Analysis Of Clinical Features Of Female Juvenile Ankylosing Spondylitis: Six Case Reports

Objective: To analyze the clinical features of female juvenile ankylosing spondylitis(JAS) and thereby to provide evidences for the early clinical diagnosis in order to get earlytreatment and improve the prognisis.Methods: We retrospectively analyzed the clinical, laboratory and imaging data as wellas the follow-up information and discussed the clinical features of six female JAS patientswhich received treatment in China-Japan Union Hospital from January2005to June2012.Results: The mean age at onset was7.67years (range,6-10years). The mean diagnosisduration was6.33years (range,2-11years). One of the patients had definite family historyof JAS. Manifestations in early stage appeared intermittently and atypically. All the patientsdid not get standard treatment in early stage. The6cases were onset as pain of peripheraljoint, including two case combined with sacroiliac joint lesions. Physical examinationshowed that4cases got limitation of waist activity, at the same time2cases got straight ofwaist when bending.2Cases got tenderness positively on bilateral lumbosacral transverseprocess with poor gait. There were five LHA-B27-positive patients. ESR was increased indifferent degree in all patients with a renge of12～72mm/h.3cases of Ⅱdegree,2cases of Ⅰ～Ⅱdegree and1cases of Ⅲdegree were found according to the radiological imagings.All patients received regular treatments. During the follow-up period, five patients wererecovered completely and one patients achieved partial remission.Conclusions: Features of female JAS to be shown as follows. The incidence of JASwas lower in female than in male. In female JAS patients, it was onset as lumbosacral painand small joints were always involved compared with male JAS patients. However, theinvolvement of entire spine was rare in female patients with JAS. Manifestations in earlystage appeared intermittently and atypically. All the patients did not get standard treatment inearly stage. The sacroiliac joint lesions of female JAS always remained in the inflammatoryphase. Female patients with JAS had a better outcome than male. So all the girls whom onsetof lumbosacral and peripheral joint pain should get timely radiological examinations ofsacroiliac joint and laboratory examinations such as HLA-B27, which combine withfollow-up information to strive for early clinical diagnosis and treatment to improve betteroutcomes.