ACTIVATION OF OPPOSITE PROCESSES – OSTEOPOROSIS AND OSTEOGENESIS IN ANKYLOSING SPONDYLITIS USING THE CLINICAL CASES

Abstract

Ankylosing spondylitis (AS), despite the development of modern science of rheumatic diseases, remains an insufficiently studied pathology. Paradoxical for AS is the simultaneous activation of two opposing processes: osteoneogenesis and osteoporosis (OP). We have described two clinical cases of patients with AS, diagnosed in the cardio-rheumatology department of the University Hospital of Semey Medical University, where the opposing processes of osteoneogenesis and OP coexist and predispose to pathological fracture of the spine. Risk factors for OP such as duration of the disease, persistent high activity, C-reactive protein, BASDAI and BASFI indices and reduced bone density values, along with a high process of osteogenesis - an immobilized spine due to ankylosis, prolonged use of non-steroidal anti-inflammatory drugs and the lack of effect of basic therapy led to a fracture spine in the clinical case of patient C. and suggests a high risk of fracture in the case of patient M. To address the problem of pathological fractures in AS patients, early monitoring of bone mineral density, further studies of the clinical use of DXA to assess the risk of fractures, and timely use of medications for the prevention and treatment of OP in AS are required.