BACKGROUND: A case history of a patient with ankylosing spondylitis and peripheral
arthritis unresponsive to the conventional drug therapy, but successfully controlled
by the use of cyclosporin. MATERIAL AND METHODS: In a 68 years old female patient
with a 36 years history of typical ankylosing spondylitis a peripheral polyarthritis
(hands, feet, wrists, and knees) developed. The patient did not suffer any other disease
known to cause secondary spondylitis (psoriasis, inflammatory, bowel, disease). After
the unsuccessful use of non-steroidal antiinflammatory drugs a combination therapy
with cyclosporin (4 mg/kg/day) and azapropazone (300 mg t.i.d.) was introduced. RESULTS:
Clinical improvement was achieved after 6 months of combined therapy, the polyarthritis
completely resolved after one year. Therefore cyclosporin was discontinued. After
one year the polyarthritis reappeared therefore the cyclosporin therapy was reinstituted
with success. CONCLUSION: Cyclosporin has proved consistently effective in our case
to control the peripheral arthritis associated with ankylosing spondylitis.
