A Clinical and Genetic Study of Psoriatic Arthritis

Psoriatic arthritis (PsA) is an inflammatory joint disease related to psoriasis. PsA has a heterogeneous structure, indicated by various manifestations like mild mono-oligoarthritis or very severe, erosive and damaging polyarthritis. Measurable inflammatory activity isn’t necessarily prominent. The aetiology is not known but genetics are thought to be of importance. The pattern of inheritance is suggested to be polygenic. The purpose of this research was to assess the occurrance of joint and axial manifestations, characterise the disease with regards to inflammatory and genetic markers, and to determine disease susceptibility gene(s) for PsA in patients. Two hundred-two patients were analyzed and 97 (48%) had inflammatory manifestations like peripheral arthritis, axial disease, undifferentiated spondylarthropathy (uSpA) and enthesopathies. Of the 67 patients (33 %) with peripheral arthritis and/or axial disease, 30 weren’t previously diagnosed. The association of clinical manifestations and potential markers of aggressive joint disease with HLA associations were analysed in 88 patients with PsA….

Contents

INTRODUCTION
Classification and epidemiology
Clinical aspects
Pathogenesis
Genetic factors
Immunological factors
Environmental factors
Vascular factors
AIMS
PATIENTS AND METHODS
Patients and controls
Clinical assessments
Diagnostic criteria
Laboratory tests
Statistical analyses
STUDY DESIGN
Paper I
Paper II
Paper III
Paper IV
RESULTS AND COMMENTS
A Prevalence study and an evaluation of a questionnaire (Paper I)
HLA antigens and inflammatory joint manifestations (Paper II)
Analysis of five disease susceptibility loci for PsA (Paper III)
Renal abnormalities in PsA patients (Paper IV)
Additional observations
CONCLUDING REMARKS
CONCLUSIONS….

Source: Umea University

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