Axial Spondyloarthritis after bariatric surgery: a 7-year retrospective analysis

• Main Authors: Thauana Luiza de Oliveira, Hilton Telles Libanori, Marcelo M. Pinheiro
• Format: Article
• Language: English
• Published: BMC 2019-02-01
• Series: Advances in Rheumatology
• Subjects: Spondyloarthritis; Bariatric surgery; HLA-B27
• Online Access: http://link.springer.com/article/10.1186/s42358-019-0050-3

Abstract Background In recent decades, obesity has become a public health problem in many countries. The objective of this study was to evaluate the main joint and extra-articular manifestations related to spondyloarthritis (SpA) after bariatric surgery (BS) in a retrospective cohort. Methods Demographic, clinical, laboratory and imaging data from nine patients whose SpA symptoms started after a BS have been described. Modified New York (mNY) criteria for ankylosing spondylitis (AS) and the Assessment of Spondyloarthritis International Society (ASAS) criteria for axial (ax-SpA) and peripheral (p-SpA) spondyloarthritis were applied. Results The mean weight reduction after BS was 49.3 ± 21.9 kg. The BS techniques were Roux-en-Y gastric bypass (n = 8; 88.9%) and biliopancreatic diversion with duodenal switch (n = 1; 11.1%). Four (44.4%) patients had no axial or peripheral pain complaints before BS, while the other four (44.4%) had sporadic non-inflammatory back pain that had been attributed to obesity. One patient (11.1%) had persistent chronic back pain. In all nine cases, patients reported back pain onset or pattern (intensity or night pain) change after BS (mean time 14.7 ± 18 months). In addition, 8 of them (88.9%) were human leukocyte antigen (HLA)-B27 positive. All nine patients could be classified according to ASAS criteria as ax-SpA and five (55.6%) patients were classified as AS, according to the mNY criteria. Conclusion Our data highlight a temporal link between SpA onset symptoms and the BS, suggesting a possible causal plausibility between the two events.