作者：Turina MC,et al.
结论：部分看似健康的HLA-B27阳性强直性脊柱炎患者的一级亲属有提示脊柱关节炎的临床和/或影像学异常。33%一级亲属能够分类诊断为脊柱关节炎。进一步随访将显示哪些一级亲属能够发展为有临床表现的脊柱关节炎。附原文：Objective: To investigate if seemingly healthy first-degree relatives (FDRs) of ankylosing spondylitis (AS) patients have clinical, laboratory or imaging features of spondyloarthritis (SpA). Methods: FDRs of HLA-B27 positive AS patients between 18-40 years were included in Pre-SpA, a prospective inception cohort study. Clinical, biological and imaging data were obtained. FDRs were classified according to several sets of SpA classification criteria. Results: We report baseline features of 51 FDRs included in this study. Twenty-nine (57%) FDRs had back pain; 2 (4%) had psoriasis, and none had other extra-articular manifestations. Three (6%) FDRs had low grade sacroiliitis, 1 (2%) had cervical syndesmophytes on X-ray, and 10 (20%) had bone marrow edema on MRI of the sacroiliiac joints. Seventeen of 51 (33%) FDRs fulfilled SpA classification criteria: 7 (14%) both the ASAS axSpA and ESSG criteria, 6 (12%) only the ASAS axSpA, and 4 (8%) only the ESSG criteria. None fulfilled other SpA classification criteria. FDRs fulfilling the ASAS axSpA and/or ESSG classification criteria had more frequently (inflammatory) back pain and had a higher level of disease activity. No difference in inflammatory parameters, peripheral and extra-articular disease and HLA-B27 presence was found. Four (12%) of the FDRs not fulfilling the ASAS axSpA and/or ESSG classification criteria had imaging abnormalities suggestive of SpA. Conclusion: A substantial proportion of seemingly healthy FDRs of HLA-B27 positive AS patients have clinical and/or imaging abnormalities suggestive of SpA. Thirty-three percent could be classified as SpA. Further follow-up will show which FDRs will develop clinically manifest SpA.
引自：Turina MC, de Winter JJ, Paramarta JE, et al. Clinical and imaging signs of spondyloarthritis in first-degree relatives of HLA-B27 positive ankylosing spondylitis patients: The pre-spondyloarthritis (Pre-SpA) cohort. Arthritis Rheumatol. 2016 May 23. doi: 10.1002/art.39766.