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| ==Overview== | | ==Overview== |
| Ankylosing spondylitis can range from a mild to progressively debilitating disease. If the disorder is not diagnosed early in its course, [[osteopenia]] or [[osteoporosis]] of the spine may occur, causing eventual [[compression fractures]] and a back "hump" if left untreated. Due to the fusion of the [[vertebrae]], [[paresthesia]] may develop. Other complications are [[aortic regurgitation]], [[achilles tendinitis]], [[Heart block|AV node block]], [[amyloidosis]], and [[pulmonary fibrosis]].
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| ==Natural History== | | ==Natural History== |
| AS can range from mild to progressively debilitating, and from medically controlled to refractive.
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| Unattended cases of AS normally lead to knee pain, and may be accompanied by [[dactylitis]] or [[enthesitis]], which may result in a misdiagnosis of normal rheumatism. In a long-term undiagnosed period, [[osteopenia]] or [[osteoporosis]] of AP spine may occur, causing eventual compression fractures and a back "hump" if untreated. Typical signs of progressed AS are the visible formation of syndesmophytes on X-rays, an abnormal bone outgrowth similar to osteophytes, affecting the spine. Due to the fusion of the vertrbrae [[paresthesia]] is a complication due to the inflammation of the tissue surrounding nerves.
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| Organs affected by AS, other than the axial [[vertebral column|spine]] and other joints, are commonly the [[heart]], [[lung]]s, [[Colon (anatomy)|colon]], and [[kidney]]. Other complications are [[Aortic regurgitation]], [[Achilles tendinitis]], [[Heart block|AV node block]] and [[Amyloidosis]]. Due to lung fibrosis, [[chest X-rays]] may show apical fibrosis while [[pulmonary function testing]] may reveal a restrictive lung defect. Very rare complications involve [[neurology|neurologic]] conditions such as the [[cauda equina syndrome]].<ref>{{cite journal | author = Nicholas U. Ahn, Uri M. Ahn, Elizabeth S. Garrett et al. | title = Cauda Equina Syndrome in AS (The CES-AS Syndrome): Meta-analysis of outcomes after medical and surgical treatments. | journal = J of Spinal Disorders | volume = 14 | issue = 5 | pages = 427-433 | year = 2001 | id = PMID 11586143}}</ref>
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| ==Complications==
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| Rarely, people may have problems with the [[aortic heart valve]] ([[aortic insufficiency (patient information)| aortic insufficiency]], [[aortitis]]) and heart rhythm problems.
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| Some patients may have pulmonary fibrosis or restrictive lung disease.
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| Entheseal-resident T cells are sensitive to IL-23 overexpression and they respond vigorously by releasing IL-17 and IL-22 which lead to local inflammatory changes and osteoblast-mediated bone remodeling. These T cells are also present in the aortic root and valve, leading to aortitis that may be seen in patients with ankylosing spondylitis.
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| ==Prognosis==
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| Prognosis of ankylosing spondylitis varies from person to person. Most patients can maintain a good function. While other patients may lose daily functions. Prognosis depends on:
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| *Onset age: The early onset age, the worse prognosis will be. | |
| *Whether organs outside joints are affected.
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| *Whether the patient is treated in time.
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| *Whether the patient is got physical therapy.
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| ==References== | | ==References== |