Case Report
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Feb 16, 2024; 12(5): 1018-1024
Published online Feb 16, 2024. doi: 10.12998/wjcc.v12.i5.1018
Ankylosing spondylitis coexisting with Clonorchis sinensis infection: A case report
Tian-Xin Yi, Wei Liu, Wen-Fei Leng, Xiao-Chuan Wang, Liang Luo
Tian-Xin Yi, Wen-Fei Leng, Xiao-Chuan Wang, Department of Rheumatology, Traditional Chinese Medicine Hospital Dianjiang Chongqing, Chongqing 408300, China
Wei Liu, Department of Orthopaedic, Traditional Chinese Medicine Hospital Dianjiang Chongqing, Chongqing 408300, China
Liang Luo, Department of Chinese Medicine, The People's Hospital of Yubei District of Chongqing City, Chongqing 401120, China
Co-first authors: Tian-Xin Yi and Wei Liu.
Author contributions: Yi TX and Liu W wrote the manuscript; Luo L summarized the case and revised the manuscript; Wang XC and Leng WF performed the data collection; all authors have read and approved the final manuscript.
Supported by Chongqing Municipal Health Commission's Key Discipline Construction Project of Traditional Chinese Medicine Bi Disease, Yu Traditional Chinese Medicine (2021), No. 16.
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: The authors have no conflict of interest to declare.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Liang Luo, MD, Attending Doctor, Department of Chinese Medicine, The People's Hospital of Yubei District of Chongqing City, No. 23 North Central Park Road, Yubei District, Chongqing 401120, China. luoliang202112@163.com
Received: December 6, 2023
Peer-review started: December 6, 2023
First decision: December 21, 2023
Revised: January 4, 2024
Accepted: January 24, 2024
Article in press: January 24, 2024
Published online: February 16, 2024
Processing time: 56 Days and 1.6 Hours
Abstract
BACKGROUND

Ankylosing spondylitis (AS) is a chronic immune-mediated inflammatory disease. The prevailing theory links AS onset to infections in susceptible individuals. Furthermore, infections may impair the immune responses. Numerous studies have investigated links between AS and various infections-bacterial, viral, fungal, and other microorganism infections. However, limited attention has been given to the association between AS and Clonorchis sinensis (C. sinensis) infection.

CASE SUMMARY

A 27-year-old male with a 10-yr history of AS presented to our hospital with inflammatory lower back pain as the primary manifestation. Ten years ago, the patient had achieved a stable condition after treatment with biological agents. However, he experienced a recurrence of lumbosacral pain with an unexplained cause 10 d before hospital admission. A lumbosacral magnetic resonance imaging (MRI) scan revealed bone marrow edema in the left sacroiliac joint, and laboratory indicators were elevated. Moreover, the presence of C. sinensis eggs was detected in the stool. The patient was prescribed praziquantel, resulting in the disappearance of C. sinensis eggs in subsequent routine stool tests and relief from lumbosacral pain. A follow-up MRI scan performed after 4 months revealed a reduction in bone marrow edema around the left sacroiliac joint.

CONCLUSION

C. sinensis infections could potentially trigger the exacerbation of AS. Clinicians should pay attention to investigating the presence of infections.

Keywords: Ankylosing spondylitis; Clonorchis sinensis; Parasites; Infection; Case report

Core Tip: This study explored the link between Clonorchis sinensis (C. sinensis) infection and ankylosing spondylitis (AS). While previous research extensively explored the association between AS and various infections, the association with C. sinensis received limited attention. The findings highlight the potential role of parasitic infections, particularly C. sinensis, in affecting AS disease activity. This study provides valuable insights into the less-explored aspects of AS etiology, emphasizing the need for further investigation into parasitic infections to comprehend and manage AS.