Anna Luiza Cavalcanti Lopes Tavares
Medical student at the Maurício de
Nassau University Center, Recife, Pernambuco, Brazil. Email: Annalutavares88@gmail.com
José Thomson Torres Ferreira
Medical student at the Maurício de
Nassau University Center, Recife, Pernambuco, Brazil. Email: jthomsontf@gmail.com
Romero de Lucena Pinto
Medical student at the Maurício de
Nassau University Center, Recife, Pernambuco, Brazil. Email: romeropinto.romero@hotmail.com
Maria Helena Queiroz de Araújo Mariano
Professor with a PhD in Rheumatology from the
Maurício de Nassau University Center (UNINASSAU) and collaborating professor in
Rheumatology at the Faculty of Medical Sciences of the University of Pernambuco
(FCM/UPE). Rheumatologist at the Oswaldo Cruz University Hospital - UPE,
Recife, Pernambuco, Brazil. Email: habhelena58@gmail.com
ABSTRACT
Introduction.
Ankylosing spondylitis (AS) is a chronic,
progressive, immune-mediated inflammatory disease that primarily affects the
spine and sacroiliac joints, and is frequently associated with the HLA-B27
genetic marker. This condition is characterized by inflammation of axial and
peripheral joints, resulting in stiffness, pain, and progressive limitation of
movement. In addition to articular manifestations, AS may also present
extra-articular involvement, with acute anterior uveitis (AAU) being the most
common, affecting up to 40% of patients. AAU is clinically manifested by severe
ocular pain, photophobia, conjunctival hyperemia, and blurred vision, often
occurring recurrently and, in most cases, unilaterally. Diagnosis is
established through detailed clinical evaluation, combined with laboratory and
imaging tests, such as magnetic resonance imaging (MRI) of the sacroiliac
joints and specific ophthalmologic examinations, which are essential for
disease monitoring. Objective. To report a case of acute anterior
uveitis as an extra-articular manifestation in a 29-year-old male patient with
ankylosing spondylitis, describing its clinical course, diagnostic process, and
therapeutic approach. Methodology. This is a case report based on
medical record review, patient interviews, and analysis of laboratory and
imaging exams. Data were collected after obtaining informed consent from the
patient, ensuring confidentiality and compliance with ethical principles of
clinical research through the signing of the informed consent form (ICF). Results
and Discussion. The patient presented with severe ocular pain, photophobia,
and blurred vision, and was diagnosed with acute anterior uveitis associated
with ankylosing spondylitis. Initial treatment included topical corticosteroids
to control ocular inflammation and nonsteroidal anti-inflammatory drugs
(NSAIDs) for pain relief and joint stiffness. Due to symptom recurrence,
biological therapy with an anti-TNF agent was introduced, resulting in
significant clinical improvement and absence of new ocular flares. The
management of AS requires a multidisciplinary approach, integrating
rheumatologists and ophthalmologists for effective control of articular and
ocular manifestations (10). Biological therapy has proven effective in reducing
systemic inflammation and preventing uveitis relapses, contributing to improved
function and quality of life (10). Early diagnosis and appropriate treatment
are essential to prevent structural complications such as joint ankylosis and
permanent visual sequelae, in addition to minimizing the impact of the disease
on functionality and overall well-being. Conclusion. Acute anterior
uveitis represents a relevant extra-articular manifestation of ankylosing
spondylitis and may cause significant visual impairment if not identified and
treated promptly. The reported case highlights the importance of integration
between rheumatology and ophthalmology for appropriate and individualized
disease management. The introduction of biological therapies has modified the
prognosis of these patients, reducing inflammation, relapse frequency, and the
risk of sequelae. Therefore, early diagnosis and adequate therapeutic
intervention are essential to preserve vision and joint mobility, ensuring
better quality of life and reducing the systemic impact of the disease.
Keywords: Ankylosing spondylitis. Uveitis. Autoimmune
Reviewed by Current Scientific Journal
on
janeiro 07, 2026
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