Sacroiliitis in Systemic Lupus Erythematosus Revisited
Neslihan YILMAZ1, Ayten YAZICI2, Banu ÖZULU TÜRKMEN3, Işık KARALOK4, Şule YAVUZ1
1Department of Internal Medicine, Division of Rheumatology, Demiroğlu Bilim University Medial Faculty, Istanbul, Turkey
2Department of Internal Medicine, Division of Rheumatology, Kocaeli University Medial Faculty, Kocaeli, Turkey
3Department of Geriatrics, Demiroğlu Bilim University Medial Faculty, İstanbul, Turkey
4Department of Radiology, Demiroğlu Bilim University Medial Faculty, Istanbul, Turkey
Keywords: Inflammatory back pain, lupus, sacroiliitis
Objectives: This study aims to investigate the prevalence of inflammatory back pain (IBP) and sacroiliitis in a systemic lupus erythematosus (SLE) population as well as the association between IBP and the frequency of human leukocyte antigen B27 (HLA-B27).
Patients and methods: The study included 281 SLE patients (16 males, 265 females; mean age 39.9±11.9 years; range, 20 to 69 years) and 100 healthy controls (HCs) (2 males, 98 females; mean age 41.2±10.1 years; range, 19 to 64 years). Participants were administered a five-item Assessment of SpondyloArthritis international Society-IBP questionnaire. Patients and controls with IBP underwent detailed clinical and laboratory examinations to detect sacroiliitis. Radiographic evaluations were performed by a blinded rheumatologist and radiologist. Interobserver reliability was assessed with Cohen’s kappa test.
Results: According to the questionnaire, IBP was present in 46 SLE patients (46/281; 16.3%) whereas none of the HC had IBP (p<0.001). In radiological assessment, 22 SLE patients (7.8%) had sacroiliitis detected by conventional X-ray and/or magnetic resonance imaging. Only one SLE patient with sacroiliitis had HLA-B27.
Conclusion: Our study showed that IBP is increased in SLE patients and IBP in SLE is not associated with HLA-B27.