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June 13, 1977

Discriminators of Ankylosing Spondylitis

JAMA. 1977;237(24):2635-2636. doi:10.1001/jama.1977.03270510057028

Only a few short years ago, ankylosing spondylitis and diseases that often culminated in spondylitis (Reiter syndrome, arthritis accompanying granulomatous bowel disease, psoriatic spondylarthropathy, and infective Yersinia spondylitis) were regarded as relatively uncommon rheumatoid variants. Being submerged in rheumatoid arthritis, these disorders received less separate attention than was their due, and because, with the exception of ankylosing spondylitis, they were regarded as relatively benign and self-limited, scant attention was paid to these spondylitic arthritides.

Changing perception resulted from the discovery that a hereditary factor played a role in the majority of instances of spondylitis. The histocompatibility antigen HLA-B27 was found in about 95% of patients who had ankylosing spondylitis and lesser but still substantial proportions of others who had spondylitic variants. Population surveys then discovered that approximately 20% of persons carrying HLA-B27 were affected by ankylosing spondylitis. At once, the estimate of the numbers afflicted in the population had to