僵直性脊椎炎之關節外表現：台灣單一中心的照護經驗

Extra-articular Manifestations of Ankylosing Spondylitis: a Single Medical Center Experience in Taiwan

目的：計算台灣地區僵直性脊椎炎關節外表現的患病率，並調查相關器官的伴隨症狀。方法：本獲取2018年6月1日至2020年12月31日三軍總醫院風濕科、胃腸科、眼科、皮膚科門診的患者資料。我們回顧了本院之醫療紀錄以確認患者是否曾診斷為乾癬、急性前葡萄膜炎或發炎症性腸道疾病。新發生關節外表現的患者則被轉介給各次專科以確認診斷。進而統計僵直性脊椎炎關節外表現患病率及相關器官的症狀。結果：在2018年6月1日至2020年12月31日期間，3％的參與者被診斷為急性前葡萄膜炎，1.5％的參與者報告了發炎性腸道疾病，5％的參與者報告了乾癬。僵直性脊椎炎患者提及眼部、胃腸道、皮膚和指甲的症狀和體徵的比例分別為63.8％、25.1％、29.6％和23.7％。結論：與一般人群相比，僵直性脊椎炎族群中的乾癬、急性前葡萄膜炎和發炎性腸道疾病更為普遍。根據這項研究，乾癬是僵直性脊椎炎患者中最常見的關節外表現，其次是急性前葡萄膜炎和發炎性腸道疾病。

Objective: To determine the prevalence of extra-articular manifestations (EAMs) of ankylosing spondylitis (AS) and survey the accompanying symptoms in related organs in Taiwan. Methods: Patient data were obtained from rheumatology, gastroenterology, ophthalmology, and dermatology outpatient clinics of Tri-Service General Hospital from June 1, 2018, to December 31, 2020. We reviewed our hospital medical records for previous diagnoses of psoriasis, acute anterior uveitis (AAU), or inflammatory bowel disease (IBD). Patients with AS and newly developed or active EAMs were referred to specialists to confirm the diagnosis. This study aimed to estimate the prevalence of EAMs of AS and symptoms in related organs. Results: During the study period, 3% of participants were diagnosed with AAU, 1.5% reported IBD, and 5% reported psoriasis. The percentages of patients with AS who mentioned symptoms and signs involving the eyes, gastrointestinal tract, skin, and nails were 63.8%, 25.1%, 29.6%, and 23.7%, respectively. Conclusions: Psoriasis, AAU, and IBD are more prevalent in patients with AS than in the general population. In this study, psoriasis was the most prevalent EAM in patients with AS, followed by AAU and IBD.