Clinical rheumatology, 1990, 9, N ~ 2
235-238
Case R e p o r t
Coexisting ankylosing spondylitis and Paget's disease I. O L I V I E R I , R. SEMERIA, D. A L O I S I , S. G I U S T A R I N I .
G.
GEMIGNANI,
A.
TAVONI,
Rheumatic Disease Unit of the Institute of Medical Pathology 1, University of Pisa, Pisa, Italy. SUMMARY The case of a 59-year-old man with definite HIM B27 negative ankylosing spondylitis (AS) and Paget's disease involving the skull, the right side of the pelvis and the proximal femur is reported. Fifteen cases with this coexistence have previously been described. Some of these, however, are patients with Paget's disease mimicking AS. It is emphasized again that attention must be paid to diagnosing AS in patients suffering from Paget's disease. Key words: Paget's disease, Ankylosing Spondylitis, Seronegative spondyloarthropathy. INTRODUCTION
phatase level. His past medical history revealed that he Paget's disease and ankylosing spondylitis had been suffering from intermittent inflam(AS) are relatively common diseases that may matory low back pain and stiffness and a desometimes coexist in the same patient (1-5). creasing range of movement of the lumbar To our knowledge, fifteen patients with this spine for 25 years. In the past few years, coexistence have been reported to date (1-5). symptoms had extended to the cervical spine. Some of these patients, however, very prob- Spine symptoms had always been ascribed to ably had Paget's disease involving the bone osteoarthritis. adjacent to sacroiliac joints, thus mimicking Physical examination showed a severe resacroiliitis of seronegative spondyloarthropa- striction of movement in all directions of both thy (6,7). We have recently seen a case with cervical and lumbar spine, dorsal kyphosis, clear radiological findings of both diseases forward craning of the cervical spine, and a which we report here. chest expansion of only I cm. Long bones and peripheral joints were normal. Laboratory evaluation showed the followCASE REPORT ing significant values: C-reactive protein A 59-year-old man was referred to our 7 mg/1 (normal
235-238
Case R e p o r t
Coexisting ankylosing spondylitis and Paget's disease I. O L I V I E R I , R. SEMERIA, D. A L O I S I , S. G I U S T A R I N I .
G.
GEMIGNANI,
A.
TAVONI,
Rheumatic Disease Unit of the Institute of Medical Pathology 1, University of Pisa, Pisa, Italy. SUMMARY The case of a 59-year-old man with definite HIM B27 negative ankylosing spondylitis (AS) and Paget's disease involving the skull, the right side of the pelvis and the proximal femur is reported. Fifteen cases with this coexistence have previously been described. Some of these, however, are patients with Paget's disease mimicking AS. It is emphasized again that attention must be paid to diagnosing AS in patients suffering from Paget's disease. Key words: Paget's disease, Ankylosing Spondylitis, Seronegative spondyloarthropathy. INTRODUCTION
phatase level. His past medical history revealed that he Paget's disease and ankylosing spondylitis had been suffering from intermittent inflam(AS) are relatively common diseases that may matory low back pain and stiffness and a desometimes coexist in the same patient (1-5). creasing range of movement of the lumbar To our knowledge, fifteen patients with this spine for 25 years. In the past few years, coexistence have been reported to date (1-5). symptoms had extended to the cervical spine. Some of these patients, however, very prob- Spine symptoms had always been ascribed to ably had Paget's disease involving the bone osteoarthritis. adjacent to sacroiliac joints, thus mimicking Physical examination showed a severe resacroiliitis of seronegative spondyloarthropa- striction of movement in all directions of both thy (6,7). We have recently seen a case with cervical and lumbar spine, dorsal kyphosis, clear radiological findings of both diseases forward craning of the cervical spine, and a which we report here. chest expansion of only I cm. Long bones and peripheral joints were normal. Laboratory evaluation showed the followCASE REPORT ing significant values: C-reactive protein A 59-year-old man was referred to our 7 mg/1 (normal
