Page 25 - MRS Abstracts March 2023

Mind the Gap: A rare extra-articular manifestation of Axial Spondyloarthropathy in the biologic era.
Dilmi Somathilake, Rheumatology clinical Fellow, University Hospital of Leicester; Dr A Moorthy Consultant Rheumatologist & Hon Associate Professor, College of Life Sciences University of Leicester
Introduction:
Axial Spondyloarthropathy (axSpA) is a form of sero-negative spondyloarthropathy principally affecting the axial joints with extra-articular manifestations involving the eyes, gut, lungs, skin, kidneys and the cardio-vascular system (CVS) of varying severity and frequency adding to the morbidity and mortality related to axSpA.
Case Report:
We report a 61-year-old Caucasian male patient with skin Psoriasis and axSpA (positive HLA B 27 and radiological sacroiliitis) for 8 years duration on anti-TNF therapy with good control of disease. Switching to biosimilar caused a flare of skin psoriasis however improved after converting back to original Biologic drug.
Treatment interruption since November, 2022 due to non-adherence to blood monitoring. Patient was investigated for chronic cough with constitutional symptoms in May,2023. CT chest showed lung nodules likely of infective aetiology without evidence of interstitial lung disease and an incidental detection of aortic root dilatation.
Patient received antibiotic for chest infection while Biologics remained on a hold and there was improvement of lung lesions. Cardiology opinion was sought for this asymptomatic vascular lesion and confirmed that it is most likely due to axSpA. Patient is awaiting PET CT to look for active inflammation at the aortic root.