![]() The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements. The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. This is particularly important when the recommended agent is a new and/or infrequently employed drug.ĭisclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. Vertebral body squaring occurs after the shiny corner sign / Romanus lesion and precedes bamboo spine. It usually involves multiple levels and typically begins in the lumbar spine. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.ĭrug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. Ankylosing spondylitis is the most common cause of vertebral body squaring. Any of these proposed treatments may require active patient's informed consent.Ĭopyright: All rights reserved. ![]() The remaining effective therapeutic options for MS are either contradictory for AS (interferon-β), have no definite data regarding their safety/efficacy in AS (glatiramer acetate, azathioprine, natalizumab, fingolimod), or their efficacy in MS-AS is associated with increased treatment risks (rituximab). Discussion: Given the fact that anti-TNFα drugs can potentially exacerbate a latent MS or induce atypical demyelination in the central nervous system, they should be discouraged or discontinued in relevant cases. The MR corner sign was defined as a triangular and sharply marginated corner abnormality in a vertebral body unassociated with osteophytes or Schmorls node. In addition, we discuss 3 more AS cases with neurological symptoms and atypical white matter demyelinating MRI lesions after anti-TNFα treatment. One of the AS-MS cases had received anti-TNFα treatment, which was discontinued due to exacerbation of the MS. Methods: In the present study, we report 2 cases of AS with definite MS comorbidity. The optimal management of these patients represents a major challenge. Background: Multiple sclerosis (MS) only rarely coexists with ankylosing spondylitis (AS).
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