40930
[10]
Maksymowych, W.P. (2012) Les biomarqueurs dans la spondylarthrite: De la physiopathologie à l’évaluation de la maladie. Revue du Rhumatisme, 79, 101-103. https://doi.org/10.1016/j.rhum.2011.10.012
[11]
Wendling, D., Guillot, X. and Prati, C. (2014) L’axe IL-23/Th17 dans la spondyloarthrite: La voie royale? Revue du Rhumatisme, 81, 447-450. https://doi.org/10.1016/j.rhum.2014.08.003
[12]
Navarro-Compán, V., Sepriano, A., El-Zorkany, B. and van der Heijde, D. (2021) Axial Spondyloarthritis. Annals of the Rheumatic Diseases, 80, 1511-1521. https://doi.org/10.1136/annrheumdis-2021-221035
[13]
Barczyńska, T.A., Węgierska, M., Żuchowski, P., Dura, M., Zalewska, J., Waszczak, M., et al. (2015) Coexistence of Rheumatoid Arthritis and Ankylosing Spondylitis. Rheumatology, 53, 279-285. https://doi.org/10.5114/reum.2015.55832
[14]
Bruzzese, V., Marrese, C., Scolieri, P. and Pepe, J. (2020) Psoriatic Spondyloarthritis and Sjögren Syndrome: A Casual Association? Reumatismo, 72, 170-172. https://doi.org/10.4081/reumatismo.2020.1287
[15]
Sattar Bv, M.A. and AL-Sughyer, S.R. (1988) La coexistence de la polyarthrite rhumatoïde, de la spondylarthrite ankylosante et de la dermatomyosite chez un patient atteint de diabète sucré et des antigènes associés. British Journal of Rheumatology, 27, 146.
[16]
Ferjani, H.L., Hiba, B.A., Nessib, D.B., Kaffel, D., Maatallah, K. and Hamdi, W. (2025) The Coexistence of Rheumatoid Arthritis and Ankylosing Spondylitis: Case Series and Literature Review. Revista Colombiana de Reumatología. https://doi.org/10.1016/j.rcreu.2024.09.005
[17]
Ouédraogo, D., Palazzo, E., Nlomé-Nzé, M., Somogyi-Demerjian, N. and Meyer, O. (2009) Ankylosing Spondylitis and Systemic Sclerosis: A Rare Combination. Joint Bone Spine, 76, 290-292. https://doi.org/10.1016/j.jbspin.2006.07.008
[18]
Traoré, M., Kamissoko, A.B., Conde, K., Wann, T.A., Barry, A. and Ndiaye, M. (2019) Association lupus érythémateux systémique, spondylarthrite ankylosante et hyperparathyroïdie secondaire. Médecined’Afrique noire, 6, 345-347.
[19]
Condé, K., Hounsou, C., Adechina, W.A., Guelngar, C.O., Keita, F. and Cissé, F.A. (2021) Association syndrome de Sjögren et spondyloarthrites: Étude de 40 observations au service de rhumatologie de l’hôpital national Ignace Deen de Conakry, Guinée. Revue du Rhumatisme, 88, A277-A278. https://doi.org/10.1016/j.rhum.2021.10.470
[20]
Abba, A., Niasse, M., Diaby, L.M. and Ali, H. (2021) Spondyloarthrites au Sénégal: Étude de 770 observations. La Tunisie Médicale, 99, 585-600.
[21]
Zhang, Y., Feng, B., Dong, J., Zhong, Y., Wang, L. and Zhao, L. (2021) Rheumatoid Arthritis Coexisting with Ankylosing Spondylitis. A Report of 22 Cases with Delayed Diagnosis. Medicine, 100, e25051. https://doi.org/10.1097/md.0000000000025051
